What does it mean????

New here so please forgive if these questions have already been addressed.  My husband was diagnosed couple months ago and I am scared to death.  He is 55 years old; psa 26; no prior psa for compairison; biopsy positive in 4 of 12 samples with 2 cores positive at 40% one positive at 60% and one positive at 80%.  It seems that these are very high numbers from some of the postings here.  Also there is perineuro involvement in 2 of the cores but MRI and bone scan were negative for mets.  Does the percentage of involvement indicate the aggressivness of the cancer??  Also are there any reliable statistics on cure or recurrance based on perineuro involvement or the percentage of involvement?   Do these numbers mean anything in ultimate cure or recurrance numbers?  He has opted for radiation rather than surgery but has not begun yet.  I am so affraid that the high percentage of involvement is an indication that this is an aggressive cancer.  His gleason score was 7 (3+4 in 3 samples and 4+3 in 1 sample). 

Your husband has two high risk factors, a psa over 10 and a grade 4 gleason; this would put him into a high risk catagory. Bone and CT scans won't show anything at this point, so you cannot rule out micro mets. The psa of 26 is very worrisome.
These are the things I would recommend:
Get a 2nd opinion on the biopsy slides from Epstien at John Hopkins and do a ploidy analysis.
Get a scan, either color doppler or MRIS to pinpint the tumor location and evaluate extra capsular extension.
Find a doctor that uses the partin tables, neuronetworks and have him explain them to you and what they indicate. You want a probability that the PC is organ confined. If there is a low probability of organ confined disease then surgery would most likely fail.
Get a PAP and a PCA3 test. These can indicate possible micromets and agressiveness.
After reviewing all of the above with a prostate specialist, most likely a medical oncologist, then a treatment plan based on his condidtions can be recommended. Until you get this information you are only guessing.
You are in a fight with PC now and if you want the best chance of winning you must determine everything about your enemy before you start fighting. Most battles are won before any fighting begins.
JohnT

Woodysgirl,

Please check-out the site below, and press the panic button, it certainly help me, when I was first diagnosed.  I am a 4+3 gleason 7, and doing great, as you can see by my stats.  Your husbands PSA is most probably the most worrying aspect, but please stay positive. 

The like below will show you many men, with high gleasons and PSA's far higher than your husbands, all doing well........................Cheers Kev

http://www.yananow.net/

Ploidy analysis you would pay extra for in pathology, may reveal if PCa is a variant and thus more aggressive, maybe $300-500 more. Dr. Bostwick and Oppenheimer do this and maybe less than a handful of others. You can still have it done as a review, second opinion on your slides and even after a long time span, the parafin wax seals these samples and they last.

Hope is eternal....my stats considerably worse than you posted, the good news is still around and currently in great shape due to overall treatments taken would be my guess. It is not the totally typical 'ride' taken by the majority patients, so maybe I am stupid as some likely believe, but alive and even playing soft rock music as a duet and enjoying things, far from disabled living. I am at year 8+ right now, which has amazed my sorry posterior to some degree, too. Fired a few docs along the way too. My story is found on yananow.net give me an email and will send you the direct link. Yeah I know it can change anytime, been aware of that all along. So I respond to others like yourself, now. While I still have that luxury.

Dx-2002  bpsa 46.6  total urinary blockage and in emergency room, 12/12 biopsies all PCa 75-95% values, gleason scores found 7,8,9's and in two about equal sets of them like that, ct and bone scan (useless) appear clear (meaningless and profittable for them). Protocols that follow not all typical types.

Welcome Woodysgirl

Worrying...probably for awhile...my wife still does to this day and it is perfectly normal. For me, no longer worry but stay aware which for me is a lot easier to deal with.

You have been given excellant advise so follow through with that and let us know how things go.

With the new advances in PCa like Provenge which some people are lining up to get, limited supply and openings right now, it may work pretty well on normal PCa because their testings were done on refractive patients in trials, FDA just approved. Right now medicare is supposed to cover 80% of it I am hearing about, so the rest is still a big bill and insurance companies may cover this in total (some of them). Cost is around $93K, we have a guy in Florida whom got proactive and called and got an confirmation to get started with treatment within a few weeks you also have to currently meet their criteria guidelines (not just anybody can get it right now), we will all monitor his journey and effects if any.

The message is say you buy time like 5 yrs.+ with currently meds and protocols, this time frame Provenge could be refined, other companies in Canada and elsewhere have similar concepts right now for 're-engeering or cells' to go back in and change or kill PCa. They may have further advances for patients whom have been waiting decades for real new choices.