Just diagnosed with Gleason 6

User

Posted 06 Mar 2025 at 21:49

Hi All

Unfortunately I was diagnosed today after a biopsy with gleason 6 cancer, even though my psa when last measured in December was 1.47. I have been put on AS and told there is no need for treatment. I will get blood tests every 3 months and an MRI annually. Whilst I understand the reason for being put on AS, I am a little anxious no curative treatment is on the table yet.

User

Posted 06 Mar 2025 at 23:58

Par for the course these days assuming the g6 lesson is small and not near the edge of the capsule.

I would be inclined to ask why you have a palpable nodule and if this impacts the risk of doing AS.

User

Posted 07 Mar 2025 at 08:48

Hello mate.

In the grand scheme of things, PSA 1.47, Gleason 6, and well contained cancer, are great results. Hopefully your cancer will be a pussy cat, your AS will be successful, and you won't require further treatment.

I don't understand why you're anxious that a curative option has not been offered, when you may never need to be 'cured'.

You need to have a positive attitude on AS. You need to feel secure, with the knowledge that you that you are being safely monitored. Your early concerns suggest that you may struggle with this?

I hope all your follow up results remain favourable.👍

User

Posted 07 Mar 2025 at 13:14

Do you have private insurance? I had similar at diagnosis 3+3 via my initial consultant, I saw privately.

They offered me active surveillance which was also rubber-stamped by the London based MDT. And the suggested timeline was perhaps wait six months or so and review.

I had a hunch something more was wrong so got a second opinion from a top London neurological surgeon Professor who agreed to do robotic surgery.

Turns out it was quite timely because the post surgery histology results showed the cancer was a lot more extensive than had been shown on scans and biopsy and was extremely close to breaking out the prostate.

Bear in mind that ~44% cases roughly are upgraded post surgery so I ended up with a final classification of 3+4.

Apparently prostate cancer tends to develop on the anterior of the prostate so they tend to be quite close to breaking out even fairly early stage which was another driver for me to act fast.

My view was ultimately some treatment will be needed at some point. For me Intervening earlier while being relatively young has advantages in terms of tolerating surgery plus hopefully reduces the probability of metastasis.

Best of luck and don’t fret too much about the treatment as it’s nowhere near as bad as you build it up in your mind. For me surgery was less uncomfortable than when I have my tonsils out in all honesty.

Edited by member 07 Mar 2025 at 13:15 | Reason: Not specified

User

Posted 07 Mar 2025 at 14:20

Yes, have Bupa through my company, this all started via Bupa (annual health assessment/Urologist/MRI scan/Urologist again) and then she referred me back to the NHS for a biopsy an saw her in her NHS clinic to discuss the results... Their assessment is because my psa is only 1.47 (well was on Dec 6th) and had only changed 0.27 on 2 years previously (and apparently even in a day your psa can fluctuate that amount sometimes), the cancer is low grade and low risk. I did ask about prostatectomy but was told I am not near that stage yet. When I spoke to a urology nurse, he mentioned hormone therapy if I was insistent on treatment but warned of the side effects and told me it wasn't needed at the moment. I guess I will give it a few months and do the quarterly blood tests and if my PSA starts rising I will have to insist on treatment either via NHS or Bupa.

Edited by member 07 Mar 2025 at 14:26 | Reason: Not specified

User

Posted 07 Mar 2025 at 14:59

Good to hear it’s thought to be early stage. You can get a second opinion either via a letter from your GP of self referring. I don’t involved my local team at all and just found a top rated high volume London consultant who worked out of a well funded teaching hospital with top end kit. Definitely use Bupa if it’s paid for by the company as it’s much faster route with less delays and private rooms etc when needed. With private I find there is better continuity and contact with the consultant. The only time I saw a CNS was for post surgery advice and catheter removal. 2hr door to door trek into London but wasn’t too bad.

Edited by member 07 Mar 2025 at 15:05 | Reason: Not specified

User

Posted 07 Mar 2025 at 16:53

Second, third or even forth opinions will only cloud your decision making process, the statistics are what count.

Of the guys on AS, after 10 years nearly all will still be alive, as will those that have treatment.

If you opt to remain on AS ask yourself how will I cope mentally knowing the the cancer is still within me, albeit behaving itself and if you still don't feel comfortable with remaining on AS, you will know in your heart what to do.

Balance this against how will treatment affect me? You may be lucky and experience no side effects, on the other hand it could worse case scenario for 10 years.

Like I said at the beginning, many opinions will make decision making difficult and no amount of advice on here will help you with this, so as Loyd Grossman used to say "let's look at the evidence". Ten year stats show AS just as good as treatment outcome, treatment may come with side effects, opinions may confuse the issue.

For me this year will be the tenth anniversary of my Gleason 6 diagnosis following a HoLEP which came after several negative biopsies along with rising PSA over a 9 year "watchful waiting" period.

Although I was offered treatment upon diagnosis, I still opted for AS and my stable PSA (every 6 months) plus two MRIs satisfies me that I took the right decision. If and when my "pussycat" wakes up I have already made up my mind on what treatment I will have which is based upon how my comorbidities may be impacted by choosing the wrong treatment.

Last thing, my father died from not with PCa aged 98, so only 22 years to go.

Good luck with whichever option you choose.

Edited by member 07 Mar 2025 at 16:54 | Reason: typo

Roger

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