High Gleason/low PSA

jimryansr

hi, I just had a biopsy. All 12 samples have an “aggressive” cancer cell sampling. My Gleason score is 9, but my PSA is only 4.4. When I search for information on low PSA and high Gleason I’m reading that this combination has a much higher mortality rate. Does anyone on here have a similar profile? I’m sorta lost…thanks

Jim

Old Salt

The really important question is whether the cancer is still confined to the prostate. What did the MRI and biopsy show in that regard?

jimryansr

thanks for your interest. The mri said it was in my seminal vesicles, but not in lymph nodes so I’m waiting on authorization for a pet scan.

Wheel

jim,

I am kind of similar. My PSA never went over 4, and my biopsy had multiple 6 gleason cores, one 7 core and one Gleason 8 core. I They place you in grade by the highest core , regardless of the other cores. the 8’s go with 9’s and 10 in protocol treatments depending on metastasis. My Decipher score was 60, intermediate, however it was pointed out to me 61 was in the high risk. It was also interesting that my PSMA Pet SUV uptake in both lobes was only mild with a lower SUV in the non Gleason 8 side. I read also not unusual in small prostates that register a mild SUV uptake to have aggressive cancer. I was also told one Gleason 8 core is treated the sane as 6 Gleason 8 cores. Your treatment could still be no different than someone with a Gleason 7 if Surgery is chosen. In your case if it’s still within the capsule and seminal vesicles you have many options available. I was worried about my 8 and thought like you about my low PSA. In my case it could be a 9 and it would not change. Don’t focus on the mortality rate as you can learn people with 8, 9 and 10’s caught early in the capsule are around for years and years even with multiple treatments.

jimryansr

wheel, thanks for the reply and for sharing your prognosis. I’m still not up on all the acronyms but am researching! I’m happy to hear there’s hope for longevity! Hope you are well.

Jim

Clevelandguy

Hi,

The PMSA PET scan should show you if there is any spread outside of the Prostate. With gleason 9 and seminal involvement you need to do something soon in my humble non medical opinion. Was the gleason 9 in the seminal vessels? I had plural neural invasion as my cancer was getting ready to leave the barn., 10 yrs later I’m still around and kickin. Your doctor team should help you decide the most effective form of treatment to deal with your cancer. I have included a link to get you familiar with some of the treatment paths forward.

https://www.cancer.org/cancer/types/prostate-cancer/treating.html

Dave 3+4

Josephg

https://csn.cancer.org/discussion/328303/high-gleason-low-psa

In general, the more aggressive the PCa, the less PSA is produced, so your situation is normal.

jimryansr

https://csn.cancer.org/discussion/comment/1716849#Comment_1716849

thanks Dave