Uptick in gleason score

In the summer of 2016 my fusion biopsy also revealed a Gleason of 3+4=7, 30% of the core.....5% was a Gleason 4. With a fusion biopsy, which is 3 dimemsional, there is ability to go back to that spot in a future fusion biopsy which I did in August of 2017.....the biopsy did not find any Gleason 4. I am continuing with Active Surveillance.

Here is the thread that was posted here in August 2017

https://csn.cancer.org/node/311533

Here is an interview with Dr. KIlotz, the expert's expert on Active Surveillance from Canada. He talks about the limits of Active Surveillance. Toward the end of the interview there is dicussion about Gleason 3+4=7 and the amount of involvement that is acceptable. You and I are still within the range for active surveilance, but coming close to the limit that is acceptable.

Listen to this interview for up to date information from this expert, especially the last several minutss.

...July 2017 Interview with Dr. Klotz https://www.urotoday.com/video-lectures/advanced-prostate-cancer/video/mediaitem/778-embedded-media2017-06-02-13-54-01.html?utm_source=newsletter_4652&utm_medium=email&utm_campaign=uroalerts-prostate-cancer-weekly    .........................................................................

If , after investigation, it is decided that Active Surveillance is no longer acceptable, consider SBRT (a from of radiation) for treatment. The cure rate is comparable to surgery while the potential side effects are significantly less

Denistd,

I do not recall your initial clinical stage and wonder if the present findings are that much worse than the previous. What is there that made you to think in a treatment? What are the latest results of the PET scans?

My opinion pairs the above comments. The best choice to care about PCa is AS if the patient's condition/status permits that. This is what you have been doing so that you know the feel in living with the unwanted guess. I think that you can rely on JH laboratories for the review of the samples. Their results will provide your doctor with arguments on the treatment, in any case you should also consult specialists in the field of radiotherapies. Your CKD affair will have no role in the final decision, but some other issues, such as any ulcerative colitis and bone health, should be investigated before you engage in any thing.

Best wishes,

VG

Denistd, FIsrt are you a one N Denis?  I have not met many.   I was G6 initially but upon the second opinion pathology, I have one core with 3+4 <5%   I did decipher test which showed an intermediate risk of metastasis.   I am going to get treated, probably RP.  I wish you Well Denis

denistd, I would seriously think hard about getting treatment. I had only 1 of 8 cores with cancer at a grade 7 ( 3+4 ) but my psa was also high ( around 7 ng/ml ). I opted for surgery  and my post op pathology was a lot worse. Gleason 8 (4+4) and all the trimmings , Lvi, positive margin, extension  .....

So evaluate all your options givin your specific diagnosis. 
For me , in hindsight, I would have chosed radiation since i did have a reoccurrence.

I only would have chosen radiation in hindsight. You are correct in that in most cases if you have radiation as a primary treatment then surgery  is most likely off the table if you have a reoccurrence. But for my case I did have a reoccurance that was located in the prostate bed that surgery  did not address probably because it was too small to see at the time of the operation. If I chose radiation first it should have radiated the area where the cancer was later found. Im I 100 % sure about this ? - No.. but I think that's how it would have went down. Like killing two birds with one stone..

Hope this clarifies my reasoning somewhat..contento

MK, didn't know anything about salvage RP. I would have thought that a reoccurrence  after primary radiation would not reoccur in the prostate that was radiated but in the surrounding tissue . Interesting what your saying. Hey Im learning something new everyday.

Hi,

Need to decide if it's a Gleason 6 or 7, it does make a difference.  Also as Old Salt said where is the tumor located?  Burried inside the Prostate or close to the edge.  Based on the Gleason & location it might help on doing something now or waiting a little longer.

Dave 3+4

You can take John's Hopkins review of the pathology to the bank.....John's Hopkins pathology depart are the experts...there is a difference among skills and facilities among pathologists.

Time to really really celebrate....continue with Active Surveillance.....

You can play, "Happy times are here again"

Best