Two Tumours

As I have no experience of this I really can't comment.  Have you tried talking to the specialist cancer nurses on the prostate cancer uk helpline?  Unfortunately they are not there at weekends but are open Mon to Fri 9am to 6 pm and on Wednesdays 9am to 8pm. 0800 074 8383  They were invaluable to me during my diagnosis and choosing treatment and so good to  know that there is someone there who can answer your questions as quite often once we got home from the hospital we had loads of questions to ask which we hadn't thought of during consultations.  The number is 0800 074 8383.

I had never used anything like this telephone service before - though I had used on line health forums.  Since then I have used a few telephone services for a couple of my other problems, such as British Heart Foundation helpline as quite difficult to get in touch with Doctors and nurses as they are very busy people and Dr Google is not always that useful and can cause more worry than anything else.

Take care

Des

Hi Bl

I have read that you can have different Gleeson scores for two different tumours.

I could be wrong but I think that is a bit unusual though, I had 2 tumours and was just quoted a Gleeson 6.

Probably the most important question u might have is, are they both contained and not near or too near the prostate capsule edge.

If contained then in theory everything should be a lot simpler

Steve

Hi

Sorry to hear about this.

It is usual to have more than one PSA test, but since investigations have already proceeded, there is little point in repeating the test at this time.

The MRI results do fairly clearly indicate malignant tumours, but this is not 100% certain until the biopsy results confirm it.

If there are 2 tumours, then although there are (very few) different types of prostate cancer tumour.  However, the most common type is an "acinar adenocarcinoma" so although it's possible the two tumours are the same type i.e. acinar adenocarcinomas, it's also possible they're different cancers.

This is something you should definitely ask, as doctors don't always tell you.  Different cancer types have different implications.

Click here to find out more about the different prostate cancer types

It is important to know if either of the tumours have grown through the prostate capsule (wall of the gland), grown into any nearby tissue e.g. the bladder, seminal vesicles or pelvic lymph nodes.  It's possible that the MRI has detected any of these and the biopsies may detect growth through the prostate capsule.

This is something you might like to ask about.  Doctors do  not tend to say anything about this if NO such things were detected.  They only tend to say anything if any of these ARE detected.  If they say nothing it's a good sign, but personally I like to be told there is NO problem, rather than just not being told anything.

The biopsies, if positive,  will result in 2 "Gleason" scores, one for each tumour.  The scores go up to a maximum of 10 and are made up of 2 numbers added together e.g. 3 plus 3 = 6.  Note that for odd numbers, the combination of the 2 numbers can be either one of 2 ways around e.g. 3 + 4 = 7  or 4 + 3 = 7.  In this example 3 + 4 is better than 4 + 3.  These numbers indicate how at risk the tumour is of spreading, or you might hear this referred to as how "aggressive".  The higher the number, the higher the risk.  If the tow score are different, it makes no difference what they are, it's the highest score that is the main concern

You can find more information about Gleason scores from the same site linked above.

You shouldn't have to ask about the Gleason score, doctors usually say, but ASK if they don't. and keep a note

If the biopsies are positive, then a bone scan should be carried out.  This is quite important, if the doctor doesn't mention one ASK why not, they will have to have a reason for NOT doing one.  A whole body CT scan might also be ordered.  These will entail a further delay and another appointment following the results.

The results of the MRI, biopsies, bone scan and CT scan are put together to give a "Staging"   This is either a "TNM" or a "number" staging.  The staging indicates how far the cancer(s) have spread. This is important as it determines what treatment options are appropriate.

If the doctor doesn't say what the TNM or numbers staging is, you might like to ASK.  Although some doctors do say, I have been through this process twice and neither time was anything said.

The doctor may just subsequently say something like the cancers are "early localised" or "locally advanced" or "advanced".  I was never told this either!

Again, you will find the link above useful.

You could guess what stage the cancers are at from what treatment options are offered, but a) personally I prefer to be told and b) if you don't know what treatment options are appropriate to each stage then the options are relatively meaningless.

You might like to ask at the next appointment about all possible treatment options, but until staging is done, then the most appropriate will not be known.

I hope this helps.