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Joe,
That is generally true. Occasionally there are some high grade aggresive cancer cells that seem to forget that they ever started out as prostate cells and don't put out much PSA. Then there are the irritated non-cancerous prostate cells that do put out more PSA then normal. Nothing is absolute, that I can think of, when dealing with cancer. It always feels like you are in a poker game with your life being bet. You can play the odds, and know the odds, but you never know if you will win the game.
Joe, as is usually the case, I agree with Frank's specific and overall comment here, BUT.......
Dr Stephen Strum has a different point of view from that expressed by your new urologist. Strum believes that in many cases, as Gleason Grades increase, the cells become more differentiated and primitive and lose the ability to create PSA. Therefore, given the same tumour volume, it may well be that the PSA 'leakage' is smaller with a higher Gleason Grade. BUT.....
Because higher Gleason Grades are usually asociated with more aggresive tumours which grow very much faster than lower grade tumours, the total PSA expressed rises because the tumour volume rises.
In other words, in terms of this theory, individual cells gradually contribute less PSA, but since there are many more cells being created, the total PSA count rises BUT......
At least 24 varieties of prostate cancer have been genetically tagged - see 24 VARIANTS at www.yananow.org/24Variants.pdf and it may be therefore that both your new urologist and Strum are correct, depending on which variety of prostate cancer they are dealing with.
I don't know if you have come across Dr Strum's book A PRIMER ON PROSTATE CANCER see it at http://www.yananow.org/Primer/PrimerBook.htm but I think it is one of the best technical books about the disease.
Terry, thanks for the enlightening response. My PSA coninues to rise (PSA-10.6,PSADT<12 mo) and yet 3 biopsies have yeilded only one core of GS6 at <5%. On 7/1 I'm having an MRI done whose results will be interpreted by software (VividLook)that is suppose to produce color pictures of tumors. (check out their website). I'll post back next week if they actually can see an tumors on the MRI.If they do see something that appears to be a tumur I plan to visit Dr Bahn for my next biopsy.
Terry, what you meant to say was that with increasing Gleason scores, into G4 and G5, that the tumour cells become LESS differentiated. Not more. Differentiation has to do with the cells becoming specific to their purpose, with prostate cells becoming mature and looking and acting like prostate cells and completely different in purpose and function than a stem cell which may have developed into a lung cell or nerve, or whatever. This de-differentiation (odd word) means the tumour cells become more primitive, and less like normal, developed, mature prostate cells.
The normal, developed, healthy prostate cell is the end result of differentiation.
There is a mathematical formula that relates psa to volume per cc of tumor by gleason grade. The lower the Gleason grade the higher the psa per cc of tumor volume. High grade PC gives off little psa per cc of tumor. It is used to estimate tumor volume if you know the psa and gleason grade. The formula used to be on the PCRI website under PC tools. Dr Bahn also uses this formula so he knows what to look for in terms of size and agressiveness when using CDU.
