Doctor Bubley’s Answers

If a guy has a strong family history of prostate cancer, should he be concerned about the BRCA gene mutation? Should his children (especially daughters) be concerned? Would testing be warranted?

Dr. Bubley’s answer:

No,  most patients with strong family history of PCa  should not be concerned about BRCA gene and not seek testing UNLESS there is also a family history of breast and/or ovarian cancer in that patients first degree (mother or sisters) relatives

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Submitted on 2013/03/30 at 6:02 pm

is it possible for seeds to migrate to urethra after a long period???

Dr. Bubley’s Answer:
Any thing is possible. Seed migration has become something of the past. We do not implant out of the prostate (some people did in the early days). We also use a linked system where the seeds are physically attached to spacers. The seeds become small rods, which is very difficult to migrate. In addition after a while there is significant fibrosis immediately adjacent to the seeds, so hard to migrate. We also stay pretty far away from the urethra to avoid excessive dose to that area.

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Dr. Bubley,

I was at the men’s group last night. I want to thank you for your great service, over the years, to all of us as PC patients. It is much appreciated!

Last night, when talking about Gleason scoring, you mentioned that a Gleason 2 is now a Gleason 3. Or something to that effect.

Q1: Is it then possible that people who know their score as 3 + 3 may be in actuality 2 + 2? Q2: If the answer to Q1 is yes, should the 2+2 people be told that they are not a 3+3? Would they really not be PC patients at all???

Hope all is well,

Dave

Dr. Bubley’s answer:
A Gleason 3  designation does not change,  but a Gleason 2 on a report should be seen as a  Gleason 3.

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Obviously, the notion that a GG 2 should be changed to or seen as a GG3 has caused some alarm, especially when it is asserted without explanation. So, why should a GG 2 be seen as a GG3, when did this policy go into effect, and who is responsible for instituting this policy?                                                                                      Thank you.

Dr. Bubley’s Answer:
In 2007 the America Society of Pathology changed the grade, and more or less did away with Gleason pattern 2 designation. The Society is made up of a panel of experts. Anyone with a pattern 2 on their pathology report should change it to a 3. So someone who was 2 + 3 is really 3 + 3