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psa 22.5

sadia
Posts: 1
Joined: Sep 2011

hi, my dad was recently diagnosed with prostate cancer, he has a psa of 22.5, and a very controvertial gleason score. we live in nigeria, when he first had his biopsy it was reported that he had a gleason score of 1+1, we however wanted a second opinion and decided to send the slides to uk, the hospital however refused to release his slides to us and instead gave us the remaining tisses samples which they had not processed, when we sent this to th UK, it came back with a gleason score of 4+4. the whole family is devastated, please any one with a similar story that went on to have succsessful treatment.tanx

prezmic
Posts: 36
Joined: Jul 2011

I have lived and worked in Africa and other parts of the third world. I would not trust much of what they do especially something as important as a biopsy analysis.

I would immediately take a vacation and travel to the UK, or wherever you are from, and have this redone.

Old-timer's picture
Old-timer
Posts: 110
Joined: Apr 2011

Relax. It probably isn't as bad as it seems at first. You need to get information you can trust. A PSA reading of 22.5 and a Gleason score of 4+4 suggests that some action may be needed soon. But you should take time to check the accuracy of the diagnosis and to learn as much as possible about treatment options.

My PSA was 4.0 and my Gleason score was 7 (3+4) when I was diagnosed in 1991 at the age of 65. The news was scary, but once I got over the initial shock, I have been OK with it. Life has been and continues to be good.

Best wishes to you and your family.

VascodaGama's picture
VascodaGama
Posts: 1554
Joined: Nov 2010

Sadia

You got above excellent advices. I would recommend your dad for redoing the biopsy and the analysis at a reliable institution(s). Biopsies are done usually by urologists and the analyses are done at a path-laboratory by a pathologist. The hospital can have both procedures done at its facilities or it sends the cores to be analysed at a separate laboratory. However, the pathologist must be an expert to identify the cancer and other characteristics of the cells in the microscopy, classify its grade and clinically stage your dad’s case.
The diagnosis process is the most important step when dealing with cancer.

The two different readings of Gleason grade 1 and 4 could be correct, if one thinks that one sample had grade 1 and another grade 4.
But, WHY SHOULD THERE BE SAMPLES NOT ANALYSED ???????

In a needle biopsy procedure a certain fixed number (above 6) of cores are taken and ALL CORES are supposed to be checked in detail. The samples sent to UK could as well be from a different person (?).
Your descriptions are very suspicious to bad practice. I would not thrust the laboratory or the doctors handling the case of your father, in particular if they would not release the core samples to you. They are in fact property of your father.

If your dad decides to get the biopsy redone, he could wait one month to allow healing of the prostate and get proper highly recommended experts to handle his case, probably in Europe. Your best shot in Nigeria may be Lagos University Teaching Hospital or the Reddington Hospital as they got departments for urology and cancer treatment, but there are no references to the physicians practicing at the facilities.

If the PSA level is correct at 22.5 (mine was 22.4 eleven years ago), your dad will have to get image studies such as MRI, CT and a Bone scintigraphy scan.
A Gleason grade of 1 is related to indolent types of cancer. Grade 4 is very aggressive and would need action the soonest. Nevertheless, prostate cancer does not spread in a matter of days. Your dad has time to consider on what to do and where to go for handling his case at “trustful hands”. Get a consultation with a proper specialist.

Welcome to the board.
VGama

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