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Post prostatectomy: What do rising PSA levels mean?

Prostate Cancer | Last Active: May 26 4:55pm | Replies (188)

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@kujhawk1978

Yes and no...the medical community in the past few years revised the grading system...

A 5 Grade Group System was created to have a better way to describe how a cancer will behave and respond to treatment.
Grade group 1: Gleason score 6 or lower (low-grade cancer)
Grade group 2: Gleason score 3 + 4 = 7 (medium-grade cancer)
Grade group 3: Gleason score 4 + 3 = 7 (medium-grade cancer)
Grade group 4: Gleason score 8 (high-grade cancer)
Grade group 5: Gleason score 9 to 10 (high-grade cancer)

A lower group indicates a better chance for successful treatment than a higher group. A higher group means that more of the cancer cells look different from normal cells. A higher group also means that it is more likely that the tumor will spread aggressively.

So, you re more likely...then again, you may have been in the less likely. My pathology report said GS 4+4 which when I fed the data from the pathology report into MSKCC's nomogram, margins, SV, ECE...it said 30% chance of BCR. Statistically that also meant a 70% chance it would not. Alas, I was in the 30% and thus why I am not a gambler.

What it does mean I think is you and your medical team should consider more aggressive treatment if the clinical data supports it.

I may be facing a similar decision, labs today, if my PSA goes up again, my radiologist, urologist and I agree it may be time to scan and then decide based on the results, my labs and clinical history. One thing we do know, one's PCa does not get "less" over time in terms of the grade group.

Kevin

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