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what does it mean gleason 7+4
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0liver posted:
My husband has prostate cancer. His PSA is 10.58. His Gleason score is 7+4[maybe 7+3> I'm alittle unsure of the last number but the 7 is correct. His prostate is very large, much too large to do the seeds. He is getting the kind of radiation that the rays can be bent. His PSA has been goiong up for the last 5 years. How did it get so out of hand!! I am told that he has a 90% to 99% chance of survival. When looked at this web site for the first time today, I'm seeing some frighting things. Am I takeiing to much for granted? Is his surrivel rate that high or are we both being fooled. I am not a wesk person. I need to know the truth. Cna you help me understand? Thank you.
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Galileo1962 responded:
Could the PSA possibly be 3 plus 4 equals 7 or 4 plus 3?
Gleason score is comprised of two Gleason grades, with the highest grade being 5, so the highest possible score is 10.

As far as radiation, you are probably referring to conformal radiation, such as IMRT.

Do you know what his clinical stage is? This is determined by if, where, and how much the tumor was felt (palpated) by the doctor.

The Partin tables do show that with a PSA over 10, and Gleason 7, his odds of having at least local spread (no longer confined to the prostate) are substantial. But the tables really apply to large groups of men, and your husband is an individual.

A benefit to having radiation (as opposed to surgery) in such cases is that the radiation can treat cancer that is no longer confined to the prostate but is still in the immediate vicinity.

The 5 and 10 year survival rates for prostate cancer *are* very high. Even if the primary attempt to cure is unsuccessful, there are treatments that can stall the cancer.

Now that I've said all that, I'm just a patient, not any kind of expert. If Dr. Moul or a more knowledgeable layperson (such as John, az4peaks) contradicts anything I have written, go with what they say, not my comments.

Best wishes to you and your husband for a successful treatment.
 
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Judyth123 responded:
Hi, I just want to let you know that you need to seek a second opinion immediately. My husband was diagnose with prostate cancer in July 2010. His PSA level was 10 with a gleason score of 7 (4 3=7). His started external radiation this past Tuesday and will continue treatment for the next 5 weeks. After radiation he will undergo brachytherapy. I am sharing all of this since it looks my your message that you guys need to be proactive. Prastate cancer nowadays is a treatable disease and if treatment is seek in an early stage the prognosis will be good. You really need some expert advise if you want a positive outcome. My husband is being treated at Dattoli Cancer Center in Sarasota and they have a good reputation among the medical community. Good luck!
 
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az4peaks2 replied to Judyth123's response:
Hi Judyth, - Rather than speculate as to the meaning in an erroneously expressed Post, I would strongly suggest that you read the following brief article and obtain the information that it recommends be acquired.

There is no 7 4 Gleason Score and the suggested information, including the contents of the Biopsy
Pathology Report would help clarify your Husband's real medical status.

I know that new exposure to medical language is often difficult to understand and any confusion about reported data results can generally be helped by knowing the exact wording on the copies of diagnostic reports. Here is what you need to know:

What every newly diagnosed PCa patient MUST know!
What EVERY newly diagnosed Prostate Cancer (PCa) patient needs to know!

By John E. Holliday, FACMPE

First, ALL Prostate Cancer patients should determine the basic diagnostic realities of their specific disease and understand their relative significance. In my opinion, EVERY newly diagnosed PCa patient needs to gather the following data, to even START your considerations. I would suggest you begin by acquiring the following diagnostic results.

(1) What was my last PSA prior to diagnosis? (If available, previous PSA readings with dates are helpful) Either get copies or write them down.

(2) What is my complete Gleason SCORE? (Primary Secondary GRADES = Gleason SCORE) ie: (3 3)= 6, (4 3)= 7, etc.

(3) What is the clinical STAGE assigned to my Prostate Cancer? (ie: T1c, T2a, T3b, etc.)

(4) Obtain a copy of the Pathology Report from the Biopsy, available from your Physician. It can contain helpful information, now and in the future. Keep it for your records!

These items, when coupled with your age and ethnicity, will provide the BASIC information necessary to BEGIN to truly understand what the status of your disease is thought to be, at the time of your diagnosis.

When embarking on any journey, when trying to determine the route you want to take, you must first determine where you are NOW, and this is that START! Without knowing this basic information, and understanding its relevance, informed decisions cannot be made and the applicable relevance of gathered information remains undetermined.

If a man has been diagnosed with early stage disease, as approximately 3 out of 4 men presenting today are, there is usually no urgent reason or necessity, to make a hurried, uninformed decision. If you feel rushed, pressured or remain uncertain as to whether you know enough to feel relatively comfortable with your choice, wait until you are. Obviously, however, there is no reason to unnecessarily prolong the decision making process beyond that time frame needed to acquire, and to understand, such information and delays should NOT be the result of unwarranted procrastination.

With this basic information, the educational learning process can begin and more INFORMED decisions are then possible. I will be happy to answer specific questions that anyone may have."

I hope this helps! - John@newPCa (aka) az4peaks
John@newPCa.org (aka) az4peaks
 
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DUKE MEDICINE
Judd W Moul, MD responded:
In general, localized prostate cancer in the modern era has an excellent prognosis after either surgery (radical prostatectomy) or modern radiation therapy.
We estimate prognosis using risk groups of Low, Intermediate and High Risk. Men with low risk have a low risk of spread (metastases); men with intermediate have a slightly higher risk, and men with high risk have a still higher risk.
Low risk men have a PSA less than 10 and a Gleason sum of 6 or less and have a clinical stage of T1c or T2a.
Intermediate risk men have a PSA between 10 and 20 or a Gleason Sum of 7 or have a clinical stage of T2b.
High risk men have a PSA greater than 20 or a Gleason sum of 8 or greater or a clinical stage of T2c or T3/4.
You should ask your urologist and/or radiation oncologist to state the stage that he/she believes your husband has. It looks like maybe he has an intermediate risk, but I would need to know his stage. Also, the number and/or the percentage of the prostate biopsy cores or needles that contained cancer is also used by many doctors to further risk stratify men with prostate cancer.
As far as survival, I would need to know more information to give you more precise prognosis. However, if he does, in fact, have intermediate risk localized prostate cancer, then I would expect him to have a 90-95% 5-year cancer-specific survival or even better. The stats at 10 to 15 years after treatment is a little worse, but, in general, he likely has a darn good chance of dying of old age or another cause and not prostate cancer. He needs to make sure he continues to follow up with his cancer doctor or urologist after treatment to make sure his PSA test is staying low. If the PSA rises back up again in the future, he may need additional cancer treatment to increase his odds of dying of old age and not having serious problems from or dying from the prostate cancer.
Overall, I would agree that his prognosis is probably excellent.
Best wishes,
Dr. Moul
 
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0liver replied to az4peaks2's response:
Thank you. he is Caucasian, age 70 Gleason 7 clinical
T2c[B2> PSA was 4 then 2yrs later 7 then this yr. 10.58

I tried to log on to your web site but was told it did not exists


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