1. < Prostate Cancer

Gleason 6 (3+3) treatments

Posted by joe1 @joe1, May 21 3:39pm

Hi,
I had a biopsy and it came back with Gleason 6 (3+3). The urologist first told me it was extremely important that I have a biopsy done every 12 - 18 months to monitor this. 3 years later with no followups and now he's telling me we will just do MRI's instead (I also have ulcerative colitis so biopsy is extra painful). He also told me my cancer is nothing and don't worry about it. Problem is, he's told me a lot of things and then told me the exact opposite, so I'm not sure if I trust him.

Question for others with Gleason 6 ....... what type of treatment/monitoring are you being treated with?

Thanks

Joe

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tuckerp | @tuckerp | Jul 10 8:12pm
In reply to @richardblackman "Tuckerp, so sorry to hear about things going on in your life. Best advice I heard..." + (show)
@richardblackman

Tuckerp,
so sorry to hear about things going on in your life. Best advice I heard (and from this group) was to get PT from a post-prostate surgery specialist. It made a world a difference (assuming you get a good PT). I saw her starting in April for about 8 visits - every couple weeks, then once a month. She really helped my kegels and other simple (because otherwise I wouldn't do them) exercises. She also helped me with diet and was a great cheerleader for me. One of the things she was good at is understanding me. I told her how I hate exercises (I do love cardio stuff though) and have trouble following routine.
So she made everything simple for me and I do some things while in the shower and maybe 5 minutes total of exercise/kegels daily. She practices in Columbia, Md for Johns Hopkins (my surgeon recommended her). FYI, when I used a pad, I found a super light, small pad that was perfect. Seems way better than whatever you're using (see attached; about 3x4 inches & as thin as an athletic sock.
I'm not an expert, but I believe the "use it or lose it" refers to erections and not to incontinence. I did discuss the erection issue with my PT and she also had some good advice. What I understood was that it's important to deal with the erectile dysfunction early, because the urologists suggested progress may be limited after a year or so. I would highly recommend you watch the video I posted about in an earlier reply https://www.youtube.com/watch?v=f0bflKbR2To
that talks about erectile dysfunction. I went to her a bunch of times and she prescribes my pills and talked about options. She also highly recommended using a PT who gave me more practical advice. I've done a couple telemed visits with her and she may willing to do those w/o an inperson visit.

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Thank you. I switched to Mayo Phoenix last summer. I am happy there. I live in the Phx area. I had all the incontinence testing done. He explained that my kegels are weak and my bladder is over active. talked about other medications. talked about an AUS. I just felt a little over whelmed. I told him I needed some time. I am caretaking so I cant afford to be down right now. Since I dont practice my kegels my daily output of urine is about 40 oz. I was spending all day changing pads. A large pad was soaked in an hour. so I have to figure out some things.

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pieperfarm | @pieperfarm | Jul 11 6:18am
In reply to @juanramirez1969 "Hello, I was just diagnostic with Gleason 6 also and my follow up appointment is this..." + (show)
@juanramirez1969

Hello, I was just diagnostic with Gleason 6 also and my follow up appointment is this week, Im not sure what to decide regarding my treatment! please advise if possible-

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I had Gleason 6 in 2017. Many times the only reason you need biopsy is to get MRI or to identify cancer. In 2023 MRI found lesion and I did my 2nd biopsy that confirmed Gleason 7 and had a HIFU procedure to remove it and Other Gleason 6 on one side of prostate. Now just active surveillance on the other side with Gleason 6. Some refer to Gleason 6 as cancer, others refer to it as irregular cells.

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1 reply
pieperfarm | @pieperfarm | Jul 11 6:24am
In reply to @richardblackman "Joe, I have two friends with Gleason 3/3 they've had for close to 10 years and..." + (show)
@richardblackman

Joe,
I have two friends with Gleason 3/3 they've had for close to 10 years and are under active surveillance. Close watch of their PSA and an MRI every couple years is their "treatment." According to their doctors, they may never need additional treatment. I had similar for 2 years, but when my PSA rose, the doc found something suspicious in a digital rectal exam, then the biopsy showed a 3/4 Gleason. That's when they said I needed treatment so had a prostatectomy (3 years later). PSA still at zero and no complaints

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I know most continence issues don’t show until in 80s. How did surgery impact erections and continence?

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pieperfarm | @pieperfarm | Jul 11 6:46am

I started active surveillance at 51 and had HIFU at 57 when it became Gleason 7. I still have some Gleason 6 on one side of prostate.

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ziggypop | @ziggypop | Jul 11 7:45am

Joe,
I was recently (december) diagnosed with 3 + 3 and asked for a decifer score. That was diagnosed an mildly aggressive cancer, both done at a local facility. I was unhappy with the Urologist (very pushy for surgery) so I made an appointment with Mayo for radiation in the future consultation. I asked Mayo to recheck the biopsey slides and they diagnosed 3 + 4 and semi aggressive cancer so I scheduled treatment for this September. My point is to make sure your cancer is 3 + 3 and find out how aggressive it is before making any decisions. Whatever treatment you decide to partake be decisive that it is the treatment YOU want to do. Every treatment comes with the possibility a side effect. Sorry I did not read the whole thread so I apologise if someone already said what I said.

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1 reply
jrhamp | @jrhamp | Jul 11 8:48am

Hi All: Background: March of 2010; Gleason score 3 plus 3; PSA: 6.47. Proton radiation therapy at Loma Linda Hospital for 2.5 months (5 minutes on the table every morning). PSA remained under 1.0 for six years. Began increasing every year to current, as June 2024 to 4.29. Had MRI last week which reveals cell configuration meaning how the cell as "changed" due to cancer. The stages in cell growth in terms of cancer possibilities is rated one (1) to five (5). Mine was rated at five (5) meaning cancer has potentially returned. Keep in mind recurrence is common after both surgery and radiation (all methods), as one in seven men have recurrence after treatment.
Now, the next step..what to do. Options are: do nothing, keep PSA test every six (6) months as watchfull waiting; undergo at PET scan (radiation) to validated the MRE scan or possibily surgery. RECURRENCE IS THE ISSUE AND HOW TO TREAT. If anyone has similar circumstances like mine, let me know what your decision was with the recurrence issue. Thanks in advance..and special thanks to Mayo Clinic for this supportive website. RH/Leesburg, Florida

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1 reply
clandeboye1 | @clandeboye1 | Jul 11 10:36am
In reply to @joe1 "Hi Richard, My PSA just went up from 4.3 to 6.4 (first time ever above 4.3),..." + (show)
@joe1

Hi Richard,

My PSA just went up from 4.3 to 6.4 (first time ever above 4.3), so I think I may be in the same situation as you. Waiting to see the doctor again. Can I ask.... was the prostatectomy done with robotic assistance? Any side effects that lingered for more than a few weeks?

Thanks
Joe

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Joe,
How fast did your PSA increase to 6.4 -- the doubling time of PSA increases is a valuable tool for your Urologist .
There are other options to Radical Prostatectomy . What is your new PSA ?
All valid questions before considering ALL your options .

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1 reply
joe1 | @joe1 | Jul 11 1:19pm
In reply to @clandeboye1 "Joe, How fast did your PSA increase to 6.4 -- the doubling time of PSA increases..." + (show)
@clandeboye1

Joe,
How fast did your PSA increase to 6.4 -- the doubling time of PSA increases is a valuable tool for your Urologist .
There are other options to Radical Prostatectomy . What is your new PSA ?
All valid questions before considering ALL your options .

Jump to this post

My PSA went from 4.3 to 6.4 in 2.5 months (max). I still haven't even heard from my urologist about it. I actually had to contact his office and tell them, and then wait a month for a telephone call from him (which is next week).

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clandeboye1 | @clandeboye1 | Jul 11 4:01pm

Joe,
Your PSA increase is concerning , although other factors may be at work . BPH , an infection etc .
DUMP YOUR PRESENT UROLOGIST -- F-A-S-T .

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clandeboye1 | @clandeboye1 | Jul 11 7:59pm
In reply to @ziggypop "Joe, I was recently (december) diagnosed with 3 + 3 and asked for a decifer score...." + (show)
@ziggypop

Joe,
I was recently (december) diagnosed with 3 + 3 and asked for a decifer score. That was diagnosed an mildly aggressive cancer, both done at a local facility. I was unhappy with the Urologist (very pushy for surgery) so I made an appointment with Mayo for radiation in the future consultation. I asked Mayo to recheck the biopsey slides and they diagnosed 3 + 4 and semi aggressive cancer so I scheduled treatment for this September. My point is to make sure your cancer is 3 + 3 and find out how aggressive it is before making any decisions. Whatever treatment you decide to partake be decisive that it is the treatment YOU want to do. Every treatment comes with the possibility a side effect. Sorry I did not read the whole thread so I apologise if someone already said what I said.

Jump to this post

Joe,
What treatment did you decide on and whhy ?

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