doubling time and gleason

I'm no expert but the higher your Gleason score then generally the more aggressive your cancer is and hence its growth / replication. I am G9 and was psa 48 at surgery. My doubling time was roughly 8 weeks which is quite severe. Post op my doubling time was still 8 weeks. After one year of HT and then coming off it , my doubling time is now approx 10 weeks.

And does doubling time tend to stay roughly the same? In other words if doubling time was, say, a year when diagnosed, and followed up, is that the rate where it tends to stay?

David

I think its quite difficult to answer and depends on the situation, if the PSA is entirely caused by cancer than maybe but pre op you just don't know.  My consultant told me doubling time / velocity isn't reliable and that I was a case in point.  I had no cancer in the end but my psa tripled in 7 months, PSA can rise for many reasons.  Score, staging and with surgery margins are more important from what I have read and understand.

Doubling time that is already short and then gets shorter and shorter is a very worrying indicator.

When dad's cancer came back his doubling time was 3 years and the urologist predicted that it would take 20 years to kill him. Within 2 years it was a dt of a year and now it is about 6 months which tells us that he is probably not going to have another 20 years unless he actually does something to slow it down.

Aggressive isn't always the right word. High risk is more precise.

G8 or more is high risk. Doubling time of 6 months or less is high risk. T2c or above is high risk.

G8 is more distorted and would often but not always grow quicker than a G6

The Gleason score is relevant. For example, a man assessed with a Gleason of 3+3 if the cancer is contained may well be recommended the option of AS. It is much more unlikely that a man with a 4+4 or higher Gleason is going to be recommended AS which reflects the relative concern. Also, cancer cells can produce varying degrees of PSA as they develop and this can be influenced by treatment. I believe spread to be the most important aspect regardless of PSA or Gleason.

Radar, regardless of your 3+4=7 Gleason, it is your staging that makes you not a good candidate for surgery. I was also a 3+4=7 but with 3TA and I was steered away from surgery by a surgeon reporting the MDT opinion. He introduced me to the RT department as he didn't think he could remove all the cancer but there was a chance that RT could eradicate it.

Well my surgery has not cured me, and it seems neither has SRT, so doubling time will become very relevant. I know you can't get a true picture about doubling time until we get into whole numbers. But like I said, before surgery, my DT ie the growth of my cancer, appeared to work out at about 5 years. My onco yesterday said it is unusual for the aggressiveness to change radically from what it always has been. RP and SRT didn't get it all, so there has always been a bit of my original PSA 13 that escaped before treatments. Undetectable but actually a tiny amount which is now apparent at 0.11.

My only hope is the cancer that I have, and that was growing very slowly, will continue to grow very slowly, rather than speed up and need HT rather soon. I know it may change, but I have to be hopeful that at G7 it does not.