Effect of surgery wait times on post op pathology.

If one gets different gleason score post op than it was in a biopsy there is no way one can prove that wait time was a cause. They will say that biopsy procedure samples less than 1% of the whole prostate and that adverse findings were missed by a probe. That is what we were told when our 4+3 came to 4+5 after waiting for RP for about 4 or 5 mos..

Wishing you the same gleason results or even lower !!! It can happen too : ))))

Unfortunately, you did not tell us anything about what was found in your biopsy, That information is really critical to answer your question.

I had a Gleason 3+4 and my surgery was not done until six months after it was diagnosed. After the surgery, my Gleason score was raised to 4+3. But that is not unusual, it Frequently happens after the surgery that the score is increased, and occasionally decreased, because they can see the whole prostate, and they can only get about one percent when they do the biopsy. It did take 3 1/2 years before my PSA started rising again.

How high was your PSA. Was anything else found in your biopsy that could make the cancer aggressive.

I know you have posted here before, but There are so many people posting and it’s hard to keep track of everybody’s symptoms.

I was diagnosed in Aug 2022 with Gleason 4 +4 and scheduled for surgery at the end of November. I caught the flu 2 days before and surgery was postponed until Jan 31st 2023. Post surgery pathology downgraded to 4+3. Did surgery being delayed have a bearing on the downgrade? Who knows but as I told my urologist, I'll take it!

@jeffmarc
Thanks for replying Jeff! Gleason 3+4 =7 in 25% of one core. percentage of pattern 4 =6%. No other adverse features.
We were offered AS but chose surgery. Diagnosed in May. RARP in September. On ADT Orgovyx 40 days before surgery. Decipher not done.

@surftohealth88
Thanks for replying Surfer! and thank you for your good wishes! Yes the Doctor said while 60% times the score is same, roughly about 20% of time lower or 20% of the time higher.

@kenhorse
Thanks for sharing Ken! you lucky guy! Your decipher score is low I guess.

@jeffmarc
PSA was 8.5

The majority of prostate cancer is slow-developing, so a few months shouldn't usually matter: as someone else mentioned, if you see a different Gleason score post-op, it's typically because the biopsy needle missed something in the haystack of your prostate.

But there are exceptions. A minority of us have very fast-moving cancer that can escape the prostate rapidly. My metastasised tumour grew so fast that it compressed my spine within a month and left me paraplegic for over a yeae. Typically, you'd be seeing Gleason 8 or 9 with a cancer like that (and even most of them don't spread that quickly).

So most likely, the delay wouldn't matter (especially if the Gleason score in the biopsy was low), but there's always a tiny risk.

@shalom7777777
This does sound like a pretty safe solution. While you do have active prostate cancer, it is not real aggressive from the looks of your biopsy.

Waiting a few months is not gonna make a difference. If they find a higher Gleason score after the surgery It probably won’t be much more aggressive,.

The odds are in your favor.

@kenhorse
This does happened and it’s really good news. I wonder if you had asked for a second opinion on your biopsy would they have said it wasn’t a 4+4.

Surgery being delayed would have nothing to do with your lower Gleason. It is more like likely a misread of the biopsy.