Prostate carcinoma

[pinkes]

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Can anyone provide me what does Gleason score 3+4 mean?? (PSA 11.2)
If biopsy shows perineural invasion, but no symptoms what are the chances of carcinoma spread?? What tests do u recommend other then bone scan?? DO u recommend CT scan/MRI?? Whats the usual cost of robotic surgery??

 

[gudog]

Can anyone provide me what does Gleason score 3+4 mean?? (PSA 11.2)
If biopsy shows perineural invasion, but no symptoms what are the chances of carcinoma spread?? What tests do u recommend other then bone scan?? DO u recommend CT scan/MRI?? Whats the usual cost of robotic surgery??

Need more info, ie, clinical stage (dre results).

Then you can more accurately predict stage with any of the calculators out there (partin tables, MSKCC calculator).

BTW, CT/MRI rarely needed for pre-treatment staging/decision making. Bone Scan usually reserved for patients with high risk features (PSA>20, Gleason grade 8-10, clinical stage T3).

 

[pinkes]

DRE was actually normal...and dint hv any symptoms..but PSA last yr was 8 n this yr 11 so biopsy was done and came out positive for adenocarcinoma...( family history positive)

Whats the usual cost for Laproscopic prostatectomy??
Why cant we operate immediately after biopsy?? someone told me wait for 15-20 days after biopsy and then go for surgery...can u tell me why??
when is the good time for bone scan?? should it be close to surgery?

 

[pinkes]

Gleason score is 3+4 ...can u tell me what does it mean?? what does 3 and 4 stand for??

 

[cpants]

Gleason score is 3+4 ...can u tell me what does it mean?? what does 3 and 4 stand for??

Google Gleason Scores. It's a histopathological grading system. Numbers range from 1-5. The first number is the most common grade seen in the specimen, the second is the second most common grade seen. Sometimes a tertiary score is reported, usually if there is grade 5 present in the specimen, but it is not one of the 2 most common grades present. These numbers have prognostic value. Lap robotic prostatectomy is very expensive. If these are questions for a patient you are treating, you should pick up any basic urologic textbook and everything will be a lot clearer. I recommend Smith's. If this is for yourself or a loved one facing this diagnosis, you should seek out the advice of a board certified urologist or urologic oncologist.

 

[pinkes]

Thanks Cpants.....I goggled gleason score..but dint get satisfactory answer so thought of asking here.....ur answer make a lot of sense....

with perineural invasion do u think it's a good idea to go for robotic surg?? (bone scan yet to be done, i ll post result once it;s done).

 

[cpants]

You need to consult a urologist in person. There are various options for treating early stage prostate cancer, and the correct choice will depend on the characteristics of the patient's disease, the patient's age and functional status, patient preference, availability of treatment options, financial considerations, and other factors. These are questions to ask the doctor.

 

[pinkes]

I have few question regarding prostate carcinoma..

1. What's the importance of perineural involvement??
2. How many Lymph nodes are usually removed during prostatectomy?
3. If Ct scan shows enlarged para aortic Lymph nodes and around illiac vessels,
what does that mean?? should they be removed during surgery or just sentinel lymph nodes biopsy is enough?
4 if after prostatectomy gleason score 9, pt3a n0 m0-----> do we need radiation or chemo treatment?

 

[Winged Scapula]

The Urology forums are not designed for answering "homework" type of questions or for offering medical advice. They are designed for applicants, residents and current urologists to address topics of interest to them.

Therefore, your question is best placed in the Clinical Rotations forum and will be moved there. Anyone who wishes to answer your questions can do so there, or you can find many of your answers in surgical textbooks rather than Google.