Just been diagnosed with prostrate cancer

Great post aksns61.

That's the kind of info that we need on this forum!

Key words "early stage disease"

What is "early stage"?

Is a Gleason 3+3 believed to be contained in the prostate considered "early stage"? What about a Gleason 4+5 believed to be contained in the prostate. Is that considered "early stage"?

 

barney,

My Gleason score was 4+3 =7. This score is considered intermediate. I consider

Great question I have monitored mine for 12 years and they doctor said Gleason 6 was the number that treatment or in my case removal would need to be decided. My bother on the other hand is at a Gleason 3 and they after telling him to keep watching it. Hope that helps.

As far as I know, in the uk, the T staging is how far or not it has spread. The Gleason score is the aggressiveness. So 3+3=6 is the lowest Gleason score. Meaning it is a slower less aggressive cancer. A 4+4 means it is more aggressive as is 5+5. But an aggressive cancer can still be contained in the prostate the same as a lower Gleason can have spread. You get a t staging in the uk this shows where it is. Got example tb1 or tb2 etc. The Gleason is nothing to do with how far it has or has not spread. It must be the same in America.

barney

Posted my reply inadvertentl, before finishing.

A 9 Gleason score is not good in my opinion. I would not think early stage. I am not a Doctor or expert, JMO. My Gleason score 4+3 was considered intermediate cancer. However, after my Urologist sent my biopsy remains for Genetic testing the results were non aggressive, which the Gleason score of 7 was contradictory to the Genetic testing which put my cancer in the nonaggresive range. Like you said, there is no one treatment for PCA and fuction of:

the aggressiveness of the PCa AND

the age of the man

That is why I chose active surivilance

I will be reevaluated in December, so, my thoughts on which cancer is early stage has lots of determine factors. .

I would like to read others opinion.

The lowest score is 2. They really don’t start treating it till it is a 6. So you are right that 6 is the lowest score that they will start treatment. 2 to 5 they wait and see. But even then if a man is up in his 80's they may keep watching it till it gets higher.

That is correct. Some don't even really consider it cancer until it hits 6. In my case, (3+3) it was low but because of the location there was more potential for it to spread and therefore prudent to take action beyond AS.

In the uk a Gleason of 2 is even counted as a cancer. So 3 is the lowest.

I agree it is intermediate, on the higher side when compared to 3+4

Honestly, from what I read in the. Last few months I think a 3+3 could be monitored for a while.

of course the question is " how long is a while"

ok

so putting aside the Gleason score, would you treat a T2b with surgery or radiation or just monitor it?

You make sense

that is why I wasted no time to have my Gleason 9 robotically removed 

Did you have a MRI as well? That would give you even more information eg an indication of any extraporostaric extension.

as I am sure you know, a biopsy is a very good estimate of the PCa, but only its removal gives a definitive pathology.

i was always worried that a biopsy can under or overestimate the PCa.

Yes, I had a MRI. The PCa was not outside of the prostate With my Gleason of 7, I would be having treatment now. But, the Prolaris score in the non aggressive range, and mortality rate of 3% of not dying in 10 years was a deciding factor of active surveillance. There still remains a possibility of treatment in the future after evaluation in December. Hopefully I can continue on. Like I said before the Genetic testing at Prolaris showed a non aggressive PCa. So, you could probably say they were contradictory of each other.

The best people to help you arrive at a treatment decision are the medical staff who know your condition. While outside forums are useful, we are only a voice of opinions. Cold numbers are only part of the whole equation and you can quickly bury yourself in a quagmire of statistics. Have very frank discussions with your health professionals. Meanwhile also have frank talk to your spouse, because they will be impacted by any of the treatment options and are key to your recovery.

Further to Aksn's comments, when it comes to possibly undergoing treatment, find one urologist you trust and be guided by him.

aksns61,

I do appreciate your reply to my status. To clarify my treatment decisions, My medical staff was very much involved in all my treatment decisions.

barney,

Just to reinterate my treatment decision. My Urologist made the decision that I go on active surveillance, I was hesitiant at first, but Along with my family, wife and 4 daughters agreed after the rest results came back from Myriad Genetics, (Prolaris) . My family and I have decided to trust his decision. but, I am a little skeptical of trusting any one, but thats just me.

This was the deciding factor in my treatment decision.

The New genetic tests make it easier to identify aggressive early stage cancers. Prolaris, which tests for 46 genes, has been shown in studies to accurately predict the aggressiveness of a patient's prostate tumour in conjunction with Gleason scores and PSA tests. My tests came back in the non aggresive range.

 

Tough call.

i like you would be skeptical about AS.

how reliable is the genetic test?

i am not sure I would go that route with a Gleason 7 which is really the best estimate.

only when a prostate is removed can one tell for sure the Gleason score, which may be different to 7

what tumor stage is it?

Stage 1, I am scheduled for another PSA reading in November. Another treatment decision can be made then.

I called Myriad Laboratories (Prolaris ) and had a long discussion with a lab tech. And with my Prolaris score, he also agreed with my Urologist, that I was a candidate for AS.

I feel like I have time to make a definite treatment decision after my next evaluation.

Did I mention I just turned 76 years old. If I had been 15 -20 years. Younger. No doubt, I would have chose treatment, My thoughts are, if I can forgo evasive treatment for what years I have left is a no brainer. No one is promised tomorrow.

Ok, so now I know you are 76. And the stage is T1.

in your position I would do as you're doing: AS, even without the Prolaris test.

 

Thanks,barney ,

Yes the stage is T1c, meaning cancer found via a needle biopsy and biopsy initiated by abnormal PSA.

There is TIa , TIb and T1c . Either 3 means cancer is present.

 

understood. Thanks.