A case of fast PC progression

One of my concerns since being here a bit over a year, is that lots of remarks are made about "how much time a person has", and don't rush, etc. etc.  In most cases I believe that may be safe advice.  But look at this case I learned about today at the clinic.

Got this all from the guy's wife while he was being zapped.  He was age 67 when dx with PC, all she remembered was Gleason 7, Stage2, didnt remember his PSA.  He had open Surgery locally right away.  Within 6 months, had reoccurance.  He did the same 39 rounds of IMRT as salvage.  He seemed ok while waiting for the radiation to settle down and to get some new readings on PSA, but complained all the time about bone pain.

He is 69 now  (hate to say this, looked like 90), he is now Stage 4 and they are doing 10 treatments of Rad on him right now only as pain relief, as his wife said that it has metasisied to his hips and halfway up his spine.  Not sure who his uro or rad oncl are, weren't local names I was familiar with.  She said they are now giving him a year at best.

Point of the story, not all PC is slow.  If Zufas sees this post, I will give him credit for one of his tenents, that there are varieties within PC, and this must be one potent variant.  Felt so sorry for the wife, and for the man as well.

What I learned from my own URO and the Rad Oncologists I have met with, that any portion of Type 4 cancer cells in the mix can cause unpredicible results.  We have guys here that are Gleason 7 like me, both in 4+3 and 3+4 formats, some have done great years after.

I like what is getting to be a current line of thinking according to my uro, that any Gleason 7 should be treated as if it were an 8, to be on the safe side.  We sure need better testing, this is proof of that first hand.  Outside of a miracle, I don''t think this new brother I met is going to make it.

I repeat this story, just to be a learning tool, not to scare anyone.  Knowledge is strength, even if we don't like the news.

Just don't shoot the messenger.

David in SC

Gleason 7 its so confusing or is it ?.  As you can see I am a Gleason 7 Guy like yourself.  The confusion comes in to play when we talk 3+4 or 4+3. 

When these two scores are broken down into their Gleason Differential, ie percentage of grades, there does not seem to be alot of difference to me.

My Gleason Differential is 60% grade 4 and 40% grade 3.  I really dont see alot of difference  if it was the other way around say 60% (3) and 40% (4). 

Unless the GD is vastly different like 90% (4) and 10% (3).

So surely all the guys like myself that are sitting around the mid range area, should all be branded as simply gleason 7. 

I would be interest to hear you thoughts, I just fail to see the big difference, when the percentages are so close.  So much emphases is placed on 3+4 and 4+3.

................Cheers Kev

Hi All,

Very interesting conversation and I guess I am going through a lot of the same thing what to do with a Gleason 8 and a rising PSA.  I finally had the Cath removed yesterday in Orlando that was a result of the surgery to remove surgical clips that migrated to my bladder neck and form stones.    That now out of the way and the burning and urgency gone I can concentrate on my rising PSA.  I am a Gleason 8 but my Path report was excellent organ confined stage t2a surgial margins and lymph nodes clear.   So why is my PSA rising?  My surgeon feels the PSA is wrong and wants another test done on Nov 16th if another rise he feels it is not a local recurrance but cells that got out prior to surgery.  The two radiation Oncologist I have spoken too both feel it could be local and that I should do radiation.  My surgeon's PA told me yesterday to go with my gut.  I told her I would like a little more professsional advice then my gut?  Do I do radation or not?

Jerry1