Uncertainty with initial Gleason Grading

User

Posted 01 Nov 2026 at 08:19

Hello there,

First time posting.

What has brought me here, is my husband was sent for initial tests December last year, as he was mainly having problems peeing (stop/start, week flow).

His PSA test was okay (though we weren’t told at the time what the reading was), so the GP undertook a rectal exam, and said the prostate was enlarged with modules.

A referral was then made to the urology department at the hospital where they also did a rectal exam, said they felt no modules, but did feel an enlargement. A few months later my husband had to to a flow test at the same hospital.
In the summer, he was contacted by the hospital who advised surgery would be needed to shave the prostate, this was undertaken 4 weeks ago. During the surgery the surgeon discovered 2 strictures, which he thought may have been the main reason for the problem with peeing. He said the prostrate wasn’t overly enlarged and he would expect to see a larger prostate in someone of my husband’s age, he is 58, but the surgeon shaved anyway.

Following the surgery, my husband has to perform self dilation, which he will have to do for life now, to try and prevent the urethra from closing up again. We were told by the urologist, post surgery that from the biopsy taken, 18% was discovered to have cancer cells. We were told that my husbands PSA was 1.8 when taken last December and he has been placed on an “active surveillance” program, with a PSA test to be undertaken in December and an MRI in January (they won’t do any sooner, as my husband needs to heal from the surgery, and the hospital advise an MRI taken any sooner could give a false reading).

My worry is that the biopsy was taken from the centre of the prostate and not the outer part and that this could have given a false reading. My husband has been told he is Gleason 6 (3 + 3), I’m concerned this may be escalated higher when the MRI is undertaken.

Has anyone else had a similar experience?

I’m reeling from this news, feel permanently knotted up in my stomach. My husband is taking it better than me, says no point in worrying about something we can’t change.

I’m 58 too. I stopped working in January this year, after working 40 years full time, and we had it all planned out. My early retirement first, my husband will carry on working until he is 63 and will then retire. We had so many plans to travel around the UK.

We have no children, it’s always been just us, though some friends and family are being very supportive (though I have heard absolutely nothing from my brother, which is a bit hurtful, but nothing I can do about that).
I just feel our whole world has been turned upside down in a matter of a heartbeat.

Sorry for the long post, I would be interested to hear if anyone else is in the same position or had similar experience.

Thanks for reading ☺️

User

Posted 01 Nov 2026 at 11:39

Hi Samanthar.

I'm sorry that your husband has urinary problems and that during surgery Gleason 6 (3+3) was found.

If it is true Gleason 6, and he hasn't got any more serious cells hidden away, there is little to worry about. Some experts, including the great Dr Scholz, argue that had the Gleason score been introduced today, true Gleason 6 would not have labelled as cancer. Others disagree.

It is the lowest possible score for prostate cancer. Cells with a Gleason score of 6 look very much like normal prostate cells. They grow exceptionally slowly and have an extremely low risk of spreading outside the prostate gland. Many specialists refer to this as an "indolent".

The cells at 18% Tumor Volume, indicates that the cancer was found in a relatively small portion of the tissue removed during your stricture surgery. Low volume combined with a Gleason 6 score is generally a very reassuring sign.

His PSA 1.8 ng/mL, level is well within the normal range for most age groups (typically under 4.0 ng/mL). A low PSA level further supports the idea that the cancer is localized, low-risk, and not actively aggressive.

All these factors suggest that he is an excellent candidate for Active Surveillance.

He should now have regular PSA blood tests every few months to check for changes; and follow-up imaging or biopsies (such as an MRI) down the road to ensure the cancer remains quiet and hasn't changed in character.

We have all been fearful when 'the big C' is mentioned. But PCa can be a pussycat or a tiger and in your husband's case its appears very much the former.

50% of men with similar diagnosis to his on active surveillance do not need any further treatment over the next ten years.

You must remember that over 50% of men aged 60, are likely to have some prostate cancer cells, it's whether they become clinically significant that's the issue. There's nothing to suggest that your husbands is.

I think the panic you're feeling has been exaccerbated by its sudden discovery during 'unrelated surgery'

Perhaps when he's recovered from the operation, they'll give him an MRI. Hopefully that will confirm there is no need for any other treatment, other than keeping an eye on things.

Please keep us updated and I wish you both the best of luck. 👍

Edited by member 01 Nov 2026 at 11:41 | Reason: Additional text

User

Posted 01 Nov 2026 at 15:46

You are right to be concerned about the result of the MRI but there is nothing to be done now but wait as the scarring from the surgery needs to heal.

Make sure the hospital sticks to the proposed dates and try not to worry.

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