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6071
Regular Member


Date Joined Jul 2008
Total Posts : 112
   Posted 11/17/2008 2:31 PM (GMT -7)   
dr told me to day i will have to get Adjuvant  radiation for the apical margin i have to see the radiation oncologist on thursday



Age 61 at DX
PSA 2/2007 5.71
PSA 4/2008 7.23
Biopsy 5/2007 Negative
Biopsy 7/2008 Positive 1 of 12 cores positive 3+4 5% To 10%
Open Radical Prostatectomy 15/10/2008
Stage pt2c
Post op staging Gleason's Score 3+4=7
up to the apical margin is focally positive
no extraprostatic extension
Seminal vesicles and lymph nodes clear
the vas and the bladder base clear
Catheter out on the 13/11/2008
 
 



Frank1205
Regular Member


Date Joined Feb 2008
Total Posts : 308
   Posted 11/17/2008 3:22 PM (GMT -7)   

6071

I am 8 months down the road after the robotic.  I have a bad margin like you.  This is a very hard personal decision to make.  You should do just as your Doctor says and I even recomend meeting with a regular oncologist.  My Doc said they now recomed seeing a Oncologist and radiation oncologist as a matter of protocol when there is a bad margin.  Many here in our situation have decided to radiate adjuvantively while others watch their PSA's very closely and consider salvage radiation if their PSA goes up measurably.  I am the latter. 

My Urologist who is also an oncologist,  recomended if he was in my shoes he would watch and wait based on what he saw. My margin was a single margin and very short.  Radiation Oncologist stated that maybe at most two cells could be left behind.  There is the rub, two cells can cause alot of problems or die off. No one knows.

I think about my decision alot, alot.  My PSA's were undetectable at 6 weeks, 3 months and 6 months this I was told is a positive thing. 

If you choose adjuvant ratiation, which I dont blame you one bit indeed,  they would not be able to start radiation until you heal adequately which can differ from man to man.  But for sure no sooner than 3 months.  You should be able to see at least your 6 week PSA and your 3 month. 

I believe that adjuvant radiation is administered in lower doses than salvage radiation. 

I wish you all the best in making your decision. Knowledge is power.  Do what's right for you.  Do some research on positive margins.   A good sight is UroToday.com.  Its free

Frank

 


Diagnosed @ 53 years old now54
DRE normal , 2004 Biospy negative - 2008 Biopsy positive (01-08-08)
10 cores, 1 positive and at 1% of that one core
PSA @ surgery 6 
Bone and Ct scans negative
clinicaly Staged at T1C - Gleason 3+3 = 6
Robotic Da Vinci performed March 27th, 2008
University of Chicago,Hospital stay 30 hours -
Catheter out in 7 days 
normaly expected leakage
Post Pathology T2C, Gleason 7, 10 % of both portions of prostate
Seminal vessels clear, fat tissue clear
single positve margin measureing less than 1/2mm 
Six week PSA < 0.1 , 4 month PSA <.05 Gen II test. 6 month PSA  <0.01
Urologist recomends to hold off on Radiation and watch PSA closely. Oncologist and Radiation Oncologist seem to lean to doing pre-emptive radiation.Uroligist says 50/50 chance of PSA re-occurence.  
I have decided to hold off and see in 3 months lets see in 9 months.
Next PSA January 2009.
11-08-08 (7months) starting to go without day pads, 100 mg Viagra seeing good results
 
 
 
 


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 11/17/2008 3:58 PM (GMT -7)   
I am like Frank above...I will wait for a PSA rise and then go the salvage route. Tough decision for guys like us. Best of luck on whatever decision you make. BTW, my doctor also recommended waiting. I think you will find doctors don't always agree whether to perform radiation adjuvant or salvage unless the margin was significant.
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 Oct 08 <.05


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 11/17/2008 5:38 PM (GMT -7)   
I'm shocked. I was shocked when my father needed adjuvant therapy as well, but all his biopsies were positive. Am I right in reading that you only had one positive biopsy that was only 5-10% involvement? I'm surprised that your urologist is already recommending RT. How does he know that he didn't get it all with only one focally positive margin? Have you had a post op PSA yet? Sorry for so many questions, I'm just so surprised. I'm with the above posters! Good luck and keep us posted!
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
Oct. 10, 08 PSA <.02
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum


6071
Regular Member


Date Joined Jul 2008
Total Posts : 112
   Posted 11/18/2008 4:30 AM (GMT -7)   

Hi Doting Daughter

and thanks to all

the Biopsy 7/2008 yes 1 of 12 cores positive Gleason (3+4) 5% To 10%

had a psa test on the 13/11/2008 hope to have the results on the 20/11/2008

tumour present in approximately 10% of the prostate



Age 61 at DX
PSA 2/2007 5.71
PSA 4/2008 7.23
Biopsy 5/2007 Negative
Biopsy 7/2008 Positive 1 of 12 cores positive 3+4 5% To 10%
Open Radical Prostatectomy 15/10/2008
Stage pt2c
Post op staging Gleason's Score 3+4=7
apical margin is focally positive
no extraprostatic extension
Seminal vesicles and lymph nodes clear
the vas and the bladder base clear
Catheter out on the 13/11/2008
 
 




Frank1205
Regular Member


Date Joined Feb 2008
Total Posts : 308
   Posted 11/18/2008 7:23 AM (GMT -7)   
6071,

We are very similar, I had 1 of 10 cores positive suggested 1% involvelement, and ended up like you with 10% total tumor volume in both lobes. My prostate was 28 cc. My Docs failed to tell me the number and length of my margins at first. Then when I asked and learned the (good news?) that it was only one and the the length was very short so I hung that on the "DECISION TREE" if you will.

6071 do you know the characteristics of your margins yet?
Diagnosed @ 53 years old now54
DRE normal , 2004 Biospy negative - 2008 Biopsy positive (01-08-08)
10 cores, 1 positive and at 1% of that one core
PSA @ surgery 6 
Bone and Ct scans negative
clinicaly Staged at T1C - Gleason 3+3 = 6
Robotic Da Vinci performed March 27th, 2008
University of Chicago,Hospital stay 30 hours -
Catheter out in 7 days 
normaly expected leakage
Post Pathology T2C, Gleason 7, 10 % of both portions of prostate
Seminal vessels clear, fat tissue clear
single positve margin measureing less than 1/2mm 
Six week PSA < 0.1 , 4 month PSA <.05 Gen II test. 6 month PSA  <0.01
Urologist recomends to hold off on Radiation and watch PSA closely. Oncologist and Radiation Oncologist seem to lean to doing pre-emptive radiation.Uroligist says 50/50 chance of PSA re-occurence.  
I have decided to hold off and see in 3 months lets see in 9 months.
Next PSA January 2009.
11-08-08 (7months) starting to go without day pads, 100 mg Viagra seeing good results
 
 
 
 


6071
Regular Member


Date Joined Jul 2008
Total Posts : 112
   Posted 11/18/2008 8:32 AM (GMT -7)   
thanks frank 1205

the surgeon did not tell me the length of my margin just told me up to the apical margin is focally positive
but the Pathology report said the apical margin is focally positive
i will see if i can find out on thursday
thanks
Age 61 at DX
PSA 2/2007 5.71
PSA 4/2008 7.23
Biopsy 5/2007 Negative
Biopsy 7/2008 Positive 1 of 12 cores positive 3+4 5% To 10%
Open Radical Prostatectomy 15/10/2008
Stage pt2c
Post op staging Gleason's Score 3+4=7
apical margin is focally positive
no extraprostatic extension
Seminal vesicles and lymph nodes clear
the vas and the bladder base clear
Catheter out on the 13/11/2008
 
 




hangin-in
Regular Member


Date Joined Sep 2008
Total Posts : 78
   Posted 11/18/2008 8:34 AM (GMT -7)   

I am in the same situation. I had a positive apical margin and I am considering radiation. My Surgeon says it is not necessary to do anything at this time and he recommends watching the PSA closesly. My first 3 month PSA test is at the end of Dec. I saw a radiation oncolgist that said it is a tough decision and that either way would be ok - my decision (Thanks!!). This is really a tough one.

So far I have no incontinence or ED problems at all so I am very hesitant to introduce new problems. On the other hand, if it lowers the risk of future cancer, I wouldn't hesitate to get radiation NOW. I still did not get the size of the margin and percent tumor invovement from my Dr. It was not on the post op pathology report. Is it available?? I am waiting to hear from my Dr.

I agree with Frank about the amount of radiation being less than if you would not have done surgey. I think it's 10 weeks instead of 14 weeks (but Im not 100% sure on that). Also you will have to wait until the surgey heals.

One thing I can say... I agonize over this every single day. I think I am postponing the decision until The end of Dec because a) that's when I get the next PSA results and b) I need to wait until the surgery heals.

Good luck to you and let us know what you decide.


Rising PSA 12/06=1.6 12/07=2.1 5/08=2.6
Biopsy 6/4/08 12 core 4 Positive 15%,15%,8%,3%
Diagnose @ Age 51 Gleason 3+3=6
Bone & Cat Scans Normal
Lapro Surgery 8/18/08 at Memorial Sloan Kettering
Pathology report stage T2c organ confined with positive apical margin Gleason 3+3 = 6 (with tertiary grade 4)
Catheter removed 8/26 - reinserted 8/29 - removed 9/2
No continence or potency problems from the get-go.
First post op PSA 10/2/08 < 0.05


hangin-in
Regular Member


Date Joined Sep 2008
Total Posts : 78
   Posted 11/18/2008 8:40 AM (GMT -7)   
By the way.. Does anyone know what "focally positive" margin means? My pathology report just states "Surgical Margins: Tumor present at apical margin". I know I need to find out the size of the margin. Is there anything else I am missing?

Rising PSA 12/06=1.6 12/07=2.1 5/08=2.6
Biopsy 6/4/08 12 core 4 Positive 15%,15%,8%,3%
Diagnose @ Age 51 Gleason 3+3=6
Bone & Cat Scans Normal
Lapro Surgery 8/18/08 at Memorial Sloan Kettering
Pathology report stage T2c organ confined with positive apical margin Gleason 3+3 = 6 (with tertiary grade 4)
Catheter removed 8/26 - reinserted 8/29 - removed 9/2
No continence or potency problems from the get-go.
First post op PSA 10/2/08 < 0.05


BillSD
Regular Member


Date Joined Sep 2008
Total Posts : 143
   Posted 11/18/2008 8:48 AM (GMT -7)   
I had RRP September 15. Signature below shows cancer present at apex margin, and perineural invasion, so I have opted for IMRT which begins December 2. My uro suggested wait and watch, but my oncologist and radiologist encouraged me to go for the adjuvant radiation treatment. My reasoning is why should I go 90% of the way to get rid of this potentially deadly cancer. Sure, even after IMRT, it may still come back. But at least I have fired all my artilery at it.
 
It's a very personal descison, and i wish you (and all of us) the best whatever we decide.
 
BillSD
 
Age 59 at diagnosis (Now 60)
PSA 4.4
05/15/2008 – Biopsy
Gleason 3+3=6
Most cores positive 40% or more, some 100%
Bone scan and pelvic/abdomen CT show no visible metastasis
06/15/2008 – Began two months Casodex 50 mg
07/01/2008 – Trelstar shot (3 month dose)
09/15/2008 – Retropubic Radical Prostatectomy
Pathology: Staging pT2c pN0 MX
Gleason post op: 3+4=7
No discrete tumor mass
Bilateral involvement
No capsular penetration (carcinoma extends into but not through capsule bilaterally)
Perineural tumor invasion (PNI): present
Perineural margin: Free of carcinoma
Bladder neck: Free of carcinoma
Distal (Urethral) Margin: Carcinoma present
Seminal Vesical: None present
Lymph Nodes: 18 nodes free of metastatic carcinoma
10/13/2008 - PSA <0.1 - disclaimer: I had HT, so...
12/01/08 - Begin 35 treatments EBRT (adjuvant radiation because of concern for positive distal margin and PNI)
 
 
 


Ken S
Regular Member


Date Joined Nov 2006
Total Posts : 120
   Posted 11/18/2008 9:21 AM (GMT -7)   
6071,

There are two camps of thought concerning positive margins and adjuvant therapy and it is a tough decision to make. After talking to three doctors, doing some reseach, and talking it over with my wife I felt I wanted to be aggressive.

My patology was very similar to yours. My urologist suggested that I see a radiologist and an oncologist and all three thought it would be a good idea to have adjuvant therapy. I choose to have adjuvant radiation to hopefully knock out any remaining cancer cells.

I believe there are studies that show you have a slightly better chance of non-recurrence with adjuvant therapy. If you did as Frank suggested and went to UroToday you should be able to find several studies concerning positive margins and adjuvant therapy.

The radiation did cause me to revert to wearing one pad a day and as of today that shows no signs of improving. ED problems are the same as they were a few months after my protatectomy and before radiation treatments.

As far as the size - I also had one focally positive margin. I asked my oncologist "What does that mean? The size of the tip of a pencil?" He said yes but they have no way of knowing if beyond that "tip" the cancer cells didn't branch out or not. I read somewhere last week that a positive margin is concidered focal if it's less then or equal to 3mm, about 1/8 of an inch.

Giving that the jury is still out as to how to treat us guys with positive margins I don't think you can make a wrong choice. For all of us, long term survival looks promising and those odds will increase as new treatments for any recurrence becomes available.

Ken
Age 54 (2006)
PSA: 2005 - 3.2, 2006 - 3.7
Biopsy 8/06, Gleason 6 (3+3), T1c
Radical Retropubic Prostatectomy 11/3/06
Memorial Hospital, Pawtucket, RI
Post-Op Biopsy, still Gleason 6 (3+3),
T2c, right apical margin positive
CT Scan 1/07, tumor discovered on right
kidney (unrelated to PCa)
Partial Nephrectomy 3/9/07
R.I. Hospital, Providence, RI
IMRT (37 Treatments) 4/23/07 - 6/14/07
PSA: 7/08 - 0.02


6071
Regular Member


Date Joined Jul 2008
Total Posts : 112
   Posted 11/18/2008 3:01 PM (GMT -7)   

hi hangin-in

i found this at http://www.malecare.com/surgery_page_5.htm

Margins It is the goal of surgery to remove all the cancer. A positive margin means that the pathologist notices that cancer cells are at the very edge of the prostate touching the ink that was applied during initial processing of the prostate gland. The pathologist will note the number and location of any positive margins. Those patients with positive surgical margins are at an increased risk of cancer recurrence. Patients with more than one positive margin are more likely to have cancer recur compared to those with a single positive margin.

Patients with an extensive positive margin (large area where the cancer is in contact with the edge of the prostate) are more likely to have recurrence of their cancer compared to those with a very small area (focal positive margins) where the cancer just touches the edge.

It is important to note that most patients with positive margins are cured. Depending on the number and extent of margins your physician may recommend post-operative radiation to decrease the risk of recurrence


Age 61 at DX
PSA 2/2007 5.71
PSA 4/2008 7.23
Biopsy 5/2007 Negative
Biopsy 7/2008 Positive 1 of 12 cores positive 3+4 5% To 10%
Open Radical Prostatectomy 15/10/2008
Stage pt2c
Post op staging Gleason's Score 3+4=7
apical margin is focally positive
no extraprostatic extension
Seminal vesicles and lymph nodes clear
the vas and the bladder base clear
Catheter out on the 13/11/2008
 
 




Frank1205
Regular Member


Date Joined Feb 2008
Total Posts : 308
   Posted 11/19/2008 6:42 AM (GMT -7)   

6071,

Interesting post,  thanks for the good reading.

Frank

 

 

 


6071
Regular Member


Date Joined Jul 2008
Total Posts : 112
   Posted 11/19/2008 7:39 AM (GMT -7)   
hi hangin-in
have a look at this page
http://www.northernurology.com/articles/radical_perineal/outcomes.html

Cancer control: Undetectable PSA is the ultimate goal of prostate cancer treatment. However, clean surgical margins are the cancer-specific goals of RPP, as some men present with more advanced disease than initially realized. The average tumor size is 7.3 grams. Positive margins are seen 16.4% of cases without seminal vesicle invasion (seminal vesical invasion (SVI) is associated with higher risk of recurrence than positive margins (18.9% if SVI included). Margins are considered 'focally positive' (less than 1 mm2) in 9.9% and 'non-focal' or multiple in 8.9.%. Follow up ranges from 3 months to 15 years. Data presented are 3, 5 & 7 - year minimal actual follow up. When comparing cancer results, it is important to understand the make up of the patient groups being compared.
Age 61 at DX
PSA 2/2007 5.71
PSA 4/2008 7.23
Biopsy 5/2007 Negative
Biopsy 7/2008 Positive 1 of 12 cores positive 3+4 5% To 10%
Open Radical Prostatectomy 15/10/2008
Stage pt2c
Post op staging Gleason's Score 3+4=7
apical margin is focally positive
no extraprostatic extension
Seminal vesicles and lymph nodes clear
the vas and the bladder base clear
Catheter out on the 13/11/2008
 
 




hangin-in
Regular Member


Date Joined Sep 2008
Total Posts : 78
   Posted 11/19/2008 8:39 AM (GMT -7)   
6071,
Thanks for sharing those links. Very interesting! I definitely need to find out the extent of the positive margin. I think it makes a big difference.
I hope things get clearer for you on thursday.
Thanks again. I really appreciate it.

Rising PSA 12/06=1.6 12/07=2.1 5/08=2.6
Biopsy 6/4/08 12 core 4 Positive 15%,15%,8%,3%
Diagnose @ Age 51 Gleason 3+3=6
Bone & Cat Scans Normal
Lapro Surgery 8/18/08 at Memorial Sloan Kettering
Pathology report stage T2c organ confined with positive apical margin Gleason 3+3 = 6 (with tertiary grade 4)
Catheter removed 8/26 - reinserted 8/29 - removed 9/2
No continence or potency problems from the get-go.
First post op PSA 10/2/08 < 0.05


hangin-in
Regular Member


Date Joined Sep 2008
Total Posts : 78
   Posted 11/19/2008 1:20 PM (GMT -7)   

Well... Since my surgeon will not be available until next week I called the Pathologist's office directly and asked about the size of the positive margin. I was told it was negliglble and they said .01mm . This sounds good but I don't know if I should be satisfied since it sounds so small. Does it make sense? Should I question it? I feel a little guilty that I don't trust them but it just sounds weird.

Is it normal to find .01mm positive margin and just note on the pathology report "Positive apical margin", and only upon further questioning by me, advise that it was really negligible at .01mm?

Anyone have ideas? Thanks.


Rising PSA 12/06=1.6 12/07=2.1 5/08=2.6
Biopsy 6/4/08 12 core 4 Positive 15%,15%,8%,3%
Diagnose @ Age 51 Gleason 3+3=6
Bone & Cat Scans Normal
Lapro Surgery 8/18/08 at Memorial Sloan Kettering
Pathology report stage T2c organ confined with positive apical margin Gleason 3+3 = 6 (with tertiary grade 4)
Catheter removed 8/26 - reinserted 8/29 - removed 9/2
No continence or potency problems from the get-go.
First post op PSA 10/2/08 < 0.05


Frank1205
Regular Member


Date Joined Feb 2008
Total Posts : 308
   Posted 11/19/2008 2:15 PM (GMT -7)   

6071,

Having a margin measuring .01mm certainly is a good thing.  But its just one piece of information that you need to consider in your decision making process.  Mine, I was told, after asking, was .5mm.  Maybe two cells could have been left behind according to the radiation oncologist .   I recomend you put this information in your file and keep researching.  Discuss with your Doctors what relevance this has, if any.

Dont ever be afraid or concerned about asking questions.  The truly good news is that you have plenty of time to look into this and be happy with a decision you make. 

Heal and get well.

All the best,

Frank


6071
Regular Member


Date Joined Jul 2008
Total Posts : 112
   Posted 11/19/2008 2:40 PM (GMT -7)   

thanks frank

but i do not know what my margin is yet

hangin-in made the post

but you right you still have to make the decision and live with it good or bad

thanks



Age 61 at DX
PSA 2/2007 5.71
PSA 4/2008 7.23
Biopsy 5/2007 Negative
Biopsy 7/2008 Positive 1 of 12 cores positive 3+4 5% To 10%
Open Radical Prostatectomy 15/10/2008
Stage pt2c
Post op staging Gleason's Score 3+4=7
apical margin is focally positive
no extraprostatic extension
Seminal vesicles and lymph nodes clear
the vas and the bladder base clear
Catheter out on the 13/11/2008
 
 



Post Edited (6071) : 11/19/2008 2:47:47 PM (GMT-7)


6071
Regular Member


Date Joined Jul 2008
Total Posts : 112
   Posted 11/20/2008 6:22 AM (GMT -7)   

in with the radiation oncologist to day no radiation for 4 or 5 months

they do not know the the length of the apical margin it is less then 1mm

first PSA < 0.1


Age 61 at DX
PSA 2/2007 5.71
PSA 4/2008 7.23
Biopsy 5/2007 Negative
Biopsy 7/2008 Positive 1 of 12 cores positive 3+4 5% To 10%
Open Radical Prostatectomy 15/10/2008
Stage pt2c
Post op staging Gleason's Score 3+4=7
apical margin is focally positive
no extraprostatic extension
Seminal vesicles and lymph nodes clear
the vas and the bladder base clear
Catheter out on the 13/11/2008
4 week PSA < 0.1
 
 




LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 11/20/2008 7:14 AM (GMT -7)   
6071...What was the reason for the delay of 4-5 months before treatment? Is that standard practice to wait that period of time?

Thanks,
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 Oct 08 <.05


Frank1205
Regular Member


Date Joined Feb 2008
Total Posts : 308
   Posted 11/20/2008 7:35 AM (GMT -7)   
I was told that they want you to be pretty well healed before they start adjuvant radiation and also they do use the post PSA tests to gauge their course of treatment. They would not have started me if I choose to, for about the same period of time.

Frank
Diagnosed @ 53 years old now54
DRE normal , 2004 Biospy negative - 2008 Biopsy positive (01-08-08)
10 cores, 1 positive and at 1% of that one core
PSA @ surgery 6 
Bone and Ct scans negative
clinicaly Staged at T1C - Gleason 3+3 = 6
Robotic Da Vinci performed March 27th, 2008
University of Chicago,Hospital stay 30 hours -
Catheter out in 7 days 
normaly expected leakage
Post Pathology T2C, Gleason 7, 10 % of both portions of prostate
Seminal vessels clear, fat tissue clear
single positve margin measureing less than 1/2mm 
Six week PSA < 0.1 , 4 month PSA <.05 Gen II test. 6 month PSA  <0.01
Urologist recomends to hold off on Radiation and watch PSA closely. Oncologist and Radiation Oncologist seem to lean to doing pre-emptive radiation.Uroligist says 50/50 chance of PSA re-occurence.  
I have decided to hold off and see in 3 months lets see in 9 months.
Next PSA January 2009.
11-08-08 (7months) starting to go without day pads, 100 mg Viagra seeing good results
 
 
 
 


6071
Regular Member


Date Joined Jul 2008
Total Posts : 112
   Posted 11/20/2008 7:43 AM (GMT -7)   

thanks lads

my next appointment is in 3 months
have to wait till I became continent
Currently working on incontinence Very minor leakage at night but go thru 1-2 pads during the day time and it will give me more time to think about getting the radiation + i will get a psa test in february 2009


Age 61 at DX
PSA 2/2007 5.71
PSA 4/2008 7.23
Biopsy 5/2007 Negative
Biopsy 7/2008 Positive 1 of 12 cores positive 3+4 5% To 10%
Open Radical Prostatectomy 15/10/2008
Stage pt2c
Post op staging Gleason's Score 3+4=7
apical margin is focally positive
no extraprostatic extension
Seminal vesicles and lymph nodes clear
the vas and the bladder base clear
Catheter out on the 13/11/2008
4 week PSA < 0.1
 
 




Frank1205
Regular Member


Date Joined Feb 2008
Total Posts : 308
   Posted 11/20/2008 8:47 PM (GMT -7)   

6071,

sounds like you are doing great.  take care.  walk, walk , walk. 

All the best,

Frank

 

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