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.
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.
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.
@@markE946 Broelaine and Turmeric, primarily taken for the bromelaine which helps my mobility, but also D3, 1000iu daily, Graviola, Astragulus, blackseed oil, occasionally MJ oil.
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👍🏽
@@ACTIVEPAIRwhy did you not want the nuclear bone scan? I know it’s radioactive but if treatment is needed then radioactivity is used if the prostrate is not removed for various reasons. It’s great news that the cancer is contained in the prostrate but with a 4 in your gleeson count, you need to not wait longish.
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
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!
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!
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.
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.
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.
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!
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.
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?
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)?
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.
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
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
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
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.
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.
@@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.
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!.
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: ua-cam.com/play/PLHj3V3RB2V-jo-HQRnJI6Ies7yw3LIrWK.html 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.
@@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!
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.
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 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.
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
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.
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.
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.
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.
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.
What natural vitamins in particular?
@@markE946 Broelaine and Turmeric, primarily taken for the bromelaine which helps my mobility, but also D3, 1000iu daily, Graviola, Astragulus, blackseed oil, occasionally MJ oil.
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👍🏽
PSMA showed no metastasis, overjoyed 😁
@@ACTIVEPAIRwhy did you not want the nuclear bone scan? I know it’s radioactive but if treatment is needed then radioactivity is used if the prostrate is not removed for various reasons. It’s great news that the cancer is contained in the prostrate but with a 4 in your gleeson count, you need to not wait longish.
@@BlueFlame-q6s 60% false positive rate on Nuclear Bone Scan!
@@BlueFlame-q6s PSMA showed no metastasis 👍🏽😁
@@ACTIVEPAIR excellent, best wishes for your future.
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
Thanks Alex and Dr Scholz for this informative video
Very important information.
Very well presented - Thank you.
THANKS FOR THIS VIDEO
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!
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!
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.
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.
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.
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!
@@phillipmackintosh8079 uh he h😮😮😮
Dr. Sholz,
What is the difference between PSMA PET-CT and PET-CT?
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.
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?
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)?
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?
How are you now
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.
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
Alex/Dr -- If blood sugar and/or weight are creeping up under ADT, is Wegovy or metformin an option to help?
Below age 55 having PSA At 40, what are the curing treatment success rate & advise please.
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
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
Any physician assuring you that you don't have prostate cancer based on a digital exam.... RUN!!!!
If the story is accurate, TOTAL QUACK!
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.
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.
@@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.
What about high Gleason score and low psa? Gleason of 9. PSa of 7
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!.
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: ua-cam.com/play/PLHj3V3RB2V-jo-HQRnJI6Ies7yw3LIrWK.html
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.
@@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!
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.
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?
Do you think it would be worth it if he's 56 rather than 76?
@@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.
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
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.
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.
@@paulcunningham6609 hi….my PSA is not high….highest was 3.9
What treatment u r getting.
@@lyfandeth hi….Thnkx. My Doctor is appealing to Medicare. Hopefully it’s approved.
@@ashbarette2513 I had a focal laser ablation. PSMA PET CT scan was clean. Just getting an MRI in a couple months. Active surveillance