Does bone mets mean higher Gleason score ?

[Tinkudi]

If one has bone mets does it equate to a higher Gleason score or not necessarily ?

can one have a non aggressive cancer which has spread to bones over a long period of time ?

[Tall_Allen]

I keep explaining to you that Gleason score doesn't matter after bone metastases have been discovered. Gleason score only has to do with the architecture of prostate cells in the prostate. It is only important as a risk factor for LOCALIZED PCa, because it correlates with risk of metastases. So, higher Gleason score cancer is more likely to generate metastases. Once there are already metastases, Gleason score is irrelevant.

Metastatic cancer is aggressive, no matter what the Gleason score in the prostate was originally. His therapy is based on the fact he has metastases, not his Gleason score.

[God_Loves_Me in reply to Tall_Allen]

100% agree

[Tinkudi in reply to Tall_Allen]

Thank you for educating us so patiently 🙏🏻

[SouthFrance]

I didn't know that, thankyou.

[Voodoo33993]

I didn't know that TA. Thank you for the great explanation.

[Jazzman2023]

Thanks TA.

I've also found that Gleason score depends to some degree, on the eye of the pathologist. Meaning, different pathologists can assign a different Gleason score to the same biopsy core.

In getting 2nd opinions, I discovered this anomaly.

Good luck !

[Chasbearcat999 in reply to Jazzman2023]

It is a peculiar art. Original biopsy on mine showed a core 30% positive 60% 3 40% 4

So I’m 3+4.

John’s Hopkins 2nd opinion on same core: 30% positive BUT 50% 4 and 50% 4.

So I became a 4+3 based on 3% of 1 sample.

[Mgtd in reply to Chasbearcat999]

The big question is did that change you treatment options?

[Chasbearcat999 in reply to Mgtd]

Not at all. MO said something I appreciated. She said “Gleason is a useful tool collectively, but we are talking about YOUR cancer here, not the the general population.” She said (even with cribiform present) that she would rather see my biopsy report than most of her patients. (5/15 low volume). And how the doc doing the biopsy took 3 extra sample at lesion location, which while thorough, skews to number of positives upward. How the remaining positives were close to lesions and 3+3s.

She did say the cribiform in her opinion took AS off of the table and she would strongly recommend definitive treatment.

Ended up SBRT, no ADT. So far, so good.

[j-o-h-n]

Good Luck, Good Health and Good Humor.

j-o-h-n

Gleason score.

[allmo]

Once you are in an advanced state there are other metrics used. PSA doubling time and per response to treatment PSA nadir, PSA 50, PSA 90, PSA undetectable, etc.; and RECIST criteria for radiologic response.