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Medical Forum / Diseases and Disorders / Prostate Cancer / April 2005Question
I'm trying to figure out PCa staging. Here is a hypothetical question. Which gentleman has the better statistics: Person A PSA 4.0 Gleason 3+3 TB1 Person B PSA 2.5 Gleasn 3+4 TB1 And Again: Person C PSA 2.5 Gleason 3+3 TB2 Person D PSA 4.0 Gleason 3+4 TB1 Also I'm trying to figure out the likelyhood of each. For example is it more likely to have a TB1 with low PSA or are they independant? Also if the PSA is low (2.5) but the Gleason is 3+4, is it more likely to be contained than if it's a PSA 4 but Gleason 3+3? Hope this makes sense. >I'm trying to figure out PCa staging. Here is a hypothetical question. >Which gentleman has the better statistics: <snip> Staging by DRE is not reliable even though it's considered a recognised step in the natural progression of a diagnosis, following a PSA test. Only the top side of the prostate can be felt and the tumour could be anywhere or all through the prostate. More accurate diagnosis can be made from a successful TRUS Biopsy. The Gleason Scores determine the aggressiveness of the tumour. For those who have had RRP, the Staging can be changed on the post-operative pathology report. Are you a student? -- Reader to complete... -- Please reply to this ng as my email adress is fake: -- Regards -- CC No, dad died of aggressive PCa. I just know one of these days the damn thing is going to rear it's ugly head. I want to be prepared. My problem is even if I ask for a biopsy when the PSA reaches 2.5, it sounds like the Gleason score is what really matters, and I have no control over that. >No, dad died of aggressive PCa. I just know one of these days the damn >thing is going to rear it's ugly head. I want to be prepared. > >My problem is even if I ask for a biopsy when the PSA reaches 2.5, it >sounds like the Gleason score is what really matters, and I have no >control over that. Dick, there is a second type of PSA test called Free PSA. While PSA should be low, Free PSA should be much higher, generally above 25. (standards may vary slightly, but a google search of Free PSA will lots about it). In my case, biopsy was prescribed because of PSA 4.3 and Free PSA 19. From: smith_bp101@hotmail.com (Dick Smith) No, dad died of aggressive PCa. I just know one of these days the damn thing is going to rear it's ugly head. I want to be prepared. My problem is even if I ask for a biopsy when the PSA reaches 2.5, it sounds like the Gleason score is what really matters, and I have no control over that. ==========hi dick - i can understand your concern over the pca. my dad died FROM pca and i was dx'ed 30 years earlier in age then he developed it. i was shocked to say the least, but also, i'm going to live a lot longer because of my awareness to pca. that is all i can tell you right now. be very aware of your psa's and watch them as you age. in my case, the pca was gland contained and it was a fluke that i stopped into for a physical because i thought i would live longer than this before developing pca. as my by line says - knowledge is the power and there is a lot of truth to that. by the way, the four cases you offered are pre op. the findings will be a lot different once the prostate hits the path table. case in point. i was T1c pre op, and T2c post op. best wishes. ~ curtis knowledge is power - growing old is mandatory - growing wise is optional "Many more men die with prostate cancer than of it. Growing old is invariably fatal. Prostate cancer is only sometimes so." http://community.webtv.net/PALMER_ENT/doc At this stage the PSA does not matter. The Gleason reading is much more accurate than PSA Gleason 3+3 is better than 3+4 TB1 is better than TB2 Reuben >I'm trying to figure out PCa staging. Here is a hypothetical question. >Which gentleman has the better statistics: [quoted text clipped - 27 lines] > >Hope this makes sense. But why wouldn't it matter? I thought the PSA wouldn't matter if it was in the neighborhood of 50 or so, but when it's either 2.5 or 4.0? How can one raise the odds that the PCa is found when it's still TB1? A & C  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 > I'm trying to figure out PCa staging. Here is a hypothetical question. > Which gentleman has the better statistics: [quoted text clipped - 27 lines] > > Hope this makes sense. What is TB1 and TB2? I have seen T1b, PCa found during a TURP, but what do you mean by TB2?..Ron You're right, I'm sorry. I meant to say T1 & T2 Dick...Then the textbook answer would be person A. But remember PSA velocity is much more meaningful than a PSA datapoint. Your PSA velocity will help you catch things early, particularly if you were to have low-risk disease (e.g. PSA, and hence PSAV, is often a less valid indicator for higher GS tumors which have a lower PSA leak)...Best wishes and good health, Ron Now its my turn.. on the 14 th. I have my RR at Ford Hosp. Talk about being nervous-I have a feeling many of you have been in same situation. Diagnosed in Jan and the operation in April.. Age 69 Psa 16.3 Gleason 7 3+4 Thank God for My faith and family Your family and faith will be more important than you can now possibly imagine. 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 > Now its my turn.. on the 14 th. I have my RR at Ford Hosp. Talk about > being nervous-I have a feeling many of you have been in same situation. > Diagnosed in Jan and the operation in April.. > Age 69 Psa 16.3 Gleason 7 3+4 Thank God for My faith and family |
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