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← Return to Gleason 6 (3+3) treatments
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As those studies show, pathological grade usually stays the same as needle-biopsy or is downgraded. Sometimes yes, it is upgraded. If there is concern of something more serious lurking unseen, there are no less than a half-dozen other non-intrusive tests and calculations that can be done to estimate this rather than getting a prostatectomy just to find out.
Yes, 2nd opinions can be valuable (I’ve had two). But, I fully understand that much of the interpretation of images, scans, and slides is often as much an art as it is a science and dependent on the skill and experience of whoever is doing the reading. It’s good to have an independent set of eyes reviewing images, scans, or biopsies. But even then, there is no guarantee that that’s what it really is. Such is life….
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@brianjarvis
Your comments are “spot on” regarding the results of the study you referenced.
The observation that upgrading was observed 24% of the time, is better interpreted to individual cases by considering the factors that predict upgrades AND downgrades.
My takeaway from that study is the following:
If your Gleason Score is accompanied with the following predictive factors, there is a higher probability that your PCa is in the “24% upgrade category” AND visa-versa.
1) Higher PSA
2) Older Age
3) Larger tumor lesions per mpMRI
4) Higher percentage of cancer in the biopsy cores
5) PCa involvement of lymph nodes per PMSA PET
One of the primary conclusions of the study was that physicians should use these “predictors” to guide their treatment recommendations.
Therefore, it’s not a good decision to jump to the conclusion that one needs to “cut it out of me” just because 24% of biopsy results get an upgraded Gleason score.
An individual that has 4 out 5 of the predictive factors may want to move more quickly to a treatment decision. However, if one has the inverse of 4 out of 5 of the predictive factors; they have even a higher probability of NOT being in the “24% upgrade category”.
Like most things in life…details matter…and it’s in the understanding of the complicated details of ones particular PCa situation that wise treatment decisions are found.