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PSA and Gleason

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Posted 2/24/2009 8:12 PM (GMT 0)

I know it's possible to have a low PSA and a high gleason score with aggressive PC. My question, is it possible to have a medium to low gleason score (4,5,6) and a high PSA?

Posted 2/24/2009 8:26 PM (GMT 0)
I have a friend who's PSA was over 12 for several years and the Biopsies all came back clean. (he had three) Then the PSA shot up and the rest is history.
Posted 2/24/2009 11:54 PM (GMT 0)
There is a table on this page which relates Gleason cell grade to PSA production
www.prostate-cancer.org/education/riskases/Strum_StrategyOfSuccess2.html
Roughly, according to the table, PSA output per cubic cm is halved with each step up in grading. i.e. grade 5 cells per cc. have 1/2 the output of grade 4 per cc. who in turn have 1/2 the output of grade 3 per cc. With normal prostatic tissue they expect to see .066 ng/mL per cc. (e.g. A "normal" enlarged prostate of say, 50ccs, should produce 50x0.066 = 3.3 ng/mL. In my own case I had quite a substantial amount of tumour (2cmx2cmx2cm within a 32cc prostate) while the PSA moved from 2.8 to 3.2 to 3.9 over 2 years. As an exercise in maths my benign PSA (normal gland) reading should have been 2.11 ng/mL.
Bill
Posted 2/25/2009 12:24 AM (GMT 0)
You can absolutely have a high PSA with a low gleason score. There are a couple of things that can cause this. A large tumor that is nonaggressive, a transition zone tumor, and PC metastisis that has spread to the lymph nodes. High PSA usually is associated with metastisis.
JohnT
Posted 2/25/2009 12:41 AM (GMT 0)

I thought the longer the PC remained in your body the more aggressive it became (gleason 5 to 6 to 7 to 8 to 9 to 10). The more aggressive, the larger the tumor. The larger the tumor the more PSA. 

I ask because the father of a friend of mine died of PC back in 2006. He had a really high PSA and a gleason of ten. My friend stated his father wasn't a gleason ten when he was first dx'ed back in 2000. 

Posted 2/25/2009 1:33 AM (GMT 0)
It's not the cancer itself that causes you any harm for they are your genetic cells, not a poisonous invader, but rather what it does. As it spreads to other areas of your body it forces out and replaces other tissue disrupting the function of those various vital organs. If it can spread to the liver and as grows it will begin to break up and disrupt liver function. If it spreads to the brain it will begin to break down the connections and the disrupt the way the brain controls and maintain the functions of your body. I guess the rate of speed this happens is somewhat dependent on aggressiveness (Gleason influence). I would assume that grade 3 cells would be quite liable to become more altered with time and increase in grade and thus aggressiveness. I wish somebody somewhere would hurry up and find a marker to attach to the errant genes so that our immune systems recognizing the marker would wipe out the cells to which they are attached.
Posted 2/25/2009 4:25 PM (GMT 0)
To; BillyMac, Thanks for the web page on Glealon cell grade to PSA production. I printed out 14 pages to read on the way to work. Have a great day ! "Bigote"
Posted 2/26/2009 1:10 AM (GMT 0)

JerseyG said...

I know it's possible to have a low PSA and a high gleason score with aggressive PC. My question, is it possible to have a medium to low gleason score (4,5,6) and a high PSA?

As you can see by my profile, my psa was somewhat moderate, but the cancer that was found was an aggressive gleason 8.  The urologist seemed to think we found an early but active cancer.  Everyone I consulted (even the radiation docs) recommended surgery, despite my preference for brachytherapy.

I have been pleased with the quick recovery and apparent success, but I am still very upset by my long term ED problems.

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