Just Diagnosed Gleason 8

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Comments

  • Georges Calvez
    Georges Calvez Member Posts: 547 Member
    #22
    Mixed bag

    Hi there,

    On the basis of that biopsy I think a score of 8 is a bit high.
    There is only one core that got an 8 and the proportion of that core was not very high.
    If the core had been shot in a different place it could have come out differently.
    Biopsies are not an exact thing, we have had people on here that have had one or two negative biopsies before a positive one, etc.
    You obviously have a fairly extensive tumour but it seems to be restricted to the left side of the prostate.
    I think a fairer score would be a 7, most likely a 7b (4+3) but maybe a 7a (3+4).
    You have a lot of grade 3 material and only a comparatively small amount of grade 4.
    I would stop worrying about pains here and there and wait for the results of the scans.

    Best wishes,

    Georges

  • Clevelandguy
    Clevelandguy Member Posts: 1,206 Member
    #23
    Trip?

    Hi,

    Another vote for going on the trip, sounds like a good thing to do before the test results & decisions. You could get a second opinion to re-grade your biopsy samples if you think that is needed.  With that said I would trust the  x+x numbers you get from your doctors and compare. We are not doctors on this board and a trained professional will be able to give you the proper answer based on their expertise and not a "I think" guess.

    Dave 3+4

  • Josephg
    Josephg Member Posts: 460 Member
    #24
    Go on the Trip!

    I agree with the folks recommending that you keep your plans and make the trip to Thailand and Cambodia.  In my own case, when I was initially diagnosed with PCa, I already had a week-long camping trip planned for the next week, a camping trip that I made every year for 36 straight years.

    Sitting on the shore of the island that I had reserved exclusively the folks joining me on the camping trip, I watched the sun rise in the morning and set in the evening for a number of days.  I reflected on my newly discovered PCa diagnosis, and I had plenty of uninterrupted time to think about things, sort them out, prioritize them, and put them into the proper perspective with everything else going on in my life.

    I found this contemplation time, in a place far away from home, to be invaluable in achieving my peace of mind, and it helped me tremendously to shift my life's perspective, and accept the fact that I would be embarking on this PCa journey.

    Go on your scheduled trip.  I guarantee that you won't regret it.

  • Georges Calvez
    Georges Calvez Member Posts: 547 Member
    #25
    Global, Highest, and Largest Volume Cancer Grade Group
    Hi there,

    Sadly Gleason Scores can be interpreted in different ways and pathologists have changed those ways often upgrading the scores.
    Thus Kitafloyd is a Grade 8 on the basis of the highest needle biopsy sample found but he would be a Grade 7 on the basis of a Global Score which takes into account all of his scores.
    There is also fairly poor agreement between the score found by biopsy and the score found when the pathologist has your prostate in hand and is slicing and dicing it.
    If Vasco was to be graded today he would be given a 6 instead of a 5, grade 2 has been abandoned so he is grade 6 ( 3+3).
    I suspect that my report would be ungraded from a 7b to an 8 as I think they have used a global grade instead of a per needle basis, I will have to take this up with Tigger the next time I see him!
    http://www.pathologyoutlines.com/topic/prostategrading.html
    https://www.ncbi.nlm.nih.gov/pubmed/30080706
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4779758/

    Best wishes,

    Georges
  • Kitafloyd
    Kitafloyd Member Posts: 12
    #26
    lighterwood67 said:

    Quality of Life

    To me, taking that trip would be quality of life adventure to me.  Go.  Been to Thailand many moons ago when I was in the Air Force.

     

    It is by far one of the most

    It is by far one of the most beautiful places I've been. The Thai are among the kindest friendliest folks I've ever encountered. This will be my 6th time there. I count my lucky stars that I've been able to travel extensively in my lifetime.

  • Kitafloyd
    Kitafloyd Member Posts: 12
    #27
    VascodaGama said:

    Have a good trip

    Floyd,

    I would follow the recommendation of your PAP and go visit the Indochina. Your present status wouldn't change till your return and now you are free from the side effects of treatments. You can try doing the scans before the trip and get a final answer from the doctors on your return with the results of the image studies in hand.

    In the above biopsy report, the Gleason 8 (4+4) found at the base of the prostate (just under the bladder) is the area close to the seminal vesicles. This makes me wonder if the vesicles are infested. Gs8 guys with SV invasion have high probabilities for spread. The MRI may provide the answer.

    Best wishes,

    VG

    Yeah I've been wondering

    Yeah I've been wondering about that possibility as well. Just accepting it and moving forward as the info comes in.

  • Kitafloyd
    Kitafloyd Member Posts: 12
    #28
    Clevelandguy said:

    Trip?

    Hi,

    Another vote for going on the trip, sounds like a good thing to do before the test results & decisions. You could get a second opinion to re-grade your biopsy samples if you think that is needed.  With that said I would trust the  x+x numbers you get from your doctors and compare. We are not doctors on this board and a trained professional will be able to give you the proper answer based on their expertise and not a "I think" guess.

    Dave 3+4

    Thanks for the reply Dave. I

    Thanks for the reply Dave. I'll bring it up to the Doc and see if a reassesment of the biopsy is possible.

     

  • Kitafloyd
    Kitafloyd Member Posts: 12
    #29
    Georges Calvez said:

    Global, Highest, and Largest Volume Cancer Grade Group
    Hi there,

    Sadly Gleason Scores can be interpreted in different ways and pathologists have changed those ways often upgrading the scores.
    Thus Kitafloyd is a Grade 8 on the basis of the highest needle biopsy sample found but he would be a Grade 7 on the basis of a Global Score which takes into account all of his scores.
    There is also fairly poor agreement between the score found by biopsy and the score found when the pathologist has your prostate in hand and is slicing and dicing it.
    If Vasco was to be graded today he would be given a 6 instead of a 5, grade 2 has been abandoned so he is grade 6 ( 3+3).
    I suspect that my report would be ungraded from a 7b to an 8 as I think they have used a global grade instead of a per needle basis, I will have to take this up with Tigger the next time I see him!
    http://www.pathologyoutlines.com/topic/prostategrading.html
    https://www.ncbi.nlm.nih.gov/pubmed/30080706
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4779758/

    Best wishes,

    Georges

    Thanks for the reply and

    Thanks for the reply and links Georges (pronounced Hor-Hay right?). Just beginning to understand the Gleason Score grading process.

  • ufknkidding
    ufknkidding Member Posts: 48 Member
    #30
    Trip?

    It all depends on your personality.  If you tend to worry more than others, have OCD or anxiety, then a trip might just add to the stress you are experiencing from the diagnosis and uncertainty. If you manage worry fairly well, then a trip could be beneficial to help you re-focus.  The PCP commenting who knows when you will be able to go on another trip just added another stressor.  On a totally side but important note, if you have a healthy sex life and trips with your significant other lead to romance, relationship building, and lots of intimacy including intercourse, I'd consider the trip even with the worries.  Partly because some of the treatments you may elect in the future could disrupt your sexual function and the trip will build some wonderful memories that will help you through the recovery phase post treatment.

  • Georges Calvez
    Georges Calvez Member Posts: 547 Member
    #31
    Go!

    Hi there,

    My best advice is to go on your holiday and enjoy yourself.
    Prostate cancer treatment is not as bad as some cancer treatments but it can affect your life quite a bit for a while or long term.
    So look on this holiday as the calm before the storm and make hay while the sun shines.

    Best wishes,

    Georges

  • Trew
    Trew Member Posts: 932 Member
    #32
    Floyd, it takes at least 6

    Floyd, it takes at least 6 weeks after the gleason nail-gun experience for your prostate to heal.  I remember at the start of that biopsy the doctor telling me to "Relax."  

     

    My PSA was never over 12, but my Gleason was 4+4 and 2 months later at the time of surgery it was a 5+4.  

    I had positive margins, and had to have radiation, then a year of hormone treatment.  

     

    Right now this Dec/Jan I am 10 yrs out from radiation.  It might be helpful to know that.  Take courage.  You are going to meet a lot of interesting poeple!   

  • Kitafloyd
    Kitafloyd Member Posts: 12
    #33
    Trew said:

    Floyd, it takes at least 6

    Floyd, it takes at least 6 weeks after the gleason nail-gun experience for your prostate to heal.  I remember at the start of that biopsy the doctor telling me to "Relax."  

     

    My PSA was never over 12, but my Gleason was 4+4 and 2 months later at the time of surgery it was a 5+4.  

    I had positive margins, and had to have radiation, then a year of hormone treatment.  

     

    Right now this Dec/Jan I am 10 yrs out from radiation.  It might be helpful to know that.  Take courage.  You are going to meet a lot of interesting poeple!   

    Thanks for the reply Drew.

    Thanks for the reply Drew. Good to meet you. Yeah... "Relax" he says. I was bucking like a bronco during mine. 10 years out is fantastic. Good for you. Very helpful, thank you.

  • Steve1961
    Steve1961 Member Posts: 625 Member
    #34
    Kitafloyd said:

    Thanks again to all who've

    Thanks again to all who've responded.

    I've been doing the HCP dance for most of the day to get the best Urilogical Oncologist that i could find.

    So now another PCP visit (new one) on Wednesday so I can hopefully get an expedited referral to see the guy I want as well as the MRI/CT/Bone scans.

    The waiting is the most excruciating part while I'm trying not to freak the hell out everytime I feel any lower back pain or some other weird feeling "down there".

    I did get a copy of my Biopsy results.

    A - F) Right Side - Benign

    G) Left Base - Adenocarcinoma, Gleason 8 (4+4) involving one of one core and 25% biopsy

    H) Left Mid - Adenocarcinoma, Gleason 6 (3+3) involving one of one core and 80% biopsy

    I) Left Apex - Adenocarcinoma, Gleason 6 (3+3) involving one of one core and 35% biopsy

    J) Left Lat Base - Adenocarcinoma, Gleason 7 (3+4) involving one of one core and 75% biopsy

    K) Left Lat Mid - Adenocarcinoma, Gleason 7 (4+3) involving one of one core and 75% biopsy

     

    On a personal note, I had a vacation planned the day after Xmas to go to Thailand and Cambodia (Angor Wat) with my better half. Planned on staying until mid January. PCP says to go because who knows when I'll get the chance to again. Oof. Staying generally positive though and super thankful for the support.

    Percentage involvment

    what exactly does the percentage involvemdnt mean ..some are 20 % some are 40 some are 80 ..I know the higher involvement is not good but what does that mean exactly..does anyone know .i thought it meant that the needle hit the tumor directly the % would be higher instead of close around it ..lam I wrong 

  • Trew
    Trew Member Posts: 932 Member
    edited December 2019 #35
    Kitafloyd said:

    Thanks for the reply Drew.

    Thanks for the reply Drew. Good to meet you. Yeah... "Relax" he says. I was bucking like a bronco during mine. 10 years out is fantastic. Good for you. Very helpful, thank you.

    Kit, I have some even better

    Kit, I have some even better news for you.  

    I just read through all the replies to you, all the terms, treatments, and I don't remember even 50% of this stuff.  What used to be everyday terminology for me, I am forgetting it, it is no long vocabulary I use.  I consider that a positive.  Those first 2- 3 years, surgery, radiation, hormone shots, AUS installed- doctors all the time.  After radiation I peed blood for like 5- 6 yrs!  And I couldn't get the AUS until a scaring problem in the urethra was solved.  I was getting scoped up into the bladder every 3 months for over a year, had to do the self-cath routine after surgery to get the scar tissue removed, and .....    I was referred to the U of Michigan and my urologist was a woman.  What an experience, and as I type this I am realizing, all that nightmare treatment stuff is pretty much behind.  I did have some scar tissue problem return last year and had an OR procedure to open up the passageway again, but over time, your vocabulary should return to normal.

     

     

     

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