Biopsy
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From: Leo on 29 Mar 2006 06:38 Hello, A favorite uncle of mine had his PSA progress upward from 13, 16 and finally to 20 that we had him undergo a biopsy. These are the results Right prostate: - Prostatic Adenocarcinoma, moderately differentiated, Gleason's score: 3 + 2 = 5 Left prostate: - Focus of small atypical glands suspicious for adenocarcinoma - fibroglandular hyperplasia Is the prognosis for this bad? Please help as I'm getting very worried. Thank you very much.
From: juniper on 29 Mar 2006 09:45 Leo wrote: > Hello, > A favorite uncle of mine had his PSA progress upward from 13, 16 and > finally to 20 that we had him undergo a biopsy. 20 is a high PSA that indicates high risk disease. What are the dates of his biopsies? Knowing the rate of increase is very helpful information. Did he have any PSA tests before that 13? What did his digital rectal exam find? Does he have any symptoms? > Gleason's score: 3 + 2 = 5 This indicates a moderately aggressive cancer. It is possible that his Gleason is worse than this, and they didn't get a representative sample. There is inforamtion about getting a 2nd opinion on the biopsies from a prostate cancer specialist pathologist. > Is the prognosis for this bad? A PSA of 20 puts him in the high risk catgory. It would be a good idea to start studying this disease in order to make informed treatment decisions. One good website is http://www.prostate-cancer.org/education/education.html#newly_diagnosed. A good book is "A Primer on Prostate Cancer". If you like videos, there are some http://uwtv.org/programs/displayevent.asp?rid=2051 and http://uwtv.org/programs/displayevent.asp?rid=2291. You can order videos here http://www.prostateforum.org/videos.cfm. "289. - "Strategy of Success in the Treatment of Prostate Cancer" by Stephen Strum, M.D. & Medical Oncologist from Los Angeles at the Fullerton Prostate Forum on 7/23/02. 2 hours. This is probably the most helpful of all of the videos, primarily for newly diagnosed men but also valuable for men who are planning ahead in case they have problems after initial treatments." Leo, I'm very sorry your family has to go through this. If you have to, though, I'm glad you're here. I am sure other people will provide better responses than this. Give us as much info as you can, and ask anything. Best wishes, laurel
From: ron on 29 Mar 2006 09:48 Hi Leo...It's rather unusual for a PSA that high to be associated with a Gleason score that low. PSA's are easy to measure accurately, Gleason scores from biopsy samples are not. Because of the known difficulty in accurately reading biopsy fragments it is usually recommended that they be read by pathologists who are experts in PCa pathology. A list of such experts can be found at http://www.cancer.prostate-help.org/cagleex1.htm I would think it important for your uncle to take this next step of having his biopsy slides sent to one of these experts for re-evaluation. Insurance often covers the re-reading. If you are able to provide more information (uncle's age, dates of PSA readings, number of biopsy cores collected, number positive, etc.), then we might be able to offer other comments...Best wishes and good health, Ron
From: Leonard Evens on 29 Mar 2006 10:49 Leo wrote: > Hello, > > A favorite uncle of mine had his PSA progress upward from 13, 16 and > finally to 20 that we had him undergo a biopsy. > > These are the results > > Right prostate: > - Prostatic Adenocarcinoma, moderately differentiated, > Gleason's score: 3 + 2 = 5 > > Left prostate: > - Focus of small atypical glands suspicious for adenocarcinoma > - fibroglandular hyperplasia > > Is the prognosis for this bad? > > Please help as I'm getting very worried. > > Thank you very much. > I agree with the others. A PSA of 20 doesn't seem consistent with a Gleason 5. It is possible that higher grade cancer was missed by the biopsy or that another pathologist might read the samples differently. You don't say how old your uncle is. That might also be a factor in deciding what to do next.
From: Steve Jordan on 29 Mar 2006 13:18
On March 29, Leo wrote: > A favorite uncle of mine had his PSA progress upward from 13, 16 and > finally to 20 that we had him undergo a biopsy. > > These are the results > > Right prostate: > - Prostatic Adenocarcinoma, moderately differentiated, > Gleason's score: 3 + 2 = 5 > > Left prostate: > - Focus of small atypical glands suspicious for adenocarcinoma > - fibroglandular hyperplasia > > Is the prognosis for this bad? > More details are required for a decent evaluation, but Leo must understand that we cannot and must not give medical advice. Laurel/Juniper has given excellent advice regarding sources for further information. I would add that the biopsy specimens must be studied by a specialist in PCa (prostate cancer) pathology. Such labs are usually known to medics, but they will not volunteer the information unless asked. They are listed under "Pathology" at: http://www.prostate-cancer.org/resource/special.html And how many specimens were taken? How many contained cancerous tissue? How much of each specimen was cancerous? Everything that is done from here on depends upon the accuracy of the Gleason scoring. Many times the score is changed when the specimens are examined by an expert. It is also essential that a complete file of every test, every item in the medical chart, must be copied and placed in the patient's personal file. This will be of immense value. And the patient has a right to the information. The local pathology report should, if done competently, include answers to the questions I asked above. This is war, and the better prepared the patient, the more likely an optimum outcome. Regards, Steve J "What are the facts? Again and again and again -- what are the facts? Shun wishful thinking, ignore divine revelation, forget 'what the stars foretell,' avoid opinion, care not what the neighbors think, never mind the unguessable 'verdict of history' -- what are the facts, and to how many decimal places? You pilot always into an unknown future; facts are your single clue. Get the facts!" --Lazarus Long |