Biopsy and Other Tests

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Comment by Arnon Krongrad, MD on July 2, 2009 at 12:58am

Jean-Jacques,

It's a bit hard to know if the cell shapes change with time or if with time we are sampling different cells with different shapes. In any event, we do know that cell shape, as measure by the Gleason grading system, is different between the biopsy and the final radical prostatectomy specimen. This change can be up or down the scale. It is more commonly up the scale, which means the biopsy under-represents the cancer more often than it over-represents the cancer.

Radiation makes it hard to grade prostate cancer and I'd defer to a pathologist for this question. Perhaps Dr. Gleiberman can comment.

Arnon

Comment by Jean-Jacques MERMOD on July 1, 2009 at 11:18am

Does the Gleason score evovle with time and in which direction following treatments?
7 years ago my Gleasen score was 9 is it likely to be the same today after radiotherapy and ADT?

Comment by Steve J on January 18, 2009 at 6:01pm

Circulating Tumor Cell serum marker for PCa monitoring, especially but not exclusively metastatic PCa.

The latest paper I have found is this:

deBono JS, et al., "Circulating Tumor Cells Predict Survival Benefit from Treatment in Metastatic Castration-Resistant Prostate Cancer."

"CONCLUSIONS: CTC are the most accurate and independent predictor of OS (overall survival) in CRPC (castrate-resistant prostate cancer). These data led to Food and Drug Administration clearance of this assay for the evaluation of CRPC."

See www.pubmed.gov and search on PubMed ID 18829513.

PubMed is a service of the US National Library of Medicine.

My med onc has offered me (extensive Gleason 9) the opportunity to have this test done. I declined but am having second thoughts because it can help to estimate the prospects even for those who are not afflicted with metastatic PCa.

A headscratcher, but in this business, what isn't?