Cancerous Prostate

Question:

I am  very concerned that surgery or radiation to treat my prostate cancer with a stage of T2c, psa 54, and gleason 6 will not be successful in eliminating and/or stopping the cancer.  Is there anyone reading this who has had similar numbers and has undergone surgery or radiation.  I’d like to speak with you regarding your results. Thank you. — Hugh S. Utterback

Response:

Hugh, PSA of 54 is very high. There is a great chance that your cancer has escaped from the prostate. Gleason score of 6, however, is a very good news (however, Gleason score sometimes goes one grade up at the post-op pathology report, I would make sure that it indeed is 6, not 7). Your age here is crucial, I think. How old are you? What does your urologist recommend? Every person is unique, and what works for one person might not work for another. The probability of you having organ-confined disease is only 15% according to Partin tables. That means that surgery may not be the best thing for you. Again, your age here is very important. I assume you are over 65, you have probably had your cancer for quite some time, since it takes long for Gleason 6 to reach the stage of T2c. G.C.

– Hide quoted text — Show quoted text – I am  very concerned that surgery or radiation to treat my prostate cancer with a stage of T2c, psa 54, and gleason 6 will not be successful in eliminating and/or stopping the cancer.  Is there anyone reading this who has had similar numbers and has undergone surgery or radiation.  I’d like to speak with you regarding your results. Thank you. — Hugh S. Utterback

Response:

I agree. Careful search for distant or lymph node mets is in order (this is one case where CT may be useful).  If no obvious mets (bone, LN), then you MAY opt for radiation after neoadjuvant hormonal ablation, but long-term hormone treatment may be in your future.  Best of luck, and keep fighting! REg.

– Hide quoted text — Show quoted text – Hugh, PSA of 54 is very high. There is a great chance that your cancer has escaped from the prostate. Gleason score of 6, however, is a very good news (however, Gleason score sometimes goes one grade up at the post-op pathology report, I would make sure that it indeed is 6, not 7). Your age here is crucial, I think. How old are you? What does your urologist recommend? Every person is unique, and what works for one person might not work for another. The probability of you having organ-confined disease is only 15% according to Partin tables. That means that surgery may not be the best thing for you. Again, your age here is very important. I assume you are over 65, you have probably had your cancer for quite some time, since it takes long for Gleason 6 to reach the stage of T2c. G.C. I am  very concerned that surgery or radiation to treat my prostate cancer with a stage of T2c, psa 54, and gleason 6 will not be successful in eliminating and/or stopping the cancer.  Is there anyone reading this who has had similar numbers and has undergone surgery or radiation.  I’d like to speak with you regarding your results. Thank you. — Hugh S. Utterback

Response:

I was 68 when first ever PSA test came back 45.5.  Biopsy cores were 6, 7, 7, 7, 8, 8.  Bone scan was clear.  Urologist gave me options or seeds (not recommended) radiation or surgery.  He implied that surgery would be most effective and that he would not continue if he judged that lymph nodes contained cancer. For three years PSA was less than 1.  When it went to 1.7 we started Lupron which in three months reduced PSA to 0.8.  Three months later it was 1.3.  Added Casodex and in one month PSA tested 0.0 where it has remained for two years.

Response:

I was 68 when first ever PSA test came back 45.5.  Biopsy cores were 6, 7, 7, 7, 8, 8.  Bone scan was clear.  Urologist gave me options or seeds (not recommended) radiation or surgery.  He implied that surgery would be most effective and that he would not continue if he judged that lymph nodes contained cancer. For three years PSA was less than 1.  When it went to 1.7 we started Lupron which in three months reduced PSA to 0.8.  Three months later it was 1.3.  Added Casodex and in one month PSA tested 0.0 where it has remained for two years.

I wish you the best of luck.   It must have been very disappointing after the surgery to have your PSA start back up.   Be encouraged that the hormone treatment should keep you symptom free for quite a long time, and meanwhile one of the newer treatments on the horizon may provide a cure.   Although my post surgical pathology report was very good and my PSA tests have been fine, I realize I could be in your boat in a couple of years.   We all hope those treatments on the horizon come to frutition. I would like to warn others who may have been recently been diagnosed with prostate cancer and are reading these postings not to jump to conclusions when they see results like this.    With a PSA of 45 and Gleason scores of 8, the doctor and the patient may have decided to try for a cure with surgery, but the chances that the cancer had already spread were fairly high to start.    If, as is true in the overwhelming majority of cases diagnosed these day, you had a significantly lower PSA and your Gleason was in the range 5-7, then your chances of a complete cure are significantly better, though of course nothing is certain in these matters. — Dept. of Mathematics, Northwestern Univ., Evanston, IL 60208

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