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From slow growth to rapid growth

mcin777
Posts: 66
Joined: Feb 2013

In 2013, had my biopsy results sent to John Hopkins.  Results are below:

1) Prostatic Adenocarcinoma, Gleason Score 3+3=6 involving 30% of one core.

2) Prostatic Adenocarcinoma, Gleason Score 3+3=6 involving 90% of one core.

3-6)  Benign Prostatic Tissue

 

Dec. 2015 MRI - Prostate 83cc.  Seminal vesicles and neurovascular bundles normal in signal

 

July 2017 PSA 7.91

 

August 2017 - MRI and Biopsy - Prostate 109ml.  Results from John Hopkins below:

 

1-3; 5-7 and 11-14 Benign Prostate Tissue

 

4.  Prostatic Adencarcinoma , Gleason 3+3 Grade Group 1 involving 70% of (1) Core

     Perineural invasion identified in this case.

 

8.  Prostatic Adencarcinoma  Gleason score 3+3 Group 1 invoving 10% of speciment.

 

10. Prostacic Adencarcinoma Gleason 3+3 Group 1 invoving 100% of (1) core

 

Clinical Stage T1c

PSA 6.7 ng/mL

 

October 2017 - Blood Test - Oncotype DX - Genomic Prostate Score .  My GPS Score was 21=low risk

Prostate Cancer death within 10 years <1%.

 

I have shared all this to say that in December my PSA jumped to 12.22.  My urologist put me on two drugs:   Finasteride to shrink prostate and Bicalutamide to get rid of testosterone and slow down growth of cancer. 

 

All my tests through October 2017 led me to believe I had slow growing cancer and have been on active surveillance.  Have any of you experienced your cancer changing gears and moving into a rapid growth mode?

Old Salt
Posts: 720
Joined: Aug 2014

Without a confirmation of the Dec PSA result, one cannot say with any kind of certainty that the cancer has morphed into a rapid growth mode. If you are concerned, please repeat the test ASAP and be sure to refrain from sex, biking and other activities that may make the PSA jump. Then, let's revisit the issue.

mcin777
Posts: 66
Joined: Feb 2013

I wish I could do that but the drug I am on will only render a score that reflects the effect of the drug on the cancer's growth.

Your suggestion is on target for those not on drugs. Thanks Old Salt

 

 

Old Salt
Posts: 720
Joined: Aug 2014

I had overlooked the fact that you already started hormone therapy. I guess one can say that your original question is of academic interest only, since you and your team have already outlined a treatment plan.

I hope that the bicalutamide (Casodex) will drive down your PSA and, more importantly, the cancer(s). Will another drug be added?

ASAdvocate
Posts: 117
Joined: Apr 2017

Totally normal result of the biopsy. I have had five biopsies. Two of them tripled my PSA, and the effect lasted more than six mionths each time.

Go back and have another PSA, or, even better, a PHI test.

mcin777
Posts: 66
Joined: Feb 2013

Other than MD Anerson do you know of any other highly recommended places to contact for another opinion on my test results?

Thank you,

Jim

Old Salt
Posts: 720
Joined: Aug 2014

Cleveland Clinic has a good reputation, I have read (no personal experience). Other highly qualified cancer centers can be found via this link:

https://www.cancer.gov/research/nci-role/cancer-centers/find

 

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3323
Joined: May 2012

mcin,

It is my understanding that PCa cells can morph over time, and go from non-aggressive to aggressive. Think about this: every man who ever had extremely aggressive PCa at some point prior had no PCa at all.  Did he go straight from none to aggressive disease, or was there some point at which he had moderate disease ? 

I had a friend fight PCa almost 15 years. During his first 13 years, his PSA was never over around 10. He went through every known therapy: Surgical removal; IMRT; HT: chemo; various post-chemo drugs (Jevtana, Zytiga). About 18 months befor passing his PSA tested one afternoon at 66. A month before passing, it went over 1,000.

I am assuming that PCa at a PSA of 10 is less aggressive than PCa at a PSA of 1,000 (since it is 100 times higher). He went into hospice not long thereafter, and I don't think his PSA was ever checked again.  I read in an oncology Journal in my urologist's office one day about a man whom the magazine claimed at one time had a PSA of over 3,000, but got back into remission. Therefore, anything must be possible. But I can see as a logical possibility that the higher numbers might just reflect more widespread disease, not increased aggression. 

If anyone has a certain answer to this question it would be very interesting to hear.  I know that blood cancers morph and change a lot.  A Hodgkin's lymphoma can readily become a non-Hodgkin's, and any lymphoma can also become a leukemia, but the move seems to always be from indolent to aggressive, never the reverse.  The only exception I've ever heard to this is one form of Non-Hodgkin's, "Mantle Cell" (MCL) is noted for frequently going back-and-forth:  It will be indolent awhile, then aggressive, and then may go indolent again.

max

hopeful and opt...
Posts: 2226
Joined: Apr 2009

Gleason 6 do not morph, and go outside the prostate; more aggressive,  Gleason tumors not immediately dectected  in the prostate will go outside

Here is a google about the subject:

https://www.mskcc.org/videos/irreversible-electroporation-nanoknife-treat-prostate-tumors

Steve1961
Posts: 250
Joined: Dec 2017

quedition about genomic testing ...how long does it take ..when the last dr I saw said he wanted genomic testing done and wants UCSF to look st the slides as well he said to come back and see him in a few weeks ..so I called after 2 weeks the case manager said it takes about 4-5 weeks fir genomic testing then another week fir UCSF To view the slides so I was seem march 4 and now have an app April 18th dors that seem like a long time to wait fir results of genomic testing thanks  

Old Salt
Posts: 720
Joined: Aug 2014

Considering the results of your biopsy, there's no rush to start treatment. And yes, sometimes one has to stand in line...

PS: you are jumping into someone else's thread; this causes confusion. Why not stick to your own one?

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