A Perfect 10 on the Gleason Score...Lucky Me?

[Explorer54]

I’ve always wanted to be a perfect ten. And now I am. Call me “exceptional.” My prostate cancer is a perfect 10 on the Gleason Score. One of my scores is 5+5. An unusual, but perfect 10. Note that scores of 8 or higher describe cancers that are likely to spread more rapidly.

The good news is that my prostate biopsy shows cancer in only 3 of the 12 samples: 5+5, 10%; 5+4, 15%; 3+5, 35%.

And I can top that: my body seems uniquely resistant to the standard medication used to treat aggressive disease.

“I’ve given this drug for 30 years and never seen this before,” says my urologist.

“You’re a mystery.”

The drug that I seem resistant to is called Eligard, and it’s one armament in the fight against aggressive prostate cancer. My urologist explains that the cornerstone of treatment for guys with high Gleason Scores like me is called androgen deprivation therapy (ADT). The goal is to reduce levels of male hormones, called androgens, in the body, and to stop them from affecting prostate cancer cells. Testosterone is not the cause of prostate cancer, but is considered essential for the growth of these tumors. Prostate cancer cells feed on testosterone, so the goal is to deny them nourishment and, in effect, starve them to death.

Eligard and another drug called Lupron are supposed to knock down testosterone levels to below 50.

After almost four months on Eligard, my testosterone is at a healthy 613.

“Never seen this before,” says my Radiation Oncologist.

“Nope. Never heard of this happening,” says the radiation oncology nurse.

Lucky me. I have elite status. Maybe I’ll become a case study.

The next step for me is to switch to another drug called Firmagon. At least it’s a more fitting name than Eligard, which as I wrote before, sounds more like an exclusive line of men’s silk underpants or neon-colored jock straps.

The mystery remains unsolved at this point. My urologist has the batch number of the vial and is checking with the drug company. I’d like to find out if my resistance to the drug is due to a bad batch or to my own body mounting a last-ditch effort to say: “No, we won’t let you take our manhood without a fight.”

Despite setbacks, the fight continues.

P.S. As my own therapy, I've been blogging to distract myself from my 44 radiation treatments at:

donsreluctantcanceradventur...

[jimreilly]

Sounds like your sense of humor is intact at least! Not the right "perfect 10" for sure. Hope things improve quickly as to a positive response to treatment!

[TimCo]

You have an outstanding attitude and humor- the solid foundation in which to win this battle. You are a resilient guy and am knowing only the best healing outcome for you.

[JimVanHorn]

Hi Explorer 54, When prostate cells multiply they release an enzyme picked up by the PSA test. When androgens are present (testosterone) they stimulate a prostate cell (both normal and cancerous) to multiply. Each prostate cell has an androgen receptor (AR) and when an androgen comes in contact with the AR it starts the cells to subdivide and make 2 cells. Lupron (Eligard - generic) tells your pituitary gland (in men) to not make any androgens. So eventually your testosterone level should go way down. Also, your PSA should go down to below 1.000. I have been on Eligard injections every 3 months for 7 years. My PSA has been 0.000 for 7 years. I have metastatic prostate caner and no sex! A small price to pay since they only gave me 5 years when I started. Testosterone is produced in the testes and the adrenal medulla, so removing your testes does not solve the problem. Keep a great attitude and let us know how it is going for you.