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Tertiary Gleason 5 pattern

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Posted 4/24/2018 5:25 PM (GMT 0)
This little factoid has bothered me since RRP. I was 3+4. I haven't found much up to date info on what a high tertiary might mean for someone. Probably a higher chance for BCR. I know pathologists write it down on their reports. For me it was RT after a year to heal up.
Posted 4/24/2018 5:44 PM (GMT 0)
As you surmised, tertiary 5 raises the risk of recurrence. Along with EPE, pT3b, and positive margins, you had a very high risk of recurrence. Here's the latest article I've seen about it:

www.urologiconcology.org/article/S1078-1439(17)30613-0/fulltext
Posted 4/25/2018 4:48 PM (GMT 0)
TA,
Thanks for using the word "had".
Posted 4/26/2018 2:07 AM (GMT 0)
No ADT ? What is your PSA now ?
Posted 4/26/2018 2:37 AM (GMT 0)
don't kid yourself Brook...15% is a lot of the most aggressive pca out there...continued treatment is warranted...
Posted 4/26/2018 6:18 AM (GMT 0)
A tertiary 5 of that dimension..,.should be considered the primary tumour...the 4 the next in consideration...and the 3 lastly regardless of size...tho location of tumours...and the pathology should certainly have a good grasp of location in this day and age also play a significant role in prognosis...do not dismiss this brook...it is NOT a little factoid...it is Major...what does your Medical team have to say? this thread is puzzling in its nature...I will say it is not getting a lot of traction...funny how that works a few "obligatory" posts and by by...I'm trying Brook...what say you?
Posted 4/26/2018 1:03 PM (GMT 0)
Don't worry guys. I was being a little self-deprecating with Tall Allen. I think about it most days. My current PSA is .1. I lost the "<" sign somewhere between RRP and radiation. As for tumour location, my prostate was nearly all cancer. No ADT. Yet.
Posted 4/26/2018 2:31 PM (GMT 0)
Brook,
My biopsy was a 4+3 high volume bag of cancer. I was giddy when the pathology report came back showing clean LNs, that is, until I saw the long face of my RO as she explained the ramifications of the revised Gleason to 4+4, focal areas of 5. That was the first of many disappointments along my journey.

Well, what’s a guy to do, except carry on? 🙂

Good luck in your journey.
Posted 4/26/2018 3:45 PM (GMT 0)
Brook do mind telling us about your medical team?? Where yo are being treated...with whom etc...it will help us help you...your case is very much treatable...you have a good attitude...imo...a bit of an edge...personally I like that in a human being...regards...
Posted 4/26/2018 6:12 PM (GMT 0)
I'm sorry the ART didn't get it all. I'm a bit surprised you didn't have adjuvant ADT with your ART, given your risk factors, but that's in the past. I hope you are working with a medical oncologist.
Posted 4/27/2018 1:52 AM (GMT 0)

mattamx said...
Brook,
My biopsy was a 4+3 high volume bag of cancer. I was giddy when the pathology report came back showing clean LNs, that is, until I saw the long face of my RO as she explained the ramifications of the revised Gleason to 4+4, focal areas of 5. That was the first of many disappointments along my journey.

Well, what’s a guy to do, except carry on? 🙂

Good luck in your journey.


My uro didn't make much eye contact during our "so here's the deal" discussion. There wasn't much good news, and the treatment options were limited. It must be a little hard for docs to deliver a rough diagnosis.

After that meeting was the only time I saw my wife truly upset about it, emotionally distraught. We went to lunch right after, and blessedly met a TV "star" who was dining there at the booth right behind us. It transformed that day into a rather happy memory!
Posted 4/27/2018 1:55 AM (GMT 0)
Come on RedWing...pant...pant..pant...tv star??? share...give us a happy memory too..... Hey its what I do...
Posted 4/27/2018 3:04 AM (GMT 0)
You can not drop a happy note into a dirge...and expect folks to do any thing but dance...its the way things work...or folks can by an act of self defiant will...force a frown...buttressed by a smile...what to do ...what to do...let it go...let it go...the meaning and intent...to and fro...
Posted 4/27/2018 1:41 PM (GMT 0)
I have been holding steady at .1 for two plus years. I am Treated at OU Medical Center, Urology and Stephenson Cancer Center (same campus).
Posted 4/27/2018 4:51 PM (GMT 0)
OU...I was a contract instructor hired by OU at the Mike Monroney center FAA Academy at Will Rogers airport in early 2007 for 6 months and again 2008 ...training new hires in ATC...classroom and Labs...also went there for initial tng...as new hire in 68...and various times for additional tng there after...love OKC...know it well...I hope you get additional advice but fear... There is a thread for gl9er's particularly in the thread lineup...the active members usually add new members name to the list..Im not a member by choice and Know lttle about advanced pca...Also and of course I should not mention this ...but of course I will...I can...at times...be a kiss of death{love that term...reveals...} to newbies...imo you have received a luke warm reception at best here...Ask specific questions if you have them...I feel you have fear in your plight...but if you are an native okie{I say that with respect} you keep a stiff upper lip and as one respondant said somewhere "carry on"... with true grit...I sincerely hope you receive the treatment you need both off line and online here at healingwell...regards logo PS all this of course could be in my own head...there is a lot in there...jousting...
Posted 4/27/2018 6:39 PM (GMT 0)
Funny logoslidat, I work for the FAA at MMAC. To jest is to joust...
Posted 4/28/2018 12:52 AM (GMT 0)
You take care of yourself Brook...these saints aint budgen...checken boxes...I tried... so I will leave with a quote from back in the day...wasn't liked then...wont be now.. ." hypocrisy is vices homage to virtue" Francois de La Rochefoucauld back further in the day
Posted 4/29/2018 8:20 PM (GMT 0)
Here is another article that mentions that tertiary 5 raises the risk of recurrence:
Integrating Tertiary Gleason 5 Patterns into Quantitative Gleason Grading in Prostate Biopsies and Prostatectomy Specimens

It says: "Presence of small (tertiary) Gleason 5 pattern is linked to a higher risk of biochemical recurrence in prostate cancer"

George
Posted 6/5/2018 1:59 PM (GMT 0)
Thanks George. That article gets pretty deep in the weeds. I guess I will consider myself a G8.
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