People like Tony on this forum are experts who have answered many many questions and done their research. Please think seriously about
following his advice. Knownledge about
all this will aid you greatly.
I would suggest that from reading your descript
ion of what the doctor said that you had cancer to or beyond the wall of the prostate, but the doctor believes he cut wide enough to get it all. A positive margin is cancer shown to the perimeter or outside the perimeter of the doctors extraction. Positive margins are what doctors try to avoid - that is they will cut a large enough diameter to take all the cancer so that there is no cancer shown to the boundary of the area cut out. Leaving any cancer in the area increases the possibility of its continued growth and spread in the body and the later return of PSA will indicate its presence. You have capsule penetration (apparently to the wall of the prostate), but the doctor thinks he got the excess outside the capsule. The pathology report will provide the information to know if this is so or not, and will guide the rest of your decisions about
what to do or not to do for further treatment.
I had non-nerve sparing surgery for the same reason described above - the surgeon thought there was a good possibility I had cancer outside the capsule and therefore cut a wider path to make sure he got it. I hope this is helpful.
Age 61 (now 62)
Original data - pre-operation
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
Margins - negative
Extraprostatic extension - negative
seminal vesicle invasion - uninvolved
1st Post PSA <.04
2nd Post PSA <.1 10/30/2008