Staging Descriptions

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Tony Crispino
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Date Joined Dec 2006
Total Posts : 8128
   Posted 11/10/2008 4:39 PM (GMT -6)   
According to the 2002 release of staging by AJCC:
 
Invasion into the prostatic apex or into (but not beyond) the prostatic capsule is classified not as T3 but as T2 disease.
Used with the permission of the American Joint Committee on Cancer (AJCC), Chicago, Illinois. The original source for this material is the AJCC Cancer Staging Manual, Sixth Edition (2002).  Some come in here with staging references that have expired.  AJCC 1992 was used until 1997.  In that staging chart there was a pT3C.  That no longer exists.  Some other changes are the tumor volume, but for the most part there is littles difference between AJCC 1997, and AJCC 2007.  My tumor was staged using AJCC 2002...
 
The description of Clinical and Surgical staging: Click Here!
 
I hope this helps...
 
Tony
 


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, Extra Prostatic Extension (EPE)
Bilateral seminal vesicle invasion (SVI); Stage pT3b, N0, Mx
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (September 17 '08): <0.1 ~ Undetectable!
 
You can visit my Journey at:
 
STAY POSITIVE!
 
 

Post Edited (TC-LasVegas) : 12/8/2008 10:05:56 PM (GMT-7)


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 11/11/2008 8:22 AM (GMT -6)   
this is good information Tony, thanks for all your research.
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
latest PSA 5-27-08 0.11
PSA July 24th, 2008 is 0.04
cancer in 4 of 6 cores
92%
80%
37%
28%
 


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 1/20/2009 12:02 AM (GMT -6)   
Let's learn together!

LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 1/20/2009 11:09 AM (GMT -6)   
Tony...related question. Does the pathology staging ever change. I know it is common for clinical staging to change after pathology. But for example a person with a T2 at pathology and then becomes locally advanced recurrent does he then become T3. And then later becomes metastasis is he restaged to T4...or is he still classified as T2 with metastasis.

Just a general question to learn more.

Thanks,
You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal-Gland 38 cc
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral (Perineural Invasion present at base) - Gleason (3+3) 6  Stage T1C
August 23 - Bone Scan - Hips, Spine and ribs marked uptake - X-Ray showed clear -Hooray
Sept 9 2nd DRE - questionable - TRUS...shadow in base - Gland now 41 cc
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (4+3) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
4 tumors in prostate - largest being 6 cm 
PSA 5 week Oct 2008 <.05
       3 month Jan 2009 .06


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25382
   Posted 1/20/2009 11:37 AM (GMT -6)   
I am still trying to understand how mine is t2c when it was contained and only on the left side, am I missing something simple here? This has bugged me since my pathology report came back.

David in sC
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3, 9/8 14.9, 10/8 16.4
3rd Biopsy 9-2008 Positive 7 of 7 cores positive, 40 - 90%, G 4+3 & 3+4
Open RP surgery 11/14/8, Non-nerve sparing, 4 days hospital, staples out 11/24/8, Catheter out on 12/15/8. Stopped flowing, new catheter put in 12/16/08, Catheter out 12/29/08. Emergency room put in Catheter # day 45, 1/5/9 - Cath #3 out, dr. did cycloscope, saw potential blockage, put in Catheter #4, 1/13/9 - removed blockage, put in Cath #5, 1/19/9 -out
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grams, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery  Scheduled now for 2/9/9
 
 


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 1/21/2009 2:09 AM (GMT -6)   
David,
Your doctor and your pathologist might be seeing things differently. I would ask to have the specimen sent to Johns Hopkins and ask for a man named Jonathan Epstein to review it. There is a compelling reason to do so. You should be fine, but be ahead of anything.

Also the manual for staging is located at the AJCC website. You don't need to buy one, but you can look at the two year removed Sixth edition Part 5 for free. It is an interesting read and may shed some light.

Tony

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25382
   Posted 1/21/2009 8:32 AM (GMT -6)   
Thanks Tony, was hoping you would find this one. When I see my dr soon for my first post PSA, I am going to ask him for starters.
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3, 9/8 14.9, 10/8 16.4
3rd Biopsy 9-2008 Positive 7 of 7 cores positive, 40 - 90%, G 4+3 & 3+4
Open RP surgery 11/14/8, Non-nerve sparing, 4 days hospital, staples out 11/24/8, Catheter out on 12/15/8. Stopped flowing, new catheter put in 12/16/08, Catheter out 12/29/08. Emergency room put in Catheter # day 45, 1/5/9 - Cath #3 out, dr. did cycloscope, saw potential blockage, put in Catheter #4, 1/13/9 - removed blockage, put in Cath #5, 1/19/9 -out
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grams, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery  Scheduled now for 2/9/9
 
 


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 2/3/2009 12:29 AM (GMT -6)   
Staging again...
Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 15, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (January 13, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 2/19/2009 12:09 AM (GMT -6)   
Bump
Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (January 13, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 2/19/2009 5:25 AM (GMT -6)   
Plus the fact that it is not easy to identify for certainty if you have spread to nodes N-x (unknown) vs. N-o (none found) or N1 (node envolved). Same goes for Mx (unknown or undiagnosed) vs. Mo or M1 or such.
It could be also that it never changed also, but that it was not diagnosed or known at original parameters of assessment. A huge number of patients are treated without knowing their true staging or no staging is even complied, my doc never had a staging for me....of course my stats probably made that about impossible to do with any certainty(higher end group maybe 30% of patients are in this area). People with low end stats are much easier to come up with a staging, now whether or not that staging is 100% is another discussion thread.
Assessment is the key to having some kind of analysis of what a person is dealing with in PCa and it is lacking big time as to the level of excellence that we actually need in this disease. So alot of judgemental decisions are being made on too little of known parameters, thus also the failure rates even in some low parameter-stats patients, the inconvenient truth on PCa.
 


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 4/10/2009 1:06 AM (GMT -6)   
Bump
Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (January 13, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 5/10/2009 3:38 PM (GMT -6)   
Bump
Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (January 13, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!

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