1. < Prostate Cancer

Gleason 4+5, up from 4+3

Posted by anosmic1 @anosmic1, Feb 4 9:41pm

It's day 85 after surgery. I'm feeling fine. But with my first follow up blood test in 2 weeks I went back and read the post-op report from the surgeon. I was Gleason 4+3 after the biopsy in late July, but 4+5 during the surgery in November. Nothing I can do now except wait for the next test, but I'm preparing myself for bad news. Gleason of 9, Group 5, has me concerned there are more challenges ahead. Cancer may be in a different location but it's starting to mess with my head.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

cooper1076 | @cooper1076 | Feb 6 5:38pm
In reply to @jeffmarc "Hopefully, you are getting a FDG pet scan, That can detect prostate cancer that does not..." + (show)
@jeffmarc

Hopefully, you are getting a FDG pet scan, That can detect prostate cancer that does not produce PSMA. Around 10-20% Of prostate cancer patients have that problem.

The NCCN guidelines Say that if somebody has a Gleason nine, they should be on ADT for at least 18 months if not 24 months. You’re getting off of it after six months was not following standard of care, Hopefully, you can get back on it and have many years, It works for most people.

Somebody in your situation usually gets Lupron and Zytiga, after radiation. . I’m working with one guy right now that has exactly that, And I know a number of other people who ended up with that treatment. Sometimes they Prescribe a lutamide instead of Zytiga. I’m just telling you this because that’s probably the things you’re going to be talking about.

You might wanna ask for a decipher test to find out how aggressive your cancer actually is how fast it’s supposed to metastasize. Of course, you already know it seems to move quickly, Ask your doctor if it makes sense.

Jump to this post

Yes. I agree in hindsight my hormonal treatment should have been longer. The good news is that I responded well to the treatment and can go back on after we locate the cancer. I am doing an Axumin scan by the way.
Also my doubling time is basically 3 months. Pretty scary.

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1 reply
jeffMar | @jeffmarc | Feb 6 8:48pm

The axumin scan is not the greatest, Most places have stopped using it, It’s not nearly as good as the PSMA pet scan, and is Not as good as the FDG scan if you don’t have PSMA.

Are you working with the center of excellence? This doesn’t sound like Up-to-date treatment.

Have you had a second opinion?

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2 replies
heavyphil | @heavyphil | Feb 7 6:46am
In reply to @cooper1076 "Yes. I agree in hindsight my hormonal treatment should have been longer. The good news is..." + (show)
@cooper1076

Yes. I agree in hindsight my hormonal treatment should have been longer. The good news is that I responded well to the treatment and can go back on after we locate the cancer. I am doing an Axumin scan by the way.
Also my doubling time is basically 3 months. Pretty scary.

Jump to this post

Axumin? I had that almost 6 yrs ago before PSMA - which is much more sensitive - came out.
Jeffmarc is correct and you need to get some clarity on this as it is old technology.

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cooper1076 | @cooper1076 | Feb 7 8:57am
In reply to @jeffmarc "The axumin scan is not the greatest, Most places have stopped using it, It’s not nearly..." + (show)
@jeffmarc

The axumin scan is not the greatest, Most places have stopped using it, It’s not nearly as good as the PSMA pet scan, and is Not as good as the FDG scan if you don’t have PSMA.

Are you working with the center of excellence? This doesn’t sound like Up-to-date treatment.

Have you had a second opinion?

Jump to this post

PSMA doesn’t show anything. That is the problem. Have undergone two of them. The Axumin is being attempted because my cancer is not being picked up by PSMA and the belief is that I am in the 10 percent category that cannot be seen with PSMA. Is there anything else I should be trying?

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1 reply
jeffMar | @jeffmarc | Feb 7 11:08am
In reply to @cooper1076 "PSMA doesn’t show anything. That is the problem. Have undergone two of them. The Axumin is..." + (show)
@cooper1076

PSMA doesn’t show anything. That is the problem. Have undergone two of them. The Axumin is being attempted because my cancer is not being picked up by PSMA and the belief is that I am in the 10 percent category that cannot be seen with PSMA. Is there anything else I should be trying?

Jump to this post

The FDG scan is the one recommended if you do not produce PSMA, not the Axumin scan. Look into it on the web and talk to your doctor about it.

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cooper1076 | @cooper1076 | Feb 7 11:46am
In reply to @jeffmarc "The axumin scan is not the greatest, Most places have stopped using it, It’s not nearly..." + (show)
@jeffmarc

The axumin scan is not the greatest, Most places have stopped using it, It’s not nearly as good as the PSMA pet scan, and is Not as good as the FDG scan if you don’t have PSMA.

Are you working with the center of excellence? This doesn’t sound like Up-to-date treatment.

Have you had a second opinion?

Jump to this post

Yes: the Axumin is the result of getting a second opinion from Dr.
Scholz who determined that a PSMA would be a waste of time at this point and would likely continue to be negative.

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