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Question for Gleason 8s, 9s, & 10s

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Posted 9/1/2010 1:25 AM (GMT 0)
For those of you with organ confined cancer AND high Gleason scores, can you share what your first post surgery psa was? My first post surg psa is this Friday, and I'm a little nervous about it. I read about one fellow whose first psa was 1.36. Has there been anyone with a high gleason whose psa has remained low for years?

I'm really concerned about battling this monster for the next several years, all the while knowing the outcome.

<sigh>

Post Edited (kbota) : 8/31/2010 7:30:13 PM (GMT-6)

Posted 9/1/2010 1:34 AM (GMT 0)
I had a pre-op Gleason 4+4 in 7 of 12 cores, 3+4 in 2. So 9 / 12 positive.

Post op path (10/2009) was 4+5, multiple positive margins. No Lymph/Seminal Vesicle involvement.

My 7 week post-DaVinci PSA was undetectable (<0.1 from Bostwick labs). At + 3 mos., the same. After my IGRT, I insisted strongly for a more sensitive test. The clinic uses LabCorp, which reported <0.01 (undetectable) in late June '10. Next test is October.

Posted 9/1/2010 1:42 AM (GMT 0)
Gleason 9. Mine was less than .03 ( lowest test point ) or undetectable. Have been staying at <.01 or .01 for 15 monts.

If you think it will get easier, you are probably mistaken. Each PSA test still causes the gut to tighten up, even after 5 good ones. Could always be the next one, kind of like Russian Roulette.

The nomograms are actually very kind to us tho, we still have good odds. It is a waiting game. But at age 59, so is a heart attack, stroke, or a car accident.

Good luck
Posted 9/1/2010 1:51 AM (GMT 0)
Well, not organ confined but I'm still at undetectable as of the last test.

I'm not sure if the anticipation will ever get easier, every time I expect the beast to be back.

Best of luck on your test.
Dave in Durango CO
Posted 9/1/2010 3:16 AM (GMT 0)
I had a path of 4+5, good path report except for perineural invasion and high gleason.  60 day psa was 0.02 but started upward until 0.27 about 8 months later, then did 38 sessions of IMRT finished in early June.  Doc says PSA test in Sept will be first clue if SRT successful. In my opinion, Gleason 8-10 is a whole different ball game.

Posted 9/1/2010 3:32 AM (GMT 0)
Old sailor is correct..The Partin and Han tables do not lie...With timely surgery, a surprising number of us are still cancer free at the 10 year milestone..And most of us are still alive, but not cancer free...
Posted 9/1/2010 10:39 AM (GMT 0)
As you can see from my signiture I am a gleason 8 and my tumor was organ contained, no positive margins or EPE. Perineural invasion however. PSA's at 3 and 6 months were < .01. Recurrence started at 9 mos. Having a gleason 8-10 is no fun. One of my worse moments with PCa was finding out that I was a gleason 8 from my path report. Try to be optimistic, it is morely likely that you are cured.
Posted 9/1/2010 11:35 AM (GMT 0)

kbota,    Many of us on the HW site have had a good outcome in spite of a high gleason score.   I had a GS 8 and my PSA has been <0.1 every test since surgery.   Goodlife is right about PSA anxiety.  Both my wife and I get very anxious with each six month test even after two years.

Carlos

Posted 9/1/2010 3:08 PM (GMT 0)
 

As you can see by my signature I was a gleaso 5+4=9 with sv invasion and lymphnodes clean. PSA rise 7 months out.

Posted 9/1/2010 6:48 PM (GMT 0)
Everything I read estimates a recurrence of Pca after surgery at about 35%however, I think if the stats were broken down by gleason scores, it would be about 80% for Gleason 8-10 and less than 20% for Gleason 7 and below.  Based on all the threads I have read, I think a person with a Gleason 8-10 should be prepared for SRT at a minimum with a very strong possibility of ADT after SRT if it fails.  I would have opted for seeds and IMRT had I known that my Gleason was a 9 - but didn't know until after surgery.  My biopsy was 5 of 28 with Pca but only two with Gleason 8 which also indicates that most Gleason scores are upgraded upon pathology.
Posted 9/1/2010 9:19 PM (GMT 0)
Old sailor,

I am not saying you are wrong, but after diagnosis, I played with the nomograms.

In the SK nomograms, (which some say are optomistic) with a T3b and epe, a Gleason 6 had a 95 % 10 year non reoceurrence, a Gleason 7 had and 83 %, and a Gleason 9 had a 71 %.

I would play the lottery every day with those numbers. I think initial PSA at diagnosis probably has as big effect. I guess this is indicative of how soon it was caught.

I remain fairly optimistic. Certainly not as dark a picture as what you are describing.

Good luck ot all you guys with the high G scores !
Posted 9/1/2010 9:59 PM (GMT 0)
Old sailor, I had Gleason 8 with Extra Prostatic Extension but had negative margins. MI had 2 out of 12 cores both Gleason 8. My PSA after 15 months was .005.
Posted 9/2/2010 12:47 AM (GMT 0)
Thanks for the post. I am a gleason 9 with lymph node involvement. I had been a zero for about two years and recently have seen a rise in PSA. I am now at .71 and go back for another test on Sept 24th. If my PSA doubles I will have to go back on ADT3 which I regret but hey I can still function. So yes there is plenty of hope for us high gleasons so stay positive and enjoy every single day.

peace to you
Dale
Posted 9/2/2010 1:43 AM (GMT 0)
What was your pathology report? I am Gleason 8 and PSA has been <.04 since the first month after surgery. I think we all get nervous thinking about the next PSA test. Good luck to you on yours.
Posted 9/2/2010 2:29 AM (GMT 0)
I think with a gleason 8-10, if you are in your 40's, 50's or 60's you need to plan for a recurrence. You may never have one, but to me it's a flip of the coin. It's hard to understand why some with positive margins or epe have no recurrence while other with contained tumors recur quickly. It is truely a roll of the dice and it sucks, Sorry for the bad attitude, but there it is.
Posted 8/28/2011 6:59 AM (GMT 0)
kbota: I am gleason 9, 15 months out from robotic surgery, also 4 months of Lupron and Casodex, combined with 34 sessions of IMRT as my protocol or adjuvant therapy, my post op psa was 0.02 and has remained less than 0.04, I will see my doctor on Monday, it's a fine line trying to balance a low testosterone and get its numerous physiological benefits, and keeping a low psa, more info I would be glad to share, write me if you wish [email protected], I would welcome your friendship, support, and information. Any information on other things I am doing like supplements, nutrition, etc, I would be glad to share with you as well.
Posted 8/28/2011 5:26 PM (GMT 0)
Gleason 9 with seminal, margin, nodes all positive. Davinci in September 2010, 5 or 6 weeks .06, 8 weeks <.03.  Had ART in February, March & April.  PSA <.03 on August 20th. Never ever give up hope.  Wishing you the best.
Posted 8/28/2011 7:41 PM (GMT 0)
I'm Gleason 8 with EPE, negative margins and nerve bundles removed. My first post op PSA was .005 and has remained at that level so far (27 months). I'll behaving my next (33 months) PSA test in October and hope to be at the same level.
Posted 8/28/2011 9:37 PM (GMT 0)
I wonder if high gleason on the biopsy it is best to have HT then radiation to be sure the surrounding tissue is treated?
Posted 8/29/2011 2:06 AM (GMT 0)
Glad to see this thread revived.

Yellow, I'll send you an email.

Ed, I'm also hoping your psa remains at "non detect"

Squirm, my uro insists that I am absolutely doing the right thing by taking two years of HT even though I was organ confined.

Time will tell, but I am like Goodlife in that I want to enjoy my good-life for as long as it lasts.

K
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