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Medical Forum / Diseases and Disorders / Prostate Cancer / April 2005Gleason probabilities
I seem to read about someone being Dx with PCa with Gleason score in the range of 6 and 7(3+4). Are these the most common type PCa behaviour? Is there a site that has a breakdown of the Gleason probabilities? Go to: http://www.prostatecalculator.org/ But you have to know your staging (e.g., T2a) as well as Gleason. I learned about the Partin yables on this ng. >I seem to read about someone being Dx with PCa with Gleason score in > the range of 6 and 7(3+4). Are these the most common type PCa > behaviour? Is there a site that has a breakdown of the Gleason > probabilities? > I seem to read about someone being Dx with PCa with Gleason score in > the range of 6 and 7(3+4). Are these the most common type PCa > behaviour? Is there a site that has a breakdown of the Gleason > probabilities? Hi Dick...In the Hopkins' study of 2,091 men between 1982 and 1999 ("BIOCHEMICAL (PROSTATE SPECIFIC ANTIGEN) RECURRENCE PROBABILITY FOLLOWING RADICAL PROSTATECTOMY FOR CLINICALLY LOCALIZED PROSTATE CANCER", M. Han, A. W. Partin, M. Zahurak, S. Piantadosi, J. Epstein and P. C. Walsh; J. Urol., 169, 517-523, 2003), they found the following Gleason score distribution upon pathologic examination of the prostate specimen: 5 12% 6 49% 7 33% 8-10 6% I suspect that if you took a large sample of men with PCa today, the distribution would be shifted to slightly lower scores due to the effects of "downward stage migration" over time. I further suspect that the results from clinical samples (needle biopsy) would also be shifted slightly lower due to the observation that clinical GS, on average, is 0.4 units lower than pathologic GS...Best wishes and good health, Ron We've had people here who were diagnosed with PSA as low as 0.06 and as high as 4900. One's PSA at Dx is largely dependent on how often you have your PSA checked, though aggressiveness is certainly a secondary factor. I'd estimate about 20% of those here are less than PSA 4 at Dx, maybe 40% between 4 to 7, and 10% 7 - 9.9999. The other 20% are double digits, triple digits and a couple quadruple digits with the triple and quadruples accounting for maybe 4%. About 40% of those here were G7, most of which were 3+4. A tad more were G6. Less than 15% were 8 or 9. I'd have to guess the most common was G6 with maybe a 4.x, maybe a 5.x  SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3bN0M0 Seminal Vesicle involvement, Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05 PSA .07 .05 .06 .05 non Illegitimi carborundum > I seem to read about someone being Dx with PCa with Gleason score in > the range of 6 and 7(3+4). Are these the most common type PCa > behaviour? Is there a site that has a breakdown of the Gleason > probabilities? Thanks Steve and everyone else. Is it safe to say, the only way to catch the PCa with G8 and above it to get a biopsy as soon as the PSA approaches 2.5 with a increase in the PSAV? IMHO, the only way to detect unpalpable PCa for any Gleason is with PSA velocity. My path report gave me a Gleason 6 with 40% of the prostate cancerous. I didn't get a biopsy pre-op until my PSA hit 4.9. I had a velocity of about 0.7 the previous four years and nobody (including myself in denial) thought anything of it "as long as PSA is less than 4.0". I have an acquaintance who is 57 with a PSA that has hovered between 5 and 6 for the last four years. Velocity 0 with nothing detected in two biopsies. Go figure. Dave Perry >....One's PSA at Dx is largely dependent on how >often you have your >PSA checked,..... Hello, greetings from Europe, Estonia. Sorry my english is limited. I do not correctly understand the text above. What does Dx mean? How can we say that Psa depends on that how often it is checked? ----- I am a prostata cancer patient with Gleason 7. I have waited now for two years what hapens. Nothing has happened. I have no symptoms. Psa has varied between 3.6 and 5.7. The ratio between two Psa's has varied between 7- 12%. My age is 62. Nothing has been done to mee (yet). Is this correct place to talk about watchful waiting? I wish all the best to all of you. Sisu Welcome, Sisu! As the violator of international courtesy in using abbreviations, I will explain. > >....One's PSA at Dx is largely dependent on how >often you have your > >PSA checked,..... [quoted text clipped - 6 lines] > How can we say that Psa depends on that how > often it is checked? "Dx" is "diagnosis". I had my PSA tested in 1998 and it was "acceptable". I had it tested in 2000 and it was 16. Had I had it tested in 1999, maybe it would have been 6 or 8. There is one man on this newsgroup who had it tested for the first time in 2000. His was 4900. If had been testing it annually, it might have been half that in 1999, and half that in 1998. A friend of mine was tested in 2001 and it was 1.2. Last year it was "acceptable". This year it was 4.4. So, if you are 40 and test it every year, the PSA will be lower than someone who has it tested every 5 years. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3bN0M0 Seminal Vesicle involvement, Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05 PSA .07 .05 .06 .05 non Illegitimi carborundum Sisu With a Gleason of 7 and at age 62 watchful waiting is, in my opinion, a bad option to select. Mine was diagnosed at age 61 with a Gleason of 6 and stage t2b. I had LRP 1/24/2005 and had a great pathology report after the surgery. It sure took the edge of my worries. Still haven't had my first post op PSA test. Your cancer has little to no chance of spreading with surgery or radiation if properly executed. My Psa is now 5.5. I have been in watchful waiting for two years. No symptoms. Are here others who are in ww? It would be good to talk with them too. Series with my Psa is (during these two years):5.74- 5.27- 4.2- 4.2- 5.1- 3.9- 3.6- 4.1- 5.7- 5.5. (Gleason was 7, as I said.) (A little I hesitate if Gleason values 2-8 are only changes in cells. And values 9- 10 are cancers.) At all events is true, that about a single prostata cancer can not be said anything sure how it develops or does it develop. What is your opinion on errors in measuring Psa. One Laboratory said it is about 10%. What do you think. I want to say however, I must be humble with my prostata cancer. Whatever can happen. And too.... at all events we die earlier or later. "All the longer medicine develops all the more sick people is found." Gretings from Europe! Sisu (= perseverance) Sisu, You have a truly remarkable case. I've never heard of prostate cancer waivering without treatment. What was you Stage? T1c? T2c? SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05 PSA .07 .05 .06 .05 non Illegitimi carborundum > My Psa is now 5.5. > I have been in watchful waiting for [quoted text clipped - 29 lines] > > Sisu (= perseverance) With a Gleason of 7, do not wait for your PSA to go up to begin aggressive treatment. Many times PSA will NOT increase significantly, but your cancer mayl still metastasize and cannot be cured. Why gamble? With a Gleason of 7, do not wait for your PSA to go up to begin aggressive treatment. Many times PSA will NOT increase significantly, but your cancer mayl still metastasize and cannot be cured. Why gamble? Gamble? That is an interesting word. If we treat it, it may spread however. One doctor said, that it is possible that the cancer spreads, is it treated or not (about 30% of cases). all the best, Sisu It may be true that 30% of all treated PCa spreads. I do not know that statistics on that. However, I believe 100% of all untreated PCa spreads. I'm not a doctor and I am not certain, but considering that cancer is basically cells that cannot die, and cells reproduce themselves, I cannot imagine what would stop an untreated cancer from spreading. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05 PSA .07 .05 .06 .05 non Illegitimi carborundum > Gamble? > That is an interesting word. [quoted text clipped - 5 lines] > > all the best, Sisu Thanks of your answering again, Steve. >However, I believe 100% > of all untreated > PCa spreads. That is a great question. Is that really so? How can we know that? And if we die for some other reason? --- I would say that if PCa is non symptomatic we must think twice what to do. One doctor said to me in Finland: There is much hysteria round this thing. But who knows? But there is one factor that we can not control: it is fear. There is also a little a question of principle: Is a non symptomatic man who has PCa sick? everything good for all of you sisu > >>However, I believe 100% >> of all untreated >> PCa spreads. > That is a great question. Is that really so? Yes. That's why it is called "cancer". > How can we know that? And if we die for some > other reason? It was still spreading. Something else just beat it to the finish line. > I would say that if PCa is non symptomatic we > must think twice what to do. Nope, once. Get educated now, select a treatment now (watch & wait, radiation, surgery, or chemicals), and begin that treatment now. Waiting for symptoms is asking for uncurable cancer we may have been able to avoid. . > One doctor said to me in Finland: There is much > hysteria round this thing. That explains Europe's delayed detection and treatment of PC, which we have to believe costs lives. > But there is one factor that we can not control: > it is fear. There is no reason to fear it if we detect it early, get it treated, and get on with our lives. Europe is not doing that. > There is also a little a question of principle: Principle? Don't we owe it to our loved ones to detect and fix PC before it seals our fate? > Is a non symptomatic man who has PCa sick? It does not matter what word one attaches to it; he is heading for trouble unless he is already so ill and/or old he's likely to die anyway within maybe 10 years AND catches his cancer much earlier than European detection usually allows. I.P. Go to www.phoenix5.org and read of the webmaster's asymptomatic prostate cancer. Cancer IS asymptomatic. It's only when it's eaten into something vital that we realize it's there. BTW, PSA is a symptom. Your PSA is unusual in that it steady. But, when it starts to go up, I hope you act on it. And I further hope you're not taking Sal Pometto or some other artificial PSA reducing substance. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05 PSA .07 .05 .06 .05 non Illegitimi carborundum > Thanks of your answering again, Steve. > [quoted text clipped - 23 lines] > > sisu Good point! I keep forgetting that caution. I.P. "Steve Kramer" <skramer@cinci.rr.com> wrote .com... > And I further hope you're not taking > Saw Palmetto or some other artificial PSA reducing substance. Why is that a good point when Saw Palmetto DOES give relief? I used to get up many times a night to pee and I don't now. I realise it is reported to mask PSA but I take bigger risks driving on the road these days. > Good point! I keep forgetting that caution. > [quoted text clipped - 3 lines] >> And I further hope you're not taking >> Saw Palmetto or some other artificial PSA reducing substance. Because if someone is using his PSA to determine when, whether, and/or how to treat his PC, he needs to know if anything he's taking affects it, and how (e.g., is it suppressing the cancer, or just the PSA?). I.P. > Why is that a good point when Saw Palmetto DOES give relief? > "I. P. Freely" <fuhgheddaboutit@noway.nohow> wrote in [quoted text clipped - 5 lines] >>> And I further hope you're not taking >>> Saw Palmetto or some other artificial PSA reducing substance. I have yet to find conclusive evidence that PSA *OR* digital examination is better than hit or miss. Eg, you find it because blind Freddie could find it. > Because if someone is using his PSA to determine when, whether, and/or how > to treat his PC, he needs to know if anything he's taking affects it, and [quoted text clipped - 11 lines] >>>> And I further hope you're not taking >>>> Saw Palmetto or some other artificial PSA reducing substance. Gut, This was in relation to a man who has Prostate Cancer and whose PSA is not rising even though he's not being treated. It was not a warning specific to a person who.... Wait! I just realized.... I don't know your history. I don't think you've told us. Have you had PCa? Did you get treatment? SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05 PSA .07 .05 .06 .05 non Illegitimi carborundum > Why is that a good point when Saw Palmetto DOES give relief? I used to get > up many times a night to pee and I don't now. I realise it is reported to [quoted text clipped - 7 lines] > >> And I further hope you're not taking > >> Saw Palmetto or some other artificial PSA reducing substance. > Gut, > [quoted text clipped - 6 lines] > you've > told us. Have you had PCa? Did you get treatment? Yeah I understand what you are saying NOW but admit I didn't understand what was being said when I posted that question. In my case, I am in here to learn because though I haven't been diagnosed with cancer as yet, the probability is great that I will be though there is no definitive answer as to whether I will or wont. I have suffered prostate problems undiagnosed until 99 since the middle 80s when I first noticed an irritating pain in the left side of my arse that wouldn't go away. I remember being on a plane going to Canada in 96 (from Australia) flying cattle class and sitting on the right hand side for that 9 hours out to Hawaii and 5 hours to Vancouver. I hope to be better informed if/when I am told "you have it and this is what we are going to do" simply because in 94 I was diagnosed with sleep apnea and had been using Internet for years by then. When the doctor told me I need to have an operation to "fix it" I immediately hit medical web sites and read university funded research and went back to him with a wad of printouts proving his operations were sh.t. He read them, contacted people he knew in USA and got back to me telling me I was correct and he would be presenting papers on why you should NOT operate in future for that condition (excepting tracheostomy of course). I hope that if I am told "operation" for my problem if I get cancer, I will know what is just an exercise in funding a surgeon's next Mercedes payment and what is definitely worth it. Well, the good news is, I've only heard only one study that linked prostate problems with prostate cancer. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05 PSA .07 .05 .06 .05 non Illegitimi carborundum > > Gut, > > [quoted text clipped - 30 lines] > my problem if I get cancer, I will know what is just an exercise in funding > a surgeon's next Mercedes payment and what is definitely worth it. " just an exercise in funding > a surgeon's next Mercedes payment and what is definitely worth it." (My first time here, so I hope this works properly) I had a VERY well known and respected urologist/surgeon tell me that the reason the first 2 urologist/surgeons I saw recommended surgery is because "that's where they make their money" and then he said "it pains me to say this because I'm a surgeon too, but I think you should have radiation, not surgery". And one of those first 2 urologists and a radiologist explained to me that the reason the first urologist was giving me one month Zoladex shots instead of three month shots was because it's more profitable. So, although your "Mercedes" comment may have been said tongue-in-cheek, even the docs speak of each other that way. On 04/17/2005 10:18:40 "Gordy" <lg36@comcast.net>, responding to an unnamed poster, wrote: > I had a VERY well known and respected urologist/surgeon tell me that the > reason the first 2 urologist/surgeons I saw recommended surgery is because [quoted text clipped - 6 lines] > So, although your "Mercedes" comment may have been said tongue-in-cheek, > even the docs speak of each other that way. I recall reading a comment by Dr. Strum to the effect that in all too many cases, doctor income is more important than patient outcome. Regards, Steve J "'MD' does not mean 'Medical Deity.'" -- Stephen B. Strum, MD Gordy wrote...snip... > a radiologist explained to me that the reason the first urologist was > giving me one month Zoladex shots instead of three month shots was > because it's more profitable. Gordy...Why not ask the uro why he gave you the 1 month shot. I'd like to give him the benefit of the doubt. Maybe the uro thought you'd schedule surgery within a few weeks and a 3-month shot would be a) wasteful and b) possibly confuse the interpretation of your first post-RRP PSA reading. Further, for people using HT to drive T and PSA down, initial 1 month shots are a good idea. A one month shot will give the uro a chance to collect a blood sample when you return in a month to see if the Zoladex is working. Better to know sooner than later...Best wishes and good health, Ron > Gordy wrote...snip... > > a radiologist explained to me that the reason the first urologist was [quoted text clipped - 10 lines] > month to see if the Zoladex is working. Better to know sooner than > later...Best wishes and good health, Ron Ron- Were I ever to speak to him again I might. But his ego and lack of candor have convinced me to seek help elsewhere. BTW - It's really frustrating to have to deal with doctors who have their own agendas, enormous egos and less-than-honest dealings with patients and each other, while trying to deal with the disease and decide which course of action (or inaction) is in one's best interest. Treatment choices often become no-brainers once we digest enough information from books, tables, trials, oncologists in all the relevant fields, authoritative websites, etc. Someone here said recently that he's an "RT" guy, as though it was a personal prediliction rather than a medical choice. I've never thought of myself as an "RP" guy, but rather a prostate cancer with certain numbers and medical attributes that made RP a no-brainer. That medical case happened to live in my body, so I gave it what the research indicated would benefit my body to the max. With different numbers and attributes I'd have gone with LRRP, the most appropriate RT, WW, ADT, or maybe even a world tour on an empty credit card. It was reassuring today as I read a new 2005 PC book from the Sloan Kettering Uro Dept Chief, as he described my case to a T and said open RRP is still the best choice for treating it. (Shouldn't surprise me; my surgeon did his residency and beyond at S-K.) I.P. ...snip... > And I further hope you're not taking > Sal Pometto or some other artificial PSA reducing substance. A number of studies have shown that Saw Palmetto does not affect PSA, but does act like finasteride and interferes with the T -> DHT conversion process...Ron Interesting. I thought I read it in Walsh that it artificially affects PSA. But, thanks for the correction. I'd rather see correct data than be right. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05 PSA .07 .05 .06 .05 non Illegitimi carborundum > ...snip... > > And I further hope you're not taking [quoted text clipped - 3 lines] > but does act like finasteride and interferes with the T -> DHT > conversion process...Ron My Psa is now 5.5. I have been in watchful waiting for two years. No symptoms. Are here others who are in ww? It would be good to talk with them too. Series with my Psa is (during these two years):5.74- 5.27- 4.2- 4.2- 5.1- 3.9- 3.6- 4.1- 5.7- 5.5. (Gleason was 7, as I said.) (A little I hesitate if Gleason values 2-8 are only changes in cells. And values 9- 10 are cancers.) At all events is true, that about a single prostata cancer can not be said anything sure how it develops or does it develop. What is your opinion on errors in measuring Psa. One Laboratory said it is about 10%. What do you think. I want to say however, I must be humble with my prostata cancer. Whatever can happen. And too.... at all events we die earlier or later. "All the longer medicine develops all the more sick people is found." Gretings from Europe! Sisu (= perseverance) How old are you? Reuben >My Psa is now 5.5. >I have been in watchful waiting for [quoted text clipped - 29 lines] > > Sisu (= perseverance) >You have a truly remarkable case. > I've never heard of prostate cancer >waivering without treatment. > What was you Stage? T1c? T2c? PT1C There are not many cases that can be looked after because almost all are operated or get radioteraphy.( Sorry I can not expess myself well, my native language is finnish) Sisu You are doing very well at expressing yourself. > >You have a truly remarkable case. > > I've never heard of prostate cancer [quoted text clipped - 10 lines] > > Sisu >You are doing very well at >expressing yourself. Thank you. I have dictionary on hand all the time. >You have a truly remarkable case. > I've never heard of prostate cancer >waivering without treatment. > What was you Stage? T1c? T2c? PT1C There are not many cases that can be looked after because almost all are operated or get radioteraphy.( Sorry I can not expess myself well, my native language is finnish) Sisu >>You have a truly remarkable case. >> I've never heard of prostate cancer [quoted text clipped - 11 lines] > > Sisu I understand you completely. The reason there are not many other cases like yours to consult is that most people consider it too dangerous to leave Gleason 7 prostate cancer untreated, unless the patient is old. You are only 62. How old was your father when he died? jimhoney by James A Honeychuck <jimhoney@worldnet.att.net> Apr 6, 2005 at 04:05 PM >How old was your father when he died? He was 67. He died on lungcancer. He smoked almost all his life. (I have stopped it over 30 years ago.) He was sick by many other ways. all the best Sisu >>You have a truly remarkable case. >> I've never heard of prostate cancer [quoted text clipped - 3 lines] > > PT1C I don't believe there is any stage such as PT1C. First, the P refers to the "pathological" stage, meaning what the pathologist finds upon examining the entire prostate after surgery. Second T1c means that the physician when examining the prostate digitally, before treatment, doesn't feel anything unusual in the part of the prostate he can reach. But after surgery, unless the whole diagnosis of prostate cancer was mistaken, the pathologist is bound to find some cancer. So the lowest pathological stage is PT2A, which means cancer was found in only one lobe. More common is PT2B or PT2C (depending on the classificatory scheme), which refer to cancer in both lobes. > There are not many cases that can be > looked after because almost all are operated [quoted text clipped - 3 lines] > > Sisu >I don't believe there is any stage such as PT1C. Sorry. My english is not so good. Do you hesitate what is printed on my papers? all the best Sisu >>I don't believe there is any stage such as PT1C. > [quoted text clipped - 3 lines] > > all the best Sisu Well, does the doctor say you have a tumor that he can feel, or not? jimhoney >Well, does the doctor say you have a tumor that >he can feel, or not No, it can ?not be felt. It has been tried many times. Also ultra voice system has been used. (I hope you uderstand what I mean.) Both systems are not very good. But in best case they tell something. My own idea is that the limit between cells classified by Gleason is not at all so sure. At least it is difficult to say where it belongs. What kind of opinion you have over there in America? Today I made this: I took 100 matches.One match describes a prostata cancer patient. Five of them I painted completely black. Then I painted 10 half black. So 85 of them stayed colorless. Now they are on the wall in my working room. By that I try to make concretical which is my situation. Those five black will die on prostata cancer. Those 10 will live still years. Those 85 will die almost normally, probably by some other way. Do you not speak over there in America about "watchful waiting" so much? I must say that in Finland we do not speak about mych too. We must remember that in any case we die. We must remember that there comes changes in men who became older and older every day. It is sick to try to do impossible. It is clear that if one has bad symptoms with prostata cancer, everything possible must be done. And at last: the desicion must be everyones own. It has been said that even a little mark of trying to change other person is hostile. We must say: tell your experience, honestly. I have been in tens of meetings where prostata cacer suffering men talk. I have talked with about 10 doctors and specialists and professors about this This is my decision ..... today..... I, or no one, can know what happens tomorrow. A little long story, but maybe it has something to say to someone. Sisu Well, I don't know how you decided how many matches should be of each color. But that is your decision about the chances of life or death, and I don't think there are any medical studies which say that you are wrong. I suppose the important thing is that you have made your decision and you are satisfied with it. jimhoney >>Well, does the doctor say you have a tumor that >he can feel, or not > [quoted text clipped - 61 lines] > > Sisu > Today I made this: > I took 100 matches.One match describes [quoted text clipped - 3 lines] > black. So 85 of them stayed colorless. > Now they are on the wall in my working room. > Those five black will die on prostata cancer. > Those 10 will live still years. Those 85 > will die almost normally, probably > by some other way. In the USA, this year, 230,090 will be diagnosed. During the same year, 30,350 will die. 1 man in 6 gets prostate cancer, but now only 1 in 33 dies of it. Last year, the ratio was 1 in 32. I assume the 1 in 6 never changes or very slowly changes in time. So, in the USA, you'd have to paint 18 matches completely black. > Do you not speak over there in America > about "watchful waiting" so much? At one time, during the 230 year history of the USA, there was no prostatectomy. At that time, essentially, the number of men who contacted PCa was probably 1 in 6 (or close to it) and the number who died were also 1 in 6 (or close to it). That was the equivalent of watchful weighting, maybe without the "watchful". When my father got PCa, they did not have PSA. They did have estrogen and they did have prostatectomies. But, no one was ever cured. Nowadays, PCa is usually diagnosed before there are symptoms (not in my father's day). And, now, it is sometimes diagnosed before it has left the prostate gland. The only cure, so far, is to get to it before it gets out of the prostate gland. So, we here in the USA would rather kill the cancer before it has a chance to kill us. > And at last: the desicion must be everyones > own. That is a fact. Every man must make the decision and live with the consequences. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05 PSA .07 .05 .06 .05 non Illegitimi carborundum >So, in the USA, you'd have > to paint 18 > matches completely black. Or we can say that 82 are not completely black. I have noticed that these numbers varies dependin on doctors. sisu The numbers I gave you came from the American Cancer Society. But, yes, of course, some doctors are better than others. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05 PSA .07 .05 .06 .05 non Illegitimi carborundum > >So, in the USA, you'd have > > to paint 18 [quoted text clipped - 7 lines] > > sisu >>I don't believe there is any stage such as PT1C. > > Sorry. My english is not so good. > Do you hesitate what is printed on > my papers? Since you say you are being treated by watchful waiting, I assume your prostate hasn't been removed. But it is certainly possible that they use different nomenemclature in Finland than is common in the US. > all the best Sisu My PSA was 5.4, my Gleason 7.. guess what, it spread to the Lymph nodes. I didn't find this out until after I had the gland removed. Now I am going to start Chemo for 6 to 8 months and then Hormone treatment. Anyone have a similar experience? By the way I am 51 years old. Welcome, David. I can, to some extent, speak for most of those here. A 5.4 PSA and G7 rarely ends up with an infected lymph node, especialy among us here. My 16 and G7 ended up with an infected seminal vesicle, but clean margins. What was your full Gleason? 3+4? 4+3? How old were you? And when we your surgery? Did they find your lymph gland during surgery? Post Op? Or later? SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05 PSA .07 .05 .06 .05 non Illegitimi carborundum > My PSA was 5.4, my Gleason 7.. guess what, it spread to the Lymph > nodes. I didn't find this out until after I had the gland removed. > Now I am going to start Chemo for 6 to 8 months and then Hormone > treatment. Anyone have a similar experience? By the way I am 51 years > old. Is there some difference between these two alternatives? all the best, Sisu Sorry, My earlier message was wrong. ----- About Gleason. How clear is the limit between, for examle 6 and 7? Wieved in microscope? Which is better alternative 3+4 or 4+3? I had 3+4. sisu The difference between 6 and 7 is not very clear at all. Several of us recommend a second opinion for Gleason Score, preferably by a Gleason expert, not necessarily a surgeon. 3+4 is better than 4+3. 4+3 means you have more of the worse stage. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05 PSA .07 .05 .06 .05 non Illegitimi carborundum > Sorry, My earlier message was wrong. > [quoted text clipped - 7 lines] > > sisu Thank you for responding- I was and still am 51. The Gleason was 4+3=7. Iknow that numbers don't indicate that it would have spread to the Lymph Nodes and the Doctors were surprised as well. It was found in the nodes during the surgery and confirmed a week later with the pathology report. Even without knowing yours Stage, your numbers were certainly in your favor. You had at least a 90% chance of clean lymph nodes. But, as has been professed here often, statistics don't mean squat when you're one of the 8 that make up the other portion of the 100%. Of course, the good news is your PSA was low and you didn't have an 8, 9 or 10 Gleason. With any luck, you'll have a few months of QOL issues, then years of good life. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05 PSA .07 .05 .06 .05 non Illegitimi carborundum > Thank you for responding- > > I was and still am 51. The Gleason was 4+3=7. Iknow that numbers > don't indicate that it would have spread to the Lymph Nodes and the > Doctors were surprised as well. It was found in the nodes during the > surgery and confirmed a week later with the pathology report. A new twist, I just got back my after RP PAS and it is .2, that is good??? I'm not sure when your surgery was, but with lymph gland involvement and not yet having been treated with chemo and HT, I think it's pretty good.... at least it's promising. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05 PSA .07 .05 .06 .05 non Illegitimi carborundum > A new twist, I just got back my after RP PAS and it is .2, that is > good??? A new twist, I just got back my after RP PAS and it is .2, that is good??? >....One's PSA at Dx is largely dependent on how >often you have your >PSA checked,..... Hello, greetings from Europe, Estonia. Sorry my english is limited. I do not correctly understand the text above. What does Dx mean? How can we say that Psa depends on that how often it is checked? ----- I am a prostata cancer patient with Gleason 7. I have waited now for two years what hapens. Nothing has happened. I have no symptoms. Psa has varied between 3.6 and 5.7. The ratio between two Psa's has varied between 7- 12%. My age is 62. Nothing has been done to mee (yet). Is this correct place to talk about watchful waiting? I wish all the best to all of you. Sisu Welcome Sisu. Dx is an abbreviation for "diagnosis." Yes, you can talk about watchful waiting here. But I think most people here will agree that watchful waiting is not appropriate for a Gleason 7 case, it is too dangerous. But I am not a doctor. jimhoney >>....One's PSA at Dx is largely dependent on how >often you have your >>PSA checked,..... [quoted text clipped - 22 lines] > > Sisu >....watchful waiting is not >appropriate for a Gleason 7 >case, it is too dangerous. Thanks of your kind answers. It is generally said here too that Gleason 7 is too dangerous only to wait. But how dangerous it is? Who can answer this? What hapens and how fast? Both Psa and Gleason digits are only statistical numbers. They are not absolute numbers, like for example alchohol promilles (0/00) in blood. Here (in Finland. I live in Estonia) doctors say that "about one certain prostata cancer no one can say anything sure" (how it behaves). And 85- 95% about prostata cancers proceeds slowly or do not proceed at all. What do you think about thoughts like this. I wish you undestand what I mean. It is quite sure that prostata cancer with difficult symptoms must be taken care. Everything good for all of you. sisu Yes, PSA is an absolute number, it is nanograms per milliliter (ng/ml). You ask how dangerous it is. Well, your case is Gleason 7 with PSA 5.7. If you know your "clinical stage," you can use the Partin Tables to get a prediction of how advanced your case is. If you don't know your clinical stage, do you know if the doctor can feel a tumor? If not, use stage T1c in the chart. If yes, use T2c in the chart. http://urology.jhu.edu/prostate/partintables.php For your case, the prediction is something like this: Organ Confined: 21(14-31)% Extraprostatic Extension: 57(43-68)% Seminal Vesicle Invasion: 4(1-10)% Lymph Node Invasion: 16(6-32)% Is your doctor waiting for your PSA to rise? Do you have heart disease which makes surgery impossible for you? jimhoney >>....watchful waiting is not >>appropriate for a Gleason 7 [quoted text clipped - 31 lines] > > sisu by James A Honeychuck <jimhoney@worldnet.att.net> Apr 1, 2005 at 02:52 AM >Yes, PSA is an absolute number, >it is nanograms per >milliliter (ng/ml). You are right the numbers itself are absolute. What they tell is not absolute at all. Limits are only agreements. So it is with Gleason too. Gleason numbers are not easy to define. What can be seen on microscope is difficult to define. Earlier Psa limit in the Usa was 10, now it is propably about 4. What next? We must notice that like this number of patients have risen very much. Medicine is bussiness too. It is good and bad. If we do a radical operation or radioteraphy the cancer may spread however. Who can say that they are just those cases that cancer spreads do we something or not? >You ask how dangerous it is. > Well, your case is Gleason 7 > with PSA 5.7. My Psa has been 3.6 at times. >If you don't know your clinical >stage, do you know if the >doctor can >feel a tumor? My observation is about doctors feeling about prostata that every time when Psa is higher he feels something and every time that Psa is lower, there is nothing. >1.Organ Confined: 21(14-31)% >2.Extraprostatic Extension: 57(43-68)% >3.Seminal Vesicle Invasion: 4(1-10)% >4.Lymph Node Invasion: 16(6-32)% Sorry I do not understand what those four rows mean? >Is your doctor waiting for your PSA >to rise? Do you have heart disease >which makes surgery impossible for you? I think like this: The doctor is doing his job. This is good, but he does not do more. The responsibility is on the patient, what is done. Everythin good to you James and all the others. Sisu > Earlier Psa limit in the Usa was 10, now it is > propably about 4. What next? I do not recall any readings the said PSA was 10. It was 4 for all the time that I have been aware. But, it is not an absolute 4 anymore. Most now look for the difference between successive PSA scores. An annual rise from 1.0 to 2.0 to 4.0 would be considered dangerous, but then so would 0.2 to 0.4 to 0.8. USA and much of the world now worries about the doubling rate. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3bN0M0 Seminal Vesicle involvement, Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05 PSA .07 .05 .06 .05 non Illegitimi carborundum by "Steve Kramer" <skramer@cinci.rr.com> Apr 1, 2005 at 11:23 AM >... It was 4 for all the >time that I have been aware..... How long? Sisu I'm not sure, sisu, when the number 4.0 became the standard for PSA. You have to remember that PSA, or at least the universal acceptance of PSA as any kind of predictor, is relatively new. That said, it was my understanding that the 4.0 standard was either the first standard or very close to it. However, doubling time as a better predictor began gaining acceptance at least 4 years ago. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05 PSA .07 .05 .06 .05 non Illegitimi carborundum > by "Steve Kramer" <skramer@cinci.rr.com> Apr 1, 2005 at 11:23 AM > [quoted text clipped - 4 lines] > > Sisu Will someone else help out on this please. Sisu says he has Gleason 7 PCa and his PSA sometimes goes down. How can that be? Sisu, here is an explanation of what the Partin Tables say about your case: >>1.Organ Confined: 21(14-31)% The chances that the cancer is only in your prostate gland are about 21% >>2.Extraprostatic Extension: 57(43-68)% The chances that the cancer is just outside your prostate gland are about 57% >>3.Seminal Vesicle Invasion: 4(1-10)% The chances that the cancer has gone further and is in your seminal vesicles are about 4% >>4.Lymph Node Invasion: 16(6-32)% The chances that the cancer is in your lymphatic system and will now spread everywhere are about 16% jimhoney > by James A Honeychuck <jimhoney@worldnet.att.net> Apr 1, 2005 at 02:52 AM > [quoted text clipped - 65 lines] > > > Will someone else help out on this please. Sisu says he has Gleason 7 > PCa and his PSA sometimes goes down. How can that be? A DRE, ejaculation within the previous 48 hours, or even riding a bike can cause an elevation in PSA. So presumably it was the luck of the day that he got tested at a higher point, then retests at lower point. J |
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