Some help understanding Pathology Report

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New Member

Date Joined Aug 2008
Total Posts : 8
   Posted 8/21/2008 2:50 PM (GMT -6)   
Received my Pathology report from the Doctor last week. It was a surprise, since it was suggested with a pre-op PSA of 4.7 a biopsy with 2 positives with less than 5% and a gleason's of 3+3, (The Urologist did feel an abnormality on one side so it was graded T2a), it was suggested there was a high probability of the cancer being prostate confined.

Had a DaVinci Prostatecomy on July 16th. Received my pathology in early August, it confirmed a Gleason 3+3, but did find one microscopic tumor involvement of the periprostatic adipose tissue. The peripheral margin was focally involved by tumor. The tumor was primarily involved in the left side of the prostate with focal microscopic extension into the right side of the prostate. The tumor was classified as pT3a. There was no involvement of the VASA Differentia, or Seminal vessel. The Doctor did not check the nodes.

Guess I didn't listen enough after I heard the Doctor say, "we may not have gotten it all, the cancer was not organ confined'. I will be going back to the Doctor shortly to find my first PSA results. Should I be considering further treatment -- hormonal and radiology?

For a year treated for infection of the prostate
one year period PSA went from 1.9 to 4.7
Urologist felt abnormality
Biopsy 12 - 2 positive cores < less than 5%
Gleasons 3+3
Surgery 7-16-2008 Prostatecomy DaVinci
Gleasons 3+3
One negative margin -- microscopic involvement of the periprostatic adipose tissue.

Veteran Member

Date Joined Apr 2006
Total Posts : 1732
   Posted 8/21/2008 2:59 PM (GMT -6)   
This is a margin positive pathology however it appears to be just one spot. "Focally positive" is a common term used. Keep in mind, this could just as easily be a clean surgery. Lets hope the surgeon got it all the first time!


Doting Daughter
Veteran Member

Date Joined Aug 2007
Total Posts : 1064
   Posted 8/21/2008 3:10 PM (GMT -6)   
Your situation is similar to my father's. He did end up having one positive node, which came as a complete shock. He had one focally positive margin and a node came back positive on the opposite side. This disease is so frustrating and nothing seems to be what it "should" be in my father's situation, however, I am hopeful that his salvage radiation was able to get rid of any remaining cancer. We decided that because of the node, he needed to undergo RT, even though his PSA was less than .1 following RP. If his pathology report would have come back with only a "focally" positive margin, we would have waited for a rise in PSA prior to doing salvage RT.
I am sorry to hear about your situation, but try to keep positive. You should have a better understanding of your next step once you receive your PSA. Hopefully, it will be undetectable.
Father's Age 62 (now 63)
Original Gleason 3+4=7, Post-Op Gleason- 4+3=7,
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin, One positive node. T3a N1 M0.
Bone Scan/CT Negative (Sept. 10, 2007)
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07, Lupron beg. Dec 03, 2007 2 yrs
Radiation March 03-April 22, 2008- 8 weeks 5x a week
July 2, 08 PSA <.02
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum

Regular Member

Date Joined Aug 2008
Total Posts : 328
   Posted 8/21/2008 3:18 PM (GMT -6)   
During my surgery the Surgeon told me he did frozen biopsys before the surgery was over to ensure that all was taken out. Where he took samples and had them read before I was finished. Curious why he didnt take a sample of the nodes. Has anyone heard of people going back in for anther surgery to remove more tissue instead of radiation or hormonal therapy. To calm your nerves I will schedule an appointment asap to just talk to him about your concerns even if your PSA is not back yet to give you some idea.


Age 37
Diagnosed 7/2008
Da Vinci Surgery 7/2008
First PSA : 4.17 5/2008
Second PSA After 2 weeks of antibiotics : 3.9 6/2008
DRE: Negative 5/2008
Bone Scan/CAT Scan: Clear 7/2008
Cystoscope: Normal 7/2008
Prostate MRI: Normal 7/2008
Biopsy : 6 out 12 Postive all on right side, Gleason 7 (3+4).
PostOp: T2c (On Both sides), margins clear, seminal clear, nodes, clear. Gleason 6(3+3).
First PostOp PSA: 9/2008

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