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Gleason 6 (3+3) treatments
Hi,
I had a biopsy and it came back with Gleason 6 (3+3). The urologist first told me it was extremely important that I have a biopsy done every 12 - 18 months to monitor this. 3 years later with no followups and now he's telling me we will just do MRI's instead (I also have ulcerative colitis so biopsy is extra painful). He also told me my cancer is nothing and don't worry about it. Problem is, he's told me a lot of things and then told me the exact opposite, so I'm not sure if I trust him.
Question for others with Gleason 6 ....... what type of treatment/monitoring are you being treated with?
Thanks
Joe
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I appreciate your concern. Perhaps I miscommunicated.
My urologist proposed no treatment at this time. He proposed Active Surveillance in light of a clean MRI report followed by a biopsy result of 3+3=6, 40% of 1 core of 12 . Grade Group 1.
I was relieved that my MRI was clear. We proceeded to do the biopsy out of an abundance of caution. I had an elevated PSA of 6.4, which had risen steadily from 4.5 two years prior and from 5.5 one year prior. Prostate size/volume was small and PSA density was high.
We will do another PSA 3 months from now.
I agree completely that another MRI one year after the first biopsy/diagnosis is the best next step. Here's hoping that MRI is as favorable as the first.
I have read Dr Walsh's book you referenced and it has served me well in preparing to be a full participant in my health care decisions.
I am age 72 and in excellent health overall. I do want to understand why my PSA readings are elevated and gradually increasing and I wonder if the mostly favorable biopsy results fully explain the unfavorable PSA trends.
How to Interpret a Negative Biopsy After Testing Positive......After a PSA score of 7, and a Transperineal Biopsy I was diagnosed by my local Urologist in late 2021 with Gleason Grade 3+3, with 1 of 12 (or 16 cores as I can't remember) with the one core testing 10% positive. The other cores were negative. Older Tech 1.5 Tesla Machine MRI showed a PIRADS 2. Placed on Active Surveillance. One year later, with a PSA of 5.7, the same Biopsy Tests confirmed Gleason 3+3. Wanting a second opinion, went to a regional NCI Comprehensive University affiliated Hospital for just a new 3.0 Tesla MRI. A PIRADS 3 lesion of approximately 4 mm was noted. Still on Active Surveillance. In April 2024, a new PSA showed 8.0. Never been that high. Sought a second opinion from same regional NCI designated Comprehensive Cancer Center affiliated with a University hospital. They did an MRI guided Transrectal Biopsy as they state they do NOT do Transperineal Biopsies. Results show all 12 cores as being BENIGN including samples taken from suspected 4 mm lesion or as they say ROI (region of interest). Recommended 6 months check-up and new PSA. I am dumb-founded. Contacted my PCP and he says "you still have cancer. they just didn't hit the cancerous area with the biopsy probe". How common is that? Anyone have any ideas or words of wisdom for me? Appreciate any and all comments!
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Hug
2 ReactionsYou have been thru the wringer and done your due diligence. I am not smart enough to even understand all you have been thru. Rather than waste any more time, I just had mine removed. Not unhappy with my decision. Nothing to fuss over now. This sort of fits in the all comments section. 🙂
You appear to be on the ball and being proactive .
Re: your rising PSA . I assume you have checked that it is not due to a urine infection or BPH .
Have you considered a Liquid Biopsy ( Biomarker Test ) 4K , SelectMDx , Prostate Health Index ( PHI ) or Decipher etc . to compliment your PSA findings ?
Regarding a Transrectal vs Transperineal Biopsy . Some states and European countries only perform the Transperineal for obvious reasons --- Less risk of serious infection ( Sepsis )
That's good for some. I don't want those cancer cells lingering. And, bone cancer is not how I want to exit the planet.
What type of radiation ? ( Brachytherapy ? )
Was it Monotherapy ie without EBRT and ADT ?
Let's stay in touch. It sounds like we may be on a similar journey. I'd like to learn from your experience on the roller coaster of a marginally positive biopsy, negative MRI, persistently elevated PSA, and Active Surveillance.
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Hug
1 ReactionMy comments: try another treatment facility and go on ADT treatments just to get that PSA down to < .01. Don’t be passive, find out what’s going on with your prostate.
Dear Clandeboye1 Yes I have had the Decipher Test. Decipher Test is used to determine risk of metastasis. On a scale of 1-100, with 1 being the least risk and 100 being the highest risk, my score was .12 which is very low risk.
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Hug
1 ReactionSorry to disagree with you, but I am not going on that sh__ ADT Unless absolutely necessary, as I have read and heard of too many stories of deleterious side effects. I am comfortable with the recommendations of both my urologist and radiation oncologist that no treatment is needed at this time, and to stay on Active Surveillance. My challenge is no one seems to be able to explain to me my last Biopsy results in relationship to previous diagnosis,
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Hug
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