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Gleason is dead ...

User
Posted 14 Sep 2018 at 14:49

This may have been discussed on the site before, if so please let me know.


The Gleason score as a means to stratify PCa Risk is dead. This research paper and its conclusions are startling and enlightening for all. Published in 2015 I am very surprised that more is not being made of this.


The study sought to validate and cross reference a Cambridge based study to one done in Stockholm. The study cohort mostly focussed on pT2, pT3a, pT3b staging accross G3+3, G3+4, G4+3 and G3+5 with only 2 G4+5's, they were all RP/Surgical samples and incorporated Positive Margin and Extra Capsular cases. Aggressiveness is measured in time to biochemical relapse (they have some neet graphs). They identified 100 genetic markers and clustered them into 5 groups with different outcomes. The groupings are made on the basis of genetic copy and transcript error rates within the Prostatic DNA.


They found that Gleason 3+3, 3+4, 4+3 and 3+5 were distributed accross all five iCluster risk categories some of those iClusters being much more aggressive than others. As you know Gleason is based on the cell architecture seen under a microscope. Gleason is a crap shoot and no indicator of aggressiveness and survival rates for PCa sufferers. New risk scale needed urgently, this should be in trial stages and a new charter for anyone undertaking AS;


1) Only for patients whoes biopy material has undergone genetic screening (see above)


2) 3 monthly PSA checks


2) mpMRI 12 monthly or event driven


4) etc ....


Fresh

Edited by member 14 Sep 2018 at 17:09  | Reason: Not specified

Base jumping without a parachute should be frowned at, never criticised. Fresh

User
Posted 14 Sep 2018 at 14:49

This may have been discussed on the site before, if so please let me know.


The Gleason score as a means to stratify PCa Risk is dead. This research paper and its conclusions are startling and enlightening for all. Published in 2015 I am very surprised that more is not being made of this.


The study sought to validate and cross reference a Cambridge based study to one done in Stockholm. The study cohort mostly focussed on pT2, pT3a, pT3b staging accross G3+3, G3+4, G4+3 and G3+5 with only 2 G4+5's, they were all RP/Surgical samples and incorporated Positive Margin and Extra Capsular cases. Aggressiveness is measured in time to biochemical relapse (they have some neet graphs). They identified 100 genetic markers and clustered them into 5 groups with different outcomes. The groupings are made on the basis of genetic copy and transcript error rates within the Prostatic DNA.


They found that Gleason 3+3, 3+4, 4+3 and 3+5 were distributed accross all five iCluster risk categories some of those iClusters being much more aggressive than others. As you know Gleason is based on the cell architecture seen under a microscope. Gleason is a crap shoot and no indicator of aggressiveness and survival rates for PCa sufferers. New risk scale needed urgently, this should be in trial stages and a new charter for anyone undertaking AS;


1) Only for patients whoes biopy material has undergone genetic screening (see above)


2) 3 monthly PSA checks


2) mpMRI 12 monthly or event driven


4) etc ....


Fresh

Edited by member 14 Sep 2018 at 17:09  | Reason: Not specified

Base jumping without a parachute should be frowned at, never criticised. Fresh

User
Posted 14 Sep 2018 at 16:11
Not new news - PCUK has been involved in funding research at the main PCa centres for a few years now, looking for techniques to identify which are the pussycats and which are the tigers. Until they have it nailed, Gleason remains a good indicator of risk but not the only indicator.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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User
Posted 14 Sep 2018 at 16:11
Not new news - PCUK has been involved in funding research at the main PCa centres for a few years now, looking for techniques to identify which are the pussycats and which are the tigers. Until they have it nailed, Gleason remains a good indicator of risk but not the only indicator.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 14 Sep 2018 at 17:04

where Lyn?. This test proves Gleason, excluding G5 (not enough data) and differentiates well on G3/4 is no good at all. It could not be implemented in trial unless tissue is being harvested. This is not the same as determining the likelyhood of getting PCa (I have already discussed bio markers trials at UCLH with researchers) its stratifying PCa aggressiveness based on science not patterns and for the first time establishing a dna driven scale for risk. Properly. Post operative prostates are no good. They have been preserved.


PSADT by itself is more useful than Gleason. Can’t load images in this website - needs improving. See my new image.


Fresh

Edited by member 14 Sep 2018 at 17:08  | Reason: Not specified

Base jumping without a parachute should be frowned at, never criticised. Fresh

User
Posted 14 Sep 2018 at 17:23

Originally Posted by: Online Community Member


Can’t load images in this website - needs improving.


Fresh



The whole thing is very poor. The search function is not intuitive, lengthy posts are lost between sending and appearing on-line, it is difficult to follow threads one has contributed to.


When typing it is sometimes awkward to correct things, hyper-links are impossible in members’ profiles and from first draughts of posts - they have to be edited. The comments page sometimes locks up, and what has been written is lost.


I only use an iPad for this site, and it seems the community board has not been fully optimised for that device as there are loads of frustrations involved when trying to submit posts. As if we haven’t got enough to worry about, coping with cancer!


Why do PCUK seem to have developed their own clunky bulletin board programme when off-the-shelf alternatives like Ultimate Bulletin Board and its more advanced successors are readily available?


MacMillan is even worse!


Cheers, John

Edited by member 14 Sep 2018 at 18:23  | Reason: Not specified

 
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