What indicates the aggressiveness of a prostate cancer?

[joancarles]

Is the aggressiveness of a prostate cancer marked by PSA or Gleson? or is it the combination of the two?

[Tjc1]

While the Gleason core measures pca agressiveness later on, its the psa doubling time rather than the number itself can determine the agressiveness of the cancer.

[joancarles in reply to Tjc1]

Thank you very much for clarifying this topic. A hug

[Tall_Allen]

If you have localized prostate cancer, the aggressiveness of the cancer is determined mainly by 3 factors: PSA, Gleason score, and stage. Genomic data can sometimes help decide whether low risk PC is more aggressive than those factors would make it appear.

If you have advanced prostate cancer, the aggressiveness is measured by a number of factors, including where metastases are and how many, PSA, PSADT, and other biomarkers like bone alkaline phosphatase, Chromogranin A, etc. Other factors include how long various treatments remain effective, how quickly castration-resistance starts, CTCs, and the pathological and genomic characteristics of biopsied tumors.

[Break60 in reply to Tall_Allen]

Lol Allen that was a nice simple explanation!

Bob

[joancarles in reply to Tall_Allen]

Thanks Tall_Allen!!

[larry_dammit]

Mine was the PSA,and that is the number that my doctor wants to see every month

[Hidden]

who knows

[Hidden]

Gleason score is a judgment of the aggressiveness of the cancer tissue withdrawn from the prostate by the biopsy. PSA can be an indication of the spread of the cancer outside the prostate, although bone and abdominal scans can pinpoint that spread. Some prostate cancer tumors don't drive a high PSA reading. My Gleason 8 produced a PSA of only 2.7.

[bigbassman]

I agree with the previous responses RE: which tests are indicators of the aggressiveness of PCa. I'd add that the ratio of free PSA to Total PSA is an early indicator of possible aggressive disease. My ratio went from around 12% to 10%, with PSA of around 10, at which point my urologist booked a biopsy for me. That figure continued to decrease to a minimum of 8%, which, in my case, seemed to correspond to my biopsy results, which were Gleason 8 (4+4), and my PSA reached a max of 18. I had one suspected met to a femur. Prior to my biopsy, I paid (lots of money) for 4K and other biomarker tests, which were inconclusive.

[Apollo123]

Hi my cancer was deemed aggressive due to my age 47 spread to lymph nodes Gleason 9 and PSA in the 30’s.

[5_plus_4]

My Uro told me mine was very aggressive due to: 5+4=9, PSA 8.1, Stage T3b, SVI+, ECE+, Positive margins. I'm one year past my RP and 7 months past RT. I had a PSA blood draw this morning, keeping my fingers crossed. Good Luck to you.

[Hidden]

Mine was deemed aggressive at diagnosis/ biopsy results. 4+5(9) P S A 629, widespread bony metastases, innumerable lung masses, left hemi pelvis lymph nodes involved. Bicalutamide, eligard, Zytiga and prednisone prescribed immediately. Also calcium citrate, d3 and k