What is the prognosis for a man with a Gleason score of 9?

Cancers with Gleason scores of 8 to 10 may be called poorly differentiated or high-grade. These cancers are likely to grow and spread more quickly, although a cancer with a Gleason score of 9-10 is twice as likely to grow and spread quickly as a cancer with a Gleason score of 8.

How long can you live with a Gleason score of 9?

PBI combined with EBRT has excellent 15-year survival in men with GS 9-10 and clinical stage ≤ T2a. While 68% of men with T3 GS9-10 are alive at 10 years, at 15-year survival was 0. These men should be considered for alternate treatment strategies, possibly with early systemic therapy.

Can you survive Gleason score 9?

We showed that radiation-based treatments and surgery, with contemporary standards, offer equivalent survival for patients with very aggressive cancers (defined as Gleason score 9-10).

What stage is a Gleason score of 9?

Stage IIIC

The Gleason score is 9 or 10, and the PSA is any level.

What is the best treatment for prostate cancer with a Gleason score of 9?

Treatment with radical prostatectomy (RP) plus adjuvant external beam radiotherapy (EBRT), androgen deprivation therapy (ADT), or both (MaxRP) provides equivalent survival outcomes as EBRT, brachytherapy, and ADT (MaxRT) in men with Gleason score 9–10 prostate cancer, according to a new study published in JAMA Oncology ...

What Does Gleason 9

Is Gleason score 9 a death sentence?

There is a perception among a lot of patients — especially when they get diagnosed — that having a high Gleason score of 8, 9, or 10 is essentially a “death sentence”, regardless of how they get treated. This is not actually the case at all. Plenty of men with Gleason 8 to 10 disease actually do well after treatment.

What is the life expectancy with a Gleason score of 10?

Maximum estimated lost life expectancy for men with Gleason score 5 to 7 tumors was 4 to 5 years and for men with Gleason score 8 to 10 tumors was 6 to 8 years.

Can a Gleason score go down?

The decrease in proportion of high Gleason score cancers, however, was due to higher rates of low-grade disease diagnosis as a result of PSA screening. The researchers show that the shift in Gleason score proportions over time is not likely due to changes in the age at diagnosis.

What is life expectancy after prostatectomy and radiation?

Based on the natural history of localized prostate cancer, the life expectancy (LE) of men treated with either radical prostatectomy (RP) or definitive external-beam radiotherapy (EBRT) should exceed 10 years.

What is the success rate of robotic prostatectomy?

The positive margin rate was 9.4% for all patients; i.e. 2.5% for T2 tumours, 23% for T3a and 53% for T4. The overall biochemical recurrence free (PSA level<0.1 ng/mL) survival was 95% at mean follow-up of 9.7 months. There was complete continence at 3 and 6 months in 89% and 95% of patients, respectively.

Can you live 20 years after radical prostatectomy?

Our study shows that with long-term follow-up RP provides excellent oncological outcomes even at 20 years. While most men do require a multimodal treatment approach, many men can be managed successfully with RP alone.

What does a Gleason score of 4 5 9 mean?

Gleason score 9 or 10 (or 4 + 5 = 9, 5 + 4 = 9 or 5 + 5 = 10) Grade Group 5. The cells look very abnormal. The cancer is likely to grow quickly.

Does prostate removal reduce life expectancy?

After 23 years the men treated with radical prostatectomy gained a mean of 2.9 extra years of life. The researchers found that the absolute benefit associated with radical prostatectomy increased by a factor of more than two from 10 to 23 years' follow-up in terms of overall mortality and disease specific mortality.

What does a PSA of 9 indicate?

Men with a PSA level between 4 and 10 (often called the “borderline range”) have about a 1 in 4 chance of having prostate cancer. If the PSA is more than 10, the chance of having prostate cancer is over 50%.

What percentage of prostate cancers are aggressive?

Yet in 10 to 15 percent of cases, the cancer is aggressive and advances beyond the prostate, sometimes turning lethal.

What PSA indicates metastasis?

Conclusions: Serum PSA < 20 ng/ml have high predictive value in ruling out skeletal metastasis.

Can a prostate grow back after radiation?

Defining biochemical recurrence

This is because after radiation therapy the prostate gland remains intact and can recover some function. This is also true if you received hormone therapy as part of your radiation treatment: As you recover, testosterone levels rise, and so does your PSA.

How common is erectile dysfunction after radical prostatectomy?

A year and a half after surgery, impotence rates ranged from 66 percent among those who underwent non-nerve sparing prostatectomy to 56 percent among those in whom a bilateral (two-sided) nerve-sparing procedure was attempted.

Is prostatectomy better than radiation?

In conclusion, modern radiotherapy is superior to prostatectomy in terms of a patient's post-treatment quality of life. Obsolete comparisons of older forms of radiotherapy and prostatectomy do not reflect current knowledge.

How reliable are Gleason scores?

Overall accuracy was 58.3%. Both, biopsy and prostatectomy Gleason score correlated significantly with disease free survival (P = 0.001), furthermore the classification (Gleason scores < 7, 7 and > 7) was highly significant (P = 0.001).

How often are Gleason scores wrong?

In 29% of cases, high biopsy scores are downgraded to 7 or less after radical surgery, study finds.

At what age is prostate surgery not recommended?

Radical prostatectomy is the preferred treatment for men with prostate cancer that has not spread to other organs, but many doctors do not recommend the procedure for men over age 70 due to a perceived higher potential risk for complications.

Can Gleason 10 be cured?

Aggressive therapy with curative intent appears to be highly successful in men with Gleason score (GS) 10 prostate cancer (PCa), according to a new study published in the International Journal of Radiation, Oncology, Biology, Physics.

What does a Gleason score of 10 mean?

Cancers with Gleason Scores of 8 to 10 may be called poorly differentiated or high grade. These cancers tend to be aggressive, meaning they are likely to grow and spread more quickly. Cancers with a Gleason Score of 7 may be called moderately differentiated or intermediate grade.

How successful is radiation after prostate surgery?

The median time from surgery to radiation was 2.1 years (range 0.3–7.4 years). After a median follow-up time of 12.2 years, the 5- and 10-year BPFS was 35 and 26%, respectively, and OS was 86 and 67%, respectively. The median biochemical-free survival after SRT was 2.3 years (26).