Clinical Trial Results: Gleason 6
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- เผยแพร่เมื่อ 10 ก.ย. 2024
- Referenced Study: Prostate Cancer Screening with PSA and MRI Followed by Targeted Biopsy Only: www.nejm.org/d...
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0:40: What is Gleason 6 prostate cancer?
3:40: What benefits does an MRI have over a random needle biopsy?
5:34: Does Gleason 6 metastasize?
7:10: What are the most important results of this recent study?
9:48: Are there any cases in which a random needle biopsy is necessary?
10:51: Why opt for an MRI first, instead of PSMA pet scan?
11:36: Should patients always try to get a 3T instead of a 1.5T MRI?
12:22: What are the downsides of treating Gleason 6 prostate cancer?
13:59: Alex's Conclusion
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I cannot fathom just how many men this short video could spare the worry, pain and cost associated with unnecessary procedures and treatments. A patient armed with a link to the Swedish study detailed in this presentation would have objective evidence when meeting with his physician that could dramatically alter the more traditional approach to prostate cancer diagnosis and care. Another very useful video! Thank you.
Oh my God! You have no idea what this news means to me. I have been on an emotional roller-coaster for the past 3 years when I was first diagnosed with prostate cancer. I have been monitoring my PSA since I was in my Forties. I am a black man with a family history of the disease. Three years ago, I noticed an increase in PSA from 2.5 to 3.5 and did some research and decided to go see a urologist. I should mention, I had no symptoms, my prostate was normal in size and a Digital Rectal Exam showed nothing of significance. However due to my family history my urologist encouraged me to do an MRI which came back showing I had 3 small suspected lesions. He recommended I do a random biopsy and a test to rule out any infection of the prostate. He then scheduled the biopsy. On the day of the biopsy, I’m lying on my side all prepared to start when I asked him if he saw the results and if my prostate was infected. It turns out my prostate was infected and the biopsy couldn’t proceed. I decided to see another urologist for a second opinion. After waiting six months, I saw a senior well-respected urologist. She eventually conducted a random biopsy, 3 out of 15 cores confirming cancer, Gleson 3+3=6 group 1, Piride 3. She wanted to do a radical prostatectomy immediately. This was the recommendation from a senior urologist, head of the department, at a learning hospital. I asked her what would she do if this were the diagnosis given to her husband. She advised me to get a targeted biopsy. She was gracious enough to recommend an excellent urologist in another country with the latest MRI machines and technology. Long story short. I redid the MRI and had a targeted biopsy 3 out of 15 samples confirming Gleson 3+3=6 group 1 Piride 3. He recommended I enter into active surveillance and do another PSA test 6 months later. What no one has really explained is how damaging a biopsy is to the prostate. The actual procedure was uncomfortable but not painful, however you ejaculate bright red blood for many weeks thereafter, for me this was very disturbing. It has been 4 months since my biopsy and my prostate is still recovering. My PSA before my first biopsy was 3.5 and 3 months after it went to 4.2. My PSA before my second biopsy was 4.0. I haven’t yet done my 6-month PSA test. Wish me luck.
I hope and pray you find a balance and pray you get a solution. I can’t even explain how emotionally I’ve been drained about my dad’s illness. This is why I’m here. And also his PSA was 514 then he started the immune therapy zoladex while he’s been diagnosed of metastatic prostrate cancer
Also getting different medications and I been the one to be with him is all round mentally draining for me so I pray yours never get to that
Sending you all the hope and care
Don't worry, you will soon get a way out to take proper management for the problem . my prayers.God bless
Thank you so much for your prayers and encouragement@@josephtf9026
Prayers for you sir. God bless.
I too have Gleason 3+3 grade 1 prostrate cancer detected and advised Robotic prostatectomy. However after doing extensive research, of course on videos, blogs, blogs on TH-cam and internet , I am forced to conclude:
1) unnecessary Biopsy on prostrate can aggregate a docile and harmless cancer into an agreessive form of cancer which can spread and metastise faster
2) Gr 1 cancer ( Gleason 6) must be left to itself for sometime say 1 year , when again the MRI should be done
3) I am going to follow Metabolic approach to dealing with my cancer, ie by starving the cancer cells and use of short bursts of Albendazol treatment
I have learned so much over the past several years by watching your videos and reading your books. In fact after being diagnosed with prostate cancer (Gleason 3+4) I had already decided on the kind of treatment that I was going to take. In 2019 it took me to go through 3 urologists before I could find a Dr (Mayo Clinic) that would do a mpMRI BEFORE a biopsy. That result was a Pirads 1. So the next three years my urologist checked my PSA every three months with a DRE. In 2022 because of my PSA 6.3 we decided to do a mpMRI. That test result was a Pirads 4. The PCRI recommended that I have a targeted transperinal biopsy. My urologist didn't perform that style of biopsy but another urologist in the clinic did and did a targeted biopsy. The urologist wasn't happy to only do a targeted biopsy and said he would note in my medical chart that I deviated from the standard medical care. The biopsy revealed that the lesion was a Gleason 3+4=7 and was favorable. My urologist said we could do active surveillance which would include a PSA and DRE every 3 months, mpMRI every year, and a genetic test. If the cancer became more active then I would have to begin treatment. Since my Dad also had prostate cancer and not know if his was a aggressive cancer I opted to take SBRT radiation. I would have preferred they would have done a targeted treatment but they did the standard radiation of the whole prostate. I would have also preferred a combination treatment but my urologist/onocologist said they did not want to 'over treat' me. Even though this past year has been a challenge, my journey has been much easier through your videos, books, and your help center.
With deep gratitude,
Duane
This advice is for anyone that’s getting a biopsy. There is a relatively new procedure called a transperineal biopsy that does NOT go through the wall of the rectum. When going through the rectum for biopsy you chance of getting an infection is about 10%! A transperineal biopsy reduces that risk to (.5%)! If you urologist, doesn’t use this method find someone who does, because catching sepsis isn't a pleasant experience.
Great info. Started out with a PSA of 5.2. Followed with MRI (pyrads 4 w/ 12mm lesion). Had a biopsy, semi targeted which revealed 3 cores Gleason 6. No symptoms and now on AS. I am 67 years old and hopeful this is something that I live with and do not die from. Thank you for your wonderful insight on this. I chose faith over fear. Thank you for asking great questions followed by informative answers.
I had a full-on blood test with Function Health. This is through Dr. Mark Hyman and associates. If I didn't take this blood test and urinalysis, I would probably have had no idea as to my PSA levels. My PSA was 13.7 as well as my FSH about the same. One of the recommendations was - "When discussing your levels with a doctor, make sure to evaluate estradiol, DHT, and your testosterone panel, including SHBG." These other tests all were good. I then went to my PCP and had another PSA test. The results: 15+. Things are looking interesting! The urologist suggested I have a biopsy (of course) and I said "your dreaming buddy and I'm not here to support the MMM (money making machine). Actually, didn't exactly say it like that to the doctor but I did in fact challenge his viewpoint. I was there for the dreaded DRE with my kid in tow (10yrs) and was told it was benign. However, we all know just how far can the doctor really get a feel (no pun intended) for the prostate. The urologist then stated the suggestion for an MRI. I stated that there may be some reasons for the elevated PSA. I'm just about there (couple of days) to re-do the PSA test only this time without possible reasons for the elevation. It does concern me when I hear others concerned with a score of 2.2 or 3 obviously. In the interim I requested through my Dr., an ExoDX test which imo is worthwhile. I'm quite frankly amazed that the needle biopsy is still done! It's essentially gambling. Interestingly, the founder of the PSA test does not adhere or recommend it. Check out his talk from England. Lastly, the urologist told me that if this PSA result is 10 or below, he will consider just monitoring, period. Still scratching my head on that one as there are others who are bent out of shape with very low single digit scores (psa).
So? How did it go?
Your PSA is too high, how big is your prostate?
I have been blessed with both BPH and good old Gleason 6 (3+3). The former ailment being a much bigger issue for me, and I finally underwent TURP surgery last July. Surgery was successful IMHO, preservation of sexual function, off the pills, no leakage. Surprisingly, my PSA is still elevated 18.6, so my urologist suggested a bone scan, which found some issues but may not be related at all to the prostate; and had another biopsy recently which showed 2 positive cores out of 12 samples. Likely line up in the queue for a PSMA Pet scan this year for peace of mind, although this is at least a 5 month wait in my region.
Thank you both🙏🇺🇸 I have learned so much!
I'm 63 and my PSA rose from 3.4 in July to now 4.5, along with my Free PSA dropping below 10, also have a family history of prostate cancer so I am having a second biopsy in 2 weeks, can't have an MRI due to metal inside. 2 Years ago I had a biopsy that was good except for a couple of samples that were abnormal. Time will tell.
As I mentioned in another comment, there is a strong correlation between vitamin D3 levels and PC. It would be advantageous for you to do some due diligence with this advice. Good luck.
Thank you. I had my second biopsy yesterday now I wait for the results.
My first MRI back in 2021 was a PIRADS 1 after my PSA jumped from 1.2 to 2.0. on dutasteride so double that PSA #.
PSA stayed steady till Thanksgiving 2023 when a UTI caused a jump to 3.2, but since came down to 2.17. Urologist ordered up another MRI, PIRADS 4, transperineal 12 core biopsy showed Gleason 7 4+3, 3+4 and 3 cores 3+3, 5 cores benign.
MSKCC downgraed the unfavorable to 4+3 to 3+4. Decipher score came back Friday at 2.9, Low Risk of spread and mortality at 5-10-15 years out that correlates with Memorial Sloan Kettering pathology. PET PSMA scan was clean other than artocoval node 2.6 suv uptake that is of no concern I'm told. So yea the targeted fusion biopsy found the Gleason 7 3+4 but also the 3 cores 3+3. I have to treat this but a relief its not aggressive, last two PSA's were 2.19 and 2.17 same range for the last 3 years.
Excellent video as well as very good speakers (Alex) not to mention Dr. Scholz's ties are always the best!
Thanks for the video & I'm so glad to find this chanel!! I'm diagnosed last year of Gleason score 3+3 of the left apex after the biopsy. I had to fight to get an MRI prior biopy, but the eurologist said he still needed to take 12 samples to make sure even the MRI did show the suspicious lesion of the left mid peripheral zone. Then he has me on active surveillance. My PSA went down from 4.09 March last year to 3.51 recently. I met with him last week and he still want to do a 12 core biopys again, said meed to do different spot to make sure not miss anything. I asked for MRI again and said no other option. I should look for another opinion per suggestion here.
I have kidney disease and was told by my urologist that I couldn't have an MRI. I had a random biopsy and found cancer in one sample, 2+3 and told to just watch it. Then my urologist resigns from his position. I really enjoy you channel and all the info provided.
It sounds like you got misinformation regarding MRI with kidney issues. To the best of my knowledge and research, you most certainly can get an MRI and or Catscan with kidney disease. I think your nephrologist would be best suited to make that call. Perhaps having to find a new urologist is a blessing in disguise
You guys are the best. Thank you for what you do!
In My case a casual PSA gave a value 17. Kept on monitoring.It was rising and rising. Needle tests on the basis of MRI images did not show cancer. After 2 to 3 years the PSA rose to 34. Now a biopsy of a doubtful area showed Adenocarcinoma with a 3+3 gleason score. Doctors at TATA cancer centre followed aggressive treatment in the year 2014 . Harmone therapy and radiation. It is 2024 and I am at pSA of
0. 40 to 0. 45 surviving with side effects.
Hi the amount of vital information we getting from watching these videos are priceless,thanks
Thank you for all you do!
My story is PSA 2.2 - had an MRI which was fine had a biopsy to double check given family history and found two very small 3+3 regions. Second MRI a year later shows one PIRADS 3 area not in same place as 3+3 was found at biopsy and PSA was 2.2. I am getting another MRI in two years time. I fairly reassured but it’s very confusing as well. I’m only 55 so I suspect something clinically significant lies in my future, but hopefully many years away.
Please read a book of Robert Marckini
So glad I switched urologist. My former urologist wanted to do a random biopsy. My new urologist ordered an MRI first. There is a pirad 3 that came up. So he’s going to recheck my PSA in July and go from there. My PSA was 2.61 but recently came back at 1.93.
MRI is not always available and neither is a "center of excellence". Please consider the world in which people live. When I arrived in Southern California I had my first MRI for active surveillance. I do appreciate your content that is very informative and helpful.
I'm just recently diagnosed and still in the process of figuring things out. I'm a few months from turning 62, no family history of PC. Last year my PSA went from a 6 to a 7 so my PCP referred me to a urologist. Had a MRI back in November, no lesions and a PI-Rads score 2. Just 2 weeks ago I did have a targeted biopsy, 14 samples taken, 2 came back with a Gleason 6, 2 Gleason 7 (3=4=7). The Gleason 7 are both on the left side. The percent of the cores for the Gleason 7 are not that high but it is still a 7. I meet with my urologist in 2 weeks to discuss how to proceed. I'm really not excited about any of the treatments available so will try and just do active surveillance - hoping the doc agrees. So far this has not been much fun, so much information but there never seems to be a good answer to how to proceed. Much appreciate these videos though.
Good luck!!!
2 Important things to look into: Joe Tippens protocol & benefits of large dosage of melatonin!
I would say, you should seriously look at the correlation between vitamin D3 levels and prostate cancer. In my opinion, it would be in everybody’s best interest to have extremely high levels of vitamin D3 in their system.
I had a biopsy done and got sick from sepsis the day after. I had no idea how close to dying I was. After close to a month after the biopsy, I got a UTI and had to be readmitted to the hospital. My PSA level was a 3.9 and went up to a 4.5 after being on some antibiotics. It looks like the antibiotics rose my PSA levels. Anyway, I was close to doing radiation, then I got convinced to have surgery. I finally went to Sloan Kettering and the doctor there suggested active surveillance. He ordered an MRI and saw some slightly moderate areas of suspicion which could be cancer. I now have to do another biopsy soon and my PSA levels have shot up to a 10.4! My Gleason score is a 3+3=6. My father had aggressive prostate cancer and treated it with radiation and he seems to be doing fine now.
Since discovering my PSA levels of being slightly elevated, I have been on a roller coaster ride as to what I should really do and wish I never got tested.
Any trauma to the prostate, will cause an elevated PSA level. Having the biopsy is extreme trauma to the prostate, and UTI also is traumatic to the prostate gland. You should wait six months and have your PSA level checked again after no trauma to the prostate. In the meantime, start taking vitamin D3 on a regular basis in 10,000 units per day doses. Do some research about the correlation between vitamin D3 levels and PC.
Not surprised that you got sepsis as there is about a 10% chance of this occurring after a transrectal biopsy. You should always opt for transperineal biopsy. If your doctor does not perform this type of biopsy, find a new doctor.
THANKS AGAIN FOR THESE VIDEOS ❤
I have been on a plant based diet and exercise. My PSA has dropped from 3.71 to 2.8. Is this good news. JLH
An interesting segment on this topic would be welcome " Prostate MRI and PSMA-PET in the Primary Diagnosis of Prostate Cancer"
Very good information
Is there a link to this study or the name of the study?
For the sake of accuracy, a squamous cell cancer is a serious one since it can spread (metastasize) but surgical removal massively reduces this possibility. Gleason 6 would be better analogized to a basal cell tumor which may grow but does not spread. However prostate and skin cell growths are unique and can’t be exactly equated.
What is a typical ramp-up learning period or case numbers for a new Proton Bean Radiation Center?
I believe that you’re arguing for not calling Gleason 6 cancer. I have G6 and therefore understand the impact of the “C” word. As a side note, my PIRADs 5 MRI abnormality showed no Gleason 6 in those needle cores. So I continue active surveillance - and can no longer donate blood to the Red Cross… :(.
One question I have is: If Gleason 6 is denoted, is that an actual tumor, or just an area of the prostate gland which is less normal in its characteristics?
IM 70 years old and my MRI came back PIRADS-5 with a 17mm lesion entirely on the left side only. Targeted biopsy in 2 months from now in March. So it is possible for the biopsy to come back negative or a Gleason 6? Lesion has not broken thru capsule. Right side shows nothing.
My PSA is 16. MRI showed a lesion. Targeted biopsy showed 3 samples of stage one cancer. A PET scan was done. Gleason is 3+3. Now I'm getting 39 weeks of photon radiation and lupron. Does that sound right?
I have a psa of 14. What are the odds of me having Gleason 6? My doc pushing for random needle biopsy.
Interesting. Don't forget, some men, (me), get an MRI that shows the entire prostate gland is a likely clinically significant tumor. In that case, shouldn't the next step be a random needle biopsy? Isn't that a situation that calls for random needle? My biopsy showed 4+3 and 3+4 pretty much everywhere in my prostate.
Also the psma pet scan
This is clinically significant. What is your doctor telling you?
Definitely warrants some serious concerns. Your doctor is the one best suited to have a conversation with you about this. It would be in your best interest to get a second opinion from another doctor that specializes in this area.
Hello i have a question i dont think i can answer....help
I had biopsy 3 years ago found 2 cores out of 18 with 3+4 5% grade 4, longest length of pc 6mm, psa fuctuating around 7!
3 mri scans 1 per year showing nothing!
Question....Does there have to be a tumour for pc to spread outside the prostate? Thank you
Yes, assuming that you had a quality 3T MRI. There pretty much has to be something visible on MRI for metastases.
However, if you want to be 100% sure that you are not the 1 in a 1000 exception to the rule, you can get a PET Scan to be sure.
For more specific questions and information, please reach out to our Helpline here: pcri.org/helpline
I'm on my second urologist having a PSA of 6 now. 1st one only had access to transrectal biopsy method though said a systematic biopsy was required in addition to targeted biopsy. 2nd Urologist this time Johns Hopkins only uses transperineal biopsies, a big plus. But still seems insistent on using both biopsy methods if I am eligible to get the possible HIFU treatment. I'm scheduled for an MRI and will continue pushback on using both biopsy methods. I am using this video link, a link to Swedish study and an excerpt from New England journal of Urology which suggests it is up to the doctor to decide this matter. MRI scan has to first verify a probable tumor before anything will be done. I do see several urological centers seem to quote as "standard of care" when they mention the biopsy requirement. Meanwhile when I check out Britain's methods they do not have this requirement.
Hello Lynn, here is video you may find helpful. Clinical Trial Results: Gleason 6 #ProstateCancer & Targeted Biopsies: th-cam.com/video/nOmK2B5Y9Go/w-d-xo.htmlfeature=shared
Well, my comment was added to the video you recommended. I wholeheartedly agree with the video. I did see it after I saw my Johns Hopkins urologist and passed it on to him on our message forum there. He hasn't responded yet. He may have just missed it because their message format is easy to miss. He is using the possible use of HIFU as requiring both types of biopsies. It seems to be a common theme since I've gotten the same message from both doctors. The only purpose I can see is they are filling a data table with both results. I have my MRI June 8, a Saturday. When I review results with the doctor assigned for that, If MRI calls for a biopsy, I will do only the targeted biopsy. I will also reject further treatment if I am otherwise qualified for HIFU except for this extra mandated random biopsy. That is my current plan. I am puzzled by the resistance I seem to get from Urologists who seem intent on getting that extra possible 5% of 3+4 small tumors which can be dealt with later with yearly MRI scans. Suggestions on Urologists who could provide my HIFU treatment if otherwise appropriate?
At minute 6:25 Dr. Scholz discusses whether Gleason 6 tumors can turn into something more aggressive. Though the answer may be no, the real point is that either a Gleason 7 or higher was not sampled or that somewhere down the line the prostate may develop a gleason 7 or higher.
Or that the person who read the pathology report was off by a small margin. Mistakes happen
My targeted biopsy revealed Gleason 6, but since my PSA was 23, I wasn't given the option of not treating.
It’s always your decision on how to proceed not your doctors. Put your foot down take deep breath and evaluate all of your options and remember your body your decisions. Finding the doctor if they don’t agree.
2018 PSA went to 10 from 3, had biopsy high Gleason score, had 28 sessions of radiation plus firmagon injections, was found to be clear after treatment. OK for two years the PSA went up to 5, biopsy again confirmed small amount of cancer with a high Gleason score. Had one scan showed no metastatic , Dr not happy sent me to a cancer hospital had a PET scan which confirmed stage 4 in the lymph glands. Have been on Erleader tablets daily and Eligard injections every three months, my PSA has been 0.1 for eighteen months now. Only symptoms are from the treatment, sweats, some tiredness, aching muscles. Does this mean cancer is in remission?
When to screen with MRI, micro-ultrasound and/or PSMA Pet Scan?
How about instead of an MRI you have a psma pet scan?
Because of the cost of a PSMA scan, a lot of Insurances won't pay for it.
Great info!
You need an actual diagnosis of cancer from a biopsy before insurance will cover a psma scan. An MRI will show significant cancer only. G6 is considered insignificant and in most cases doesn't even show on an MRI.
If cost is not a problem, is the psma pet scan the better choice?
Yes, the PSMA pet scan is the "gold standard " now.
Absolutely, I did 4 MRI & 3+4 Cancer didn't show up until I did PSMA Pet Scan
great had a urilogist who wnated do to a random biospy one me without mentioning the MRI
The sequence usually is random biopsy before MRI. An MRI is not a diagnosis. Diagnosis only comes from a tissue sample biopsy.
any urologist that is any good would do an mri first
@@rustyme1122
I disagree with the sequence reference above. You get the MRI first which shows something then that would indicate that you need a biopsy. Why would you do something so invasive unnecessarily and then follow up with an MRI that makes no sense.
@@njboesman Because an MRI is not a diagnosis. And also insurance. Insurance will not pay for an MRI before initial biopsy in most cases.
@@rustyme1122 you are correct, but if you get a spike in your PSA of over 30% year over year, that would be cause enough for approval by insurance. All insurance companies are different, sometimes its the way its presented to them for approval. MANY times we've had the physician resubmit the request regarding bills and such. IMO having an invasive and costly biopsy could be avoided with a less costly MRI. I would like to think, insurers think the same way as it only makes better sense.
Yes, why are MRI's significantly less costly in the EU
So, a G6 doesn't turn into a G7? My insur does biopsies not MRIs
How do you know you have a G6 then if you don’t get coverage for biopsies. Did you pay out-of-pocket for a biopsy?
My PSA level is normal based on my age (64) now 2.2 vs 2.4 6 months ago and I'm on Finasteride for my BPH. My PSA level at 2's has been stable for the last 5 years. Both my MRIs show 0.04 cm lesion. Last MRI says lesion is small and stable. My PSA density is 0.07 per MRI. Also my 4K score says I'm low risk for PCA. My ExoDx test last month says i have 21% chance of getting cancer. My urologist thinks the lesion is not cancer and not eager to for biopsy. Should i get Prostate biopsy?
No biopsy in my opinion. Is there PC in your family? But don’t weigh that as a reason to do a biopsy. My PSA has been elevating since 2017 (1.9 - 5.8). My follow up MRI (Dec/2023) indicated no change and one lesion actually “resolved itself” (I don’t think I really ever got a great answer on why). My Decipher is very low a 0.23, low risk. However, the pathology report to me is where the rubber meets the road. The pathology report is the most concrete and factual information. I do have more 3+4 but low percentage. Also, the way the Mayo Clinic words the Gleason report as opposed to UCSF, where I did the follow up biopsy and MRI is a little unclear, though the doc said no significant change. With all your good results, density being so low, I would think you skip it and do it when and if the numbers change significantly. Thanks for sharing!
@@MM-sf3rl. What was the driver that made you do the biopsy? Is it the increasing PSA level or the lesion on your MRI?
@@BMT-by5ve It was the standard protocol for active surveillance. Because having 3+4, all on one side of the prostate, I think I need to be more aggressive. Kinda, you can’t manage what you don’t measure. However, due to having no perceivable change in the MRI, the doctor agreed not to biopsy the benign side. In high sign I wish I would have. The biopsy isn’t a big deal; at least for me. However, they never discuss ejaculating blood, which is the most fu!ked-up thing about the biopsy. It goes away in 3 weeks.
@MM-sf3rl Thanks for sharing. But I'm curios what made you decide to get the biopsy the first time?
@@BMT-by5ve PIRADS 5 was found at the local imaging center (2 Tesla). Mayo Clinic downgraded it to PIRADS 4 (3 Tesla). Either 4 or 5 would mean “clinically significant cancer is likely to be present”. From the American College of Radiology, PIRADS 4 and 5 are recommended for biopsy. Other factors was the gradual rise in PSA, one brother who recently has PC, and desire to collect facts - pathology report.
Gleason 6 but PSA=13...does that change the decision to have the biopsy?
Ditto
My situation is similar. Rising PSA topping out high 13s. Nothing significant on last two MRIs. Doc still wanted to do yet another random biopsy, just to be sure. I agreed. One core showed 5% G6. No big deal. I've had two random and one targeted biopsy and 3 MRIs. Bottom line is I have no significant cancer even with a high PSA. My advice is insist on a 3T MRI and trust the images. If nothing is there, there's nothing to worry about. G6 typically is so insignificant it doesn't even show up on an MRI.
If you have a G6 diagnosis, you must have already had a biopsy.
@@rustyme1122 I have had 2...a clean biopsy, and one that resulted in the Gleason 6..they want me to have another after a year due to the high PSA
@@Allessio777 Instead of another biopsy, insist on a 3T MRI. It's time to take images and see what they show.
i had a targeted MRI based biopsy for elevated PSA. i wanted this procedure to minimize the cores taken to 8-12. To my surprise they took 15 cores. 5/12 were positive for cancer but 3 were taken from the same suspect area. All 3 were positive. This made the gleason score 3+4. My question is - isn't this double or triple counting of the same area?
Is it possible Biopsy's generate a significant amount of revenues for doctors ?
Define significant. While I’m sure that there are some abuses by doctors, doing biopsies unnecessarily, I feel that this is more often the exception than the rule.
В одном ролике вы говорите что глисон 6 , не дает метастазы и не расспространяктся ,, и это не опасный вид рака ,, а в другом вы говори те что , глисон 6 может перерасти в более агрессивный рак ,, это как?? Если 6 не стойт даже лечить а лишь наблюдатся ,, спасибо
Здравствуйте, вот видео по Gleason 6, которое может помочь: th-cam.com/video/a0sjUallZQU/w-d-xo.html
If G6 NEVER goes anywhere why does G6 need to stay on AS?
What study has been done that shows that G6 will NEVER go anywhere?
What are the other risk factors that confirm G6 will NEVER go anywhere?
What study has been done that shows G6 does not mutate to G7 - 10 or grade 4 or 5?
What evidence says that you can confirm with conviction that pattern 3 and G6 will NEVER go anywhere?
I wonder, if someone has G7, weren't they a G6 at some point???
I think, in some ways, they are now expression that this thought pattern is evolving, i.e., 3+3 in a benign cell. And this clinical study confirms the premise. It may also be that you will not find cribiform or interductal or other aggressive cancer cells in 3+3 or even 3+4 (not a doc so not sure if that is the case). I wonder if it would hold true when having a genomic test done. All 3+3 are not aggressive cells and the genomic test would confirm that it will never become aggressive.
@@boblongmore907At diagnosis in 2010, I was a G6. But my cancer was discovered during a digital rectal exam where the tumor was easily felt. I opted for surgery and the pathological Gleason was 3+4.
I did appreciate Dr. Scholz's analogy using skin cancer. The needle biopsy found the G6 (basal cell) and the surgery found the G7 (melanoma).
His premise is that a 3+3 is really a 3+3 and there are no other areas with a higher grade.
what about PIRADS.?
This is just a metric used for the an MRI. It’s based on a scale of one to five whereby one and two typically mean nothing to be concerned about three is equivocal. Four and five indicate suspicious areas that need to be further investigated with a biopsy.