Positive Margin

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Bootheel
Regular Member


Date Joined Oct 2007
Total Posts : 300
   Posted 2/20/2008 10:00 AM (GMT -7)   
I'm about 4 weeks post op.  My path report indicated 1 positive margin .3cm on the right side. Does that mean that the tumor extends .3cm over the margin or .3cm from the margin? Anyone out there with a similar path that could explain it.  I would be very grateful.
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
Post-op
Gleason 7 (3+4)
1 positive margin (.3cm)
T2C 


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8122
   Posted 2/20/2008 12:49 PM (GMT -7)   
Of course I assume the pathology was drafted like mine so here goes: The size of the extension area is .3cm across at it's widest point. Very small but how far it extends cannot be specified because they did not get all of the extention. This is a very small penetration and is likely locally focal. Just for clarification, a positive margin is carcinoma to the point of where the knife made the cut. When a prostate is removed it is removed with some facia tissue and the wall of the prostate contained inside the specimen. The entire ares surrounding the prostate that is cut out is called the surgical margins. If any edge is positive then it is likely that carcinoma is on the other side of where the knife cut and still present. This does not mean that the "leftover" cancerous tissue is able to survive without the prostate gland, but rather it is possible that it has locally metastisized. You doctors seem to feel that it is so small (.3cm) that it does not as yet warrant a stage III diagnosis. They will still recommend radiating the area to be safe. And you may be done with it at that point. Good Luck and stay positive!

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!
 
Prostate Cancer Forum Moderator

Post Edited (TC-LasVegas) : 2/20/2008 1:32:29 PM (GMT-7)


Bootheel
Regular Member


Date Joined Oct 2007
Total Posts : 300
   Posted 2/20/2008 1:03 PM (GMT -7)   
Thanks for the clarifying the situation for me Tony, I guess I'll have to wait and see what my PSA is in May. Hopefully it will be undetectable.

Joe
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
Post-op
Gleason 7 (3+4)
1 positive margin (.3cm)
T2C 


flippin out
Regular Member


Date Joined Mar 2006
Total Posts : 137
   Posted 2/20/2008 1:44 PM (GMT -7)   

Positive has been quite a subject it would seem as many P/C victims that have had a positive margin report have had some further therapy

I have just completed Proton radiation Performed at @ Loma Linda CA after having been told that my (CLOSE positive margin) was showing a rise in the PSA trend. After Robotic surgery 17months prior @ City Of Hope CA

I am now a member of the Brotherhood of the Balloon painless but time consuming and have been told many positive things regarding the procedure.

I wish you well and stand with you as you are not alone in this venture we have many brothers out here and as many people working toward a cancer free goal!   


Jeff 11
Regular Member


Date Joined Jun 2006
Total Posts : 24
   Posted 2/20/2008 5:03 PM (GMT -7)   

Hi I have a question on margins. I had a margin in an area of capsular incision. The way it was explaned to me is that if a cell left behind was cut in half the possibility of growth in the future is remote. My question is are all focally positive margins always in an area of capsular incision ?

Thank You Jeff

 

 

 


Bootheel
Regular Member


Date Joined Oct 2007
Total Posts : 300
   Posted 2/20/2008 8:00 PM (GMT -7)   
Hi Jeff, I'm not savvy on most of this. I learned alot from Tony. I think he would be a better source for more detailed information.

Joe
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
Post-op
Gleason 7 (3+4)
1 positive margin (.3cm)
T2C 


Bootheel
Regular Member


Date Joined Oct 2007
Total Posts : 300
   Posted 2/20/2008 8:05 PM (GMT -7)   
Hey Tony,
if your around, Try and Help Jeff if you can. I don't know enough to help him.  Maybe you could shed some light on his situation.
 
Thanks and God bless,
Joe
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
Post-op
Gleason 7 (3+4)
1 positive margin (.3cm)
T2C 


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 2/22/2008 7:39 PM (GMT -7)   
smurf    BUMP for Tony
 
tongue   Hey ~ Bootheel,
Sending a HUG your way.... and letting you know we are all right here while you are on your healing/recovery stepping-stone.... and we will be here for your PSA too!!!!
Continue taking care of yourself and moving forward!
Gentle Hugs and Warm Thoughts surround you.
In Friendship ~ Lee & Buddy
 
:-)  Hey ~ Jeff,
Here's a little more information to add to your knowledge base... 
 Hope this helps you ~ Lee
 
 

**Excerpts taken from “Dr. Patrick Walsh’s Guide to Surviving Prostate Cancer”

by: Patrick C. Walsh, M.D. (Professor of Urology, The Johns Hopkins Medical Institutions) and Janet Farrar Worthington.   Copyright 2001

 

 

Page 145

**What about Perineural Invasion? 

As cancers grow, they compress normal tissue, looking for “elbow room”—spaces with less resistance, where they can spread.  Nerves are usually surrounded by some empty space; for cancer, this is the real estate equivalent of a nice suburban lot with a big backyard—plenty of elbow room.  Thus, it’s not uncommon to find prostate cancer in the spaces around the nerves; this is called ‘perineural invasion.”  Because the nerves are most common close to the surface of the prostate, the findings of perineural invasion on a biopsy suggests that the cancer is close to the edge of the prostate, and may well have penetrated the capsule.  However—this is important to keep in mind—cancer that has penetrated the capsule can still be cured.  Which makes this a paradoxical finding—because, although men with perineural invasion are more likely to have capsular penetration than men without it, perineural invasion has no long-term impact on whether or not a man can be cured.  For this reason, some noted pathologists have suggested that it should not even be commented on when found in a biopsy, because it’s not worth worrying about.


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

4th PSA 2-13-2008 (23 months) Less than 0.1 Non-Detectable :)

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