Your Gleason Score Matters |  

We have them both here though!

Hi, I'm an electrical and mechanical kind of guy, but have been doing some reading. Your post struck a note with my thinking, so I'll share my thoughts below. The root cause of "biochemical recurrence" is metabolic, which is the same reason for the cancer to occur in the first place. (Aside from the "insults" to cell mitochondria from carcinogens in our diets and the environment, electro-magnetic exposure, hypoxia, etc) But instead of addressing the metabolic roots of cancer, the SOC (standard of care) clips the dead leaves off the tree, so to speak, without making the tree healthy "from the roots" first. So "of course" there will be a biochemical recurrence. Read Dr Thomas Seyfried's book- "Cancer as a Metabolic Disease". The first thing that should be done with any early stage cancer patient is to put them on a tailored Keto diet. This reduces serum glucose, which removes one of the two energy sources for cancer cells (any type of cancer cell, anywhere in the body) The second and final source of energy for cancer cells is glutamine, which can be reduced through fasting. Even intermittent fasting helps reduce glutamine. Also, glutamine reducing drugs such as "DON" may used, when it becomes available. Reducing glucose and glutamine removes the fuel source for cancer cells to produce ATP thru fermentation, and the cancer cells become weakened. (Normal cells with healthy mitochondria are like "flex fuel" vehicles, making energy thru oxidative phosflorylation. They can use glucose and even make ATP with the ketones from burning fat, but cancer cells cannot, because of their damaged or mutated mitochondria) After the cancer cells are weakened thru this targeted "starvation", relatively small doses of SBRT or chemo may be used to further damage the cancer cells, without toxifying the patient. This is done gradually, to avoid dumping an abundance of dead cancer cells into the body, giving time for them to be eliminated naturally. The patient actually becomes stronger on the Keto diet. Contrast this with the emaciated patient receiving chemo, with their hair falling out and constant sickness. Then the hospital kitchen brings them a meal high in carbohydrates and sugar! Exactly the fuel that cancer thrives on! WHAT'S WRONG WITH THIS PICTURE? Reduce carbs to about 50 grams max a day, and reduce sugar to 5 grams max a day! Eat healthy fats like salmon, avocados, cruciferous veggies like cabbage and broccoli, real food! Stay away from processed foods. Doing this will weaken any type of cancer cell, slow, stop, and possibly reverse tumor growth. Then if further action is needed, radiotherapy or chemo can be used in a "one, two punch" to eradicate or manage a tumor. Dr Thomas Seyfried calls this the "Press/Pulse" method of cancer therapy. If the metabolic origins of cancer growth are not addressed, the proverbial "can has only been kicked down the road", and of course there will be a "biochemical recurrence", because absolutely zero has been done to address the metabolic environment of the body. Instead, after failing with radical prostectomy, the SOC moves to chemical castration, and after failing with that, the cancer has metasticized, and the SOC falls on its face again and then the patient dies. The SOC fumbles around with chemo, operations, etc, chasing cancer like they're herding cats. To ignore the metabolic origins of cancer is unscientific and obtuse, and harmful to patients that need help.

I am extremely new to this. I am 3+4 Gleason score. 61 years old. Coming up to 15 years no alcohol. I am very happy for this forum. Thank you for your story. I wish you the best.

That is so intense and we are so sorry you have gone through this. We are not able to answer case questions on our comment section but we can help you through our Helpline who can speak with you either by phone or email. Here is the link to contact them: pcri.org/helpline

hai perfettamente ragione. Dopo prostatectomia radicale il mio psa sta correndo ma dopo 3 pet psma gallio 68 con psa 0,24- 0.54 - 1,14 non viene fuori ancora nulla. Penserò ad eventuale terapia soltanto quando una pet psma evidenzierà qualcosa.

I'm going tomorrow for an MRI.... My PSA was 5.1......... I'm going to do the same thing you are..... I've talked to too many guys who had it removed and the problems they are having now are worse. Quality of life is important. I've also read articles of studies done.. one took 10 guys.....5 were treated with removal or radiation, hormone treatments.. long story short the 5 treated and the 5 not treated both groups lived another 10 years...... Pray for me, I'll pray for you....

This video is I think the best yet it puts everything in perspective and shows men there is definite hope whatever grade you have! Thanks

@@edwright4745 I'm praying for you. I got my MRI results and I have an 8mm lesion in the left anterior portion of the prostate. As far as they can tell, they don't see anything else in the prostate, lymphnodes or pelvic area. I found a report of an old full body CT scan I had done 15 years ago because of an auto accident. It showed a "calcification" of the prostate. It wasn't mentioned by the physician at the time, so I thought nothing of it and filed it away. I'm beginning to wonder exactly what they're seeing on the MRI. Haven't scheduled the biopsy yet. I'm trying to remain hopeful.

Everyone needs to be their own patient advocate!! I spent days researching prostate ca and treatment for my husband. My husband was diagnosed with prostate cancer even with a normal PSA. Why? HIs PSA results from 6 months before that one was 2 points lower, and that is a big red flag for cancer if your PSA results changes by 2 points in 6 months. We know of someone who said he waited to late, and was diagnosed with prostate ca years ago .First thing he had was a radical proctectomy. Off course the cancer was not gone, and it spread. He had salvage radiation and chemo., was told by his doctor-(not sure if it was an oncologist), that he has cancer somewhere in his body. I asked him what was the results of his PSMA Pet scan. He said they never did that exam. OMG why?? He said he is now on lifetime hormone treatment to remove his testosterone. I told him, he needs to strongly insist on this exam. How can you treat metastases if you don't know where it is in the body? Definitely the PSMA pet scan should be done, along with other exams to confirm the correct staging of prostate ca, especially if a MRI prostate shows highlighted regions, and a high risk Gleason score is found. Always get a second opinion on the biopsy, which may change the Gleason score, and get a decipher test done as well. Extended PSA and testosterone tests. With all of this information a more informed decision can be made as to the different options to treat prostate cancer. Yes, his urologist he's had for years, wanted to jump into surgery. You have to take a step back and understand all of your options, get recommendations, and try to seek out the best oncologist. My husband now has a treatment plan, two oncologist from two different states has coordinated his plan. It does not include surgery. Thanks to God alone, my husbands is more into checking things out medically, and staying on top of routine exams and testing. I think he was told a 90-93% cure rate, and with yearly surveillance that he will not likely die from prostate cancer.

I am a doctor and I have never heard anything from Dr. Scholz that sounds crazy. Sounds like your doctor was insecure. Sorry you had that experience

You need to change Drs, that is absurd

Stop doing research??? What???!!! Crazy!

Sounds like its time to find a new Dr. My experience is many Dr's don't like to be questioned. They seem to know it all. Not every Dr. but enough to be frustrated.

Well wishes and positive thoughts sent…be well!

Good Luck John. Keep spirits up. Husband G score 9 - two tumours in the prostate and it had got out to surrounding tissue. Had robotic surgery (oldest patient this surgeon had operated on). Recovered quickly. Bladder good. PSA not as expected post op. Doubled twice fairly rapidly. Went on to do 36 radiations to pelvic floor (shot of hormone to help radiation but no hormone since). PSMA scan following radiation - no detectible cancer. Last two PSA tests since - 0.008 and >0.008.

My husband was diagnosed Gleason 9 in 2021, with mets to some abdominal lymph nodes. With 26 rounds of radiation and ADT (hormone) therapy, he's been in remission for almost 3 years, with his PSA remaining

in harmone therapy which tablet you used with in 2 years please help me

@@ajayzarekar270 In 2021, my husband was diagnosed with Gleason 9, PSA 24, mets to the lymph nodes. He initially received 26 rounds of radiation, and has been on ADT therapy since then, which includes Lupron injections every 3 months and daily Abiraterone (Zytiga) + prednisone. His PSA dropped to

You did not have any surgery, just radiation and ADT. I was just diagnosed, 10 of 18 cores positive 1 3+3, 8 3+4, and 1 4+5. Bone scan, CT scan and PSMA CT PET all negative for spread. Most of the cancer is in the right lobe. Urologist presented 2 options surgery, radiation or radiation, and 2 to 3 years ADT. Seemed negative about the second option thought surgery was best, but because it is mostly on the right said ED 60 to 70% and incontinence 5 to 10. I currently have an appointment with another doc to see if I would be candidate for single port RP What were your side effects. Thinking I may be heading in the wrong direction.

Hi ​Ron, being G10 and highly aggressivei was advised to have the whole pelvic area zapped. PSMA is not perfect, it can detect cancer down to about 2mm, radiologist was very keen to zap pelvic area to make sure he caught any microscopic cells that may have escaped and were not showing on scan. He said you have one good shot at this do it all and do it hard.@ronwise4380

​@@ronwise4380 hi Ron did you get my reply, old fart here may have messed it up.

@@user-pj2wn9ch2c Just read it thanks for getting back. Have decided to go radiation route rather than surgery. Looking for a good place to go near me

My psa went 7.2 to 12 to 27.1 over 3 months. The MRI was bad and they told me radiation was needed right away. Nothing ever said about what type of cancer it was, how fast it grew, or what options I had except surgery wasn't an option

I have a tendency to pepper doctors with lots of questions. You have to be your own advocate. If a Dr. doesn't answer questions or seems irritated, the it may be time to move on.

Were you getting yearly MRI's between 2019 and 2023? I am 3+3 and on AS. I get my PSA checked every 6 months (it goes up and down) get yearly MRI's. They will repeat the biopsy when the 4T MRI indicates any changes (or my PSA spikes significantly) PSA naturally goes up with age and fluctuates so it's part of the puzzle but a small one once PC is confirmed. MRI's and biopsy's are the gold standard to indicate changes.

That’s the biggest fear of active surveillance -the Katy bar the door problem if you wait. I would like Dr Scholz to address that because what you experienced seems really problematic.

@ericb547 I had my biopsy about a month ago that revealed Gleason 4+4. I have a bone scan, pelvic MRI and PSMA PET scan in the coming weeks. I spoke to a couple of friends that had it. One went the surgery route, the other did radiation treatments. It was good to get their insights.

I wish you the very best outcome.

best of luck

@@brockjennings The PET scan is the best. My Gleason score is 4+4 with limited bone metastases. I've just finished ten radiation treatments on a rib, and next week I start twenty radiation treatments for prostate. I hope yours has a great outcome.

​@@mrbr549 Thanks for the information. Good to know their other 4+4 folks going through treatment. Best of luck to you as well 👍

Please check with a Proton beam therapy.Best hospital for this treatment is Loma Linda medical center,California.Hope this will help you

How old are you? Some say tradition have long term effects like bladder or kidney cancer after 15 years. Is it true?

I'm 69.I wanted active surveilance,but the Dr. recommended treatment.Surgery or Radiation.I opted radiation.But I selected a very good Radiation Oncologist,from NY Memorial Sloan Kettering.If you skip treatment chances are it's going to metastize.Get regular checks for early detection of other cancers that may occur.But it's important to treat it.

Agreed with that 200% .

As soon as I found out I had prosthetic cancer I started juicing eating steamed tomatoes and no more tapioca which is high in carbohydrates.

Please check with Loma Linda Medical center.Proton beam therapy they have a great testimonial.Also Read the book of Robert Marckini.

Hello, we are not able to answer case questions on our comment section but we can help you through our Helpline who can speak with you either by phone or email. Here is the link to contact them: pcri.org/helpline

If the mri showed two spots then they should do a mri biopsy showing what the Gleason score is for those two spots.

What are your treatment plans Tommy?

@@keithcolegrove2924 radiation and hormone treatment 🥴

Not a doctor. I've read that the density measure has to do with PSA levels as they relate to prostate size and the size of the mass targeted. Generally, lower is better and 0.24 is fairly high. 0.16 is low.

@@1dariansdad So that means tge bigger the prostate the bigger the psa reading Latest reading is 9 but 14 last year, so seems my prostate is small compared to psa reading , I wonder how much of an indicator And thanks!

I took it on myself to take a course of FenBen.

@@bruceharkness4497Please share your method and results.

Good question

My biopsy was all over my prostate. He took 12 samples. The cancer was found in the upper portion. We ran a Genomics test on the samples to see just how aggressive the cancer was. Sadly, it was aggressive. So, no active surveillance.

I can only explain what my husband is doing. Testing: biopsy Gleason of 4+3, decipher test, MRI prostate and PSMA pet, only showed highlights in the prostate. Treatment: 1 shot of hormone treatment, which lasts 6 months(Lupron), 2. and 1/2 months later... radiation seeds by one oncologist who does 500 or more of these procedures-most in the country. Then wait a few more weeks , then do radiation treatment once a day for 5 weeks. After all of this, he will be placed on active surveillance. His urologists' wanted to jump to proctectomy. After urologist recommendation for a oncologist, he has two oncologist in 2 different states. The one shot hormone treatment is first because it remove testosterone which feeds the cancer. It knocks it the cancer down, like sticking it in a freezer, should slow/stop growth. Then treatment with radiation seeds in the area of the cancer-highlighted by the MRI prostate, along with a ultrasound of the prostate. After the radiation seeds starts wearing off, then start with the localized radiation treatment-5 min a day for 5 weeks. He was given 90-93% cure rate. My husband is lucky, both oncologist coordinated his treatment, everything was discussed in detail, before he started. Being 65 he wanted to make sure the first battle with cancer was the strongest. Every cancer case is different, I hope you both get the answers you seek and get the best treatment for the cancer.

I am not a doctor.....Is your doctor a urologist or an oncologist? Was a biopsy recommended? Do you do PSA testing every 6 months or yearly? Have you had extended PSA testing, or testosterone testing? If you don't have an oncologist who specializes in prostate cancer, I would suggest you at least have one visit, just to have an over view of your medical/cancer history and medical tests scores to see where you stand today. In my husbands case he had a normal PSA test, but it was a red flag because his PSA 6 months before that was 2 points lower. Biopsy came back a Gleason 4+3, Decipher test of the biopsy tissue, MRI prostate showed highlighted areas in the prostate. PSMA Pet Scan only highlighted in the prostate. He is now going through cancer treatment. All the urologist wanted to do was surgery, remove the prostate. After he declined surgery, the urologist recommendations was to see an oncologist due to the positive cancer diagnosis. The 2 oncologist reviewed all results, came up with the best treatment for the cancer. Any cancer diagnosis should always be followed by an oncologist. Research and get the best.

I do know of a couple of folks who got second opinions on post-RP pathology. The same idea that drives many folks to get second opinions on needle biopsy samples.

HoLEP is not indicated for cancer.

You can find the questions you need to ask on the American Cancer Society site. I brought these questions with me when going over biopsy results with my oncologist. I had 4.2 PSA. Biopsy showed Gleason 3+4 in two cores with extra capsular extension. I decided after much research, discussing every option with the Dr, talking to others who’ve had or have prostate cancer, and my age, to have it removed this past March at 65 yrs of age. Post op biopsy showed a positive margin on one side(cancer cells outside the margin of the removed prostate)which was Gleason 3+4, stage 2(low to intermediate risk), no spread to lymph nodes or seminal vesicles. Six week PSA was undetectable. I’ll follow up every three months for a year. Nerves were spared so incontinence and ED has been minimal. Subscribed low dose Cialis has helped with that. Every case is unique. Educate yourself as much as possible. Good luck on your journey👍🏻 www.cancer.org/cancer/types/prostate-cancer/detection-diagnosis-staging/talking-with-doctor.html

Have you considered a Genomics on the samples? My Genomics results helped me make a decision.

The Gleason score is determined based on the analysis of a prostate biopsy. So you should be able to get that score from your urologist if indeed you had the biopsy. Because you are in treatment, your Gleason score is at least 3+4, and higher, but honestly, you probably have metastatic PCa, and knowing the Gleason score is less relevant.

Seems like you are hormone resistant. With the medication you are on, your psa should be undetectable. You need a second ontological opinion. Discuss more aggressive therapy.

On 1/11/24, my PSA was 11.65, referred for MRI and Biopsy. MRI on 2/4/24 yielded Impression results, "No multi-parametric MRI evidence of clinically significant prostate carcinoma." PI-RADS Assessment: "Very Low (Clinically significant cancer is highly unlikely to be present)." Biopsy on 2/13/24 provided a "Gleason Score of 4+3=7" with 2 of 18 cores showing 3% and 10% "Adenocarcinoma of the prostrate" and "Grade Group 3." Decipher test results, "High risk - .67." Next on my agenda is a PSMA-PET scheduled for 3/18/24.