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My Pathology Post RALP - originally PSA 135
Prostate Cancer | Last Active: 2 days ago | Replies (7)Comment receiving replies
@jeffmarc Jeff, Does the administration of ADT + lutamide lower the Gleason score when given pre-surgically?
If someone is a G8 at biopsy (with a majority of cores showing G8), is a lower Gleason score from surgical biopsy a ‘true’ Gleason score? I mean, months of ADT lower PSA so a lower Gleason score may only reflect this temporary finding.
And since Gleason is quantitative vs qualitative, aggressiveness is really not decreased …right??
All I mean is that when a Gleason is downgraded on surgical pathology, that is wonderful news; but is that downgrade the same if ADT + lutzmide was involved? Thanks,
Phil
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@heavyphil
After surgery, they are able to look at the whole prostate. Dr. Epstein said, in The latest PCRI conference, 30% of the cases have a change in Gleason score 50-50 up or down.
You are correct for sure, About the fact that what you do can’t change the Gleason score. It doesn’t go down as a result of any drugs. The changes are due to being able to see more of the prostate and in some cases, I suspect, are due to getting a better pathologist. It was mentioned during the conference that you should check the expertise of the pathologist that looked at your after surgery prostate. Was that doctor a specialist in prostate cancer or were they a specialist in breasts or other cancer analysis?. That can make a big difference in what the results show.