..Hello I am new here..

According to the 2013 Johns Hopkins white paper, there is a primary and secondary grade in the Gleason pattern. For example, the most common pattern-the primary grade-is 3 and the next most common pattern-the secondary grade- is 4, the Gleason Score would be 7 or 3+4. But if the primary grade is 4 and the secondary grade is 3, the Gleason Score would be 4+3 and this would be considered to be more aggressive. In other words, the primary grade carries more weight than the secondary pattern in determining the aggressiveness of the cancer. While it is true that Gleason scores of 8, 9, or 10 to be high grade, a score of 7 is considered intermediate, and by the time the cancer is Dx'ed, this can make a lot of difference in determining the final prognosis.
I am no tooth fairy and would not use anecdotal evidence in describing this cancer which I have fought for 6 years now. All of this info can be found on pg. 40 of the above mentioned JH White Paper. I didn't expect a veteran member to be so misinformed or so rude. In my reply to Nick I only meant to imply that G7 can be as tricky as a G9 if not caught in time. As I pointed out at the start of my reply to Nick I had some problem discerning the date of his Dx. This led me to warn him about the importance of the time factor in the aggressiveness of both G7s and G9s. I have seen the same comment made here by both 7s and 9s. Let's try to be a little more polite and informed around here, please . . . Q

A hard 7 is not as aggressive as a gleason 8 or above period. Thats why they have gleason scores. So as to differentiate cell differentiation. There is a difference between the word " tricky" and the phrase "as aggressive" All the dramatics and theatrics does not change facts. New folks here are arguably more impressionable and take what seasoned survivors say to heart. You were the one in an earlier post that was so keen on facts, so I thought I would provide you with some and ease Nicks possible fear from your incorrect statement. No matter how you spin it , you are by definition, wrong. I actually thought you were a new poster and see that you are, but a vet in the disease, which in my opinion makes your claim even more disturbing and, to me, comes more from showmanship than concern. Facts are facts This is my last comment on this issue

..John T,
..There are 2 nodules one was detected from the DRE test from three different Urologists. The internal 3T cardiac coil MRI (Done before the BX) showed the two. The results of the MRI are as follows, Seminal vessels: unremarkable, Lymph nodes: No pelvic adenopathy, Osseous structures: No suspicious lesions identified, Urinary bladder: unremarkable, the IMPRESSION stated nothing of capsular extension so I am think there is none. Dr Richstone who comes highly recommended (I know that is subjective) makes no reference that the cancer is systemic. I know he will take out the whole prostrate, seminal vessels, lymph nodes and Tie some tubes, not sure what else. I hope he can spare my nerves (A bit selfish on my part to keep mentioning but I want them:) I was Staged T1c / Lee Richstone is noted to specialize in PCa but he is still not a Medical Oncologist as far as I know. I will look into one this week as it is my job to cover all the bases. ..John T......Thanks and KIT......

John T said...
Nick,
Sorry you have to be here, especially at your age. A G9 with a nodule puts you in a very high risk category. Did the MRI show the nodule? and was it consistent with extra capsular extension? Surgery is only effective for a contained tumor. Did your doctor give you a PAP test, as this is the best indicator of a systemic rather than a contained disease.
Before you consent to any treatment you have to determine the likely hood of systemic spread vs the likely hood of a contained tumor as the treatments are significantly different. MRI of the prostate with a 3T MRI with coil or a multi parametric MRI should be able to give you a good indication. A normal 1.5T MRI will not. Also you doctor should use the Partin tables and other nomograms to establish the probabilities of a successful surgery and go over these with you.
You best bet would be to get a second opinion from a medical oncologist specializing in prostate cancer to further stage you, so you fit the correct treatment to your stage of the disease. Surgeons and Urologists usually don't do a very good job in staging.
A list of Prostate Oncologists and their contact information can be found in the appendix of "Invasion of the Prostate Snatchers" by Dr Mark Scholz.
For very high risk patients a combination of treatments is usually recommended as this stage must be treated very aggressively as a local treatment usually has a low success rate compared to combination treatments.
JohnT

There was confusion in my mind visa vis appleseed and upstate guy. I apologize for my harsh post,as i also get carried away in a thread or 2, or 3…...