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Gleason 8?

User
Posted 24 Nov 2018 at 12:23

My Dad’s doctor found his PSA was 6 in some results from 7 weeks ago. Since then he has been chasing the hospital for the scan and the biopsy and the results (they haven’t been very forthcoming). 

 

Yesterday he was told he has aggressive prostate cancer and the Gleason grade is 8. He needs a bone scan to identify if it has spread to his bones before any treatment can be given. 

 

He was told it was contained within his prostate but with it being aggressive can it still spread? I am expecting so if they are doing a bone scan?

 

Can anyone offer any advice with these results? What was your story if you had G8 please? How can I support my dear Dad? We are very close, I am pregnant too with complications so need to keep my blood pressure down as my son was born sleeping earlier this year. With other family deaths to say this year has been hard would be an understatement. 

 

Thank you in advance for any help you can offer. 

 



User
Posted 25 Nov 2018 at 01:04
My local urologist said that my PSA of 2.2 when I was 55 would warrant further testing, months or years down the line. “But then I do see a lot of men with prostate cancer”. Nothing was done as the NHS class anything under 4 as ‘normal’.

At the next test, seven years later, it was 16.7!

Water under the bridge, now of course, but I am still dismayed by the long gap.

Cheers, John.

User
Posted 24 Nov 2018 at 16:18
Hi Betty,

Please give us a profile of Dad’s initial symptoms, clinical diagnosis, i.e Gleason score ?+?=?, staging T?N?M? and his age to assist the wise old heads here who have ‘been there, had that’ to be able to offer advice.

Moreover, please order the ‘Toolkit’ information folder from this charity. Use the search function on the website above. It is very comprehensive and will tell you all you need to know, going forward.

I think G6 is non-aggressive, G7 & G8 are intermediate aggressive, and G9 and G10 are buggers that are best avoided! I was G7 and am still here a year later, cancer-free, and have never felt so well!

I think your Dad will be AOK once all the test results are in and then a treatment plan is in place. Listen out for the magic words of medi-jargon “With curative intent” when you see the urologist.

Best of luck for the future, and for your new arrival.

Cheers, John.

User
Posted 24 Nov 2018 at 17:51
Coventry City are still in Division Three like my G 4+3=7, diagnosis, now gone... 🤞

Funnily enough, I don’t wish for promotion to a higher division on a personal basis😉

Cheers, John.

User
Posted 24 Nov 2018 at 20:35
As my profile shows aged 58 at diagnosis, PSA 6.1, Gleason 8 (4+4). Survived 14 years thus far.

Ray

User
Posted 24 Nov 2018 at 23:44
For a man of 50, a PSA over 3.1 should lead to consideration of referral. For a man in his 60s, a PSA of 3 would be considered well within normal range.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 24 Nov 2018 at 23:53
I think there is a typo - his Gleason score must be G8(4+4).

The Gleason says how deformed the cells are, so 1 is normal and 5 is really distorted. The first number is the score for the most common pattern of distortion in his biopsy samples, and the second number is the next most common pattern. So of whatever % of his cores were actually cancerous, they were all of pattern 4 which is very deformed and therefore considered to be high risk. It would be useful if you can find out what % of the samples was cancerous - whether it was 5% or 100% makes a significant difference to treatment options.

It can be contained in the prostate AND still have spread to the bones, yes. That's because prostate cancer can spread to nearby tissue by bursting out of the prostate (which apparently doesn't apply to your dad) or via the lymphatic system to lymph nodes (may or may not apply to your dad) or it can go to soft organs (rarely) or bone (more common but not a certainty in your dad's case).

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

User
Posted 24 Nov 2018 at 23:53

PSA levels are generally expected to increase naturally as a man ages and be within certain ranges. 3 for a man of 65 as he would have been two years ago, is within normal upper limit. Whether he should have been further monitored might well depend on what was felt in a DRE (Digital Rear Examination) and any symptoms or suspicion that despite his relatively moderate PSA for his age might have raised concern. In fact an enlarged Prostate could of itself lead to a significantly higher PSA than Dad had. So based solely on PSA at that time, it is understandable why he was not subjected to further investigation.

PCa can advance at different rates due to a number of variables not least depending on the type of PCa he has (It has been said that there are at least 27 different types and they can vary considerably in how much PSA they show.)

Edited by member 25 Nov 2018 at 00:00  | Reason: Not specified

Barry
User
Posted 24 Nov 2018 at 23:57

Mine was 4+4.  People use the term aggressive although I don't believe Prostate Cancer is usually as aggressive as other cancers.  High Risk is often used for Gleason 8 to 10.   

Other factors in High Risk are Positive Margins and psa greater than 10.

I have just the Gleason high risk and hope it didn't leave my prostate which should mean it won't come back.  Although all these things are statistical and you can be lucky or unlucky.

A doctor told me I was more likely to have a heart attack.  Although that didn't wholly please me.

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User
Posted 24 Nov 2018 at 16:18
Hi Betty,

Please give us a profile of Dad’s initial symptoms, clinical diagnosis, i.e Gleason score ?+?=?, staging T?N?M? and his age to assist the wise old heads here who have ‘been there, had that’ to be able to offer advice.

Moreover, please order the ‘Toolkit’ information folder from this charity. Use the search function on the website above. It is very comprehensive and will tell you all you need to know, going forward.

I think G6 is non-aggressive, G7 & G8 are intermediate aggressive, and G9 and G10 are buggers that are best avoided! I was G7 and am still here a year later, cancer-free, and have never felt so well!

I think your Dad will be AOK once all the test results are in and then a treatment plan is in place. Listen out for the magic words of medi-jargon “With curative intent” when you see the urologist.

Best of luck for the future, and for your new arrival.

Cheers, John.

User
Posted 24 Nov 2018 at 17:51
Coventry City are still in Division Three like my G 4+3=7, diagnosis, now gone... 🤞

Funnily enough, I don’t wish for promotion to a higher division on a personal basis😉

Cheers, John.

User
Posted 24 Nov 2018 at 19:43

Thank you so much for your kind reply.  My Dad was born and bred in Batley and is 67, he said he may know you as he knows so many people there!! 

His score was 4+8= 8. I am still getting my head around how that is worked out to be honest.

Dad had pain down below in 2016 and had as PSA test then and it was 3 (told nothing to worry about). He had a routine check up recently just because of his age, no symptoms other than he has had a bad back all my life, and score came back as 6. That prompted the MRI and then the biopsy.

He has been treated at Pinderfields and they have been rubbish. I would be happy to remortgage my house and get him done private to be honest but he won’t! 

I hope you cancer stays at bay and you become the oldest surviving member in your family. 

 

User
Posted 24 Nov 2018 at 19:45

Thank you for your kind message. I have posted below his history. He is 67.

I am still navigating this site so bear with me. 

 

 

User
Posted 24 Nov 2018 at 20:35
As my profile shows aged 58 at diagnosis, PSA 6.1, Gleason 8 (4+4). Survived 14 years thus far.

Ray

User
Posted 24 Nov 2018 at 21:10

Great to hear this, thank you for your time. 

User
Posted 24 Nov 2018 at 21:12

Does anyone know if PSA of 3 should have been looked into with my Dad two years ago please? 

User
Posted 24 Nov 2018 at 23:44
For a man of 50, a PSA over 3.1 should lead to consideration of referral. For a man in his 60s, a PSA of 3 would be considered well within normal range.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 24 Nov 2018 at 23:53
I think there is a typo - his Gleason score must be G8(4+4).

The Gleason says how deformed the cells are, so 1 is normal and 5 is really distorted. The first number is the score for the most common pattern of distortion in his biopsy samples, and the second number is the next most common pattern. So of whatever % of his cores were actually cancerous, they were all of pattern 4 which is very deformed and therefore considered to be high risk. It would be useful if you can find out what % of the samples was cancerous - whether it was 5% or 100% makes a significant difference to treatment options.

It can be contained in the prostate AND still have spread to the bones, yes. That's because prostate cancer can spread to nearby tissue by bursting out of the prostate (which apparently doesn't apply to your dad) or via the lymphatic system to lymph nodes (may or may not apply to your dad) or it can go to soft organs (rarely) or bone (more common but not a certainty in your dad's case).

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

User
Posted 24 Nov 2018 at 23:53

PSA levels are generally expected to increase naturally as a man ages and be within certain ranges. 3 for a man of 65 as he would have been two years ago, is within normal upper limit. Whether he should have been further monitored might well depend on what was felt in a DRE (Digital Rear Examination) and any symptoms or suspicion that despite his relatively moderate PSA for his age might have raised concern. In fact an enlarged Prostate could of itself lead to a significantly higher PSA than Dad had. So based solely on PSA at that time, it is understandable why he was not subjected to further investigation.

PCa can advance at different rates due to a number of variables not least depending on the type of PCa he has (It has been said that there are at least 27 different types and they can vary considerably in how much PSA they show.)

Edited by member 25 Nov 2018 at 00:00  | Reason: Not specified

Barry
User
Posted 24 Nov 2018 at 23:57

Mine was 4+4.  People use the term aggressive although I don't believe Prostate Cancer is usually as aggressive as other cancers.  High Risk is often used for Gleason 8 to 10.   

Other factors in High Risk are Positive Margins and psa greater than 10.

I have just the Gleason high risk and hope it didn't leave my prostate which should mean it won't come back.  Although all these things are statistical and you can be lucky or unlucky.

A doctor told me I was more likely to have a heart attack.  Although that didn't wholly please me.

User
Posted 25 Nov 2018 at 01:04
My local urologist said that my PSA of 2.2 when I was 55 would warrant further testing, months or years down the line. “But then I do see a lot of men with prostate cancer”. Nothing was done as the NHS class anything under 4 as ‘normal’.

At the next test, seven years later, it was 16.7!

Water under the bridge, now of course, but I am still dismayed by the long gap.

Cheers, John.

 
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