Confused by PSA/Gleeson/TNB

I think they look at a number of factors when classifying prostate cancer including gleason score, psa and staging. Any one of these can put you in the high risk group.

Looking at your numbers I think your staging will put you in the high risk group. 

T3b prostate cancer refers to a stage where the tumor has spread to the seminal vesicles. It may also extend outside of the prostate on both sides.

Hi Brizzy1. The risk group criteria can be found here:

www.macmillan.org.uk/.../staging-and-grading-of-prostate-cancer

Hi Brizzy1, the results from your treatment are excellent, and hopefully will be all you ever need, but because your cancer was metastatic," it was in the seminal vesicles," suggests a degree of aggressiveness, and as such there can be no guarantee every single cancer cell has been eliminated, hence for now you are classed as high risk mostly as a precaution, and to make sure should there ever be a recurrence, it's caught very early and taken care off.

Eddie 

Hello Brizzy1 . As Sandberg has said, each of the different elements in giving you the diagnosis can have different risk factors but the experts tend to treat according to the highest risk which in your case is the T3b which puts you in the very high risk group. The hope is that the initial radical treatment has done the job but there is a chance that some cells may have already spread before this could happen so hormone therapy tends to be added in for a longer time. Prostate cancer is usually made up of different types of cells (heterogeneous) which respond well to initial treatment. As time goes on any cells which might have escaped could have seeded and might start to grow, especially if you have been on HT for a long time resulting in a recurrence or a progression. These cells will multiply in their same image (homogeneous) which are less receptive to HT but usually can be treated with radiotherapy if there are only a few sites (oligometastatic). At a 10 PSA it is classed as being on the cusp of the next risk group but the rate at which it got there is also taken into account.

These risk groups are not perfect indicators of your risk for developing recurrent, aggressive prostate cancer. Currently, there are extensive, ongoing efforts to develop tests that can aid physicians in more accurately telling the difference between cancers that will become fatal from those that will sit in the prostate without spreading. 

Monitoring with the PSA means that any increase will be quickly caught and treatment to keep the cancer at bay can be instigated. Your current level is excellent and I hope it stays like that.