Update from K2
I'm scheduled for a radical prostatectomy in a couple weeks. The ultrasound suggests SVI - stage 3 cancer.
Age = 51
Gleason = 3 + 4 (6 core 85% involved average)
PSA = 16
With my PSA level I was expecting a higher Gleason score, as was my doctor - I can only hope it holds in the post operation samples. Since so much of the biopsy samples contained cancer cells (85%) the pathologist had ample tissue to find higher score cells. Therefore I'm thinking my Gleason score might hold. But I know upgrades are not rare in post op analysis.
Of course I'll will know a lot more following the RP - namely lymph node involvement and type of SVI.
Dr. Patrick Walsh's book seems to indicate little benefit of a RP with SVI. I've read a several studies that disagree. Apparently one benefit to younger men is the prostrate is much smaller (my case) leaving more tissue to cut at the margins. And there seems to be a somewhat statically significant benefit to eliminating the cancerous mass.
Apparently there are several types of SVIs - some (?) with somewhat more favorable statistics. Does anyone have details differentiating these SVI types?
I could use a dose of HW wisdom right about now.
Post Edited (English Alf) : 3/5/2011 4:36:45 AM (GMT-7)
You had both adjuvant radiation therapy an adjuvant hormone therapy (Casodex and Lupron) before waiting to see if there would be a post RP rise in PSA? I fully anticipate my post op will suggest I'm a poor candidate for the zero club with RP alone - it would seem prudent to just keep blasting this thing.
And yes I'm cT3 due to both lobes involved. My high percentage biopsy involvement 85% ave. (all 6 cores) is also an adverse finding. As I mentioned previously my Gleason = 3 + 4 was a wee tiny bit of kind of good news if it holds. From what I gather with a cT3 prostate there's a pretty small probability of getting a lower Gleason score. My general doctor told me I did have a fairly good free PSA but I've yet to get the number - perhaps that played a role.
Obviously at this point SVI is only suspected from the ultrasound, which did look sketchy on my left side and given the volume of cancer in the prostrate it seems quite plausible. My urologist seem to think it was indicative of SVI.
A while back I stumbled across a study discussing a few different ways SVI can present its self but I don't seem to have saved it. My urologist indicated internal invasion was preferable - which sounds logical. Better confined to an organ than not -especially if you don't need the organ.
Make a toast to me when you celebrate St. Patrick's day as I'll be having my RP : )