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After the biopsy, diagnosis in the biopsy report

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User
Posted 01 Oct 2025 at 06:09

Biopsy was performed one week ago, and I received the results yesterday.

It showed Gleason 4+3, on both sides, but most of the tumor was in the cores from the right side (funny thing is that on the mpMRI, the right side looked less worrisome).

According to the doctor, surgery will hopefully take place in early November.

Honestly, I wasn’t expecting cancer, let alone a 4+3… but it is what it is. I cried a bit, but I have to accept it. Let’s see what they find during surgery if eventually takes place.

One question: I know that after surgery they can reclassify the results for worse. Has anyone ever seen a case where the final results were actually better than those from the biopsy?

Edited by member 02 Oct 2025 at 19:56  | Reason: Not specified

User
Posted 01 Oct 2025 at 07:50

Hello, mate.

I'm sorry that your biopsy results weren't as good as you had hoped for.

As regards your query of whether Gleason scores can be downgraded. Research shows that after prostate surgery Gleason scores are often upgraded and downgraded. On average about 25-30% are upgraded, 10-15% are downgraded.

Best of luck with your operation. 👍

Please keep us updated.

Edited by member 01 Oct 2025 at 07:51  | Reason: Typo

User
Posted 01 Oct 2025 at 08:01

Sorry to hear of the shock. Did they classify it as 2.x or 3.x?

My Gleason was downgraded BTW. From 3 5 to 3 4

All the best Rob

User
Posted 01 Oct 2025 at 09:43

Hi Adrian, thanks. I've got my 6 monthly in a few weeks.

 

Saw all your results are good. Catch you soon.

Rob

User
Posted 01 Oct 2025 at 10:37

Hi Chema

My post-surgery pathology downgraded me from 4+4 to 4+3 and down-staged me from 3a to 2c. 

Hope the operation goes well

Best wishes

Kevin

 

User
Posted 02 Oct 2025 at 19:54

Originally Posted by: Online Community Member

Hello, mate.

I'm sorry that your biopsy results weren't as good as you had hoped for.

As regards your query of whether Gleason scores can be downgraded. Research shows that after prostate surgery Gleason scores are often upgraded and downgraded. On average about 25-30% are upgraded, 10-15% are downgraded.

Best of luck with your operation. 👍

Please keep us updated.

Thank you. I hope the surgery will take place (I need a PET and hope there are no surprises), and if the surgery takes place, I hope the results will not show a worse diagnosis.

I keep you posted.

User
Posted 06 Oct 2025 at 00:03

Hi Chema. Just saw this and wanted to chime in. My biopsy last year was downgraded after surgery from 4+5 to 4+3. A pretty big jump. I had something like 19 or 20 cores taken during the biopsy. The scores of each were all over the place. I had literally every combo possible from 3+3 (3+4,4+3,4+4) and one had 4+5. The biopsy also turned up some cribriform pattern as well.

 

The histology report following my RARP was done at a different lab and they apparently didn't find any G5 nor was there any mention of cribriform. So, was I lucky, or was the first lab right? All I can do is remind myself what my surgeon told me before surgery: "I don't care what grade cancer you have. We're removing it anyway."

User
Posted 06 Oct 2025 at 15:50

Hi Chema

My post-surgery pathology did not change (3+4) but down-staged me from 3a to 2c. 

Best wishes

Fred

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User
Posted 01 Oct 2025 at 07:50

Hello, mate.

I'm sorry that your biopsy results weren't as good as you had hoped for.

As regards your query of whether Gleason scores can be downgraded. Research shows that after prostate surgery Gleason scores are often upgraded and downgraded. On average about 25-30% are upgraded, 10-15% are downgraded.

Best of luck with your operation. 👍

Please keep us updated.

Edited by member 01 Oct 2025 at 07:51  | Reason: Typo

User
Posted 01 Oct 2025 at 08:01

Sorry to hear of the shock. Did they classify it as 2.x or 3.x?

My Gleason was downgraded BTW. From 3 5 to 3 4

All the best Rob

User
Posted 01 Oct 2025 at 09:27

Hi Rob, 

Great to hear from you again. 

By  2.x and 3.x.  Do you mean, if Chema's cancer is stage 2 and stage 3?

So,  your Gleason was downgraded 8 (3+5) to 7 (3+4). Mine went the other way, upgraded from 8 (3+5) to 9 (4+5)

I hope that your post op PSA results are still good.

Edited by member 01 Oct 2025 at 09:39  | Reason: Typo

User
Posted 01 Oct 2025 at 09:43

Hi Adrian, thanks. I've got my 6 monthly in a few weeks.

 

Saw all your results are good. Catch you soon.

Rob

User
Posted 01 Oct 2025 at 10:37

Hi Chema

My post-surgery pathology downgraded me from 4+4 to 4+3 and down-staged me from 3a to 2c. 

Hope the operation goes well

Best wishes

Kevin

 

User
Posted 01 Oct 2025 at 15:43

Thanks all for your answers.

Originally Posted by: Online Community Member

Sorry to hear of the shock. Did they classify it as 2.x or 3.x?

My Gleason was downgraded BTW. From 3 5 to 3 4

All the best Rob

I don't know the T classification. I only have the pathology report about positive cores.

User
Posted 02 Oct 2025 at 19:54

Originally Posted by: Online Community Member

Hello, mate.

I'm sorry that your biopsy results weren't as good as you had hoped for.

As regards your query of whether Gleason scores can be downgraded. Research shows that after prostate surgery Gleason scores are often upgraded and downgraded. On average about 25-30% are upgraded, 10-15% are downgraded.

Best of luck with your operation. 👍

Please keep us updated.

Thank you. I hope the surgery will take place (I need a PET and hope there are no surprises), and if the surgery takes place, I hope the results will not show a worse diagnosis.

I keep you posted.

User
Posted 06 Oct 2025 at 00:03

Hi Chema. Just saw this and wanted to chime in. My biopsy last year was downgraded after surgery from 4+5 to 4+3. A pretty big jump. I had something like 19 or 20 cores taken during the biopsy. The scores of each were all over the place. I had literally every combo possible from 3+3 (3+4,4+3,4+4) and one had 4+5. The biopsy also turned up some cribriform pattern as well.

 

The histology report following my RARP was done at a different lab and they apparently didn't find any G5 nor was there any mention of cribriform. So, was I lucky, or was the first lab right? All I can do is remind myself what my surgeon told me before surgery: "I don't care what grade cancer you have. We're removing it anyway."

User
Posted 06 Oct 2025 at 15:50

Hi Chema

My post-surgery pathology did not change (3+4) but down-staged me from 3a to 2c. 

Best wishes

Fred

User
Posted 02 Nov 2025 at 09:22

Hi,

Tomorrow I’m expected to fly to the hospital. On Tuesday, a PSMA PET scan is planned, and if there are no bad surprises and everything goes well, the surgery is scheduled for Wednesday.

I’m quite nervous — not only about the possible surgery, but also about what they might find in the scan or during the surgery (or after it), if eventually is performed. Anyway, at this point, all I can do is hope for the best and prepare for the worst. I’ll keep you updated.

Thank you all for your support.

Edited by member 02 Nov 2025 at 09:26  | Reason: Not specified

User
Posted 02 Nov 2025 at 09:52

All the best Chema. I remember in Jan 24 I was waiting for a PET PSMA scan and then had RP in Feb 24.

I was very nervous myself. My journey since has been good.

Please just remember you are on the road to recovery and just make sure you keep to any apointment and tests.

All the very best.

Rob

 

User
Posted 02 Nov 2025 at 10:16

Hi. Chema.

Good luck, mate. 👍

Forgive me being nosy, but where are you flying to for the op. Is it in Spain?

User
Posted 03 Nov 2025 at 14:46
Hi Chema .

Best of luck with your surgery, my pre surgery biopsy was 3+4=7 the post surgery histology was 3+3=6 so downgraded.

All the best Jeff.

User
Posted 05 Nov 2025 at 23:21
All the best Chema
 
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