Looking for explanation on Pathology Report

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Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 12/8/2008 10:25 AM (GMT -6)   
My post-surgery pathology report is very good.  This is, however, one line that sounds like its not as good or perhaps I am reading to much into it.  It will put it down here, letter for letter, and see if any of you more experienced members can give me a take on the verbage.  My doctor does believe in the current theory, that rapid psa velocity in the year before surgery often means additonal spread down line, despite having the surgery.
 
Surgical Margin Status:
 
   Left Posterior Lobe:   Infiltrating tumor microscopically appears to extend to marked left posterior margin.
 
(Note:  in my case all of the cancer was on the left side)
 
David in SC
Age 56, 56 at DX
 
PSA 2007 5.8
PSA 9-2008 14.9
 
3rd Biopsy 9-2008 Positive
7 of 7 cores positive, ranging from 40 - 90%
2 tumours noted, Gleason 4+3 and 3+4
 
Open RP surgery completed on Friday, November 14, 2008 at
St. Francis Hospital, Greenville, SC, Dr. Ronald Smith - Surgeon,
Non-nerving sparing, 4 days in hospital, staples removed 11/24/8
 
Post-surgery Pathlogy Report:
Gleason 3+4=7, pT2c pN0 pMx, Prostate 42 grams, tumor 20% cancer
Contained in capsular, neg. margins apex, bladder neck, right lobe, neg. in seminal vessels and lymph nodes. Left lobe: infiltrating tumor miscroscopically appears to extend to marked left posterior margin


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 12/8/2008 11:26 AM (GMT -6)   
Dave...not 100% positive here, but it appears that microscopically the cancer was very close the edge of the prostate surgical site but wasn't deemed as a positive margin, just real close. Being that most PCa cancer tumors are located near the edge anyway, it was just noted that it was very close to the edge. I don't see anything to be alarmed by that statement.

Good news overall on a good path report...looks like you will be heading towards the Zero club now.

Followup question...you were given a path staging of pT2c and not pT2b?  Being that only one lobe was involved why were you giving the both lobe staging of pT2c?


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

Post Edited (LV-TX) : 12/8/2008 9:33:31 AM (GMT-7)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 12/8/2008 11:39 AM (GMT -6)   
Not sure, on the final biopsy pre-surgery, they noted two nodes with cancer, 4+3=7 and 3+4=7, don't know why it shows now with one, confused, will have to ask doctor next time I see him.
Age 56, 56 at DX
 
PSA 2007 5.8
PSA 9-2008 14.9
 
3rd Biopsy 9-2008 Positive
7 of 7 cores positive, ranging from 40 - 90%
2 tumours noted, Gleason 4+3 and 3+4
 
Open RP surgery completed on Friday, November 14, 2008 at
St. Francis Hospital, Greenville, SC, Dr. Ronald Smith - Surgeon,
Non-nerving sparing, 4 days in hospital, staples removed 11/24/8
 
Post-surgery Pathlogy Report:
Gleason 3+4=7, pT2c pN0 pMx, Prostate 42 grams, tumor 20% cancer
Contained in capsular, neg. margins apex, bladder neck, right lobe, neg. in seminal vessels and lymph nodes. Left lobe: infiltrating tumor miscroscopically appears to extend to marked left posterior margin


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 12/8/2008 12:21 PM (GMT -6)   
Purg,

Means, node negative, contained to the left lobe with one microscopic (less than 5 cells if I remember right) area that extends to the posterior (back side) inked margin. It does not say that it is "through" or beyond" or "positive"; just up to. Final path calls it a PT2c NO (node negative) MX (Mets not assessed).

Gleason scores change pretty often from the clinical finding to final pathology. Lesser is always a good thing! Be glad of this!

Simply put, this is a promising, as in contained, report. The pathologist could see nothing he/she can call positive. Now, go try to relax and let your body heal :>)

Swim
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 12/8/2008 12:31 PM (GMT -6)   
Swim,

I am very happy with it, its much better then I thought, or my doctor originally thought it would be. I am hoping this will be it for me with PC, other then the rest of the healing process, which I know will take much time.

Thanks,

David in SC
Age 56, 56 at DX
 
PSA 2007 5.8
PSA 9-2008 14.9
 
3rd Biopsy 9-2008 Positive
7 of 7 cores positive, ranging from 40 - 90%
2 tumours noted, Gleason 4+3 and 3+4
 
Open RP surgery completed on Friday, November 14, 2008 at
St. Francis Hospital, Greenville, SC, Dr. Ronald Smith - Surgeon,
Non-nerving sparing, 4 days in hospital, staples removed 11/24/8
 
Post-surgery Pathlogy Report:
Gleason 3+4=7, pT2c pN0 pMx, Prostate 42 grams, tumor 20% cancer
Contained in capsular, neg. margins apex, bladder neck, right lobe, neg. in seminal vessels and lymph nodes. Left lobe: infiltrating tumor miscroscopically appears to extend to marked left posterior margin

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