Gleason score of 9?

lchillin

I am a fairly heathly 61 year old male who has just gotten a prostate cancer diagnosis with a Gleason Score of 9.  Biopsy was done and read by very experienced staff at Washington University School of Medicine in St. Louis.  Described as T2B.   Bone Scan and CT scan came back negative for any mets but I know that only means none were detected.  Any advice?  Doc wants the Prostate out as soon as possible. 

hopeful and optimistic

Information to get started

I am sorry for your diagnosis.

Please read these recent discussions so you can obtain some knowledge. Afterward pls repost with more specific information about you, the information from your biopsy report, to include the percent involvement, (how much of each core that was positive was cancerous), how many cores were taken (and amount positive), PSA history, results of digital rectal exam, any other diagnostic tests than the bone scan and ct scan, any second opinion on the biopsy by a world class pathologist, etc, etc

http://csn.cancer.org/node/258414

lchillin

hopeful and optimistic said:

Information to get started

I am sorry for your diagnosis.

Please read these recent discussions so you can obtain some knowledge. Afterward pls repost with more specific information about you, the information from your biopsy report, to include the percent involvement, (how much of each core that was positive was cancerous), how many cores were taken (and amount positive), PSA history, results of digital rectal exam, any other diagnostic tests than the bone scan and ct scan, any second opinion on the biopsy by a world class pathologist, etc, etc

http://csn.cancer.org/node/258414

PSA 8.6 followed by 8.1. 

PSA 8.6 followed by 8.1.  Biopsy was 12 cores all 6 on the left positive.  Digital exam was suspect from the beginning.  Nodular feel of left side.  I think the pathology doctors at Washington Unveristy Medical School would be considered first class.

 

hopeful and optimistic

hopeful and optimistic said:

Information to get started

I am sorry for your diagnosis.

Please read these recent discussions so you can obtain some knowledge. Afterward pls repost with more specific information about you, the information from your biopsy report, to include the percent involvement, (how much of each core that was positive was cancerous), how many cores were taken (and amount positive), PSA history, results of digital rectal exam, any other diagnostic tests than the bone scan and ct scan, any second opinion on the biopsy by a world class pathologist, etc, etc

http://csn.cancer.org/node/258414

Please make comments, or ask

Please make comments, or ask questions about the information that you find in the csn threads that I referenced?

In the cores that were positive, what were the gleason scores, what was the percent involvement of each score that was positive?

Was there any periniel involvement, what else did the biopsy report indicate.

Did you have an MRI with a Tesla 3.0 magnet or any type Pet Scan?

What type doctors are on your medical team?

The Pathologist that looked at your slides is probably first class. Below are the ones that are world class, one of which I recommend that you contact for a second opinion

WORLD CLASS PATHOLOGISTS and Labs, once again according to “the Primer on Prostate Cancer” which I keep in my desk and often refer to.

David Bostwick (Virginia) 800 214-6628

Francisco Civantos (FL) 305 325-5587

Jon Epstein (Maryland) 410 955-5043

David Grignon (Michigan) 313 745-2520

John McNeal(California) 650 725-5534

Jon Oppenheimer (Tennessee) 888 868-7522

Dianon Laboratories 800 328-2666

UroCor 800 411 1839

(UroCor and Dianon have recently merged into one company)

 

lchillin

hopeful and optimistic said:

Please make comments, or ask

Please make comments, or ask questions about the information that you find in the csn threads that I referenced?

In the cores that were positive, what were the gleason scores, what was the percent involvement of each score that was positive?

Was there any periniel involvement, what else did the biopsy report indicate.

Did you have an MRI with a Tesla 3.0 magnet or any type Pet Scan?

What type doctors are on your medical team?

The Pathologist that looked at your slides is probably first class. Below are the ones that are world class, one of which I recommend that you contact for a second opinion

WORLD CLASS PATHOLOGISTS and Labs, once again according to “the Primer on Prostate Cancer” which I keep in my desk and often refer to.

David Bostwick (Virginia) 800 214-6628

Francisco Civantos (FL) 305 325-5587

Jon Epstein (Maryland) 410 955-5043

David Grignon (Michigan) 313 745-2520

John McNeal(California) 650 725-5534

Jon Oppenheimer (Tennessee) 888 868-7522

Dianon Laboratories 800 328-2666

UroCor 800 411 1839

(UroCor and Dianon have recently merged into one company)

 

Gleason score was 4 + 5 in 60

Gleason score was 4 + 5 in 60 % of the needle cores.

No periniel involvement.

Have the Telsa 3.0 done this week.

This is my doc...

http://wuphysicians.wustl.edu/physician2.aspx?PhysNum=1308

 

Kongo

Second Opinion

I'm sorry to read of your diagnosis.  As I am sure your doctor explained to you, this is a serious condition wtith and advanced stage of cancer.  I do hope you seek second opinions for treatment.  Removal of the prostate in patients with advanced Gleason scores is a controversial subject with widely varying opinions among experts.  The unfortunate fact is that despite the negative bone scan, the liklihood of metastasis is high and removing the prostate will do nothing to curb the growth of prostate cancer outside the prostate and that is the aspect of this disease that is deadly.  Prostate cancer inside the prostate isn't fatal, it's when it spreads to other organs that this disease becomes fatal.

Surgery carries many risks to your quality of life and it is likely that even with a succesful surgery and no side effects that you will need to seek radiation treatment for the cancer that has spread.  A radiation oncologist can describe your options to treat this disease without removig your prostate.  I hope you avail yourself of these other opinios before you make final decisions.

Best of luck to you,

 

K

hopeful and optimistic

Kongo said:

Second Opinion

I'm sorry to read of your diagnosis.  As I am sure your doctor explained to you, this is a serious condition wtith and advanced stage of cancer.  I do hope you seek second opinions for treatment.  Removal of the prostate in patients with advanced Gleason scores is a controversial subject with widely varying opinions among experts.  The unfortunate fact is that despite the negative bone scan, the liklihood of metastasis is high and removing the prostate will do nothing to curb the growth of prostate cancer outside the prostate and that is the aspect of this disease that is deadly.  Prostate cancer inside the prostate isn't fatal, it's when it spreads to other organs that this disease becomes fatal.

Surgery carries many risks to your quality of life and it is likely that even with a succesful surgery and no side effects that you will need to seek radiation treatment for the cancer that has spread.  A radiation oncologist can describe your options to treat this disease without removig your prostate.  I hope you avail yourself of these other opinios before you make final decisions.

Best of luck to you,

 

K

In the threads that I

In the threads that I referred to you there has been discussion of various kinds of Pet Scans. Please look closely into having the best one available. If cancer is detected, this will help in a treatment decision, and some, but not all radiolist use this information in determining where to concentrate their efforts. 

Basicallly the MRI with the tesla 3.0 magnet will show much finer rsolution than the bone and ct scan, The purpose of the mri is to iconfirm possible extracapsular extension that will help in your decision making

I have no experience with your doc . however from reading his bio, to me your doctor appears to be a very competent surgeon at an excellent  center of excellence.

You want to interview a radiation oncologist, the best that you can find. You may wish not to have surgery since the potential side effects of multiply treatments are cumulative

Additionally you want a Medical Oncologist on your team. The medical oncologist knows the most about the administering of drugs, and is the expert. It is very possible  that you may need to have hormone therapy.  In my opinion, the Medical Oncologist is the most impprtant part of your medical team. Try to find a Medical Oncologist that specializes in only prostate cancer., the best that you can afford.