Ok here is what my brother found out today

His PSA was 3.31 up from 1.8 last year
So that’s different than what he told me .
He had the MRI and biopsy
It is Pc stage T1c ?
He meets with a surgeon and a radiologist
Gleason score 4 + 3
Most on the right side ..
So ... in a nut shell what do you guys think ?

4+3 is "high intermediate" risk. Mid-range on the serious scale. It does mean treatment is needed. The gene test will also help identify his future risk. The MRI can help determine if any spread is happening.

Where is he located?

I also assume this raises MY risk factor

Well I never had pc that I know of
But I do worry about it .
I have enlarged prostate and have had for years .
I’m 61 yrs old
I’ll include my PSA numbers below.
I always post on here after my yearly check up and everyone tells me I’m fine , haha
Hope they are correct .

cvc said...
I also assume this raises MY risk factor

There are DNA mutations that predispose one to PCa (and breast cancer) and run in families, such as BRCA mutations. Genetic testing on a blood sample can reveal these mutations. There are also genomic tests on the RNA of one's biopsied malignant tissue to determine the risk of one's own particular prostate cancer to metastasize in the near future (e.g. within the next 5 years). Since you spoke of a test for "spreading" in your brother's case, I assume you brother had a genomic test done to evaluate the risk of his cancer metastasizing.

Djin

Post Edited (DjinTonic) : 11/16/2020 6:17:36 PM (GMT-7)

cvc said...
I believe he said they are doing the dna genetic test
He looks nothing like me , black full head of hair brown eyes , I’m bald with green eyes !
Maybe that means I don’t have the pc gene , hopefully
Ha

He may not have a familial mutation. These mutations don't mean you will get cancer-- they only increase one's risk for developing cancer. You can't go by traits like hair growth or hair and eye color. You can ask your doc about (blood) testing for you, given your brother's PCa diagnosis.

Djin

Post Edited (DjinTonic) : 11/16/2020 6:26:16 PM (GMT-7)

cvc said...
What specific blood test ?

These DNA tests usually check for many mutations across disease groups-- various cancers, coronary disease, etc. You doc can fill you in. You want to know about any and all genetic predispositions. These reports usually list the mutation and the related risk (e.g. "You have mutation XYZ on chromosome number ___ , which gives you a 1.5 x average risk of colon cancer," etc. There are similar tests from different companies. I don't know the specifics; you family doc does.

Djin

Post Edited (DjinTonic) : 11/16/2020 6:55:37 PM (GMT-7)

I recommend your brother start a PCa file with complete copies of all his tests (he just needs to request these from his docs' offices). If he meets with consultants for possible treatment plans, he should tell the staff he wants copies sent to him of all reports when he registers at his first visit. These include PSA results, biopsy report, imaging reports, genetic and genomic testing, etc. These may be important not only in the near future, but also perhaps many years from now. All reports should be complete and not summaries and have the name and signature of the author. Having them all and in one place makes it easy to locate one if needed.

We don't trust our memories for something like a grocery list, nor should we for cancer diagnosis, treatment, and follow-up.

Djin

Post Edited (DjinTonic) : 11/16/2020 7:47:11 PM (GMT-7)

So how does the low PSA make his chances better given the Gleason 4 is so serious

cvc, there are cases out there of very high Gleason score cancers with very low PSA. At this point, his G-score is the driver. PSA is meaningless now that he has a positive, 4+3 biopsy. I'm going to suggest the standard things for all newly diagnosed men:

1. He should ask his doctor to send his biopsy slides down to Johns Hopkins for a second opinion. They will either confirm his 4+3, or they may modify it. Either way, this is important.
2. He needs to get himself into consultations at a regional cancer center, where he can meet with experts in the different treatment protocols. Make sure he talks to people who are well practiced in whatever is offered there. There are multiple options for radiation (internal "seeds", external beam, SBRT, etc), and he needs to get information about all of it.
3. Someone suggested he get copies of everything and keep it in a folder. I'd add, get a spiral notebook and a pen to write down questions and answers. Even better, he needs to take someone with him to consultations to take notes and help remember the questions.
4. Then, he needs to make a decision and get going at it. Especially if his 4+3 is confirmed. A diagnosis with a lot of G4 is serious.

Ok thx guys and I will copy and paste this .
I’m hoping he takes advise if this or at least his dr makes good suggestions .
I have followed my own PSA close for years and I do have an enlarged prostate and I’m 61 soon to be 62.
Having an older brother with Pc now seems that I should be even more concerned

Does his practice have an online patient portal like MyChart? If so, all his tests and pathology reports are there. No need asking the doctor’s office for copies.