Update on Pathology for Frank1205

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Frank1205
Regular Member


Date Joined Feb 2008
Total Posts : 308
   Posted 4/4/2008 11:19 AM (GMT -6)   
I only had 1% of 10 needle cores test positive on my origiinal biopsy and I was very close to waiting.  In my case it seems I made the right decision looking back now to take it out.
 
I realize their are many brothers on this site with conditions that are staged much higher than mine but I am a little disappointed with the following information.
 
Seminal Vessels clear
Fat tissue around prostate clear
Gleason score up from 6 to 7
10% of both lobes cancerous
up from T1C to T2C
Cancer contained to the prostate
Tumer located in distal area of prostate
One close or positive margin in the distal portion of the prostate.
 
Going to talk to Oncologist but not sure if anything will be indicated at this time.
 
All in all it could be alot worse.  I guess I will have to watch the PSA pretty close now.
 
Take Care,
 
Frank
Frank S.
diagnosed 01-08-08 53 years old 
DRE always normal
Abnormal PSA for 5 or more years
2004 Biospy negative
2008 Biopsy positive (01-08-08)
10 cores, 1 positive and at 1% of that one core
Highest PSA 10 ever
Lowest PSA   4
Current PSA   6
Bone and Ct scans negative
Staged at T1C
Gleason 3+3 = 6
Robotic Da Vinci performed March 27th, 2008
University of Chicago
Dr. Arieh Shalhav
surgery at noon out to recovery at 500 pm
in recovery 3.5 hours
Cardiac arthmia issues
Surgery thursday pm home friday pm
Catheter out in 7 days typical early indications
 
Post Pathology
T2C
10 % of both portions of prostate
Seminal vessels clear
fat tissue clear
Tumor on bottom of prostate distal
1 close margin
going to meet with oncologist to discuss treatment options if any
Gleason 7
 


DanmanBob
Regular Member


Date Joined Feb 2008
Total Posts : 467
   Posted 4/4/2008 12:11 PM (GMT -6)   

Frank,

Is the "close or positive margin" the part that you are concerned about?

Everything else looked pretty good from what I could tell.

Keep your chin up!

DanMan Bob



Danman Bob
Age 57
Nerve-sparing, open prostate surgery November 13, 2007
Gleason score 9, PSA 14
Biopsy result - 9 of 12 sticks showed cancer
Despite high Gleason score, cancer was confined to the prostate
Possible post-surgery radiation therapy...decision likely in late April 2008, depending upon PSA at that time
Unrelated surgery January 2008 delayed incontinence recovery, which is now showing good signs of improvement (fraction of a pad a day as of March 2008)
Began using Viagra 3 times a week December 2007 to stimulate blood flow
Began using Osbon Erec-Aid Esteem manual pump for therapy mid-February 2008
Will probably begin using bimix injections in addition to Viagra and pump in May 2008

Post Edited (DanmanBob) : 4/4/2008 1:44:03 PM (GMT-6)


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 4/4/2008 12:16 PM (GMT -6)   

Frank-

The news sounds pretty good if you ask me!  Try not to stress too much about the close margin (close is better than positive margin).  Take care of yourself, recover from surgery and we will continue to pray that they got it all.  I know it is easier said than done.  Keep us posted and keep the faith! 

God bless,

Chayna


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
Lupron beg. Dec 03, 2007 2 yr
Radiation started March 03, 2008 7 weeks 5x a week
2 weeks of radiation down!!!
 
 


Jayadub
Regular Member


Date Joined May 2007
Total Posts : 89
   Posted 4/4/2008 12:30 PM (GMT -6)   
Frank it was nice chatting with you the other day. I have to say the 2 above have given good advice, results look good. You need to relax if possible and concentrate on healing and not worry. Pathology is a very subjective process and even the Gleason upgrade is nothing to be alarmed about. Pre and post treatment anxiety seems to run rampant with PCa since you are reminded every 3-6 months that you are not considered cured till you can string together 5-7 years of low to no PSA scores. The distal area near the colon, by the way is the most common location for tumors of the prostate. Take care and heal up. Hope to chat again soon,

John

54 years old

PSA 5.6 on 3/20/07

DRE: Negative

Biopsy on 4/20/07 

Results 4/25/07:

3 out of 12 cores positive, 2 on the right lobe with 5% adenocarcinoma Gleason 3+3, 1 on the left lobe 10% adenocarcinoma Gleason 3+4, overall Gleason graded 7 Cancer T1C.  After web research discovered Proton Beam Therapy and called Loma Linda. Completed consultation with Dr. Luu on 7/5/2007 and started treatment at Loma Linda on 7/26/07. Completed treatment 44 on 9/28/07. 0 treatments remain. Side Effects remain minimal. 1st PSA result on January 28th is 1.1.


mlbsm
Regular Member


Date Joined Mar 2008
Total Posts : 85
   Posted 4/4/2008 12:57 PM (GMT -6)   
Frank,

The way my Dr. explained it to me, the pathology people coat the Prostate with what they call "Ink".
If there are any traces outside of this ink, the cancer has spread outside of the prostate.

Your report says cancer is prostate contained.

I would look upon that as being extremely good news and not fret until and unless the Dr. tells you otherwise.

We're all in your corner,

Billy
DIAG. 2/08
DRE POSITIVE
PSA 6.8
CONTAINED, LEFT SIDE, GLEASON 9
LUPRON, (3 MO.) 2/28
SURG, SCHED. 3/26/08
RRP, 3/26, HOME 3/31
BIOPSY REPORT:
GLEASON SCORE, 3+4
LEFT NERVE BUNDLE REMOVED, RIGHT RETAINED.
LEFT AND RIGHT LYMPH NODES NEGATIVE FOR MALIGNANCY.
BLADDER NECK , NEGATIVE FOR MALIGNANCY.
TUMOR CONFINED TO THE PROSTATE, INKED EXTERNAL SURFACE FREE OF INVOLVEMENT.
BILATERAL VAS DEFERENS, NEGATIVE FOR MAILIGNANCY.
BILATERAL SEMINAL VESICALS, NEGATIVE FOR MALIGNANCY.

WAITING NOW FOR 1ST POST OPERATIVE PSA, WHICH WILL DETERMINE VERY LITTLE DUE TO LUPRON INJECTION.

BASICALLY, THE "WINDOW OF OPPORTUNITY" THE PHYSICIAN WAS SEEKING WAS REACHED AND HE GOT IT ALL.


Frank1205
Regular Member


Date Joined Feb 2008
Total Posts : 308
   Posted 4/4/2008 2:25 PM (GMT -6)   
Terminology is so important sometimes when describing something this important. I have one Positive margin on the distal portion of the prostate above the urethra. Thank you for your encouraging words all.

Doc called since I last posted and stated that there was a lot more cancer than he believed, it was in a different place than he believed. This pre-surgical knowledge was all based on a Uroligist biopsy who I had little confidence in.

My only concern is of course the positive not close (sorry) margin. I will be making an appointment to see an oncologist and hemotoligist to get informed if the PSA does not respond as expected.

Doc says I have a 16% chance of reoccurence of cancer. If reoccurence of PSA occurs there is a 50/50 chance it will be significant. I will have a PSA in 6 weeks then in 3 months and we will acti accordingly to those indications.

I guess I will have to wait a few years to get my medical cure.

If I had to do it again I think I would have insisted on a MRI and/or wait for another biopsy to give the surgeon the most information about my condition we can get. May have changed his approach may have not.

Thanks again,

Frank
Frank S.
diagnosed 01-08-08 53 years old 
DRE always normal
Abnormal PSA for 5 or more years
2004 Biospy negative
2008 Biopsy positive (01-08-08)
10 cores, 1 positive and at 1% of that one core
Highest PSA 10 ever
Lowest PSA   4
Current PSA   6
Bone and Ct scans negative
Staged at T1C
Gleason 3+3 = 6
Robotic Da Vinci performed March 27th, 2008
University of Chicago
Dr. Arieh Shalhav
surgery at noon out to recovery at 500 pm
in recovery 3.5 hours
Cardiac arthmia issues
Surgery thursday pm home friday pm
Catheter out in 7 days typical early indications
 
Post Pathology
T2C
10 % of both portions of prostate
Seminal vessels clear
fat tissue clear
Tumor on bottom of prostate distal
1 positve margin distal at urethra
going to meet with oncologist to discuss treatment options if any
Gleason 7
 


Frank1205
Regular Member


Date Joined Feb 2008
Total Posts : 308
   Posted 4/4/2008 2:29 PM (GMT -6)   

Hi Billy,

Maybe some other members can chime in on this,  I thougth they ink the prostate and if the ink touches the cancer on examination that is called a positive margin.  This is the way it was explained to me.  The Doc did not sound too worried about this for he said the dye just infultrated ever so sllightly to this cancer.

 

Frank

 


Frank S.
diagnosed 01-08-08 53 years old 
DRE always normal
Abnormal PSA for 5 or more years
2004 Biospy negative
2008 Biopsy positive (01-08-08)
10 cores, 1 positive and at 1% of that one core
Highest PSA 10 ever
Lowest PSA   4
Current PSA   6
Bone and Ct scans negative
Staged at T1C
Gleason 3+3 = 6
Robotic Da Vinci performed March 27th, 2008
University of Chicago
Dr. Arieh Shalhav
surgery at noon out to recovery at 500 pm
in recovery 3.5 hours
Cardiac arthmia issues
Surgery thursday pm home friday pm
Catheter out in 7 days typical early indications
 
Post Pathology
T2C
10 % of both portions of prostate
Seminal vessels clear
fat tissue clear
Tumor on bottom of prostate distal
1 positve margin distal at urethra
going to meet with oncologist to discuss treatment options if any
Gleason 7
 


norskie
Regular Member


Date Joined Jan 2007
Total Posts : 376
   Posted 4/4/2008 2:38 PM (GMT -6)   
Frank

You sound somewhat close to myself and I had an area that got into the margin as well even though my report stated capsul contained. But one of the reasons you chose your plan of action I am sure as was my case was in the event it came back you could take other action. In my case I do have a returning PSA after going down to undetectable for two tests. At about 10 months after surgery I had a reading of .2 and growing. I will begin salvage radiation on April 14th and they feel real good about my chances of getting it this time because chances are it is microscopic cells that escaped and survied in some of th tissue. I am very optimistic that we can get it this time but in your case don't worry yourself too hard, they may have it all and it is gone, it's hard to wait but the future PSA tests will tell you. Good luck in your journey and I hope that it never does come back and the need for future treatments will not be required.

Norskie
norskie
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.


Jayadub
Regular Member


Date Joined May 2007
Total Posts : 89
   Posted 4/4/2008 2:39 PM (GMT -6)   

The doctor is only going by the same nomograms that are avaiable to all of us. Try using the Sloan-Kettering form to create your own.

I think you need to be positive about this and realize that there is an 84% chance that you are cured. tongue

Look for the good and dwell on that rather than vice-versa. I know it is soon, but your attitude and positive thoughts will help you deal and heal quicker than the negatives.


Frank1205
Regular Member


Date Joined Feb 2008
Total Posts : 308
   Posted 4/4/2008 3:14 PM (GMT -6)   
Thanks Norskie,

We are very similar in our histories. Time will tell as to what I need to do.

Thanks for sharing your experience.

Frank
Frank S.
diagnosed 01-08-08 53 years old 
DRE always normal
Abnormal PSA for 5 or more years
2004 Biospy negative
2008 Biopsy positive (01-08-08)
10 cores, 1 positive and at 1% of that one core
Highest PSA 10 ever
Lowest PSA   4
Current PSA   6
Bone and Ct scans negative
Staged at T1C
Gleason 3+3 = 6
Robotic Da Vinci performed March 27th, 2008
University of Chicago
Dr. Arieh Shalhav
surgery at noon out to recovery at 500 pm
in recovery 3.5 hours
Cardiac arthmia issues
Surgery thursday pm home friday pm
Catheter out in 7 days typical early indications
 
Post Pathology
T2C
10 % of both portions of prostate
Seminal vessels clear
fat tissue clear
Tumor on bottom of prostate distal
1 positve margin distal at urethra
going to meet with oncologist to discuss treatment options if any
Gleason 7
 


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 4/4/2008 7:47 PM (GMT -6)   
Hi Frank,
Hang in there. You need more information from the docs. You may be in a watch and wait position. You know my motto and I extend it to you ~ Stay Positive! If it did extend it was very small and very likely local. Radiation may be recommended but watch and wait may be good. A positive mind is very valuable here. So don't do much more than heal that surgery and you are right keep a monitor on it.

Thank you very much for you very kind words on my update. You are a great contributor here. You and Billy have my prayers for a successful mending. I too had a buddy who we shared the experience with. It sure is nice to have that simultaneous sharing. You two stay close and stay here. We are a great support group.

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. 
Years in Remission (3/23/07): 1
Visit my Journey at:
 
STAY POSITIVE!
 
Prostate Cancer Forum Moderator


Frank1205
Regular Member


Date Joined Feb 2008
Total Posts : 308
   Posted 4/4/2008 8:11 PM (GMT -6)   
Thanks Tony I appreciate it.
Frank S.
diagnosed 01-08-08 53 years old 
DRE always normal
Abnormal PSA for 5 or more years
2004 Biospy negative
2008 Biopsy positive (01-08-08)
10 cores, 1 positive and at 1% of that one core
Highest PSA 10 ever
Lowest PSA   4
Current PSA   6
Bone and Ct scans negative
Staged at T1C
Gleason 3+3 = 6
Robotic Da Vinci performed March 27th, 2008
University of Chicago
Dr. Arieh Shalhav
surgery at noon out to recovery at 500 pm
in recovery 3.5 hours
Cardiac arthmia issues
Surgery thursday pm home friday pm
Catheter out in 7 days typical early indications
 
Post Pathology
T2C
10 % of both portions of prostate
Seminal vessels clear
fat tissue clear
Tumor on bottom of prostate distal
1 positve margin distal at urethra
going to meet with oncologist to discuss treatment options if any
Gleason 7
 

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