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Bamboo
New User
Joined: 29 Nov 2007
Posts: 3
Location: Chicago
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 Posted: Thu Nov 29, 2007 5:48 pm Post subject: Relatively low PSA - High Gleason |
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I'm 57 years old, about 25 pounds overweight, but I excercise regularly and have had a very healthy diet for the last 20 years.
I’ve been getting PSA tests each year for the past 6 years with my annual physical exam. In 2005, my PSA was 2.4. In 2006, it was 3.7. In May of this year, it had jumped to 6.1. After running me through a regimen of antibiotics, the PSA again tested at 6.1, so my physician suggested a visit to a urologist, who recommended a prostate biopsy.
I have no symptoms whatsoever. My prostate is not enlarged (according to the urologist and my GP), I have no pain, uraniary issues or sexual dysfunction. According to the urologist, the prostate appeared normal on the ultrasound prior to the biopsy.
I got the results of the biopsy last Tuesday, and they were not good: At least two samples with Gleason scores of 4+4 and 4+5 respectively. The urologist recommended that I immediately have a bone scan and CT scan (which I completed this past Monday), and will be getting the results of tomorrow. The urologist also told me that, at a minimum, I will need to have my prostrate removed.
I've spent a lot of time reading since last Tuesday - and here's what's confusing me: there appears to be a relative correlation between PSA scores and, if cancer is discovered, Gleason scores. It seems to me that a PSA of 6.1 (confirmed twice - so I presume it's accurate) would suggest that the 8 and 9 cancer that was discovered is probably still isolated. Am I missing something here? |
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johnw100
Senior User
Joined: 15 Apr 2006
Posts: 202
Location: australia
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| Posted: Thu Nov 29, 2007 7:43 pm Post subject: Re: Relatively low PSA - High Gleason |
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Lots of things can affect PSA numbers including prostate size. There is not necessarily any correlation between PSA number and Gleason score which measures how agressive the cancer is.
Gleason readings are subjective: it could pay to have a 2nd reading of the slides.
It's unusual for a bone scan to show anything with PSA readings under 20. Many of the various other kinds of tests do not always give the clear cut results sometimes suggested, depending on the equipment available. Diagnostic Center for disease Sarasota claim good results.
As you suggest, it is possible that it is still confined to the prostate. Treatment options could be surgery, or radiation with hormonal therapy.
Most important aspect is to select a top doctor, regardless of the method or treatment chosen. |
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brainman
Site Admin
Joined: 13 Oct 2005
Posts: 5617
Location: Tennessee
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| Posted: Thu Nov 29, 2007 7:59 pm Post subject: Re: Relatively low PSA - High Gleason |
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Bamboo, I am very sorry about your cancer diagnosis. It does sound like your medical team is taking the appropriate, aggressive steps to deal with it. Tomorrow, when you get the results from the scans, it is possible that they will be able to stage it for you.
Like John, I have never hear of a PSA to Gleason Score correlation. I imagine that the stage would have to be relatively low but even that at this point is not a certainty. The Gleason Score is a measure of how aggressive the cancer is, so you may have caught it early. That does correlate with what John said about bone mets not usually being detected if the PSA is bellow 20.
On a side note, the owner of the CancerForums site is an oncologist at UoC Medical Center....
You are in my thoughts and prayers.
_________________
Jim
Administrator and long-term cancer survivor
1992 Astrocytoma grade 2, left motor strip
2005 Recurrence this time said to be an Oligodendroglioma grade 3, same location.
http://cancerforums.net/viewtopic.php?t=2405
My Story Part 1: http://cancerforums.net/viewtopic.php?t=2528
My Story Part 2: http://cancerforums.net/viewtopic.php?p=7350
My Story Part 3: http://cancerforums.net/viewtopic.php?t=8029
Twitter: @JimHawkins54 |
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Replicant
Moderator
Joined: 01 Nov 2006
Posts: 744
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| Posted: Fri Nov 30, 2007 10:43 am Post subject: psa and Gleason |
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Like the others, I have not heard of a correlation between total PSA and Gleason, although I have seen a small study that correlated free/total PSA ratio ("free PSA") to Gleason scores. That study was from the University of Alexandria, Egypt.
A certain percentage of men who get diagnosed with prostate cancer have very low PSA scores--a 2004 study by the National Cancer Institutes found that 15% of men in a control arm of the study had prostate cancer in spite of the fact that they had PSAs below 4.0 ng/mL and normal DREs. They were only biopsied because they were part of the study.
Another study, released in 2005 by the Fox Chase Cancer center, found 25% of men at high risk for prostate cancer were diagnosed with it, despite having a low PSA (2.5 or lower). |
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Replicant
Moderator
Joined: 01 Nov 2006
Posts: 744
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| Posted: Fri Nov 30, 2007 11:01 am Post subject: low PSA/high Gleason prognosis |
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As a newbie I can't post links, but you should be able to Google this and find it. The prognosis for low PSA (less than 10) and high Gleason (8 or higher) is surprisingly good.  The study, conducted by the Cleveland Clinic, found that men in this category treated with prostatectomy or radiation had a 64% chance of being progression free 5 years later. Adding hormone therapy (ADT) to the primary treatment led to even better results. The lead author was Dr. Patrick A. Kupelian and the article on the UroToday website is dated 6 January 2003. |
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brainman
Site Admin
Joined: 13 Oct 2005
Posts: 5617
Location: Tennessee
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