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Gleason scoring

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User
Posted 17 Apr 2018 at 17:01

Oh dear, Lyn, amongst your many fine qualities is not mathematics. The rate of PSA growth is constant, an arithmetic progression with constant intervals. Only if you rebase the calculation at each step could it be said to be slowing down in percentage terms.

So, Vivienne, I suspect the onco will be guided by your dad's wishes but if I were he, I would not fear RT at this stage. Equally, the numbers are very low and another three months probably would not affect matters greatly. The oncos tend to look at PSA doubling time. In your dad's case, it is six months. I have had worse!

AC

User
Posted 17 Apr 2018 at 17:51

My maths is fine - doubling time from first post-op PSA to next test was 3 months and if it had stayed at the same doubling rate this most recent test would have been 0.12 but it was only 0.09 so the growth rate has slowed from 100% increase (first 3 months) to 50% increase (2nd 3 months). Oncos and uros rebase at each test to calculate doubling time. I would agree with you if we were measuring something along a line or ruler - the rate of increase would be steady - but we are measuring replicating cells so the growth is in multiples rather than linear.

My instinct is that at these tiny numbers, doubling time is not necessarily reliable anyway - it could now flatten out I suppose.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 22 Apr 2018 at 21:48
Hi Viv,

My OH has had a very similar path to your dad.

Psa 9, surgery in Dec 14 -, Gleason 5 plus 4 but clear margins. All well until May 16, when psa went from undetectable to 0.05 to 0.06 to 0.08 in six months.

Our surgeon decided that it would be sensible not to wait until it rose further, and my oh had radiotherapy 12 months ago.

He has had no bowel symptoms apart from a bit of urgency during and immediately after. However, his incontinence, which plagued him from the surgery but had significantly improved took a backward turn, and is now back to square one.

It’s not an easy disease, but he knows he’s luckier than some.

 
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