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MRI indicates growth but Gleason down?

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User
Posted 13 Aug 2026 at 16:47

Hi all, I’d be interested in people’s experience that may be similar to mine. I’m 59 and was diagnosed summer 25 (last year). T2 Gleason 7, PSA rising from 4s to 6.7.
2nd MRI spring 26 showed growth and follow up biopsy showed a reduced Gleason score of 6 (received today). 
whilst disease is contained, there is radiological and biochemical progression (think that’s correct terminology). I am still considered low risk.

I have been offered radiotherapy or surgery. I have requested another PSA and have time to make a decision.

given the side affects associated with the treatments I’d be keen to put off as long as possible, but this obviously is a risk (or is it?)

I was therefore wondering if anyone else has been in this situation? I shall definitely get a 2nd opinion when the next PSA result comes through.

 Thanks for reading 

 

 

User
Posted 13 Aug 2026 at 20:58
Sounds to me like a second opinion would be worthwhile. Sometimes results can vary depending on who is making assessment. Some might see a 3, (arguably not cancer), whereas others might come down on the side of 4. Perhaps 3.5 might be more accurate, although I haven't heard of this being used. Grades are often changed when a Prostate is subject to greater scrutiny when in a Petri dish in a lab.
Barry
User
Posted 14 Aug 2026 at 08:00

Hello, mate.

It is possible, that the second biopsy missed the '4' cancer cells, that the first biopsy picked up. 

During my period of active surveillance I had two biopsies, initially they indicated Gleason 6 (3+3), but the later one showed an area of 7(3+4), another of 7(4+3), another of 8(3+5) and finally, after my prostatectomy,  I  was upgraded to Gleason 9(4+5). It all got very bewildering.

I think, it's rare for a 'true' and accurate initial Gleason to increase. Obviously they missed the more aggressive cells in my first biopsy. The bloke who did it must have been an awful darts player. 😁

It surprises me how poor PSA checks can be as indicators, and how hit and miss biopsies can be be. 

Here's an excellent video on treatment options and their possible side effects.

https://youtu.be/zYTU94-8pTc?si=xW83bOb0AVFQFD2l

Good luck with whatever treatment you chose. 👍

Edited by member 14 Aug 2026 at 08:04  | Reason: Add link

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User
Posted 13 Aug 2026 at 20:58
Sounds to me like a second opinion would be worthwhile. Sometimes results can vary depending on who is making assessment. Some might see a 3, (arguably not cancer), whereas others might come down on the side of 4. Perhaps 3.5 might be more accurate, although I haven't heard of this being used. Grades are often changed when a Prostate is subject to greater scrutiny when in a Petri dish in a lab.
Barry
User
Posted 14 Aug 2026 at 08:00

Hello, mate.

It is possible, that the second biopsy missed the '4' cancer cells, that the first biopsy picked up. 

During my period of active surveillance I had two biopsies, initially they indicated Gleason 6 (3+3), but the later one showed an area of 7(3+4), another of 7(4+3), another of 8(3+5) and finally, after my prostatectomy,  I  was upgraded to Gleason 9(4+5). It all got very bewildering.

I think, it's rare for a 'true' and accurate initial Gleason to increase. Obviously they missed the more aggressive cells in my first biopsy. The bloke who did it must have been an awful darts player. 😁

It surprises me how poor PSA checks can be as indicators, and how hit and miss biopsies can be be. 

Here's an excellent video on treatment options and their possible side effects.

https://youtu.be/zYTU94-8pTc?si=xW83bOb0AVFQFD2l

Good luck with whatever treatment you chose. 👍

Edited by member 14 Aug 2026 at 08:04  | Reason: Add link

 
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