What Does Gleason 7 Mean? | Ask A Prostate Expert, Mark Scholz, MD

[@stanknowlton7043]

My cancer escaped the prostate, went through the seminal vesicles and up into the backbone. After surgery, hormone treatment and radiation, all at the same time, my psa is almost non-detectable after eight years. Always hope.

[@surya779]

Hello sir, my father is diagnosed for the same problem. His prostates cancer penetrated to nearby lymph nodes, pelvic area and lumber spine. His Gleason score is 4+3 and 3+4. PSA is 246. The dr is suggesting only hormone therapy, no surgery, no radiation and told us the life expectancy is 2 to 5 years. Can you please share your treatment plan and experience with us. Thank you so much.

[@your_royal_highness]

Well I sure am glad your situation worked out and I hope the respondent’s dad does well. Mine was (is?) a 3+4 with apparently a fairly large lesion and I got treated with the nanoknife. It uses electricity so no radiation, no cold, no heat. Mine was at the bottom of the prostate. I had a perineal biopsy and it was confirmed on the Gleason that way. I was told by the surgeon my PSA should drop by about 30%. My first (and only to date) test showed an 80% drop in the PSA. So, I am well aware this is a lifetime surveillance situation. My continence is fine, I had already suffered some ED but I would admit it is worse, but I would trade that for not having urinary issues any day. Both my regular urologist and his partner, the surgeon said I did the right thing. The surgeon said he himself had agreed to active surveillance with 5 patients and when it was time for an intervention, the cancer had spread in 4 of 5. I sometimes regret not having done more research or getting another opinion but all in all, I probably did the right thing. I am 70, the surgery was done beginning of May 2022 and my first PSA was in August. Due for another in a month or two. Fingers crossed. I will do another biopsy, I will do another MRI and will do regular PSA tests. I hope the next biopsy (my 4th) will be the last for a long time. If it recurs, which i know is a possibility, I will have to decide at my age, if it is really worth it to do another nanoknife (which had an impact for at least 5 weeks) is worth it.

[@Steven-wg3fm]

@@your_royal_highness ok

[@glenrose7925]

This talk directly answered some of my questions. Thanks, you guys are terrific. So much more informative than 15 minute visits with a urologist. All of your discussions are educating me so I can make good decisions about my own treatment, should I need it and decide to go forward. i am 74 with 3+3 diagnosed two years ago. PSA fluctuating between 4.9 and 7.5 all the time. My recent MRI shows some growth in the identified lesion. I was worried about that but this discussion gave me some good information to factor into my thinking. At 74 my decisions are weighed against how long my natural life may last and my slowing sex drive as well. Even if I go to 3+4 I may elect to do nothing. Thanks again.

[@khcopter]

That video is the best one so far. I feel like my doctor lied to me. I’m definitely getting a second opinion he wants to remove the prostate with a score of 3=4 . No cancer in the lymph nodes all contained within the prostate gland . He told me radiation absolutely wouldn’t work. I just can’t believe how helpful this video has been to me thank you so much for making it!!

[@timbruce8366]

Never trust a Urologist's opinion alone. Do your research Like these videos) and get at least one more opinion..

[@khcopter]

@@timbruce8366 I had proton treatment finished the 38th session in August it works!!

[@timbruce8366]

@@khcopter I have the book by Robert Marckini discussing proton beam. I would strongly consider this if and when the time comes. Am currently on active surveillence.

[@boblongmore907]

What is he? Urologist, Surgeon or radiology oncologist. IN MY CASE I'VE TALKED TO ALL 3.

[@williamwaters4506]

What was your outcome?

[@zahidchaudhry9694]

My psa level came high today,after going through various medical channels I luckily came across your channel and was so relieved to hear you explain every possibility in detail,now at least I know what to ask my doctor. God Bless you Doc

[@atb2manboberconsulting744]

Probably best explanation of Gleason score I have heard in my ten years of treatment post radical prostatectomy.

[@boblongmore907]

I'm looking at surgery. How did yours work out? What was your Gleason? Mine 3+4=7... 3/14 cores have c cells

[@SinnerSince1962]

@2:15, NO! They are not telling patients the ramifications of the scores, and gloss over the meanings of them as if patients don't really need to know (just do as I say, don't question me). I've basically had to dig for every bit of information, and the PCRI has been my savior! My gosh, if it weren't for Dr. Scholz's videos, I'd have been totally lost. I wish I was a multi-millionaire so I could lavishly donate to this cause. For men, it's right up there with St. Jude's as far as I'm concerned.

[@doconn]

Great resource to educate and aid in participating in making decisions about treatment. Thank you for providing the information in a way that's easy to understand and it covers the entire journey of treatment to include options if the cancer returns.

[@ThePCRI]

Thank you!

[@chrisburnett9905]

One of the things almost never addressed in these videos on PSA and Gleason scores is the likelihood of urinary and sexual dysfunction following prostate treatment. Having gone through successful treatment (radiation) nearly 10 years ago for a Gleason 7 (4 plus 3) grade cancer I know that the fear many men have of side effects is very real. I've totally lost the ability to get an erection and hold back large quantities of urine in my bladder. However, at age 70 now, I'm happy to be alive and still in relatively good health. I'll take the tradeoff.

[@johnmchale8308]

I was diagnosed with 2 cores 4+3, 3+4 originally at a great institution in New York City, went across the street to Memorial Sloan Kettering and it was downgraded to 3+4 for both.....pretty unsettling grade 3 down to Grade 1. I had my biopsy 6 weeks ago, just had my followup PSA still steady at 2.17 double that because I take dutasteride so basically 4.35 been at this range for about 4 years now.....

[@surya779]

My father is diagnosed for the same problem one month ago. His prostates cancer penetrated to nearby lymph nodes, pelvic area and lumber spine. His Gleason score is 4+3 and 3+4. PSA is 246. The dr is suggesting only hormone therapy, no surgery, no radiation and told us the life expectancy is 2 to 5 years.

[@dipakchauhan6269]

How is your father now ?

[@jamessteffany9228]

l'll pray for your father. I've been diagnosed at 4+3 7 on the geason scale also!! My surgery starts in October!!🫰

[@clark3830]

Sometimes it is found by TURP procedure as in my case.

[@SinnerSince1962]

Yep, they usually biopsy those cuttings.

[@chriscars3578]

I have been told that I am between 7/8 score and I am not sure on which route to go down 🤔 r

[@dougg1075]

What did you decide?

[@DarrenYoung-vt9ic]

I have score 3 plus 4 equals 7 I n Been told to do active surveillance wat do I do

[@keepitsimple007]

I’m the same - am doing active surveillance. Doctor was the one who suggested it. I have changed my diet and exercise/ stretch more.

[@camiloquesada5731]

@@DarrenYoung-vt9ic how many percent of pattern 4 do you have?

[@DarrenYoung-vt9ic]

90 per cent 3 ten per cent 4

[@DarrenYoung-vt9ic]

@camiloquesada5731 90 per cent 3 ten percent 4

[@DarrenYoung-vt9ic]

@camiloquesada5731 90 percent 3 ten percent 4

[@terryodonnell2873]

Can you discuss the importance of only 1 tissue exam being a 4+3. Versus let's sat 6 or more 4+3’s.

[@ThePCRI]

Hello, our prostate cancer helpline may be able to ​help with your question. Please feel free to contact us here: pcri.org/helpline

[@priyankapatil4112]

Which treatment is best for Gleason 3+4 please suggest?

[@ΜΗΝΑΣΑΡΓΥΡΙΑΔΗΣ]

Hi my gleason score was 3+5 i allready took 28 radiations also i take hormon therapy, the question is for how long i'll take the hormon because the radiation Doc says 6 months but the urologist insist for a year, thank you

[@bryanmanderville4196]

Get another Opinion quickly or a few I had a doctor thought he was going to kill Me with injections now I am in a great cancer Institute in Miami Florida and no more hormones for the time being with a prostate my psa is 0.06 was 13.7

[@dipakchauhan6269]

How is your health now sir

[@antonioreyes6120]

What is Gleason 4+4 with PSA of 7.3

[@ThePCRI]

Just based on that information, that appears to be some level of high-risk prostate cancer, and more towards the favorable end of high-risk, but there are a few caveats. First, we usually recommend getting a second opinion on a pathology report from a center that has pathologists who specialize in genito-urinary cancers to confirm that the interpretation of Gleason 4+4 is correct (we usually recommend Jonathan Epstein, MD at Johns Hopkins, but there are other options). Then there is the question of whether your biopsy was a random 12-core biopsy or whether the biopsy was performed after an mpMRI that detected a suspicious lesion. It is possible for a biopsy to miss higher grade cancer, but that likelihood is a lot lower if an mpMRI was used to inform the biopsy process. Your doctor should recommend a body scan, hopefully a PSMA PET scan since they are the best that are available (except for the ~10% of people whose cancer does not produce PSMA), and that scan will be able to tell you if there is any obvious spread. If there is, then that will change the stage depending on where it has spread and to what extent. Also, if is a scan is clear, it is still possible for there to be microscopic spread, and that likelihood can only be calculated using the Gleason score, PSA, tumor volume, etc. If the risk of there being microscopic spread is high enough--which is usually is in "high risk" prostate cancer--then adjuvant hormone therapy is usually used to improve cure rates. So, that isn't enough information for thorough staging, but based on what you have said so far, the cure rates for high-risk prostate cancer, especially towards the favorable end of high risk, are pretty high, especially with combination therapy. Here is our playlist of our staging guide videos for high-risk prostate cancer: kzbin.info/aero/PLHj3V3RB2V-ietm3-kNkx48kbUnbtunL8 And you are welcome to contact our free helpline at pcri.org/helpline if you have any more questions.

[@johnmarshall448]

There are some men who have not posted a comment about having prostate cancer because they are dead. Get a PSA test and do not procrastinate.

[@jojoromano]

I think the doctor was not able to explain what does a Gleason 7 mean, which is my grade or score.

[@ThePCRI]

Hi, please reach out to our Helpline team so they can help you regarding your specific case: pcri.org/helpline

[@sherindumond4290]

Husband is Gleason score 7 Psa was 3 during Dre a lump was found he has one lesion plus an additional 6 smaller lesions total biopsi samples 18 dr has an appt set up to talk to radiologist in 4 weeks having a bone scan done today going March 6 th to discuss if radiation or surgery based on my husband decision . Original mri showed an aggression lesion scale 5 we have talked to friends who has had radiation and those who have had surgery the friend who has had radiation states he wish he had surgery he is much younger than my husband the other friends who had surgery has not regretted it as of right now husband is leaning toward surgery he is 72 no major health issues blood pressure controlled

[@boblongmore907]

Vids r informative re explanation of Gleason. Drs do not explain. Diagnosed with 3+4=7 Gleason. GG2, 3/14 cores with c cells, PSA 4.2. Ive spoken to Urologist, Surgeon & radiology oncologist. At the moment looking at radiation or surgery.

[@motorrunnenmolly8031]

Thank you Doctor. all my doctors in Canada are not updated on the latest technology. Is there a chance you could direct me to someone in Canada that is updated.because my family doctor will not go against the uraolagest specialist here!? thank you once again and your wonderful host.

[@4HisGlory07]

Hi. I am about three months into this. The first urologist SAID wanted to immediately do a biopsy as he had checked my psa in his clinic saying i was at 10-after I had a bladder infection. I stewed about the 10 for a few weeks and had it tested by the VA-it was 5.5, NOT 10. Now two years later two labs show a 10. So I had the big mri and it shows two , 2mm spots and one small lesion in the capsule. My present urologist has me scheduled in 5 days to have a fusion mri biopsy. I live near Seattle, and only find the one clinic that offers this mri directed biopsy. I have not found any reviews on this dr. Did you find any drs to help you. ?

[@motorrunnenmolly8031]

Doctors don't tell you that there is other things that make your P.S.A. go higher mine was really low they did a biopsy they could not find anything.I know one thing watch out for dirty cancerous biopsy needles it's sad to say its all a numbers game to them for money.

[@susangoodman4925]

@@4HisGlory07 Drs. Scionti and Sperling in FL look good. Separate clinics, much less invasive than surgery and radiation.

[@tomslick2058]

A 2mm tumor is mighty small even eith a high Gleason. I guess size doesn't matter.

[@jamespmullin21753]

High risk 7

[@snakemanmike]

I am getting my 36th of 39 radiation treatments today. I have been on hormone therapy for 3 months. I am told that I need to take "at least" 12 months of it. My Gleason was 4+3=7. My cancer had spread beyond the prostate, so the margins after surgery were not clear. There were no cancer cells detected in the lymph nodes. However, I have started having chronic headaches, so I am getting an MRI of the brain on Monday to make sure it hasn't spread there. I am scared.

[@johnmchale8308]

Stop with the Kamala Harris campaign ads please....I'm not here to listen to politics and listen to any political party !!!!!!

[@ThePCRI]

We don't have any control over the ads that play before our videos! KZbin decides what to show based on their own algorithm

[@jamessteffany9228]

Thank you for your explanation. I was diagnosed at the score 4+3 at which is at 7 on the geason scale. having surgery in October!l 🫰