I recently met a survivor who was having difficulty understanding his advanced prostate cancer.
He was recently diagnosed with a PSA of 2.4 but a Gleason of 9 (5+4). In addition, he had a positive bone scan. What was confusing to him was how he could have an aggressive cancer (Gleason 9) and such a low PSA. I explained that it isn’t uncommon to have very aggressive advanced disease with a low PSA. Someone once described it to me by saying that “it’s as if the cancer just forgot how to make PSA.”
The take home message for us is that we should never assume that because our PSA is low, our cancer is not aggressive. Even with a low PSA we need to know our Gleason score to help us to make the best possible treatment decisions.
Joel T Nowak, MA, MSW