Low Gleason Score (6 or 7) + High PSA? | Prostate Cancer | Mark Scholz, MD

Low Gleason Score (6 or 7) + High PSA? | Prostate Cancer | Mark Scholz, MD | PCRI

Рет қаралды 42,634

2 жыл бұрын

PCRI's Alex asks questions submitted by men in different situations that all involve low Gleason scores but high PSAs. Dr. Scholz is a medical oncologist specializing in prostate cancer, and he explains the significance, or lack thereof, of PSA when staging prostate cancer.
0:09 I am 74 years old with a high PSA (close to 80) but a favorable Gleason score of 3+4 with a very small amount of 4. Do I need to be concerned about metastases?
1:55 Can BPH or prostatitis be the culprit in situations when men have low Gleason scores and high PSAs?
3:01 How do you feel about active surveillance in a Gleason 6 prostate cancer if the PSA is high?
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The Prostate Cancer Research Institute (PCRI) is a 501(c)(3) not-for-profit organization that is dedicated to helping you research your treatment options. We understand that you have many questions, and we can help you find the answers that are specific to your case. All of our resources are designed by a multidisciplinary team of advocates and expert physicians, for patients. We believe that by educating yourself about the disease, you will have more productive interactions with your medical professionals and receive better individualized care. Feel free to explore our website at pcri.org or contact our free helpline with any questions that you have at pcri.org/helpline. Our Federal Tax ID # is 95-4617875 and qualifies for maximum charitable gift deductions by individual donors.
The information on the Prostate Cancer Research Institute's KZfaq channel is provided with the understanding that the Institute is not engaged in rendering medical advice or recommendation. The information provided in these videos should not replace consultations with qualified health care professionals to meet your individual medical needs.
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Пікірлер: 48

@aslammalik2317 5 ай бұрын

Needle Biopsy gave my Gleason score as 3+3, at my native place Srinagar ( Jammu & Kashmir India) . The test was repeated at Tata Cancer Hospital at Mumbai. The pathology lab at Mumbai gave gleason score as 3+3 . My PSA was 35 with a gleason score of 6 . My treatment at Tata institute at Mumbai included Harmone Therapy followed with Tomo Therapy ( Radiation ) The treatment was concluded on Fab. 20, 2015., At this stage is on January 2024 my pSA is 0.52. Treatment started on August 2014. Radiation was started in Fab 15, 2015.

@ACTIVEPAIR Ай бұрын

Thanks again👍🏽 My PSA was 43 in Nov 23, biopsy in Jan 24 and diagnosis Feb 24. Gleason 3+4=7. Not had any ‘normal’ treatment yet but because I kept declining Nuclear Bone Scan I was offered the PSMA CT PET scan so just awaiting results. Not rushing into anything yet👍🏽

@mmazkoory3628 2 жыл бұрын

Thanks Alex and Dr Scholz for this informative video

@jsusna1972 2 жыл бұрын

72-year old here, Gleason of 3+3(1 core of 12), PSA has fluctutated from 7-11 since biopsy in 2011. Still a good candidate for Active Surveillance? Thanks so much for posting these videos. They are very informative and take away a lot of the myths surrounding prostate cancer and present the information in an easily understood fashion.

@josephmaher1350 Ай бұрын

Very well presented - Thank you.

@jamestyrer6067 5 ай бұрын

THANKS FOR THIS VIDEO

@dino6161 6 ай бұрын

Wonderful info ! My PSA currently 20 7 years after a biopsy where my Gleason was 7 ( I forget whether this was 3 plus 4 etc) Ive been happy to use whatevr natural vitamins etc i hear about that might help to avoid the surgery I was urged to do, and now it looks like I've made the right decision, from what I've heard here.

@duanemcclun Жыл бұрын

I appreciate your informative videos. What's frustrating for me my urologist won't refer me to a medical oncologist and I have to have a referral. I'm a 66 year old male in Iowa who has been checked yearly (PSA and DRE) for last 20 years due to my father having prostate cancer. 2018 had a 4k score test showing 7% low chance. 2019 MPMRI showed nothing for a Pirads 1 low risk. PSA began fluctuating and began having 6 month PSA and DRE. 2022 had a PHI showing low risk of cancer (PSA 6.3), have BPH. mp MRI showed chronic Prostatitis and Pirads 4 (highly likely cancer) in an area. I'd like to hear from a medical oncologist but urologist won't refer me and the oncologist requires a referral - FRUSTRATING

@matto4647 2 жыл бұрын

65 year old. Just had second MRI showing BPH and inflammation no lesion. Biopsy showed one core out of 12 5% 4+3. PSA 18 Scheduled for focal cryotherapy. Is focal just based on biopsy OK.

@ernestovillarin7404 Жыл бұрын

Dr. Sholz, What is the difference between PSMA PET-CT and PET-CT?

@2Majesties 2 жыл бұрын

Alex/Dr -- If blood sugar and/or weight are creeping up under ADT, is Wegovy or metformin an option to help?

@saam7408 2 жыл бұрын

58 y/o on active surveillance based on Gleason group 2 (3+4 ) and very low volume 4 ( less than 5 % in single core) and PSA of about 4.8 . Had mp MRI with one area of Pi Rad 3 last yr. My MD wants to go a confirmatory biopsy at a major referral center now that is almost 1 yr since Dx . He wants to use same mpMRI for targeting the biopsy . Is a yr old MRI ok or should it be repeated prior to biopsy?

@jeffdavis4898 2 жыл бұрын

7.5 years ago psa 4.9 biopsy 1 4+3 and some other 6 and 7s. prostatectomy biop showed svi...now psa every three months. Post op psa started at ND but for the last yrs persistent at 0.04. Whats going on? Doc seems concerned but no action.

@dayu3970 Ай бұрын

I am 73. My PSA was 16 and my Gleason was one 4+3, 4 3+4, 3 3+3 out of 12 random biopsy samples. My urologist suggested surgery. I don't know if this is the best choice. Please advise. Thank you so much!

@AbdulRauf-np1uy 3 ай бұрын

71 year old having Gleason of 3+ 4 and 4+3 in reviewed biopsy, PSA of 4.9 , PSma pet scan confirmed localized disease. Can I still go for active surveillance. Diagnosed in November 2023 . Before 2 months psa came down to 4.2

@spencerian4853 4 ай бұрын

Below age 55 having PSA At 40, what are the curing treatment success rate & advise please.

@christophersargeant615 2 жыл бұрын

I had PSA 26, Gleason 3+4=7, MRI shows spread to neck of right femur and small parts of the pelvis. Can I expect a normal life-span?

@vic9098 Жыл бұрын

How are you now

@taiwanfocus4385 6 ай бұрын

I thought PSA usually is in the single digit range, but this video talks about PSA in the 70's. What does it mean? does it actually mean PSA 7-8 (which is considered high already)?

@speedypete3725 Ай бұрын

Have CLL CANCER, getting treated with the drug Imbruvica, before my psa was 4.0 now on drug it is 12.0. Would this drug effect my psa reading?? Thank You

@sandraredmond4812 Жыл бұрын

What about high Gleason score and low psa? Gleason of 9. PSa of 7

@dorseyjack3206 5 ай бұрын

My PSA is 21 and my Gleason scoe is 3+4 I am 73 years old

@gioralitvak9738 2 жыл бұрын

Historically I’ve had a low PSA score, never more than 2. Last year I had labs and my PSA was 1.95 but what’s called FREE PSA, which needs to be higher than 20 at minimum was only 10. That concerned me and after some research on line all the studies said “cancer.” My then urologist did a digit exams assured me I don’t have Prostate cancer. Nevertheless I asked and got an MRI which indeed showed a lesion. I found a different urologist to do the biopsy and I HAD aggressive Prostate cancer which required either radiation or surgery. CHECK YOUR FREE PSA LEVEL. Just to make sure. Regular low/high PSA isn’t always conclusive

@Vinny.X 2 жыл бұрын

Any physician assuring you that you don't have prostate cancer based on a digital exam.... RUN!!!! If the story is accurate, TOTAL QUACK!

@Vinny.X 2 жыл бұрын

Me personally, I would pretty much never consider prostatectomy except for some kind of extreme circumstance such as where proton therapy isn't beneficial and prostatectomy might give you some kind of palliative relief, etc. Typically, there is very little chance of the surgery saving lives and very great chance of the surgery making you miserable. Just my opinion.

@andresmsuarez5718 Жыл бұрын

wondering mine i have free psa 30 but psa its 4.82 in the 4kscore (4.3). i see urologist in couple weeks. he make me do this 4kscore , i going to get also a bladder ultrasound.

@schmingusss 18 күн бұрын

@@Vinny.X After watching countless men talk about their prostate cancer journeys on this platform, I've come to the same conclusion as you Vinny. The cancer always seems to pop up again. Unless of course there is a bias as men who are cured after their prostatectomies aren't posting videos any longer.

@vasileiosfrangos8055 2 жыл бұрын

First of all I appreciate your video and the info about this topic. I am 58 years old. Diagnosed with prostate cancer, gliason score 7 and with most being 3+4 and less being 4+3, psa score 90. all examinations resulted that the cancer hasn't spread and is still inside the prostate. Psma pet scan also shows that the cancer hasn't spread outside. One month ago I finished the 39 radiations and I am still continuing the Hormone therapy. Of course you never know what will happen in the future but according to your experience and knowledge do you think I have good chances to get rid of this problem? Thank you from Greece!

@ThePCRI 2 жыл бұрын

Hello, Our helpline may be able to provide you with some information about cure rates and remission rates for men in situations that our similar to yours. Since you are in Greece, they can correspond with you via email. You can submit a form here, and they will contact you: pcri.org/helpline.

@Vinny.X 2 жыл бұрын

Just FYI, no scan or test can tell you there is no cancer spread outside of your prostate. All a negative scan can tell you is there is no spread LARGE ENOUGH TO BE DETECTED outside of your prostate. In other words tiny cancer lesions will not be detected. Technology isn't there yet.

@Vinny.X 2 жыл бұрын

PSA 90 is really high and increases your chance of spread outside of the prostate. I'm not advising you of anything but you might want to discuss with your doctors having preventative proton therapy to your pelvic lymphs now rather than possibly later if lesions are detected. There is no perfect exact answer to that question, so maybe discuss with your doctors that know your case.

@phillipmackintosh8079 2 жыл бұрын

In 2019, I was 58 with a Gleason 8 and a PSA of 93. Multiple tests showed it was NOT metastatic. Three years later I am cancer free, having completed hormone therapy, and brachytherapy and a five-week course of External Beam Radiation (this was fascinating). My most recent PSA was 0.05. There is hope my friend. Every good wish!

@heehow9664 Жыл бұрын

@@phillipmackintosh8079 uh he h😮😮😮

@MFCorcoran 2 жыл бұрын

Hi thanks for your videos! 54 y/o single, 4+3 Gleason 7. High volume. PSA 31. All scans (NM bone, MRI and recent PSMA PET) are clear / organ confined. Docs want surgery or HD braechy therapy followed by external beam radiation. Really haven't come to grips with either definitive treatment course. Any other options I can look at? Thank you!.

@ThePCRI 2 жыл бұрын

Hello, We have this playlist of videos that are relevant to intermediate-risk prostate cancer, which our organization refers to as the "Teal" stage prostate cancer: kzfaq.info/sun/PLHj3V3RB2V-jo-HQRnJI6Ies7yw3LIrWK Intermediate-risk ranges from "favorable intermediate- risk," or "Low-Teal" as we call it, which are cases with a small amount of Gleason 3+4 (and less than 15%-20% Gleason 4) to "unfavorable intermediate-risk," or "High-Teal," which are cases of high volume Gleason 4+3, which seems to be what you are describing about yoursitutation. This is all assuming that the pathology grading has been confirmed by pathologists with a lot of experience in prostate cancer (or, more generally, genito-urinary cancers) if appropriate. We have more videos that you can find by searching things like, "PCRI Gleason 4+3," "PCRI Teal," or "PCRI intermediate-risk," for example. If you have any further questions, feel free to contact our free helpline at pcri.org/helpline. We have patient advocates who are trained to help men research their options for these kinds of situations and to help you form questions to best coordinate with your physicians.

@MFCorcoran 2 жыл бұрын

@@ThePCRI thank you. I have watched quite a few of, if not all, of those videos. I will review and try to fill in any gaps. I was particularly interested, after seeing "treating high risk, Gleason 8, a modern approach", in how to determine whether I am a candidate for PSMA PET assisted AS. My docs at U of Penn are dismissive. I would love to have more information about this (and how it relates to my particular cancer) before moving to another treatment. Is there anyone on the east coast who shares Dr. Scholz views on this? Does Dr. Scholz take telamed appointments? Thanks again! You all are wonderful!

@Vinny.X 2 жыл бұрын

Hi, first off, no test can definitely say organ confined. See other post. Also, if considering any kind of beam radiation look into proton therapy. Very high patient satisfaction. I have zero financial interest or job connection of any kind to proton therapy.

@ashbarette2513 2 жыл бұрын

Hi… I have been diagnosed of prostate cancer with 3+4, 4+3 and 3+3. Medicare has denied Pet Scan. What are my options. Thank you very much for your informative videos

@lyfandeth 2 жыл бұрын

Ash‐ Your doctor's Medicare billing assisstant should know a workaround. I.e. an MRI of the bladder "with focus on the prostate". That gets billed as the bladder MRI, which is one billing code, but tells the radiologist to make sure the prostate in fully imaged. I don't know if PET vs MRI will be an issue, but docs usually can work with Medicare IF the papers are properly coded.

@paulcunningham6609 2 жыл бұрын

If you have a high or increasing PS and confirmed PCa diagnosis Medicare will approve a PSMA PET CT Scan. Just has one myself with a PSA of 9. and biopsy of only 3+3 after focal laser ablation.

@ashbarette2513 2 жыл бұрын

@@paulcunningham6609 hi….my PSA is not high….highest was 3.9 What treatment u r getting.

@ashbarette2513 2 жыл бұрын

@@lyfandeth hi….Thnkx. My Doctor is appealing to Medicare. Hopefully it’s approved.

@paulcunningham6609 2 жыл бұрын

@@ashbarette2513 I had a focal laser ablation. PSMA PET CT scan was clean. Just getting an MRI in a couple months. Active surveillance

@maxthemagition Жыл бұрын

So a 76 year old gets up three times a night to wee and goes to the doctor who takes a blood sample and it comes back with a PSA of 11. He gets a letter from the hospital to come and get an MRI because his PSA is high. He gets his MRI And gets another letter to go and get a biopsy and then within a few weeks is asked to meet with a consultant who gives him the bad news….Gleason score of 4/3. The consultant recommends radiotherapy and hormone treatments. So far the poor pensioner has had to suffer a biopsy which has no doubt damaged his prostate because his semen had changed colour and is now clear (where did that come from he wonders?). Also stress knowing that his reproductive organs will be zapped and possibly castrated with chemicals. God knows what his future will be….. All because he went to the doctor about getting up to go the the toilet three times every night. Was that visit to the doctor worth it?

@schmingusss 18 күн бұрын

Do you think it would be worth it if he's 56 rather than 76?

@maxthemagition 18 күн бұрын

@@schmingusss I dare say yes, because cancer is cancer…the earlier caught, the better and radiation treatment can almost cure it along with Hormone therapy, if localised and contained inside the prostate as was my situation. I do not know anything about the surgery. Given the choice I would opt for radiation therapy because today all my troubles with the after effects seem to have diminished, almost gone after 6 months . The NHS has total experience and knowledge in dealing with cancer and I cannot praise it enough.