Canadian with Gleason 6 needs advice

I was recently diagnosed with a Gleason six (3+3 ) from six core samples. Because of the Canadian health care system, I am not sure what all of the options are. I am able to travel to the US if the treatment would be better. Would a second opinion on my biopsy be a good idea? Please chime in with any advice or suggestions.

Thanks in advance.




  • truckerman
    truckerman Member Posts: 2
    Biopsy details

    Stage t1   prostate ( 6 sites 6 cores ) needle core biopsys ( s16-3188 ) -adenocarcinoma of prostate ,nos/acinar type . Overall Gleason score, all cores 6 (3+3)-3 cores positive / 6 total cores - Carcinoma involves the following sites with corresponding linear spans - Right base 1.5mm in one core (and 5% of one core). Right mid 2mm in one core ( and 5% of one core ). Left base 1mm in one core (and 5% of one core ). -Extraprostatic extention: Not identified. -Perineural invasion: Not identified. - Lymphovascular invasion: Not identified.   Right apex and left apex of gland appear negative for invasive carcinoma. Left mid core contains an atypical small acinar proliferation.

  • Swingshiftworker
    Swingshiftworker Member Posts: 1,017 Member
    2nd Opinion and Treatment Choices

    Sorry that you had to join us here as another PCa patient but you can take some solace in the fact that your cancer is considered relatively low risk and the outlook for treatment and remission is excellent.

    Getting a 2nd opinion on your PCa biopsy slides is always worthwhile.  Dr. Jonathan Epstein at Johns Hopkins is considered the leading authority in this area and gave me a confirming 2nd opinion (Gleason 6 - same as yours) on my slides back in 2010. 

    You can find a discussion regarding this topic in the following thread:

    My post dated Jan 19th in this thread gives a link to the Second Opinion website at Johns Hopkins and also references a post in which I summarized the various treatment options available.  Not sure if all of the treatment choices would be available to you under the Canadian medical system but, if you are free to travel to the US and able to pay for the treatment you want, that is always an opinion.

    As a low risk PCa patient, you have time to do the research necessary to determine which treatment would be best for you and you should take all of the time you need to make that decision.   There are many regulars here (including me) who will be happy to give you our opinions but just bear in mind that none of us are doctors and that our opinions are born out of our personal epxerience in dealing w/this cancer.

    Good luck!




  • Guber4
    Guber4 Member Posts: 8 Member
    edited February 2017 #4
    What prompted the biopsy to

    What prompted the biopsy to begin with?  A lot of missing information.

  • Old Salt
    Old Salt Member Posts: 1,352 Member
    edited February 2017 #5

    I read elsewhere that Canada has a well-developed Active Surveillance system in place. I suggest that you investigate that further.

    Three small (Gleason=6) lesions were identified, two on one side and one on the other. Perhaps this makes you ineligible for active surveillance?

  • Clevelandguy
    Clevelandguy Member Posts: 1,035 Member
    edited February 2017 #6
    Second opinion


    If you feel you have a great doctor(s) and hospital network then I would trust them, if not a second opinion would not hurt.  There are two basic paths to follow to get rid of the PCa, one is surgery and the other is radiation.  If you are young, active survalence might be something to look at.  Just remember active survalence will just push off the decision to a later date on your course of action unless you are in your late 70's or more.  My mind would not let me keep the cancer in my body so I chose to remove it but that's up to you.  Look at all the treatments & resulting side effects, study study, read, read, then plot your course of action.  Good luck in your journey, let us know your progress and if any of us can help.

    Dave 3+4