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Gleason Score

califvader's picture
califvader
Posts: 108
Joined: Aug 2010

i just got my lab report back today and my gleason score is: 3+3=6. From what i understand the lower the number the less aggresive your cancer. Is that correct? Is 6 good or bad?

Skid Row Tom's picture
Skid Row Tom
Posts: 125
Joined: Apr 2010

This comes from the Phoenix5 web site:

A score of 2 to 4 is considered low grade; 5 through 7, intermediate grade; and 8 through 10, high grade. A tumor with a low Gleason score typically grows slowly enough that it may not pose a significant threat to the patient in his lifetime.

My initial Gleason was 3+3=6, but after surgery, it was 3+4+7.

mrspjd
Posts: 694
Joined: Apr 2010

Califveder,
Welcome back again...Are you the same poster that posted a thread asking about Lupron Depot
(the picture and user name are the same)? If so, in your Aug. 11, 2010 post you stated your doctor had suggested Lupron Depot treatment and you were investigating it and the side effects. I'm most perplexed and wondering why your doctor would bring up hormone treatment prior to obtaining your biopsy results and prior to informing you of your PCa staging (T1-T4)? And if you already had your Gleason of 3+3=6, why was your doctor discussing hormone treatment (Lupron) unless there are other factors about your PCa that you have not shared/mentioned? Sorry if I sound a little harsh, but it doesn't add up.

As many of the folks here will tell you, PCa staging is not just about the Gleason score, although 3+3=6 is a good start. That happens to be the same Gleason score my husband INITIALLY received back in Feb of this year. If you don't yet have a copy of your biopsy report, I suggest requesting it from your doctor. I'm sure you'll get alot of advice/feedback in this thread about Gleason scores in general and your specific Gleason score question. I'm guessing that feedback will ask you for more details, such as # of biopsy cores taken, # of positive cores, percentages of cores positive, PSA info, PNI (peri-neural invasion) identified, etc. You're going to need that biopsy report to answer these questions.

Your Gleason score is only one piece of the big PCa picture puzzle--you will need to gather as many puzzle pieces as possible to see what YOUR PCa picture looks like.

califvader's picture
califvader
Posts: 108
Joined: Aug 2010

i was intially diagnosed with postate cancer in 2003. i had a radical done the same year. for some reason my urologist never did tell me my gleason score, only my psa level. from 2003 to now my psa has slowly elevated to 4.8 which was taken six months ago. recently my urologist ordered a bone scan and another psa test. bone scan came back negative and the psa dropped to 3.3. i do not know why the psa dropped but it is a good thing. just prior to these recent tests my urologist was suggesting lupron therapy so i was investigating it. Now, because of my recent down grade he wants to wait another six months and retest. i know it's kinda of confusing but thats what happened.

califvader's picture
califvader
Posts: 108
Joined: Aug 2010

one other thing. i had to send away to the lab for my gleason score because it was bioposyed so long ago they were the only ones who had the record. i receive the report today in the mail and i finally found out what my gleason score was after all these years.

mrspjd
Posts: 694
Joined: Apr 2010

Califvader,
Thank you. Your new information begins to shed more light on your PCa history and current status. So the 3+3=6 was your pre RP Gleason back in 2003? And seven years later, your PSA is now around 3 or 4? Do you have a yearly history/record of your PSA from '03 till now? How about a copy of your post RP pathology report? Your August 11th "Lupron" thread stated your doctor "recommended" Lupron...did he/she discuss salvage radiation in addition? At this point, I am going to defer to the post-RP rising PSA experts & other "unwilling club members" on this discussion board who, I'm sure, will give you some excellent and diverse opinions & advice. All the best to you.

Gentlemen.....what say you?

califvader's picture
califvader
Posts: 108
Joined: Aug 2010

thank you for your advice.

califvader's picture
califvader
Posts: 108
Joined: Aug 2010

thank you for your advice.

2ndBase's picture
2ndBase
Posts: 220
Joined: Mar 2004

Yes the lower the gleason score the less aggressive is the cancer. 6 is very common and not a score that should have you worrying about not surviving. Mine was a 9 and at age 52 it was a terminal diagnosis from the start. I have survived nearly 7 years and am in hospice care today, but I still have a two jobs and play golf 3 times a week. You will get a lot of advice about what to do next and just decide for yourself what path you take. I took very little treatment and have had a great quality of life. I never let stress in and have a wonderful wife and sons who give me hope. I wish you all the best in the future.

Kongo's picture
Kongo
Posts: 1166
Joined: Mar 2010

Vader,

As you likely know by now, the rising PSA several years after your RP can really be an indication of only one thing...your PCa has returned. Increases in PSA after RP are fairly common and I just read a report of a VA study that showed 34% of men who have RP will see a recurrence of cancer within five years.

Most doctors today will tell you that a PSA greater than 0.2 ng/ml is indicative of cancer and yours is much higher than that.

If you've been taking your PSAs regularly since your RP, you ought to be able to calculate your PSA velocity fairly easily using the Sloan-Kettering nomograms that can be found on the web.

I would urge you to see some second opinions on course of action but most RP failure options include additional treatment with IMRT radiation and hormone therapy. They will also want to do additional bone scans and other tests to determine if the cancer is contained in the prostate bed or has spread to other parts of your body.

As always, the earlier you seek treatment for this the better you odds of finally getting it all.

Best of luck.

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