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Re: 2nd opinion on biopsy elevated to Gleason 8 - need advice!
Al,
Several things come to mind.
First, because one of the cores is evaluated as Gleason 4 4 does not mean your biopsy result is also an 8. Cause the overall result encompasses all the cores, hence I believe you are still a 7.
Second, even though one of your cores has an 80% cancer finding, dont assume that the cancer volume is large overall. I had two cores with cancer as high as that and after surgery (2 months later) my pathology report was 10 to 15% cancerous tissue overall. Likely your urologist and mine were both skillful in taking the cores where cancer volume was highest.
Third, I do not agree that you should request bone scans and such. With your low PSA you can be assured that they will come up negative. Even on the off chance that some cancer has left the area you can not expect it to show up on the bone scans yet. Of course if your doctors want it you should comply.
Finally, I would do some research on the Internet or wherever on the implications of having the stronger cancer finding in the apex area. I don't know much about that myself, but I do think there are some implications, and you might as well understand them.
Best wishes
