New member with questions about pathology report

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New Member

Date Joined Sep 2008
Total Posts : 5
   Posted 9/5/2008 5:25 PM (GMT -6)   
Hello everyone. I've been reading this forum for the past month, since my partner was diagnosed, and have found your collective wisdom and sympathy incredibly helpful during this confusing time. My partner was diagnosed in late July, had a radical prostatectomy three weeks ago, and is recovering well. When he got his pathology report, his doctor told him that Gleason score went up, from 6 to 7. Here's what his report looks like:

Gleason pattern 3/4 (combined score=7)
Tumor involving bilateral lobes,
with postiive right gland margin and bilateral apical margins.
No evidence of seminal vesicle invasion or extracapsular extension.
Largest single slide diameter=1.3 cm.
TNM Stage=T2C

Can you help us make a little more sense of this? For instance, I think I understand what the positive right gland margin means, but not the "bilateral apical margins" or the slide diameter, or "NO MX R1." His doctor thinks that the surgery went well, overall, but that he'll have to be closely watched over the next months to see if any cancer has spread. Despite the positive right margin, his surgeon thought he got it all, and that it was confined to the prostate itself. There's no sign of it in the lymph nodes, nothing in the seminal vesicles; he doctor spared the nerve bundles, too. Do we have reason to feel relatively confident? Any information would be really appreciated. I am trying not to be too nervous -- it isn't good for either of us.

New Member

Date Joined Sep 2008
Total Posts : 5
   Posted 9/5/2008 6:27 PM (GMT -6)   
I think I've answered some of my own questions by looking more carefully at the staging terminology.
Here's what I've found:

T2c = Involving both lobes
N0 = No regional node metastasis
MX = Metastasis cannot be assessed
R1 = residual microscopic disease (which means positive surgical margin)

So, anyone out there with a similar Gleason score or stage? I would love to hear about your experiences, and your assessment of prognosis.
Thanks, Siennese

Regular Member

Date Joined Sep 2008
Total Posts : 143
   Posted 9/5/2008 6:29 PM (GMT -6)   
I am no expert, and will have my own surgery in ten days. I have been studying intensely for four months, since my biopsy. Many men would be pleased to get these results, becuase it appears the cancer has not spread. That is the ctrical factor, and if your doctor's analysis is correct, your partner should have a good outcome. Of corse, every situation is differtent, but from what I have learned, this is a good pathology. Hope some of the seasoned pros will add their comments.

Bless you and your partner.

Bill in SD

New Member

Date Joined Sep 2008
Total Posts : 5
   Posted 9/5/2008 8:41 PM (GMT -6)   
Thanks, Bill, for the encouragement :-) Good luck with your own surgery!
I'm reassured that this is a pretty good pathology report. But I think we're both worried about the positive margins, than just about anything else. My guy is struggling in part because he thinks it's so unfair -- he was careful to have his PSA regularly tested, had a biopsy immediately when his PSA rose, even though his doctor said he could probably wait and see for a few months. Then, when the biopsy came back positive for cancer, he scheduled surgery for as soon as his doctor would permit it (which was once he healed from the biopsy). I think even his doctor was surprised that he found a larger amount of cancer than expected (a lot in the right lobe, a smaller amount in the left). Anyway, my guy is left wondering what more he could have done to find the cancer sooner.

Doting Daughter
Veteran Member

Date Joined Aug 2007
Total Posts : 1064
   Posted 9/5/2008 9:21 PM (GMT -6)   
Sorry to hear about your partner's dx, but glad you found us here at HW. My father had a somewhat similar report, however, my father's was worse. He had a lymph node come back positive, therefore, our plan of action will be different than yours. However, I agree with your doctor, there is not a lot you can do until the first PSA comes back. Hopefully, it will be undetectable, which there is a good chance it will be and then you will have to stay on top of the PSA's. IF, there is a rise, he may need additional radiation at some point, BUT, you both should be very happy and hopeful that he will not. Stay positive and try to focus on the recovery. Best wishes to you and yours!
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

New Member

Date Joined Sep 2008
Total Posts : 5
   Posted 9/6/2008 11:05 AM (GMT -6)   
This site is wonderful -- thanks so much for the reassurance, and for the advice. You're right. It's better to stay positive and not dwell on what might come next. Thank you, again.

Tony Crispino
Veteran Member

Date Joined Dec 2006
Total Posts : 8128
   Posted 9/6/2008 11:35 AM (GMT -6)   
Amen, siennese,
I've been here almost a couple years and my motto is stay positive! I have met some great people here, and you will be supported well. Whatver happens next, I preach that there is life after cancer in my blog. Stay close, and keep us updated. You have our hand when you need it!

Age 46 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007 @ The City of Hope
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 (May 9 '08): <0.1
I will continue HT until May '09. 
Years in Remission (3/23/07): 1
Visit my Journey at:
And at:

Tony Crispino
Veteran Member

Date Joined Dec 2006
Total Posts : 8128
   Posted 9/6/2008 11:44 AM (GMT -6)   

Welcome Siennese! 


Welcome   to  ~ HealingWell ~ 


A   Special Warm Welcome  to  You !


Knowledge gives us POWER.  POWER takes away the fear. 

~     ~     ~     ~     ~     ~     ~     ~     ~     ~     ~     ~     ~

  Click  on  link  below for important information that will help you ~ help us!!

                                                                   >>  Welcome New Members ~ to HealingWell 

The information (link) listed above is to help you get around the forum!   

This is a journey best traveled with friends.   

Welcome ~ New Friend from all the members here... on 


Know Your Forum Moderators

v      Doting Daughter ~  Moderator for Prostate Cancer Forum 

v      James C ~  Moderator for Prostate Cancer Forum

Veteran Member

Date Joined Apr 2008
Total Posts : 1382
   Posted 9/6/2008 4:24 PM (GMT -6)   
Welcome to the club, and please communicate openly and freely. You will find many wise people as well as friendly people, and everyone has each others best interest at heart. Sorry you had to join, but since you did have to I cannot think of another place any better. Please keep us posted as to your journey.
Any thing I can help with please feel free to ask, whether here at the forum or via email.

peace and love
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
Currently on Lupron
I go to The Cancer Treatment Center of America
Married with two kids
latest PSA 5-27-08 0.11
PSA July 24th, 2008 is 0.04
cancer in 4 of 6 cores

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