Bad Post-Op Path report

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Regular Member

Date Joined Oct 2007
Total Posts : 300
   Posted 2/7/2008 9:15 PM (GMT -6)   
Just got the word from my doc on the Path report.  Gleason 7 with positive margins.  My wife and I are devastated.  Anyone out there in the same boat with positive advice?
Age 65
Diagnosed 10/12/07
PSA 6.3
Biopsy 18 core samples, 2 positive <5%
Stage T1a Gleason 6 (3+3)
LRP  1/29/08

Regular Member

Date Joined Apr 2007
Total Posts : 101
   Posted 2/7/2008 10:23 PM (GMT -6)   
Hi Bootheel,

Sorry to hear about the negative path report, but don't be so quick to have a pity party, many treatment options are available for your situation. Sit back take a little time to gather your wits and strength then start asking your Docs for what options are available and what they think you need to do. The gleason score is not really above the average by much and many of us have had a positive margin or more than one. Sounds like you are probably going to be a candidate for possibly IRMT therapy at the most. Many of us on this forum have had much worse path reports and after adjuvant treatment are doing fine. Be positive and don't let this get you down, you will be fine. Most pca is curable!!! Good Luck....JWB
age: 62
PSA 4.57 - Positive DRE
Biopsy 3-19-07 - Gleason 4+4=8
Negative bone scan 3-20-07
DaVinci 4-24-07
Catheter out 5-01-07
post op pathology:
positive margin left side of prostate
left seminal vesicle involved (both removed)
No lymph node involvement
New gleason score 9
T3B....radiation consult on 5-9-07.
June 5, 2007 1st psa post surgery 0.62
June 27, 2007 second psa post surgery 0.59
June 27, 2007 started Lupron injection (24 mos)
September 6, 2007 scheduled to be marked and prepped for radiation therapy.
Start IMRT therapy on September 13, 2007.
September 26,2007 psa test .08
Finished IMRT therapy October 31!!!
January 17, 2008 psa test .05...

Veteran Member

Date Joined Feb 2007
Total Posts : 1219
   Posted 2/7/2008 10:24 PM (GMT -6)   
I'm so sorry that you & your wife are going through this. It's really is traumatic and shocking and not what you were expecting at all. My husband and I understand your feelings and all that comes with it. You need some time to come to grips with this and deal with the emotions you're going through.
It was that way for my husband & I too at first, but then we had to make decisions. So you move forward and go to Plan B. Well, actually we didn't have a plan B cause it never entered our minds we'd need one, we didn't know about this forum and didn't know anyone else in our situation! So I'm very glad you & your wife are here, on this forum with people who will want to help you both. I know you will find comfort here.

One thing is certain, it's a good thing you had surgery or you wouldn't have known about this. So, you made the right decision there.
Since your surgery was so recent you still have healing to do. Continue to take good care of yourself and that goes for your wife, too. It's important you both get enough rest - you will be able deal with things better. I'm sure your doctor is planning to meet with you and go over your options. As you know from posting here - there are quite a few of the guys who have had your same result and they will be a big help to you.

My wish for you both is peace.

Husband Diagnosed 11/17/05 Age: 63 PSA: 7.96 No Symptoms
2/09/06: LRP - Post Pathology - Gleason 4+3 Stage T2b NO MX
3 mo. PSA: 11.8 Stage T3a
6 mo. PSA: 18.8 Stage IV Systemic w/ distant lymph node involvement
Start HT - Lupron 3 mo. shots
12/06/06: PSA 0.8
03/07/07: PSA 0.3
06/06/07: PSA 0.1
09/05/07: PSA 0.1
11/27/07: PSA 0.1

Regular Member

Date Joined Oct 2007
Total Posts : 300
   Posted 2/7/2008 11:04 PM (GMT -6)   
Thanks JWB and MyMan for your support and compassion. We didn't have a plan B either. I
will start doing the research when the fog clears, just like I did when I was first diagnosed.
God Bless,
Age 65
Diagnosed 10/12/07
PSA 6.3
Biopsy 18 core samples, 2 positive <5%
Stage T1a Gleason 6 (3+3)
LRP  1/29/08

Regular Member

Date Joined Jan 2007
Total Posts : 165
   Posted 2/7/2008 11:23 PM (GMT -6)   

Hey Bootheel

Take a deep breath.....  When I found out about my positive margins, about one year ago, I felt like I was kicked right in the mouth.  I wanted despartly to forget about this cancer and just have checkups every six months or so.  Honestly, I probably wouldn't be reading this forum as frequently as I do, if that had been the case.  What will be will be, and I have dealt with the situation I am in.  As you can see by my signature line, I ended up getting adjuvant radiation therapy when my PSA rose to .08, before the reoccurance level, but when something was still there.  My doctors showed me studies that indicated RT within the first year for those with positive margins will decrease the percentage of reoccurance.  One year after surgery and three months following RT, my PSA is 0, and my attitude has improved tremendously.

I was very happy that I chose surgery, so that I had the second option after finding the positive margins.  Be thankful that you know how much cancer you have, and you have additional therapy available to you!  You will find a number of us on this forum who are in the same boat, so keep logging on and listen to your heart and doctors.

Age 57 at diagnosis,  PSA 4.7 (up from 3.2 one year ago)
Biopsy November 8, 2006 1 of 10 cores positive 5% LEFT Side Gleason 3+3
Robotic surgery January 19, 2007
Post Surgery Pathology Stage T3a, Gleason 3+4, positive margins and capsular penetration RIGHT Side
Post Surgery PSA:  March 5:  0.01
5 month PSA, June 13, 2007:  0.08
Adjuvant therapy began June 26 with Zoladex injection
Radiation began August 23, ended October 8
First post radiation PSA, December 18, 2007:  0

Regular Member

Date Joined Oct 2007
Total Posts : 300
   Posted 2/7/2008 11:34 PM (GMT -6)   

Thanks Hawkfan for the positive reply.  I've seen your posts before.  We are both originally from Seattle and now live in New Mexico.  I will put my e-mail in the control panel if you want to chat.


Age 65
Diagnosed 10/12/07
PSA 6.3
Biopsy 18 core samples, 2 positive <5%
Stage T1a Gleason 6 (3+3)
LRP  1/29/08

Tony Crispino
Veteran Member

Date Joined Dec 2006
Total Posts : 8128
   Posted 2/7/2008 11:58 PM (GMT -6)   
Hey Joe,
I certainly know you guys are taken back with this. But you have a great deal of options. I had a similar experience as have the other responders. It's a tough break, and there's some work ahead. I agree with all the above posts, and like Susan says, we had surgery because of the definitive pathology report and we didn't expect any issues. While my high PSA was indicative of a possibility we weren't going to get good news, we didn't expect it but we are glad we have the information. I have done well and have an undetectable PSA. We are not done with our attack plan and will stay vigilant in our research. But know one thing. You can still do quite well with this. The treatments are contraversial for our stage but you have to study the options closely. I've done this and have complete control over my treatment. I have something else for you too. My prayers and promise to answer any questions you might have regarding my experience. Have a close look at the group that has responded you here today. This sight is awesome, and so are these people. God Bless you dear friend. STAY POSITIVE!

Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology: Gleason 4+3=7, positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (1/08): <0.1
I will continue HT until May '09. 
Visit my Journey at:

Regular Member

Date Joined Jul 2007
Total Posts : 242
   Posted 2/8/2008 7:47 AM (GMT -6)   

You're in my thoughts and prayers, bootheel. I'll be following your treatement and progress as long as you post. 

From reading the posts of the guys here who have had positive margins and follow up treatment, it appears that your chances for success are pretty good. God's speed to you.


Diagnosed: March 25, 2007. Age 49
Biopsy: Gleason 6. Five of twelve samples positive with <5% each. No perineural invasion seen.
Surgery: May 21, 2007
Post-op Pathology: Upgraded to Gleason 7 (3+4), negative margins, negative capsular penetration, negative seminal vesicles, lymph nodes left intact, multifocal perinural invasion, 15% of prosate involving cancer in both lobes. T2c
Continence: Out of pads at five weeks. Seven months post-op I'm fully continent.
Erections: Yes! With the assistance of Cialis.
Post Surgery PSA: Three tests, all <0.1
Family history: Great-great grandfather died from PC. My Father had his prostate removed at age 67 in 1997 and has had an undetectable PSA ever since. I was diagnosed at a much earlier age and had a more agressive cancer than my father. Go figure.

Regular Member

Date Joined Jan 2007
Total Posts : 376
   Posted 2/8/2008 9:54 AM (GMT -6)   

Sorry to hear about your post surgery pathology report. My situation is slightly different from yours in the fact my pathology report looked good after surgery and it was contained. 9 months and two undetectable test later my 3rd on cam back at .2 and not in January it was .3 so it appears I will be on my way to some follow up radiation treatments. That 9 month appointment I remember well and it actually hit me harder I think then being told in the first place I had Pc. After a day to get my sights set again I have the attitude of how lucky I am to at least know I have it, have done the first set, surgery and still have options. I could still be running around and not know that I even have Pc. My doctor is real optimistic because of my post surgery pathology report that what I have is in the prostate bed area and some radiation should and hopefully take care of it. I go back again towards the end of March for one last validation PSA test and meet with a Radiologist to set the next steps. It sounds like we might be able to travel these next steps close together. I won't let it get me down and will be source of information and help to others in the future. The other reason I am lucky is I found this site with so many wonderful people who provide answers and most importantly support. Hang it there, you will be in my prayers and we will travel together.

Age 49, PSA 6.22 on 9-26-06
Biopsy 11-01-06, 2 of 13 cores 10% cancer, 2 other cores abnormal Up-dated 20% prostate cancerous
Gleason score 3+3=6 After Pathology report 4+3=7 a couple agressive Grade 5 cells found
Da Vinci surgery 01-09-07 UW Madison
Pathology Report- cancer 100 % capsual contained 1-18-07
Catheter removed 1-18-07 suffered bladder spasms Catheter reattached 1-18-07 Catheter removed 2nd time 1-24-07
1st & 2nd Post PSA Blood Test .1 and less - Undetectable
3nd Post PSA Blood Test 01-17-07 .3-Next action awaits me.
Next PSA Scheduled and meeting with Radiologist set for 3-27-08
Incontenence-Pad free since end of May 07 4 1/2 months post surgery 
ED back to 95% prior to surgery - no medication required.

Regular Member

Date Joined Jan 2007
Total Posts : 102
   Posted 2/8/2008 1:49 PM (GMT -6)   
Hi Bootheel:
I am in a similar position.  I thought going in that there was nothing to worry about and that my surgery will cure me.  What a negative surprise to learn that I was gleason 7 and positive margins.
The other folks here have given good advice.  It is a surprise, but it is not the end of the world. 
As for me I will probably be facing radiation..I'llfind out in 3-4 weeks.  And there is a decent chance this radiation will cure me provided the cancer has not left the prostate bed.
52 Year Old DBA by profession; amateur pianist by passion.
June 2006:  PSA 4.6.  DRE prostate enlarged.  
Aug  2006:  Second opinion confirms first.  Biopsy suggested.
Sep  2006:  Biopsy results positive one lobe.  Gleason 3+3.
Nov  2006:  RPA performed at Fletcher Allen in Burlington VT.
Nov  2006:  Pathology report: Stage T3a and Gleason 3+4.
Dec  2006:  PSA 0.1
Feb, May  2007:  PSA 0.0 (under 0.1)
Aug, Nov  2007:  PSA 0.1
Trying my hand at blogging.

Regular Member

Date Joined Jul 2006
Total Posts : 474
   Posted 2/8/2008 2:25 PM (GMT -6)   
Bootheel - at least wait until you get that first PSA test back. We were in your shoes, but with an "undetectable," our surgeon recommended we wait to do anything. Please note, if it had been anything BUT undetectable, we would have considered our next treatment steps aggressively. With a seriously upgraded pathology staging, we were at a 30%-50% chance of return. Now, 16 months post-surgery, we're still undetectable and our percentage of return has dropped dramatically. It's a gamble, but so far a good one.

Everyone (and their doc) is different - we just wanted to heal and get things back to normal, before we had to face anything else. We're there now and hopefully will stay that way.

You still have many options to consider, along with the worries. While that bad path report shakes you out of la-la land (as it certainly did us), there may be some very good news for you ahead.
Husband: Age 67
PSA had doubled in 14 mos to 4.3/Gleason 6
da Vinci 8/06 in Austin with Dr. Randy Fagin
Post surgical path shows encapsular penetration; possible bladder neck involvement.
PSAs remain undetectable; no further treatment at this time.
Next PSA: April 08

Veteran Member

Date Joined Apr 2006
Total Posts : 1732
   Posted 2/8/2008 3:31 PM (GMT -6)   
Many well wishes, thoughts and prayers to ay Bootheel,

Hang tight and get healthy agian first. Worry about what might happen IF it does. I have a policy..worry when someone tells me it's time to worry. Until then...let life happen.


Doting Daughter
Veteran Member

Date Joined Aug 2007
Total Posts : 1064
   Posted 2/9/2008 2:43 PM (GMT -6)   


Sorry to hear the news.  I think the day my father got the call regarding the pathology report was the worst day of our lives.  It felt like we had made it through the surgery, which we thought would be the worst part, and we all came out of surgery so hopeful. The call from the surgeon devastated us all.

 I will say that our entire family handled the news differently.  My father said he wasn't doing anything else.  (Mind you, this is while he still had in his catheter and was a week post op). I jumped into action reading everything I could, which became an unhealthy obssession.  My mom broke down.  My husband, who happens to be a doctor, really managed to stay positive.  God bless him.  Cancer was taking over all of our lives and not for the good.  You asked for positive news right...well..I am happy to tell you that my dad has recovered extremely well from the surgery.  He is on his second month of Lupron and doing very well.  He is scheduled to begin radiation within a month and we are holding on to the hope that he will be in the group that beats this thing for good.  We had an amazing talk of cancer and have all regrouped mentally and have united as a family for round two.  None of us want to be here, but we have options.  As previous posters have mentioned, we are so lucky that radiation and HT is an option.   My dad will be the first to tell you that they are not the most glamourous options, BUT, they are better than the alternative.  You can do this and know that you have a family here supporting you. 

P.S. My last note from experience....the doctors will tell you different things, get all the information you can, make a decision and don't look back.  Peace be with you.



Father's Information
DX July 15, 2007
Age 62 (now 63)
PSA 5.5
Original Gleason 3+4=7 
Post Surgery Gleason- 4+3=7
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin
One positive node
Bone Scan/CT Negative (Sept. 10, 2007)
T3a N1 M0
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07
Lupon beg. Dec 03, 2007 2 yr
Radiation soon to follow

Regular Member

Date Joined Oct 2007
Total Posts : 300
   Posted 2/9/2008 3:02 PM (GMT -6)   

Thanks for your support. We are already researching all of our options and trying to keep a positive attitude.  Our pre-op biopsy indicated <5% so we assumed that it was discovered early on and had no Idea that it had spread beyong the prostate. My lymph nodes were clear so hopefully it is still in the prostate bed.


P.S.-  We are originally from the Seattle area and retired in New Mexico.

Age 65
Diagnosed 10/12/07
PSA 6.3
Biopsy 18 core samples, 2 positive <5%
Stage T1a Gleason 6 (3+3)
LRP  1/29/08

Regular Member

Date Joined Jul 2007
Total Posts : 242
   Posted 2/9/2008 5:26 PM (GMT -6)   
My biopsy indicated cores with <5% too. However, even though my post-op pathology report indicated negative margins and negative capsular penetration, the Gleason went from a biopsy of 6 to a post-op 7 (3+4). Obviously more aggressive than what the biopsy indicated. Hang in there, Bootheel.
Diagnosed: March 25, 2007. Age 49
Biopsy: Gleason 6. Five of twelve samples positive with <5% each. No perineural invasion seen.
Surgery: May 21, 2007
Post-op Pathology: Upgraded to Gleason 7 (3+4), negative margins, negative capsular penetration, negative seminal vesicles, lymph nodes left intact, multifocal perinural invasion, 15% of prosate involving cancer in both lobes. T2c
Continence: Out of pads at five weeks. Seven months post-op I'm fully continent.
Erections: Yes! With the assistance of Cialis.
Post Surgery PSA: Three tests, all <0.1
Family history: Great-great grandfather died from PC. My Father had his prostate removed at age 67 in 1997 and has had an undetectable PSA ever since. I was diagnosed at a much earlier age and had a more agressive cancer than my father. Go figure.

Veteran Member

Date Joined Nov 2006
Total Posts : 1464
   Posted 2/9/2008 5:32 PM (GMT -6)   
Hey Bootheel,

Sorry to hear about you path report. You still have many options available and can turn this thing around. Having had surgery you know exactly what is happening and can take action to get it resolved.

Good luck...

Age 73. Diagnosed 11/03/06. PSA 7.05. Stage T2C Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Catheter out on 12/13/06.  Dry on 12/14/06.
Pathological stage: T2C N0 MX. Gleason 3+4.
PSAs from  1/3/07 - 1/17/08 0.00. 
Next PSA test on 7/17/08
"Patience is essential, attitude is everything."

Veteran Member

Date Joined May 2006
Total Posts : 2542
   Posted 2/9/2008 9:52 PM (GMT -6)   

Dear Joe & Loved One,

It’s time to let your mind and body do some healing…. There is time to do more research but you need a well-deserved break to re-group and gain strength (mentally and physically).  The what if’s???  will drain you…  Both of you need to take some “down” time!!!!

We are all here ~ to share the strength of love and support that will help to guide you in the days and months to come.  The sharing of so many journeys allows all of us to learn and gain knowledge… that we need to continue our daily walk in the path that we are on.  Some have more stepping-stones in their path… Your friends here are walking with you ~ so the path will be a little smoother.  Continue reaching out ~ you will feel all of us surrounding you!

Our thoughts and prayers will be with you as you continue to move forward...

In Friendship ~ Lee & Buddy


Your journey is important.... so I'm linking them here!

Threads started by bootheel


Post Surgery Rehab

Generic Viagra

Surgery over



Pathology Report

Not scared anymore

Perineural Invasion

mama bluebird - Lee & Buddy… from North Carolina


v          We invite you to visit our personal thread:  Click Here:  “Our Journey” ~ Sharing is Caring 

April 3, 2006  53 on surgery day

RRP / Radical Retropubic Prostatectomy

PSA 4.6   Gleason  3+3=6    T2a   Confined to Prostate

3rd PSA 08-07-2007 Less than 0.1 Non-Detectable :)

Regular Member

Date Joined Jun 2007
Total Posts : 152
   Posted 2/9/2008 10:09 PM (GMT -6)   
Hey Bootheel,

I'm in the same situation and I waited 6 months before making the visit to the Radiation Oncologist because I wanted it to go away but no chance. I am heading in this Monday for my CT Scan & MRI and then IMRT should start by the end of February. I'm very lucky because Duke has a great program for families to talk to other families in a group session about cancer, treatments and how to deal with it. The group also is really focused on the kid's in the family and how to help understand what's going on and what to expect. You might want to check into to something like that even if you don't have young children just to help answer questions.

Good Luck and my thought's and prayers are with you and your family.
Age 44
PSA 4.8
Gleason 3+3=6
Biopsy - 3 of 12 (2@20% / 1@80%
Da Vinci 7/31/07 @ Duke
2.5 hr. surgery, released from Duke with in 14 hrs.
Saved both nerve bundles. 
Foley out 8/10/08
Positive Pathology Report 
Near left side nerve bundle
New Gleason 7
Oncology visit in the near future for radiation
Back to work 3 weeks following surgery - Sales
9/13/07 - 1 Post PSA Undetectable less than 0.1 
9/17/07 - Pad Free! 
10/11/07 - ED, Trimix injection .2cc Tooo much but it worked. Now on .05cc, 3 times a week
No luck with viagra or pump. 
11/19/07 - 5 mth. PSA 0.1 (Ouch)
02/11/08 - Scheduled for CT Scan and MRI
Radiation treatments to start at the end of Feb. (6 weeks, 5 days a week)  

Regular Member

Date Joined Jul 2007
Total Posts : 86
   Posted 2/10/2008 8:16 AM (GMT -6)   
Bootheel, there is not reason you can't continue treatment and beat this thing.  I am going through radiation right now, on my 23rd out of 40 and doing okay.   Once again trying to close the chapter on PC, hopefully this time we get it done and so will you.
DX 8/05 Gleason 5, Mayo clinic Second Opinion Gleason 6, PSA 2.8
Da Vinci surgery Dr. Dasari, Centennial Nashville 9/24/05
Pathology Report Gleason 6, 15 % on left side only very near to the edge of capsule, too close to call on margins, doc's said to watch it very closely, final decision T2A
PSA's have basically ranged from <.04 to .05 for two years.
no E.D. and no Incontinence, feel very blessed
PSA Nov 07 = .06
PSA Dec 10th 07 =.07
Started Guided IMRT on January 7th, 2008 to treat prostate bed and lymph nodes

Veteran Member

Date Joined Jun 2007
Total Posts : 789
   Posted 2/10/2008 6:36 PM (GMT -6)   

Hi Bootheel, it's a pain going through all these stages, I myself remember the biopsy, then the shock of the diagnosis, then having the op, and feeling "well, that's all over" then recovering and getting on with life, then finding my pathology and PSA not so good, now I have finished IMRT and hoping again that it is finally over.

Guess you just have to go along with the flow, nothing much else really that you can do, I have been a bit down at times, but still trying to live my life as normally as possible.

Good luck to strong!

Regards Mal.

age 67 PSA 5.8 DRE slightly firm Rt
Biopsy 2nd July 07 5 out of 12 positive
Gleason 3+4=7  right side tumour adenocarcinoma stage T2a
RP on 30th July,
Post op Pathology, tumour stage T3a 4+3=7, microcsopic evidence of capsular penetration, seminal vessels, bladder neck, free of tumour, lymph nodes clear, no evidence of metastatic malignancy, tumour does not extend to the apical margins.
Post op PSA 0.5 26th Sept. next PSA 26th Oct. seeing Radiation Onocologist 31st Oct. PSA 0.5 23rd October. Started radiation treatment on 5th Dec, to continue until 24 Jan. 08. Finished treatment, PSA on 25th Feb.

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