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Gleason 3+4 A.S. or treatment?
Prostate Cancer | Last Active: Jan 13 12:14pm | Replies (33)Comment receiving replies
My biopsy confirmed by a different pathologist earlier this year was Gleason 3+4 on one out of 18 cores. I learned that the 3+4 intermediate risk group as a whole was extremently hetrogenous with some in the group similar in biological risk category to Gleason 6, while others were very high risk similar to Gleason 8 , 9 or 10. Before making any decision on what type of treatment I would seek (or before determining if a treatment was necessary right now), I had a GPS genomic test done. Unfortunately, my GPS score was 47, showing the very aggressive and high risk biology of my cancer. If my GPS score was below 20, my risk would have been very similar to Gleason 6, and I would have definitely considred active sureveillance, intead of treatment. But given a GPS score of 47, I evaluated surgery vs radiation and settled on surgery, primarity to say "good bye and good riddance" to my very enlarged prosate which has caused me all kinds of urinary issues for many years, even - and specially after - a TURP surgery. You are definitely a candidate for active surveillance given the low risk biology of your cancer - so - unlike me - you have two viable choices: AS or definitive treatment. Choosing between the two options is a very personal decison weighing in the pros and cons of many factors including your values and life priorities. In my case, if my GPS score was low, I probably would have chosen active surveillance to postpone the initiatiaion of treatment sideffects as much as possible, knowing full well that I will get treatment if and when the PSA reaches a certain threshold. That is also taking into consideration the reality that with a cancer behaving like 3+3, there is a finite possibility that I may never have needed treatement.
Replies to "My biopsy confirmed by a different pathologist earlier this year was Gleason 3+4 on one out..."
@soli What a fantastic post, soli…so many men STILL don’t realize that not all Gleason scores are alike - even if the numbers are!
The degree of aggressiveness is a big red, flashing beacon begging you to take your treatment to the next level. Thanks again,
Phil
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@soli
I apologize , I posted my earlier response before completing spell check. Here is spell-cheked version of my earlier response.
My biopsy confirmed by a different pathologist earlier this year was Gleason 3+4 on one out of 18 cores. I learned that the 3+4 intermediate risk group as a whole was extremely heterogenous with some in the group similar in biological risk category to Gleason 6, while others were very high-risk similar to Gleason 8, 9 or 10. Before making any decision on what type of treatment I would seek (or before determining if a treatment was necessary right now), I had a GPS genomic test done. Unfortunately, my GPS score was 47, showing the very aggressive and high risk biology of my cancer. If my GPS score was below 20, my risk would have been very similar to Gleason 6, and I would have definitely considered active surveillance, instead of treatment. But given a GPS score of 47, I evaluated surgery vs radiation and settled on surgery, primarily to say "good bye and good riddance" to my very enlarged prostate which has caused me all kinds of urinary issues for many years, even - and specially after - a TURP surgery. You are definitely a candidate for active surveillance given the low-risk biology of your cancer - so - unlike me - you have two viable choices: active surveillance or definitive treatment. Choosing between the two options is a very personal decision weighing in the pros and cons of many factors including your values and life priorities. In my case, if my GPS score was low, I probably would have chosen active surveillance to postpone the initiation of treatment side effects as much as possible, knowing full well that I will get treatment if and when the PSA reaches a certain threshold. That is also taking into consideration the reality that with a cancer behaving like 3+3, there is a finite possibility that I may never need treatment.