am I a 6 or an 8?

Rigby

Regular Member

Joined : Oct 2013

Posts : 237

Posted 4/3/2014 3:38 AM (GMT 0)

My pre-surgery Gleason was 8. Post surgery it is 7 (3+4). But as you see in my signature, I had a very tiny surgical margin in one location. I don't recall them saying what type of cells were closest to the edge. If the more aggressive cells are more likely to move to the outside, then I figure I'm an 8 since it's the type 4 cells that closest to escaping. If the more predominant type 3 cells are closest to the outside, then I'd call myself a 6 since the others were removed along with the prostate. Does that make sense? How does the tumor propagate? Are the more aggressive cells always closer to the outside?

Veteran Member

Joined : Feb 2010

Posts : 5892

Posted 4/3/2014 3:43 AM (GMT 0)

Split the difference. You're a 7

.

ed

Purgatory

Elite Member

Joined : Oct 2008

Posts : 25448

Posted 4/3/2014 4:25 AM (GMT 0)

You are a 7, post surgery pathology trumps biopsy pathology. If you want to know for sure for sure, have a second reading of the post surgery pathology by a higher level source.

Bobbiesan

Regular Member

Joined : Mar 2012

Posts : 413

Posted 4/3/2014 10:52 AM (GMT 0)

Rigby,

Definitely have a second opinion. Some of the best pathologists, like Epstein, will specifically look at the cells at the positive margin and report it back to you. There was a place on the Johns Hopkins request paperwork where, now get this, the PATIENT could state things would like to be checked during the second path (fancy that, patient input...)

It is not that expensive and may even be covered by ins. if your surgeon signs off (you'd have to check on that).

I didn't want to start TRT if my margin had the "4" of my "3 + 4". It was "3" there at the margin, so I started TRT at the 2 yrs out point. A gamble, I know, but I have had the "light bulb on" response that some men get on TRT. Now, with a normal T level, don't wanna go back...

Good luck,

Robert

JNF

Veteran Member

Joined : Dec 2010

Posts : 5986

Posted 4/3/2014 11:17 AM (GMT 0)

My doctors treat the highest G found. I was 3+3, 3+4 and 4+3. My uro didn't downgrade because of the threes. They won't hurt you. Undertreat the fours and they can hurt you. You clearly are a 3+4=7 based on your pathology. You can only be a 6 if you are truly 3+3=6. Seek a second opinion, but it is unlikely to come back a 6. Even if it didd, I would be suspicious in light of the biopsy and first pathology.

acsd

Regular Member

Joined : Aug 2013

Posts : 46

Posted 4/3/2014 12:56 PM (GMT 0)

We actually called the pathologist that did the work on my husband's surgical specimen. She described in detail what the cells looked like at the site of his EPE.

I don't think the pathologists deal with patients directly that much...but she seemed very willing to spend time answering all our questions.

logoslidat

Veteran Member

Joined : Sep 2009

Posts : 7585

Posted 4/3/2014 2:36 PM (GMT 0)

your a 7 un less you had a tertiary score. If the 4 is the margin, thats why they call it hi intermediate, if its a 3 low intermediate risk. We are however, allowed to view it anyway we want.

PeterDisAbelard.

Forum Moderator

Joined : Jul 2012

Posts : 6432

Posted 4/3/2014 3:33 PM (GMT 0)

Unless you can come up with more information the answer to your question is "no". You are not a 6, nor are you an 8. You are a 7. You are intermediate risk, slightly on the low side.

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