Wednesday, 17 August 2011

The Results.

Before I get to the actual results, I think I need to explain the finer points of Gleason scores and staging systems...the finer points being what I understand them to be anyway !

I assume somebody called either Mr Gleason or Dr Gleason made these up which is why it is called a Gleason score...I haven't a clue and am guessing but will put it on my list of things to ask the consultant the next time we see him.
I think the Gleason scores only relate to prostate cancer cells..I assume there are different scores for different cancers made up by different people with different names..I dunno. I might ask that too.

Anyway, there are 5 different pattern types of cancer from nos.1 through to 5. Number 1 being the least aggressive and number 5 being the most.
When they take the samples from the prostate (cores), they generally take about 12.
The prostate,for those who dont know is a walnut shaped thingy just below the bladder and around the urethra which makes the white stuff that produces sperm among other things and is also something to do with contractions during orgasms.

All the cores are looked at and all the cancers found are assigned a pattern number according to the picture of patterns. The most cancers cells with that pattern are given a number and then the next most are given a second number, and those two numbers are then added together to give the gleason score.
For instance 3+3 is a gleason of 6 and 3=4=7 and 4+3=7...when you have a gleason of 7, the numbers making that 7 make a difference. A 3+4 is less aggressive than a 4+3 because the first number is the most cancer cells present......geddit?, nah, me neither !...I do really, I am just trying to make you feel better !

Then we have the staging system which is T, N and M
T means the tumour size and how big or small it is. T1 means that it is very small and still encapsulated T2 means it is a bit bigger but still not broken through, T3 means it has broken through and is on the move and T4 means its on the run.
N stands for either get No which means your lymph nodes are OK and not diseased or you get N1 which means its spread to your nodes.
Then you have M which stands for metastisized....either Mo which means no spread or M1 which means its spread to other parts of your body. When you are in the cancer club, you get to call the M bit, mets.

So, Ady had pissed himself, been to the doctors, been to the urologist, been shot up the arse with the biopsy gun and now we were back off of the consultant for the results..

The drive from our house to the hospital is about 45 minutes. Normally we have lots to talk about and generally chatter away, but today, we were lost in our own thoughts and the drive was done in pretty much silence. The girls were at school, well one was at school and the other was on an end of year school trip. She had asked us to let her know the results while she was away via the headmaster ( we are friends and have mobile numbers and he knew what was going on), so we agreed we would do that.
As the town the hospital was in was getting nearer, there was a bloody great storm brewing there...I said to Ady "bloody hell, it feels like we are driving into the lions den"...he agreed and said "yeah the weather does look a bit shit, have you brought a coat?"..we both knew that of course I hadn't !

Jumping forward to the consultants office cos I am bored of typing irrelevant shite about the weather and anyway, we really weren't looking forward to seeing the consultant again cos he was SOOO rude the first time we met him !
Oh no, hang on, lets go back to the waiting room. I will never forget when we were sitting in the waiting room, well hospital corridor actually, waiting to to see the consultant and a couple came out of his office and sat down opposite us. The poor man looked like he had been hit by a bus, just staring into space with the biggest look of shock and worry and his wife sat next to him trying to give him words of comfort, which you could see he just wasn't registering.
I remember feeling desperately sorry for them. I wanted to go over and ask if there was anything I could do, But then the oncology nurse called them and we were called into the consultants room and I was immediately shot back into the realization that we are now walking into the place that man and his wife have just come from......

Mr R ( the consultant) was MUCH more pleasant this time, in fact, he even smiled and he was a bit taller and younger than I remembered him from the month before.
As he we were all walking into the room, he said " well, there is a little bit of cancer there"...even though google has told you that this will be the case, it makes it no better being told it by the man who knows!!

We sat down and started talking about it and Mr R advised Ady to have surgery to remove the prostate. He then started rummaging through Ady's notes and said "Have you had any scans yet?"..."No" we said, "Oh well you need to have some because I dont like the number on your PSA test in relation to your small prostate"
I asked the gleason score and we were told it is a Gleason 7 (3+4).
So the diagnosis so far is
Prostate cancer
Gleason 7 (3+4)
PSA 24.5 (27 was the immediate number but on closer inspection is was moved down)

He said that this had been growing all the time he had colon cancer and possibly before and lets see what the scans say.

Off we went, back into the waiting room/corridor, to wait for the oncology nurse to call us, just like the couple before us.

Heather ( the onco nurse) was very nice and she booked Ady in for a bone scan within the next two weeks, but explained that he would have to wait for the MRI on the prostate area and pelvis until the end of July because they need to wait for the prostate to settle and stop bleeding so they can get a clear picture and this will take about 6-8 weeks from the biopsy.

She told us that the biopsy report said that the cancer was on the left of the prostate and that of the 12 cores taken, 5 on the left were positive for cancer. At this point, I need to say that taking biopsies it similar to a game of battle either get a hit, or you miss. If you miss, it doesn't mean that cancer is not there, it just means they missed the spot.

Our cancer bus ride has come to another stop where we have to wait, and wonder,and worry, and wait, and google,and think of the worst, and think of the best, look after the girls, go to work, worry,wait, wonder, hope..........

We didn't want to ruin Stephs holiday but we also didn't want to lie and we promised we would tell her, so we decided along with consultation with Charlotte, that we would tell her that they thought there might be a bit of cancer but daddy needed more tests and that she should enjoy her holiday as we didnt really know anything.
The headmaster knew everything and was extra nice to her for the rest of the week.
When she came home, we told her everything and explained our reasons for not letting on too much and she completely understood and thanked us. She also said "I wondered why Mr D was being so nice to me"  haha

I must talk about Brian sometime...he is great and cheers my day up !!

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