Together we will beat cancer


Gleason score downgraded after surgery

21 Feb 2011 13:01

Hi all

Following my robotic radical prostatectomy just before Christmas 2010, and the follow up with the surgeon last week, I received a copy of the letter sent to my GP. It appears that the Gleason 3+4 found on the initial biopsy was downgraded to 3+3 when the removed prostate was examined, although it was also restaged to pT2c, which means that it was found in both sides, whereas on diagnosis it was positive on the right side only.  The other good news is that it was organ confined, the surgical margins were clear and my PSA was <0.1.  I am making a good recovery from the surgery and will be returning to work in a few weeks. I suffer from minor stress incontinence which is improving every day, but I'm still waiting for my little soldier to stand to attention. I was 57 last month.

Plugging my results into the various on-line calculators available, it appears that I have around 95% probability of being cancer free in 10 years time - which is a huge relief after a worrying time. Even so, I hesitate to use the word "Cured" as I don't wish to tempt fate! It appears that the difference between the various T1 and T2 stages doesn't appear to have any significant effect on post surgery relapse, although the difference between Gleason 3+3 and 3+4 has a minor effect.

I must emphasise that I wouldn't have known about having Prostate Cancer if I had not asked for PSA blood test! My slowly rising PSA was monitored for several years, and eventually triggered a biopsy. This monitoring meant that my cancer was caught while still at an early stage. 

Early prostate cancer usually has no symptoms so for most men it can only be found via a PSA blood test.  I heartily recommend EVERY man over 50 to ask his doctor for this test. It could save your life; it has probably saved mine. The surgery is not as bad as you might think, and the side-effects are tolerable.


Re: Gleason score downgraded after surgery

21 Feb 2011 21:09 in response to telemando

Hi Bob

I cannot tell you how delighted I am to hear your good news.  That really is great 

It's not unusual to have the Gleason Score downgraded following biopsy. G3+3 certainly is good news, especially as margins were clear, and all confined. Your PSA should in the future be undetectable [<0.01 or <0.001 depending on Lab' equipment] IF  at any time in the future your PSA does rise a bit, it still isn't cause to panic. Sometimes PCa tissue is left behind, and can start up again. If this does happen, usually a few doses of RT [Radiotherapy] clears up the problem. Just keep an eye on the PSA levels.

You raise a good point about PSA testing. It's a political 'hot potato', and one that often crops up. In my experience, [such as it is] I am hearing of more men being diagnosed in their early to mid forties, not neccesarily because of a history of PCa or BCa in the family either. There was an interesting article in DEC 2010, and I will paste in the link for you. It's called "Experts Scrap Prostate Screening" and has caused uproar in the world of PCa.

It's well documented that the PSA test cannot tell with 100% accuracy that cancer is present. However, unless all Men are made aware of a PSA test in the first place, how is anyone supposed to know? I believe in the PSA test from the viewpoint that at least you have an idea of what is going on, and can monitor the situation, over a number of years if necessary. But if you have no clue what it all is about in the first place, how can you help yourself?

35,000 Men in the UK are diagnosed with PCa each year. 10,000 Men in the UK die from this disease each year. That makes for some frightening statistics for a curable disease.

I fully applaud any and all efforts to raise Mens awareness of this completely curable disease if caught early enough. However, it is an unfashionable cancer, compared to a lot of the higher profile ones. There is also currently a petition running, lobbying Parliament about the new CANCER REFORM STRATEGY. This proposes targeting peoples awareness of the most common types of Cancer, and to go to their GPs in a timely fashion to get checked out if they think there is a problem. Of the £11 Million earmarked for this campaign, £0.00 is allocated towards raising awareness of Prostate Cancer........

Interestingly enough, the UK is about one of the last countries in Europe which do not routinely screen PSA levels after 50 years of age.......

In my humble opinion, if we can raise awareness, the rest will fall into place, but it will be a fight.

I truly applaud your efforts to help raise this issue amongst Men. It is individuals like yourself, who carry the flame of awareness, which will make the most difference to Men of the future. It is no longer acceptable to sit back and accept the old fashioned ideas that PCa is 'just an old mans disease'. there are far too many young men being diagnosed at an advanced stage, where no cure is possible, to put lie to that belief nowadays.

I wish you all the very best of everything Bob, and at the very least, a long and happy life WELL into old age.

With regards and best of wishes as always



Message was edited by: jadziadax

Re: Gleason score downgraded after surgery

21 Feb 2011 22:57 in response to jadziadax

Hi Jadzia

It's a scandal that men aren't routinely called for PSA testing. My GP had taken part in an early PSA screening trial and she was horrified when the decision not to screen was announced.

When I return to work I will try to persuade as many men as possible to get their PSA checked.  Even if it falls within the "normal" range, it is still useful to have a baseline for future comparisons. 

As a result of my brush with cancer, my brother in law (who's 75) had his PSA checked, followed by a biopsy. It appears that he too has an early stage but probably non-aggressive cancer. At present, the medical advice is to wait and see what happens since it will probably never cause him any trouble. More importantly, his son (aged 40) is now aware that there is prostate cancer on both sides of the family and can get himself checked and monitored.

On a more personal note, I'd like to thank you for your caring, informative and supportive posts over the last few months.  You should be declared a national treasure Wink


Re: Gleason score downgraded after surgery

22 Feb 2011 16:47 in response to telemando

Hi Bob

Thanks for the compliments, but not certain I should be a national treasure Anyway, you are more than welcome, and I am delighted I was able to help a little.

Since my dad was diagnosed just over a year ago [G10, T4, advanced spread] I have learnt, and still am trying to learn, as much as I can about this disease. Our time, we know, is limited with Dad now, but I still hope and pray that we are lucky, and beat some of the odds.

By doing what you are doing, raising awareness, you will be making a huge difference. Just telling men about the PSA test could save a large number of lives. We all do what we can, and hope its enough to make some kind of difference. This is my contribution to the fight, and it was a pleasure to help you out.

Best of luck in everything, and I am always here if you want to chat about anything, or, you are always welcome to mail me via my profile page.