Small Volume Cancer...PSA 20 Gleason 8....anyone similar

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soccerj3
New Member


Date Joined Sep 2006
Total Posts : 8
   Posted 9/3/2006 7:31 PM (GMT -6)   
Hi,
I am trying to get more information for my father.  He was diagnosed this week with Prostate Cancer.  PSA was 20.  Eleven biopsy sampled, one came back with Cancer.  Urologist said he was surprised that sample was small volume,NOT large.  What does that mean?  His gleason is 8.
 
He goes for bone and cat scan this upcoming week.  Can anyone comment on the small volume and is there anyone else who had a high gleason, high psa and has been treated.  He is very depressed and seems like he is giving up.
Thanks

spinbiscuit
Veteran Member


Date Joined Apr 2006
Total Posts : 818
   Posted 9/4/2006 5:50 AM (GMT -6)   

Hello soccerj3,

The high readings of the Gleason and PSA are of concern, but the urologist said SMALL VOLUME with only one of eleven cores possive for PCa that is HOPEFUL. In any event the bone and cat scans will give a better indication of what your dad is facing.

He has to take heart in knowing that what ever the tests show there will be a state of the art therapy availabe to treat his PCa. The advance in the treatment technologies over the past 5-10 years has made PCa the most curable of all the cancers. First thing is know what you're dealing with; get control of the emotions, and then you can form an effective strategy to beat this PCa.

You have found the right sight. Everyone here will help you and your dad get through this most difficult time. We are all going through it as well.

Glen

 


soccerj3
New Member


Date Joined Sep 2006
Total Posts : 8
   Posted 9/4/2006 7:06 AM (GMT -6)   
Thank you so much for responding.  I am trying to be positive and relate stories that I have found similar to his stats that have been successful.  He is only thinking about dying a painful death.  I am hoping that the tests this week show no or minimal spread of his cancer. I will keep you updated and thank you for your kind words.
 

bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 9/4/2006 8:07 PM (GMT -6)   
Hi Soccerj3 & Dad,

Keep in touch... we are all here to help you both get through this!!!

"GOD Bless You"
It's a little prayer "GOD Bless You"... but it means so much each day,
It means may angels guard you and guide you on your way. ~author unknown~

Take care and know we care.
Lee & Buddy
mama bluebird
~  ~  ~  ~  ~  ~  ~  ~  ~  ~  ~  ~  ~
Buddy 53 RRP April 3, 2006 PSA 4.6 Gleason 3+3=6 T2a Confined to Prostate
June 29th PSA Less than 0.1 Non-detectable 


Rick54
Regular Member


Date Joined Jul 2006
Total Posts : 40
   Posted 9/5/2006 11:45 AM (GMT -6)   

You asked what "small volume" meant - your father should ask his urologist. 

However, I will hazard a guess.  Typically, each core is scored as to both the Gleason score (meaning the degree of cell alteration from normal) and the percent of the core that has cancerous cells.

As an example, I had 4 of 12 cores that had cancer - all were Gleason 6 (3+3).  However, one was 40% cancer, one was 10%, and the other two were "small focus".  For me, this is a preliminary indication of where the cancer might have started (near the 40% core) and that it is spreading (although note that prostate cancer is very slow growing).  Of course, we will not no for certain until the prostate is removed (next week) and the whole gland is send for testing.

By the way, you shour read (if you haven't already) the earlier message titled "Gleason Score" - it is really good.

You will see lots of threads here with men after various treatments for prostate cancer and doing really well.  Take heart, there is plently of hope ahead.

 


soccerj3
New Member


Date Joined Sep 2006
Total Posts : 8
   Posted 9/5/2006 1:12 PM (GMT -6)   
THank you Rick for your response.  I will let you know what happens once we get the results of bone and cat scan.  I am very positive that he will be treated and be able to manage his cancer.  I think he is just so overwhelmed (understandably) now!

petal
Regular Member


Date Joined Sep 2006
Total Posts : 33
   Posted 9/6/2006 12:03 PM (GMT -6)   
hi soccj3

my dad was told he had pc last week . i too am stressed out by this news . he will be going for a bone scan in two weeks . i only joined this site and have already started to understand things a bit more . i am also more positive after reading some of the letters people have wrote . i feel like i have made some new friends who totally understand . you too will get great comfort from this site . stay positive . my dad is also more positive since reading these threads . good luck with things .

best wishes

petal

soccerj3
New Member


Date Joined Sep 2006
Total Posts : 8
   Posted 9/6/2006 1:05 PM (GMT -6)   
Hi Petal,
THanks for your thoughts and I am sorry that you and your dad are also going through the same thing.  Do you know your dad's psa and gleason?  My dad's high numbers upset me and I am looking for any positive news regarding his condition!  I am hoping and praying that the scans are negative!
 

soccerj3
New Member


Date Joined Sep 2006
Total Posts : 8
   Posted 9/7/2006 3:55 PM (GMT -6)   
GOOD NEWS!!
My dad's scans came back NEGATIVE.
He is having the Da Vinci surgery in Oct.
1 of 11 biopsied with 50% cancer in just the one.
Told him cancer is aggressive with gleason 8 and psa 20 but it looks like for now they got it early.  Will be hoping they can get it all out during surgery and that it has not started into lymph nodes.
A sigh of relief for now!
 

spinbiscuit
Veteran Member


Date Joined Apr 2006
Total Posts : 818
   Posted 9/7/2006 5:25 PM (GMT -6)   
Hi soccerj3,

That is very good news, and we will all be praying for your father's complete recovery. Please keep us updated on his progress.

Glen

soccerj3
New Member


Date Joined Sep 2006
Total Posts : 8
   Posted 9/7/2006 6:05 PM (GMT -6)   
THank you for the kind words.  It has been so nice to be able to read what others have gone through....and opinions.  I am going to research the Da vinci surgery next for him.
 

Patcharoni
New Member


Date Joined Sep 2010
Total Posts : 7
   Posted 9/18/2010 9:48 PM (GMT -6)   
My husband was diagnosed in July 2010. PSA 2924, gleason 8, compression fracture repaired with kyphoplasty. Trelstar injection August 6, zometa infusion Aug 25. Started 13 sessions of radiation for lower back.

Tests on Sept. 8 show lymph node and bone improvement, psa 494. We are pleased, but wonder if we should be doing anything else.

Is there anyone with high numbers and bone mets? What about triple hormone therapy?

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 9/19/2010 6:11 AM (GMT -6)   
I am basically scared out of my blank____ too and still basically a daily reminded on the future of this. The good news is that this is older news, Dx 2002 with some omnious stats that probably make your stats look alot more tame. Thus you might do way better than you are thinking about even though this is an individualized disease, direct comparisons are not necessarily apples and apples. Thus far it has been alright and exceeded my expectations after looking over those nomograms, Partin tables and various abstracts from medical studies and other patient histories.

Patcharoni- go to www.yananow.net and compared experiences/mentors-patient histories as to what some people did to keep alive...Trueman Seamans story is one you might wish to know about.
Dx-2002 total urinary blockage, bPsa 46.6 12/12 biopsies all loaded 75-95% vol.; Gleasons scores 7,8,9's (2-sets), gland size 35 normal, ct and bone scans appearing clear- ADT3 5 months prior to radiations neutron/photon 2-machines, cont'd. ADT3, quit after 2 yrs. switched to DES 1-mg, off for 1 yr., controlled so well, resumed, using intermittently, pleased with results

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4227
   Posted 9/19/2010 4:00 PM (GMT -6)   
Soccerj,
I'm sorry about your dad. Just because the scans showed clear it is not an indication that he is, just an indication that the cancer has not yet grown to the point that it can be seen by the scans, which are very poor at picking up small amounts of PC.
With a Gleason 8 and a psa of 20 your dad is in a high risk catagory; which means there is a high risk that the tumor is not contained. A small G8 tumor would never generate a psa of 20, so before you make any treatment decision, the cause of the excess psa must be determined. It may be an infection or it may be micomets. If it is micromets then surgery will not cure it.
The best recommendation I have is to see a medical oncologist specializing in PC and get a ploidy analysis on your dad's biopsy slides from Bostwitch Labs. You certaintly want to more know before your dad under goes a major treatment that may not cure him.
JohnT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT


Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3747
   Posted 9/19/2010 4:49 PM (GMT -6)   
John T is correct..The PSA 20 and just one sample positive do not add up..You should know this,,The biopsy can completely miss a tumor or it can just nick one, so the sample core shows just a small percentage of cancer. Had that biopsy needle been moved just a few MM, it could have missed it completely or the sample might have been a much higher percentage..Biopsies are NOT a perfect indicator. Other things could be contributing to the high PSA number...

Find yourself a copy of "A Guide to Surviving Prostate Cancer" by Dr. Pat Walsh and get yourself up to speed on exactly what you are facing. Look for the newer 2007 revised edition.

With the Gleason 8 confirmed (you might have a second, expert, pathology lab confirm that, Bostwitch is the best, your only real choice at this point is surgery or radiation..Read John and my case histories carefully. They tell a story...
Age 68.
PSA at age 55: 3.5, DRE negative. Advice, "Keep an eye on it".
PSA at age 58: 4.5
PSA at age 61: 5.2
PSA at age 64: 7.5, DRE "Abnormal"
PSA at age 65: 8.5, DRE " normal", biopsy, 12 core, negative...
PSA age 66 9.0 DRE "normal", 2ed biopsy, negative, BPH, Proscar
PSA at age 67 4.5 DRE "normal"
PSA at age 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RRP performed Sept 3 2010

Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 9/19/2010 5:57 PM (GMT -6)   
Fairwind,  you and John T have responded to a 4 yr. old post.  The thread was inadvertantly bumped by Patcharoni who asked for help with her husbands recent PCa diagnosis with a gleason 8 and a PSA of 2924.  Zufus responded and I am sure she would appreciate any other comments.
 
Carlos

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3747
   Posted 9/19/2010 7:46 PM (GMT -6)   
Thanks Carlos...

Patcharoni, welcome to the board..You threw us a curve ball by opening that old (2006) thread..You should just start your own thread and you will get a lot of help..

You need to find a Medical Oncologist who specializes in Prostate Cancer or at least one who is very familiar treating it.

Patcharoni
New Member


Date Joined Sep 2010
Total Posts : 7
   Posted 9/24/2010 5:46 PM (GMT -6)   
Thanks for the info. I'm not very computer literate, and I don't even know how I found that particular "thread". I suppose this will get easier with practice.

My husband is only 54, and we are completely blindsinded! The good news is that his PSA is 454 after 30 or so days after his first Trelstar injection, and his lymph nodes and bones seem to be responding well to the hormone therapy.

I'll try to start my own thread.
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