BIOPSY, GLEASON SCORES, mines 4+5=9 or grade 5..............QUESTION?

[Mrtroxely]

hi everyone

My prostate biopsy was taken,

The surgen took 8 cores(4mm)

He said he was taking them from the side with the lesion

8 out of 8 had cancer

I was given gleason score of 4+5=9

After lots of looky and learny.

Gleason score has massive impact on treatment and decisions.

I.e. a gleason of 8 moves 50% slower than one of 9...

QUESTION 1, how many core in biopsy do doctors normally take? I thought minimum was 12???

QUESTION 2, could the biopsy results be wrong?

Ive got freinds with diagnosis same advanced prostate cancer, same age 49-50y old as mine with lower gleason scores gleason who been around over 10y with no chemo or radiotherapy, just ADT......

SO BEFORE THE POOH POOH ing, live for the daying,

With teenagers in their gcse year, im trying make good decisions now that help me going forward.

Thank you all.

👍

[Justfor_]

Correct, min 3 cores per quadrant making a total of 12, plus any additional cores from suspected areas identified through mpMRI. FYI, I had 20 cores taken, 6 of which came GS 4+4=8.

As to your other query, regarding PSMA PET/CT, my arguments for taking it can be found in this post:

healthunlocked.com/prostate...

[Mrtroxely in reply to Justfor_]

Hi, thank you

I only had 8? Not sure if that actually has a bearing??? He took the core biopsy from the areas of intreset?

I read your post, and the link.

I sort of understand your point regarding a scans? Doesnt seem consise? Ive done allot of looking, and researching for my own information benifit? Mostly internet trying to find facts from real clinical trials and comparisons.

Not easy....

[lcfcpolo]

Hi. Sorry that you find yourself here but welcome. I noticed that you stopped Enzalutamide. This has worked for 2 years for me but I understand the side effects.

An alternative is Abiraterone (Zytiga). The recent PEACE trial showed that Abiraterone and Chemotherapy together is the best combination. If your doctor will not prescribe, then call the Prostate Cancer UK nurse team. Please go for the Chemotherapy though. Hopefully some others here will tell you how few side effects they had. Many appear to carry on working.

I wish you good luck but this is a very serious diagnosis. Please hit it as hard as you can.

[Mrtroxely in reply to lcfcpolo]

thank you.

I read your profile.....

I thought my divorce was the most painfull thing id experience....it still sort of tops my cancer diagnosis at the moment....

I feel your struggle being single/even dating, I have to make decisions on my own and live by them, I need make good well informed decisions as they effect my mortgage, mt twin boys (15).

I know its harder, there are guys wholl say, do this, do that, I climbed mount Vesuvius, I sky dive at fucking weekends.while wifey cooks, cleans, gets kids, brings a wage.

Im still trying pay the mortgage, maintenance, kids pocket money, bills and everything else while getting few benifits and trying cling to a self employment!!!!

Its all change, and pisses me of hearing just have faith...... Theres more to this!!!!

Anyway you need a chat feel free message,

Im down south...

[Mrtroxely]

hi, thank you

ill add to my profile,

I was dx ed with psa 19.5(they thought to be low for my diagnos in general)

After 1 -2 months ADT 0.96

4+ months ADT 0.1

[Tall_Allen]

One's Gleason score is the highest Gleason score of any of your cores, so taking more cores cannot lower your Gleason score. But at this point it doesn't matter what your Gleason score is, since you are metastatic.

[Mrtroxely in reply to Tall_Allen]

thank you.

That makes it clear.👍

2 of my friends very diagnosis are virtually the same, both at ages of 50.

One has been around for 10 years, no chemo, no radio therapy, looks n sounds good.....

Other been around 5y had thigh bone removed and replaced with titanium

Both not had chemo or radiotherapy????

Both on gleason score of 7......

I beleive the gleason score does have impact on decision making???

Whats your thoughts

[Tall_Allen in reply to Mrtroxely]

As I just said, your Gleason score has no impact on your decision making, because you are metastatic. Your friends were not metastatic.

[Mrtroxely in reply to Tall_Allen]

yes, at their diagnosis, both friends were metatastic.....

Both similar ages,

One friend prostate leasion, leaked out in pelvice, hip and rib bones 2012 at age 50, gleason 7.

Other was in bones

[Tall_Allen in reply to Mrtroxely]

One doesn't choose one's treatment based on anecdotes. Clinical trials are conducted with thousands of men.

[Mrtroxely]

couldnt bare side effects...

Just me but felt like I was surving a night mare, mumbling, stammering, no sleep, musxle spasms at night, suicidal lows,

2-3 weeks of them I feel good

Really good, good enough not to want to alter that!!!

[tango65]

Since your cancer is oligometastatic you could have radiation to the prostate and the mets which may prolong life.

One of the most effectives therapies for mCSPC is ADT plus abiraterone plus docetaxel, or ADT plus darolutamide plus docetaxel (triple therapies).

If you do not want to do chemo, then ADT plus abiraterone is a very effective therapy.

[Farn]

As already suggested if you can’t get on with Enzalutamide you are able to switch to Aberaterone under the NHS did you discuss with your oncologist

Or maybe apalutamide ?

[Mrtroxely in reply to Farn]

Thank you.

Was offered applutimide....oncologist said virtually same drug and I was better taking chemo....

Aberaerone looks like something for another go later.

Hope you ok dude.