First time post , needing a little help !

Thank you both so much , yes I thought Gleeson 3 and 3 was a great result! But  the psa has jumped in such a short time. I made your point about the template , but they said as they could see some thing on mri a target approach would suffice. We will be really determined for the template biopsy now. 

Really appreciate your time and kind words xxx

Hi Lynn , thanks for the response , yes they said if this one is higher , they will repeat in a week , and then another biopsy , gp has written a letter to the consultant today. Yes that makes perfect sense about the upgrading, and reassuring to know your thoughts about the enlarged prostrate to the psa levels , he has been given tamsulosin, which seems to be working. 

An increase in Prostate size which happens to men to varying degrees as they grow older can account for some increase in PSA but this is usually a slow process but may be accelerated by growing tumours. There are so many variables and consultants with the tools that are available to them plus histology are best placed to give an opinion on a specific case . That being so, perhaps is is best not to speculate but seek more precise opinions from consultants, particularly when what they say may appear to be contradictory.

hi guys , we still here lurking in the background, hope you amazing people are all well .

So from psa 2.9 in August we now find ourselves at 5.2, psa tests every 6 weeks have seen slight increases  every time, we have said we really want the template biopsy now , although still low in psa terms , are we right to be concerned that a Gleeson score of 6 previously, that some further action is warranted? 

Feeling deflated , probably phycological as hitting a whole new number 😥😥 advice would be very much appreciated xx

It is not common for a Gleason to change from one thing to another (ie G3+3 becoming a G4+4) but it is possible that the G3+3 is very active and / or that there are other clusters elsewhere in his prostate that are a higher grade. 

I stick with my previous comment though. If he is not yet ready to have radical treatment then it seems pointless having a template biopsy. If on the other hand, he is thinking "I am only 43, this cancer needs to be dealt with now" then he can go straight for the radical surgery / radical RT option. I am not sure what a template biopsy adds either way. 

Anecdotally, it often seems the very young men diagnosed end up having a more aggressive, more determined cancer. I think if this was my brother or friend, I would be pushing for more detailed scans and radical treatment.

I can't remember whether you have completed your family yet? If not, time to deal with that aspect might be the only really persuasive argument for delaying treatment now?