Can containment be assured pre-op?

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Veteran Member

Date Joined Dec 2008
Total Posts : 673
   Posted 12/7/2008 3:37 PM (GMT -6)   
Hello again,
I had a bone scan done Friday, won't know until 17th. Before any complete prostate removal are there others tests I can ask for to see if it's in lymph system, blood, perineum, other, MRI? And actually, does this really help?
I've read several articles where really don't know until they open you up and look. My GP sort of mirrored that.
I'm going to my GP tomorrow to get a copy of the biopsy report so I can update properly here.
I did have a hernia op with mesh, lower left groin 2 years ago. Does that influence procedure/outcome?
I was starting to look at daVinci,  nerve sparing (dependent on what they find once they have a real look during surgery) since local surgeon, Joe Chin and Paulter have several hundred between them (from what I've seen so far).
Clearing my head is getting better...still a way to go.
Thanks to all the guys and gals that post here...has left me starting to put things at arms length...I'm grateful for that. Haven't told my kids yet as oldest daughter due for 1st grandchild within a week (Yahooo).
Grandpa Mikey term is viewed somewhat as an oxymoron in my family smilewinkgrin
Present Status: 5 of 8 biopsies positive for adenocarcinoma, December 3/08, both lobes.
Present Status: Tumour in lower right and upper right lobe.
Present Status: Tumour in lower left and central left lobe.
Present Status: Gleason Score 3+3
Present Status: Cancer 40%-75% on samples...don't have exact details yet...but will soon.
Present Status: recommended radical prostrate removal, open surgery.
Present Status: PSA 5.3 Nov 2007, PSA 7.3 June 2008.
Present Status: Married to beautiful wife for long time. Started going out 36 years ago.
Present Status: 3 great grown kids, one at home to finish college.
Present Status: Becoming 95% Scared Stupid (an improvement).

Regular Member

Date Joined Apr 2008
Total Posts : 270
   Posted 12/8/2008 12:06 AM (GMT -6)   

Your PSA, the sonagram, DRE, and biopsy are what doctors use to diagnose your situation.  Of these the PSA and biopsy probably tell more than anything else, with the biopsy being the most important.  However, sometimes as you will note from those on this forum with many who tell their story the pathology (following surgery) sometimes changes the diagnosis for the better or worse.  The pathology is by far the most complete data because the prostate is removed and sliced / diced examined.  This is one of the advantages of surgery over radiation - that is knowing more factually about your cancer and particularly whether it is contained in the prostate.

Doctors use the pre-surgery or pre-treatment data to estimate whether the cancer is contained, and some formula's have been used based on historic data to arrive at percents of containment - these are helpful, but are only best estimates.

Your situation looks to be reasonably early at a gleason 6, however, it is bilateral and according to the biopsy your tumor size is a high percent.  You should check the web sites with the calculators, but from what I have seen there is a higher than 50% chance it is confined.  But, even if it is not confined there are other treatments.  Keep your chin up.



Age 61 (now 62)
Original data - pre-operation
PSA: 5.1
T1C clinical diagnosis, Needle biopsy - 10 cores, Gleason 7 = 3+4 in 1 core (40%), 7 cores Gleason 6 = 3+3 ranging from 5% to 12%
All scans negative
Lupron administered 4/9/2008 for 4 months (with idea I would undergo external beam radiation followed by seed implants - then I changed my mind).
Robotic DiVinci surgery - Dr. Fagin (Austin) May 19th
Post operative - pathology
pT2c NX MX
Gleason 3+4
Margins - negative
Extraprostatic extension - negative
seminal vesicle invasion - uninvolved
1st Post PSA <.04
2nd Post PSA <.1 10/30/2008

Veteran Member

Date Joined May 2008
Total Posts : 1010
   Posted 12/8/2008 10:18 AM (GMT -6)   

Hi Mike,

There are test that can be done to estimate the extent of the cancer. CT scan, MRI, circulating tumor cell, ProstaScint, and X ray. You can also use the Partin Tables to determine the statistical probability of confinement to the gland. The link will take you to the John Hopkins site and the site explains the use and results of the calculator. In any event post surgery pathology is still the most accurate.

Your question regarding the hernia repair was the same that I asked of a surgeon when investigating alternatives. His response was that it spoiled a couple of cutting planes but was no real obstacle to open surgery and would not effect the outcome.

Congratulations on becoming a Grand Parent. Like the bumper sticker says "if I had known that my grandchildren would be so great I would have had them first."

Good luck to you and best wishes for a speedy recovery.


Diagnosed 04/10/08
Age 58
PSA 21.5 (first and only test resulted from follow up visit to emergency room for kidney stone. first time for kidney stone too)
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear
Chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Lupron injection on May 15 and every four months for next two years
PSA test on July 14, 08 after 8 weeks hormone .82
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 to be full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
Second Lupron shot 09/11/08
Next PSA test by oncologist 03/09

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