Postive Margin

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Frank1205
Regular Member


Date Joined Feb 2008
Total Posts : 308
   Posted 4/6/2008 1:40 PM (GMT -6)   
I was told Friday that I had one positive margin but the cancer was incapsulated..  How can that be?  I was told that I had a very unusual place for a postive margin, described as distal at the penis.  Now after considerable research I believe they mean at the bottom of the prostate and research indicates that the five year good PSA is only 56% good. 
 
Now my Doc says I still have an 86% of being cancer free.  I also read that a positive margin means surgery failure.  Man,  I did not know that.  All the Surgeons I interviewed stated their clear margins were 5% or less.  I now believe I read that DaVinci is positive margins 35-45 % and open a little less.
 
I am trying to stay positive but I am feeling  better from surgery everyday and I guess I am getting fiesty.
 
Anyone have knowledge of a positive distal marging and where by the cancer is considered contained or encapsulated.
 
Thanks,
 
Frank
 
 
Frank S.
diagnosed 01-08-08 53 years old 
DRE normal
High 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
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
5 hour surgery , 3 hour recovery
Unexpected Cardiac issues appear and disappear?
Hospital stay 30 hours
Catheter out in 7 days  expected leakage
Erectile funtion back on line 9 days
 
Post Pathology T2C, Gleason 7, 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 at this time.
 


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 4/6/2008 2:02 PM (GMT -6)   
Hi Frank,
I have heard the opposite on the daVinci vs. open thing, so don't put too much into statistics. They vary from surgeon to surgeon. Someone once told me that with open the surgeon can feel cancer and continue cutting until it's removed. Consider this. My daVinci surgeon was also a reputed open surgeon, and he told me you can feel the prostate once it's removed, too. He told me that it can be much more magnified in the screens they use so that you can see much better with daVinci. This debate can last a lifetime. My surgeon did see suspicious tissue and had to stop cutting to prevent damaging the rectum. He was right.

On the margins thing. Your best guage will be the way your PSA goes. Statistically, according to NCI (National Cancer Institute) 85% of patients treated will have good results with initial teatment. Of those 98% will be cured. For the remaining 15% that did not get good initial results, the results vary based on the aggressiveness of the cancer and the amount of spread. You apopear to be on the very light side of penetration, if at all. Careful with those nomagrams as they can scare anyone. Stay positive and be well.

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


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 4/6/2008 8:12 PM (GMT -6)   
Not sure about the DaVinci, I had a radical and it was aborted when they discovered that it had spread to my lymph nodes. Sounds to me like you are on the road to recovery. Stay positive and stay active.
My PSA at diagnosis was 16.3
age 46 (current)
My gleason score from prostate was 4+5=9 and from the lymph nodes was 4+4=8
I had 44 IMRT's
Casodex
Currently on Lupron
I go to The Cancer Treatment Center of America
Married with two kids


Frank1205
Regular Member


Date Joined Feb 2008
Total Posts : 308
   Posted 4/6/2008 10:00 PM (GMT -6)   
Thanks Tony and Dale,
 
It is great to communicate with folks when you need to.  Welcome Dale I read your information on the caring bridge.  What a wonderful name for you business.(Livanadream)  Zion is just down the street from me,  relatively speaking.  Your Aunt and you do speaking engagements for PCa or just motivational stuff.  I dont want to go on for we should not speak of businesses an such on this site and rightly so.  I dont want the great moderators hear to get mad at me.  But very interesting work you are doing.
 
All the best in your situation.
 
God Bless
 
Frank
Frank S.
diagnosed 01-08-08 53 years old 
DRE normal
High 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
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
5 hour surgery , 3 hour recovery
Unexpected Cardiac issues appear and disappear?
Hospital stay 30 hours
Catheter out in 7 days  expected leakage
Erectile funtion back on line 9 days
 
Post Pathology T2C, Gleason 7, 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 at this time.
 


woodstock97
Regular Member


Date Joined Apr 2008
Total Posts : 44
   Posted 4/8/2008 6:48 AM (GMT -6)   
Hey All: I'm similar to Frank. I have 2 small positive margins and my doctor has stated that I have an 80% chance of nothing coming of this. This also surprised me, by his optimistic view?
All the reading I have done on +sm, states your chances are reduced significantly. By as others have mentioned, all we can do is wait till psa's are check over the next several months. Kep me informed all. Thanks and good luck.

Pre op. 2.5 psa 4/12 cores positve, gleason 6. Kevin from Poughkeepsie, NY

IdahoSurvivor
Veteran Member


Date Joined Aug 2007
Total Posts : 1015
   Posted 4/8/2008 7:49 AM (GMT -6)   

Hi Frank,

I'm so sorry the pathology was not what you hoped for and we all wished for you.  I have read much that there is a great deal of hope for those with positive margins in your particular situation.  I would trust Tony as a voice of experience and support as well.  It is not simple to "turn on" or "turn off", yet I like Tony's "stay positive" advice.

It also seems good to me that your gleason score did not jump in the post-op report.

We'll keep you in our thoughts and prayers.

Kind regards,


Barry ~ (a.k.a. "Idaho") - Prostate Cancer Forum Moderator

 

Da Vinci Surgery July 31, 2007… 54 on surgery day
PSA 4.3  Gleason 3+3=6  T2a  Confined to Prostate

1st PSA  09/11/2007  <0.04 (undetectable)

2nd PSA 12/10/2007  <0.04

3rd PSA  03/17/2008  <0.04

My web site: http://pca-info.blogspot.com

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