The American Society of Clinical Oncology has reported that patients with Gleason 8 to 10 cancer and PSA values of 2.5 ng/mL or less may harbor hormone-resistant disease that is more lethal than other forms on non-metastatic, node-negative cancers. Prostate cancer specific mortality was 2.15 times higher for low-PSA, high-grade patients than others studied by the National Comprehensive Cancer Network. (NCCN) It is possible to have metastatic disease with a low-PSA as with high-grade cancer the prostate my not produce much PSA. I was diagnosed with high-grade cancer yet my PSA has never been more than 4.4. The study also found that ADT might not improve survival of low-PSA, high grade PCa patients. Further research is needed to learn the best treatment. Clinical trials are needed.
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Gleason4042
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I seem to fall into this category .. My oncologist spoke to me about this. It was part of his decision to "wait and see" this past year. Says I'm metastatic just can't see it. Held back from HT. Two scans a year .All show nothing.
I was diagnosed Stage 3, Gleason 8 (4+4) PSA 12 in March of 2016. At 62 (no signs other then BIG fatigue) June 2016 had robotic RP. After the RP my PSA rose twice no stopping . I went into radiation 3 months later. I went into radiation with.042 PSA came out with .080 (39 sessions later). Essentially doubling in radiation. First time I heard of PSA persistent from radiologist. Never zeroed. My doubling is every 3.9 months since June 2016 and I'm currently at 1.350 PSA as of last month. I have been accepted at UCSF for their Ga68-PSMA scan trial. Scan next month. Hoping if this works may be a scan that not only helps me but may be one for all in the future. With single digits now "seen or not" HT is coming most likely by years end.
John.. don't know if your asking me? Here is mine. 12 at diagnosis March 2016. DaVinci removal June 2016 . First PSA after removal .024 August 2016. First of July last month 1.350
John 205. My first inking of trouble was when a small nodule was detected during a DRE and PSA was 4.4. I was advised to wait on active surveillance as the Urologist told me 4.4 was not unusual for a man of 71. His comment concerning the nodule was, "I am not impressed". I never understood that comment. Eight months later I went to a different Urologist and the exact same condition was found, small nodule with PSA of 4.4. This time i insisted on a biopsy as I had read up on the subject. Three days later I was informed I had high grade prostate cancer in four cores. Gleason 6,7,8 and 9. I sent he biopsy to John Hopkins for a second opinion and it was upgraded to Gleason 6,7,9 and 9. I was informed the chances of microscopic cells having spread beyond the prostate gland was 100%. I went through 40 radiation treatments and none months of ADT. PSA went down to 0.01 and has been increasing slowly for the past four years. PSA is now at 0.25 which is low of course but the study I mentioned indicates this could be more dangerous than high PSA.
I flunked the DRE test despite a PSA reading of only 2.7. I was quickly referred to a urologist who immediately scheduled and then performed a biopsy. 5 of 12 cores positive; Gleason 8 in 1, 6 in 1, and the rest 7's. Also started ADT (after we had to kick the the slow moving insurance company's ass to authorize the eligard). Had HIFU surgery. PSA undetectable for a while but now at 0.2.
Many studies on ADT have shown intermittent ADT is as successful as continuous. The side effects were more than I wanted to put up with. I stopped the Lupron shots after three 30 day injections. Lots of contradictions concerning this.
I was hoping someone would have information regarding the low PSA, high grade cancer. Since I could not find anyone that was able to get one of the latest PET/MRI scans to detect if their cancer is spreading with a low PSA it seems hopeless even though this condition may be even more serious than high PSA, high grade cancer. We know highly differentiated cancer cells may not produce much PSA so how does a person with this condition get tested?
Do you have Ductal Adenocarcinoma? If so, what is or has been your treatment path? I am always watching for others like me to hear their treatment plan.
Zytiga and Lupron and Prednisone. I just had radiation to my bladder, spine, and Prostate. That's all I get..... everything else is palliative for me ...
I’ll also be following this. My husband was Gleason 9, SVI and extraproststic extension all with a PSA of 2.3. PSA remains undetectable since RP. PET PSMA did not show any Mets and nodes were all clear.
My insurance insisted I have a chest Xray before they would approve a CT scan, why I don't know. My CT scan is scheduled for tomorrow (8-17-18) and a bone scan on Monday, (8-20-18). I will find out the results on Thursday, (8-24-18). With a PSA of 0.21 they probably won't find where the cancer cells that are increasing are at. At least I hope I won't be one of the people that find out too late the cancer cells are in numerous places but the PSA just didn't show it.
My chest x ray, CT scan and bone scan has all been done. No mets were found. I was told the bright spots showing up in my back is arthritis. I hope this is accurate but still wonder if a Ga68/scan might show something.
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High grade prostate cancer: Large Tumor, High Gleason (9), Low PSA. What next?
Low PSA (Less than 2 ng/ml) but high Gleason (9) cancer which spread to liver
