Help with Stage

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FairRider
Regular Member


Date Joined Jan 2008
Total Posts : 32
   Posted 2/11/2008 8:26 PM (GMT -7)   
We have had a new diagnosis via biopsy and sent slides to Johns Hopkins for confirmation. While the information was more detailed, there is NO STAGE noted. Where does that preliminary stage come from? The path report, the doctor, a rubric?

So many predictors need an accurate stage and I am not sure if we are a T1c or T2C.

Thanks,

FairRider
Age 54
PSA 2.8 in 1999, PSA 2.88 in 2004 - did not follow-up until 12/2007 :(
PSA 5.6 1/2008, but 4.37 on repeat
DRE - unremarkable
Free PSA ratio 0.11
Biopsy 1/25/2008 - 10 Cores - 5 each side. 4 with adenocarcinoma (2 each side)
Gleason 3+3=6 and 3+4=7 - No Stage given on report, maybe T2c?
Planning Robotic Surgery
DECIDING SURGEON & location - INPUT WELCOME!


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8122
   Posted 2/11/2008 9:35 PM (GMT -7)   
It appears to be T2c, but they will classify it at T1c because of the potential of imperfections of everyones prostate. Typically a T1 is on one side, or lobe. But because the biopsy can penetrate to the other side, it might not be clear. What would be more helpful is if you can state which cores are positive. But not to worry about that. It is the post operitive pathology that will matter the most. You do not appear to be stage III and your numbers would concur that.

Tony
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:
 
STAY POSITIVE!


Tim G
Veteran Member


Date Joined Jul 2006
Total Posts : 2246
   Posted 2/12/2008 12:25 AM (GMT -7)   
In the T classification system there are 4 T Categories described below. A biopsy pathology report only gives the Gleason score

"There are 4 categories for describing the local extent of the prostate tumor, ranging from T1 to T4. Most of these have subcategories as well.

T1: Your doctor can't feel the tumor or see it with imaging such as transrectal ultrasound.

T1a: The cancer is found incidentally during a transurethral resection of the prostate (often abbreviated as TURP) that was done for benign prostatic hyperplasia (BPH). Cancer is present in less than 5% of the tissue removed.

T1b: The cancer is found during a TURP but is present in more than 5% of the tissue removed.

T1c: The cancer is found by needle biopsy that was done because of an increased PSA.

T2: Your doctor can feel the cancer when a digital rectal exam (DRE) is done, but it still appears to be confined to the prostate gland.

T2a: The cancer is in one half or less of only one side (left or right) of your prostate.

T2b: The cancer is in more than half of only one side (left or right) of your prostate.

T2c: The cancer is in both sides of your prostate.

T3: The cancer has begun to spread outside your prostate and may involve the seminal vesicles.

T3a: The cancer extends outside the prostate but not to the seminal vesicles.

T3b: The cancer has spread to the seminal vesicles.

T4: The cancer has spread to tissues next to your prostate (other than the seminal vesicles), such as the bladder sphincter (muscle that helps control urination), the rectum, and/or the wall of the pelvis. "

From American Cancer Society


Age 59 PSA 2.6 PSA velocity quadrupled in 1 yr 
1 of 12 biopsy cores positive (5%) 
Open surgery June 2006  Cancer confined to one small area of the prostate Gleason 5
Post-op PSA's non-detectable


aus
Regular Member


Date Joined Sep 2006
Total Posts : 211
   Posted 2/12/2008 8:16 PM (GMT -7)   
The way TNM stage categories set out on the ASC site indicates that all stage T2, (a, b & c) are tumors felt by DRE, and tumors not felt by DRE are T1 (a, b & c).
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