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I have a prostate cancer (gleason score 6).

Posted by pk52 @pk52, 1 day ago

I am diagnosed with prostate cancer (Gleason score 3+3). I have completed both biopsy and repeat biopsy. Still under active surveillance. My PSA went from 10.42 to 11.68 in six months. I am worried about possible progression.

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Profile picture for frank1964
frank1964 | @frank1964 | 1 day ago

3+3 is not accounted as cancer and can not metastasis. What about MRI? Have you had one taken? What is your age and prostate volume?

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jim18 | @jim18 | 23 hours ago

A 3+3 is as low as it gets with prostate cancer so nowhere to go but up. You did not say how many cores were involved or what percentage was cancerous which could make it more serious. The good news is active surveillance (AS) is all that is needed. The bad news is that even if you get surgery with the risk of ED and incontinence you will still need to monitor for prostate cancer recurrence. Not much difference from AS. Best is to follow AS (information posted above). It can be many years before treatment is required.

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charlesprestridge | @charlesprestridge | 20 hours ago

You will need to study all the pieces to the puzzle from your tests so far, and future tests.

1. Pirads5 lesion is a piece of puzzle. Indicates lesion may be higher than 3+3. What is size of lesion? Larger the lesion can indicate more concern.

2. Biopsy cores only sample a small part of prostate. If you post your MRI and biopsy results, you will get better feedback.

3. 3+3 biopsy cores may mean 3+3 or it may mean 3+4 parts of lesion were not sampled.

4. Lesion being close to capsule wall increases concerns.

Best Wishes.

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pk52 | @pk52 | 18 hours ago
In reply to @frank1964 "3+3 is not accounted as cancer and can not metastasis. What about MRI? Have you had..." + (show)
Profile picture for frank1964 @frank1964

3+3 is not accounted as cancer and can not metastasis. What about MRI? Have you had one taken? What is your age and prostate volume?

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@frank1964
I have had MRI. The volume of my prostate is 33cc. 74 years old.

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pk52 | @pk52 | 18 hours ago
In reply to @jeffmarc "Many doctors consider 3+3 to be pre-cancerous. For a long time, doctors were treating people 3+3,..." + (show)
Profile picture for Jeff Marchi @jeffmarc

Many doctors consider 3+3 to be pre-cancerous.

For a long time, doctors were treating people 3+3, then 14 years ago the medical community felt that was overdoing it and stopped doing PSA tests. Today we’re getting a lot of people with advanced cases because of it.

How many cores Had 3+3? If more than six, then it makes more sense to do something about it if less than six, then active surveillance makes the most sense.

Did anybody ever give you an idea how large your prostate was? I know somebody whose PSA was 50 and had multiple biopsies and they never found anything because he had a huge prostate. Having BPH can also cause the PSA to be higher than it should be.

Here are some videos from doctors that discuss active surveillance for somebody like you

Here is a video with Dr. Laurence Klotz, one of the experts on active surveillance. He can give you answers as to why you would or would not be a good candidate for active surveillance.


Here is a video by Dr. Epstein discussing active surveillance and more

Excellent Fred Hutch doctor video: Dr. Claire de la Calle

Active Surveillance for Intermediate Risk Prostate Cancer w/ Dr. Claire de la Calle | Ep. 288

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@jeffmarc
Total number of cores is 10
Number of positive cores is 4

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Jeff Marchi | @jeffmarc | 17 hours ago
In reply to @pk52 "@jeffmarc Total number of cores is 10 Number of positive cores is 4" + (show)
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@jeffmarc
Total number of cores is 10
Number of positive cores is 4

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@pk52
Pretty easy to evaluate four 3+3’s in a biopsy as well within Active surveillance requirements.

Somebody with a 3+3 may never have prostate cancer, or it may be many years off.

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bobgolf | @bobgolf | 6 hours ago

I would ask to have the biopsy material sent to either Polaris or Decipher for testing as to the aggressiveness of the cancer. Many doctors and their patients base any potential treatment, in part, on how that test turns out. I am like you, two biopsies, both showed some Gleason 6, now on Active Surveillance. My score came back low aggressiveness. I will say a prayer all goes well for you.

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pk52 | @pk52 | 5 hours ago
In reply to @frank1964 "3+3 is not accounted as cancer and can not metastasis. What about MRI? Have you had..." + (show)
Profile picture for frank1964 @frank1964

3+3 is not accounted as cancer and can not metastasis. What about MRI? Have you had one taken? What is your age and prostate volume?

Jump to this post

@frank1964 I had MRI. 74 years old.

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Profile picture for pk52
pk52 | @pk52 | 5 hours ago
In reply to @charlesprestridge "You will need to study all the pieces to the puzzle from your tests so far,..." + (show)
Profile picture for charlesprestridge @charlesprestridge

You will need to study all the pieces to the puzzle from your tests so far, and future tests.

1. Pirads5 lesion is a piece of puzzle. Indicates lesion may be higher than 3+3. What is size of lesion? Larger the lesion can indicate more concern.

2. Biopsy cores only sample a small part of prostate. If you post your MRI and biopsy results, you will get better feedback.

3. 3+3 biopsy cores may mean 3+3 or it may mean 3+4 parts of lesion were not sampled.

4. Lesion being close to capsule wall increases concerns.

Best Wishes.

Jump to this post

@charlesprestridge Biopsy and repeat biopsy confirmed gleason 6 = 3 + 3. MRI was ok

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