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← Return to Biopsy vs Surgery Results
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Prostate Cancer | Last Active: Aug 29 9:17pm | Replies (44)
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I was 4+3 from the biopsy, 4+5 after surgery. My surgery also detected some adverse factors (bladder neck invasion, cribriform, multifocal and others) so my biopsy really underplayed my actual condition. The surgery results also led me to be more aggressive in follow-up. My PSA was only 0.04 a year after surgery, but was trending in the wrong direction so we decided to move ahead with Lupron and 39 radiation treatments. I've been undetectable since March but the Grade 5 determination after surgery has me watching closely. Next PSA is a little more than a month away.
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@anosmic1 Your experience is a textbook reason why it’s never a good idea to rely only on PSA and Gleason score in making a treatment decision.
Though various studies get slightly different results, data from this paper from the UK in 2019 showed that initial grade and pathological grade matched 59% of the time, was downgraded just 16% of the time, and was upgraded just 25% of the time —> https://bmcurol.biomedcentral.com/articles/10.1186/s12894-019-0526-9
(So, 75% of the time the pathological grade is the same or better; only 25% of the time it’s worse.)
There are about a half-dozen other biomarker tests and scans that often can detect when something worse is lurking unseen, and can play a role in making a treatment decision.