Gleason 6

Darrin

I was diagnosed with Gleason 6 last January (2021) after a TURP surgery. 82 prostate chips were sent to the lab from the TURP with 1 sample showing cancer. Since then, I have had an MRI and Biopsy with both coming back clear. I am 56 and doing Active Surveillance. My last 3 PSA's have come back between 1.0-1.3. My urologist is wanting to do yearly MRI's and Biopsies. I am good with MRI's and 6 month PSA checks but not sure yearly biopsies are necessary.......

Rob.Ski

Did you get second opinion on pathology?

J69

Darrin, I went on active surveillance when first diagnosed with a GL 6. My Urologist just watched my PSA. He left after a couple of years. My new Urologist said we needed to see if there was any progression with a biopsy. That turned into a GL 8. IMHO, don’t watch and wait too long. More aggressive prostate cancers can show low PSA scores while they grow and or spread. My PSA score for those two years never got above 2. My best to you.

JJO

I had a urologist who, like yours, wanted to do yearly biopsies for AS. I went for a second opinion to Dr. Scott Eggener, a leading expert at the University of Chicago. He said that yearly biopsies were not necessary and I switched doctors. My new doctor generally does them every 2 years. However, there is a yearly MRI, and if the MRI shows anything new, or if the PSA jumps, we do a biopsy more frequently. It is important that you have a urologist who specializes in prostate cancer and has a large AS program.

Darrin

https://csn.cancer.org/discussion/comment/1693879#Comment_1693879

https://csn.cancer.org/discussion/comment/1693879#Comment_1693879

https://csn.cancer.org/discussion/comment/1693879#Comment_1693879

No I have not..... should probably look into that.

Darrin

https://csn.cancer.org/discussion/comment/1693890#Comment_1693890

Thanks for sharing. I was thinking that every 2 years would suffice with yearly MRI's and 6 month PSA checks but you have given me something to think about.....

Darrin

https://csn.cancer.org/discussion/comment/1693909#Comment_1693909

My urologist stated that if the MRI's show anything or my PSA jumps up then she would do an immediate biopsy but I have been reading where with the Gleason 6 diagnosis, biopsies should be done every 2 years as opposed to yearly .....Thanks for the information.

centralPA

What was your PSA before the TURP, and what was it after?

I know after a HoLEP, which is similar to a TURP but removes more tissue, the PSA becomes more sensitive to cancer since most of the PSA-generating normal prostate tissue is gone.

Similar effects are seen after a TURP. As an example you can google on "Transurethral resection of the prostate for patients with Gleason score 6 prostate cancer and symptomatic prostatic enlargement: a risk-adaptive strategy for the era of active surveillance"

Darrin

https://csn.cancer.org/discussion/comment/1693948#Comment_1693948

It was higher, around 2.0 ....Thanks for the information looking at it now....

Old Salt

With such a low PSA and the frequent testing (MRI and PSA), I tend to agree that a biopsy every other year makes sense.

BTW, a biopsy samples only a (very) small portion of the prostate and does carry some risk (infection etc.)

Darrin

https://csn.cancer.org/discussion/comment/1693968#Comment_1693968

Yes the risk of infection concerns me......Thanks.......