What is a Gleason Score?

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Denny - - 01 Feb 2004 18:39 GMT

Brand new here. I'm 52. Just went through a cystoscopy and prostate
biopsy. Gotta wait till February 17 for the results.
According to the physician's assistant who gave me my physical in
November of 2003, my PSA went from 1.9 in 2002 to 5.1 in 2003.
But he didn't forward that to my urologist. I had to mention it to my
urologist (two months later) before he contacted the pa and had the test
faxed to him.
I know I have an enlarged prostate, but did I make a mistake by not
asking for another blood test from my urologist before what I went
through on Tuesday?

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jimhoney - 01 Feb 2004 18:58 GMT

Gleason score is explained here http://urology.jhu.edu/news/6/4.html , among
other sites.

What would you have learned from another blood test?

5.1 is about borderline cause for concern. I suppose most doctors would
offer to do a needle biopsy in your case. Chances are you have benign
prostatic hyperplasia, but even if it is prostate cancer it will be curable.

jimhoney
PSA 5.7 at age 52
Gleason 6 PCa
RRP, cured, no significant aftereffects

> Brand new here. I'm 52. Just went through a cystoscopy and prostate
> biopsy. Gotta wait till February 17 for the results.
[quoted text clipped - 6 lines]
> asking for another blood test from my urologist before what I went
> through on Tuesday?

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Louis V. Spielman - 01 Feb 2004 18:59 GMT

A Gleason score is a measure of the advancedness/aggresiveness of the cancer
developed from the biopsy samples.

The cancer is rated by the disorganization of the cells in the sample and is
scored from 0 to 5, 0 being no cancer and five being highly advanced. Two
scores are given. The first score is that of the most prevalent grade of
cancer found in the samples, the second is that of the second most prevalent
grade in the samples.

Mine was 4+5 = 9. Generally speaking a 4+5 is better than a 5+4 though both
total 9, The worst possible score is 10+10.

The Gleason score, in conjunction with the PSA, and also the bone scan and
MRI/MRSI results is used to determine the stage the cancer is at and the
possible range of treatments.

Good luck.

Considering that your PSA more than doubled... you made the right decision
in having a biopsy taken.

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Alan Meyer - 01 Feb 2004 21:24 GMT

> Brand new here. I'm 52. Just went through a cystoscopy and prostate
> biopsy. Gotta wait till February 17 for the results

I suggest you call your doctor's office and ask for the results over
the phone without waiting for the next appointment. If you have
a problem, getting the results by phone will enable you to do some
research and prepare your questions before you meet the doctor
on Feb. 17.

> According to the physician's assistant who gave me my physical in
> November of 2003, my PSA went from 1.9 in 2002 to 5.1 in 2003.
[quoted text clipped - 4 lines]
> asking for another blood test from my urologist before what I went
> through on Tuesday?

Your PSA numbers set off two alarms. One is that it's above the
normal range, especially for a man who is only 52 years old. The
other is that the rate at which the PSA went up is pretty fast - more
than 2.5 times in one year.

I think getting a biopsy now and not waiting was the right move. It
was unpleasant but, if you have cancer, it could save your life to
find out about it now, before it gets worse. I waited months after
getting my high PSA numbers before getting the biopsy and I
could have kicked myself when I found out I had cancer. I'm not
the only one on this group who has done that.

I finished radiation treatment a couple of weeks ago. It will take
as long as a couple of years before I know if it worked. If it didn't,
I'll always wonder (or least for the years left) whether I could have
cured it if I had gotten the biopsy right away.

Alan

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Danny McCarty - 01 Feb 2004 22:44 GMT

>Subject: What is a Gleason Score?
>From: DennyFromGa4@webtv.net (Denny -)
[quoted text clipped - 11 lines]
>asking for another blood test from my urologist before what I went
>through on Tuesday?

No. More than doubling in only a year is not good news, and a PSA of 5.1 is
too high, anyway. Another PSA would not be needed, but you might have had him
do a fPSA to see if it was more than 25%, as it should be, or if a course of
antibiotices would bring it down to 2 or so again.

A Gleason Score is a visual interpretion of the appearence of a prostate cell.
The pathologist examines a cell and says, "it looks normal", which is a "1", or
he says "it looks extremely ragged and disorganized", which is a "5". He looks
at many cells, groups them, and records the most abundant and the next most
abundant, assigning a number from 1 to 5 to each. So 4 + 3 is worse than 3 +
4. No one bothers to treat a Gleason of 4 or less, and rarely a Gleason of 5.

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dale.j. - 01 Feb 2004 23:00 GMT

> do a fPSA to see if it was more than 25%, as it should be,

Miy free PSA was 18 and I had the Pca. It's a test that I would want to
have.

Dale J.

Signature

Email: dalej2@mac..com

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Steve Kramer - 02 Feb 2004 10:54 GMT

Denny, if you already have an enlarged prostate, then I would suggest that
your rise in PSA is probably due to that. Men who have enlarged prostate
can get prostate cancer, but not to any degree more often then men without
enlarged prostates.

However, a rise in PSA does occur with prostate cancer and it is silly not
to have it checked out.

Fire your doctor. No increase in PSA should be ignored.

Signature

Prostate Cancer Survivor (so far), not a doctor
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000
PSA .1 .1 .1 .3 .4 .8
EBRT 05-07/2002 @ 47
PSA .3 .2 .2 .2 .3
Erection 05/12/2003 @ 48
HTbegins 07/21/2003 @ 48
PSA .1
Lupron 7/03, 8/03, 12/03

>
> Brand new here. I'm 52. Just went through a cystoscopy and prostate
[quoted text clipped - 7 lines]
> asking for another blood test from my urologist before what I went
> through on Tuesday?

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Bill Denton - 02 Feb 2004 16:30 GMT

I'd have wanted (and did have) a month on an antibiotic like Cipro and
a followup PSA to rule out prostatitis before getting skewered.
Forgive my cynicism but: uros don't make any money prescribing drugs
but a biopsy is a quick thousand or so. Ask your doc what PSA it would
have taken to get his attention.

Bill Denton
RP 2/12/03
Memphis

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jk - 02 Feb 2004 23:36 GMT

> Brand new here. I'm 52. Just went through a cystoscopy and prostate
> biopsy. Gotta wait till February 17 for the results.

Why do you need to wait so long? Mine took about 1 week.

Signature

JK Sinrod NY
Sinrod Stained Glass
www.sinrodstudios.com
Coney Island Memories
www.sinrodstudios.com/coneymemories

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Denny - - 03 Feb 2004 00:36 GMT

JK, I have no clue. That is when they have scheduled me to get the
results of the tests. This, pardon the pun, is unexplored territory for
me. And I'm not the sharpest knife in the drawer.
But thanks to all the replies to my postings, I'm learning.
Denny

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Alan Meyer - 04 Feb 2004 19:02 GMT

> JK, I have no clue. That is when they have scheduled me to get the
> results of the tests. This, pardon the pun, is unexplored territory for
> me....

Denny,

A lot of doctors want to tell the patient bad news in person
so that the patient can ask questions and hear that there are
treatments available - and so not get as depressed about it.
So they schedule the report when they have their next
appointment time available.

I think you'll do better however if you call his office and ask
for the results of the test now, or as soon as they have them.
If you don't have cancer, it will give you two weeks free of
anxiety. If you do, it will give you two weeks to bone up on
the disease and learn something about your options so you
can ask intelligent questions when you meet with the doctor.

When the doctor told me I had cancer he proceeded to explain
about Gleason scores and staging and multiple options, but
I couldn't hear or understand it. After the words "You have
cancer", the rest started to just blur into noise. It was only
after I had time to adjust that I was able to get my brain in
gear and start learning.

If the doctor's staff tells you they prefer to give the results in
person, tell them why you want them now. It seems perfectly
reasonable to me and I would hope it would be to them.

That's my advice but, of course, you have to do what you're
most comfortable with - not what I or anyone else is most
comfortable with.

Good luck.

Alan

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jimhoney - 04 Feb 2004 19:09 GMT

> > JK, I have no clue. That is when they have scheduled me to get the
> > results of the tests. This, pardon the pun, is unexplored territory for
[quoted text clipped - 33 lines]
>
> Alan

I agree. Urologist called me at my office to tell me. No problem, and much
preferable to another trip to the urology clinic.

jimhoney

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