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Posted 8/12/2013 7:44 PM (GMT 0)
Hi,

My dad has been recently diagnosed with prostate cancer after a prostatectomy. His Gleason score is 2+3=5. He had invasive adenocarsinoma three months ago. There still is blood in urine occasionally while he urinates. In addition, mononuclear infection cell infiltration was detected. He is 72 years old and had by-pass surgery ten years ago. His diabetes is under control with a pill. Nothing major interms of his insulin level. Just wanted to get a better sense of what to think since his doctor is not sharing much with us. Only think I know is he is getting an injection every three months along with blood work.

Looking forward to hearing from you guys and thank you so much in advance for all the support.

Ber
Posted 8/12/2013 7:49 PM (GMT 0)
after a biopsy you mean?

Not sure I've ever heard of anyone treating a 2=# let alone a 72 year old.

Can you clarify?
Posted 8/12/2013 7:54 PM (GMT 0)
Gleason 2+3 is very rare today but many doctors are still practicing on these patients. Age 72 is a bit on the high end for prostatectomy but it too still happens.

Bersey,
I think there is a bit of missing information. The reason to operate on a man with coronary history, diabetes, and upper age scale at 72, followed by injections leads me to believe that your father might be withholding information.

Of course if all else is correct, then he should continue healing and be doing well soon enough.

Hang in there and stay positive.

Tony
Posted 8/12/2013 8:05 PM (GMT 0)
Ber,

Welcome to the HealingWell board, although I wish you didn't need to.

A pathology Gleason score of 2+3=5 is not impossible, but it is very low and very rare. I can't imagine why a 72 y.o. man who's had bypass surgery and diabetes and such a low Gleason score would have surgery for this, and certainly not (Lupron?) shots every three months afterwards. Nothing about this conforms to current standards of care. Did he contract the infection as a result of his surgery? There may be more to this.

- Allen
Posted 8/12/2013 8:13 PM (GMT 0)
Bersey,

Welcome to the forum. I'm sorry you have worries about your dad. We'll try to help.

We're all pretty confused here about the operation you describe as a "prostatectomy". That operation is a usually a treatment for prostate cancer and I can't see a man being diagnosed with prostate cancer after having that operation. Are you sure his operation wasn't a Trans-Urethral Resection of the Prostate (TURP)? That would make more sense to me.

A TURP is an operation that men have to help them urinate when their prostate has grown too large and is blocking their flow.
Posted 8/12/2013 8:29 PM (GMT 0)

Bersey said...
Hi,

My dad has been recently diagnosed with prostate cancer after a prostatectomy. His Gleason score is 2+3=5. He had invasive adenocarsinoma three months ago. There still is blood in urine occasionally while he urinates. In addition, mononuclear infection cell infiltration was detected. He is 72 years old and had by-pass surgery ten years ago. His diabetes is under control with a pill. Nothing major interms of his insulin level. Just wanted to get a better sense of what to think since his doctor is not sharing much with us. Only think I know is he is getting an injection every three months along with blood work.

Looking forward to hearing from you guys and thank you so much in advance for all the support.

Ber

Hi Ber,
Because of his age he might not be a candidate for a radical prostatectomy after the prostatectomy (also kown as a TURP).

Your Dad should get a bone scan to rule out bone metastasis and if negative he should be a good candidate for what is known as Active Surveillance (AS). Be sure that his treating doctor is current about what is required with AS to prevent further progression. I would question the injection every three months w/o signs of metastasis.

Wish you and your Dad the best possible outcome,

RalphV
Posted 8/12/2013 9:54 PM (GMT 0)
Hi everyone,

I am happy and so emotional to get so many feedback in less than couple of hours. THANK YOU!!! Well, his bone and lung test results came clean. It was also cleared that the cancer is not anywhere else but the prostate. His PSA level was 15,56.

I am not sure if my dad is hiding anything from the family but the facts (results) I shared here was directly from the doctors' official forms. His doctor is in his mid 40s and also teaching at a university and attends many seminars. I would think he has the most up-to-date information. :(
Posted 8/12/2013 10:00 PM (GMT 0)
It sounds more like your father had a Gleason grade 5 component in his Gleason sum. That would make sense for such an aggressive approach. Do you have the biopsy paperwork? It should say the number of positive cores and the Gleason Score of each.

Tony
Posted 8/12/2013 10:51 PM (GMT 0)
Tony,
I think her father had a TURP that was positive for PCa with a GS 5 (2 + 3).
Remember: prostatectomy = TURP

RalphV
Posted 8/13/2013 2:30 AM (GMT 0)
Bersey,

We are not criticizing his doctor or second-guessing his treatment here. We're just helping you guess what is going on with your dad and, although I am still a bit confused, here is my guess:

When your dad had his recent operation to help him urinate better they removed some parts of his prostate that were pressing on his urethra. They had a pathologist look at the parts that were removed and he indicated a Gleason 5(2+3) abnormality was seen along with some evidence of inflammation. Looking at the tissue removed is a standard part of the operation and Gleason 5(2+3) is not usually considered an alarming condition (not usually called "cancer").

Your father's PSA is somewhat high (at 15.56) and that may have worried your dad's doctor enough to do some scans -- which look good and don't indicate that there is a lot of aggressive cancer there.

You also indicated your dad is getting a shot every three months. This sounds like hormone therapy to keep the cancer from spreading. That is a good therapy for a man your father's age if he has cancer that needs treating. You said that your dad and his doctor may not be sharing everything with you. There's probably a few things you haven't found out because that Gleason 5(2+3) wouldn't usually need any treatment at all. Since he is getting hormones there is probably some reason why his doctor thinks he needs it.

But overall, unless I am guessing completely wrong, things with you dad don't sound that dire from a prostate cancer point of view.
Posted 8/13/2013 5:43 AM (GMT 0)
A good point, Peter.

A Gleason 5 is a very mild form of PC. Such low Gleason grades usually do lurk around the center of the prostate, which is why they are usually discovered during a TURP. This is why Gleason scores of less than 6 are usually not detected in standard biopsies.

As with you, I do not see any reason why this type of cancer (if it truly is a Gleason 5) would need any treatment at all.

Chuck

Resident of Highland, Indiana just outside of Chicago, IL.
July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA Sept. 2011 was 5.7.
Local urologist DRE revealed significant BPH, but no lumps.
PCa Dx Aug. 2011 at age of 61.
Biopsy revealed adenocarcinoma in 3 of 20 cores (one 5%, two 20%). T2C.
Gleason score 3+3=6.
CT of abdomen, bone scan both negative.
DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
My surgeon was Dr. Matthew Tollefson, who I highly recommend.
Final pathology shows tumor confined to prostate.
5 lymph nodes, seminal vesicles, extraprostatic soft tissue all negative.
1.0 x 0.6 x 0.6 cm mass involving right posterior inferior,
right posterior apex & left mid posterior prostate.
Right posterior apex margin involved by tumor over a 0.2 cm length, doctor says this is insignificant.
Prostate 98.3 grams, tumor 2 grams. Prostate size 5.0 x 4.7 x 4.5 cm.
Abdominal drain removed the morning after surgery.
Catheter out in 7 days. No incontinence, occasional minor dripping.
Post-op exams 2/13/12, 9/10/12, PSA <0.1. PSA tests now annual.
Semi-firm erections now happening 14 months post-op & VERY slowly getting a bit stronger.
Posted 8/13/2013 12:55 PM (GMT 0)
Bersey, are you in the U.S. or U.K. ?

Gleason grade 2 is almost never used in the U.S. when reporting cancer..Usually, in the States, the Gleason is reported as 3+3=6 when any cancer is found..But a very minimal cancer could indeed be reported as 2+3=5. This type of prostate cancer is almost never fatal.

If the cancer was discovered during a TURP procedure to relieve urinary problems, his doctors may wish to perform a standard prostate biopsy to get a better picture of the extent of his cancer..
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