My pathalogy report today

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Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2460
   Posted 2/17/2009 3:42 PM (GMT -6)   
Hi,
I just got back from the doctor's office to get the catheter removed and get the pathology report. He said the Gleason score was 4+4 and that it was bilateral. There was no lymph node nor seminal vesicle invasion. The margins are clear. There was perineural invasion. Both nerve bundles were removed (bye bye ED). The final TNM is T3 Nx Mx. Thank you all for helping me and supporting me during this roller coaster. I'll have a PSA test in 7 more weeks and start the new post surgery journey with all of you.
Age: 67
5ft 10 inches 182 lbs
Retired in 2001 and living in Austin TX.
Dx 12/30/08
Robotic surgery performed on Feb 9th
Surgeon: Dr. Randy Fagin, Austin TX.
12 sections tested 2 with cancer
Left Medial Apex 4.0 mm. Gleason score 9 (4+5)
Left Lateral Apex. 2.0 mm Gleason score 8 (4+4)
Negative CT scan and bone scan done on 1/16
PSA 3.5


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 2/17/2009 4:00 PM (GMT -6)   
That report sounds pretty good, Really routine for the seriousness of your initial numbers. Clear margins, no extension, PIN is routine. Sorry about the nerves...All in all a good start on a lifetime of recovery. Will be waiting with you for your first psa results.
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
16 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix .35ml 2X week continues
PSA's: .04 each 3 months


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25382
   Posted 2/17/2009 4:03 PM (GMT -6)   
Well, there's good news in the report concerning margins, etc. Your biopsy stats were fairly tough, so not any real surprises. We are here for you brother, as you continue to recovery, and as you await that first post surgery psa. Think positive

David in SC
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Right nerves saved, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05
 
 


sandstorm
Regular Member


Date Joined Dec 2008
Total Posts : 194
   Posted 2/17/2009 5:22 PM (GMT -6)   
old67

Thats not too shabby of a path. report. Sure am sorry about the nerve bundles. Still plenty of hope left though, hand in there.
Age at DX 57
5-18-07 PSA 7.7
5-06-08 PSA 4.6  8% free psa, but stable
10-23-08 PSA 5.65 4% free psa
11-04-08 biopsy
11-11-08 2 of 12 cores positive
Gleason 3+3  6  stage t1c / post-op 3+4  7  stage t2c
CT and Bone scan negative
Da Vinci RRP 01-09-09
Catheter removed 1-15-09
Pathology Report says it's gone!
First Post-op PSA due 2-17-09


gpg
Regular Member


Date Joined Jan 2009
Total Posts : 180
   Posted 2/17/2009 6:39 PM (GMT -6)   
Wishing you a speedy recovery,

There are means for the erectile issues, right now just get well and look forward to your first 0 :)

Scott
Diagnosed @ 48yo 04/07
focal, low volume tumor gleason 6
RRP 07/30/07 robotic
Persistance of PSA
IMRT 11/07-01/08
Emerg, cysto obstructed bladder 01/08
Persistance of PSA
08/08 learned Dr. left significant amount of prostate
12/08 PCA3 negative
12/08 saturation biopsy 36 cores 24 having normal prostate tissue
12/08 referred whole to med malprac attorney


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 2/17/2009 6:47 PM (GMT -6)   
James C. (mod-squad and brother of PCa) I know you meant to say perinureal invasion is not uncommon to see when looking at 12 biopsies or so. PIN is not the acronym for that just so others do not get confused if looking at data and things, PIN is a possible precancerous condition seen by pathologist and is not defined as being PCa. (maybe you meant PNI for perinueral invasion??)
 
 Perinureal invasion means in effect- biopsy shows it hit a blood traveling source (vein or nerve type of thing)...it also does not prove PCa migrated....it means it is a possible path, so if a patient sees this the verbage sounds omnious " Perineral Invasion" I think it scares people more than it should. Heard this from informed docs. I don't know if there is an abbreviation for perinureal invasion????


 

Post Edited (zufus) : 2/18/2009 5:44:57 PM (GMT-7)


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 2/17/2009 7:20 PM (GMT -6)   
Old67,
it's great you are on the mend and have crossed that first bridge. But I am certain your doctor mention concern for your T3 staging and high risk cancer. The negative margins is good but it is clear he had reason to believe the outer wall of the protate was penetrated. Did he mention extraprostatic extention?

Still, you can do very well. You should look next into whether it is prudent to consider adjuvant therapies such as radiation or homonal therapy. I say this not to panic you but rather be prepared for what lies ahead. My tumor was larger and more advanced, but the Gleason less. Still my surgeon directed my to clinical oncology right out of surgery. And within two weeks of my surgery I was in my first visit to a prostate cancer hematologist. You can do very well and I expect you will. But please look ahead and be proactive.

Out of curiousity, he stated no lymphatic invasion yet signalled unknown in the TNM. How many lymph nodes were dissected?

Peace and good healing.

Tony
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!


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2460
   Posted 2/17/2009 10:16 PM (GMT -6)   
Thank you Tony,
I just emailed my doctor with the questions you raised. I also asked him to mail me (or I can pick up) a copy of my pathology report. He did say that there was EPE but because of the wide margins he did during the surgery he believes that at this point no further action is needed. I'll have to wait for the first PSA test. If there is cancer beyond what he took out would the PSA test show it? Can a zero first PSA be a false negative?
Age: 67
5ft 10 inches 182 lbs
Retired in 2001 and living in Austin TX.
Dx 12/30/08
Robotic surgery performed on Feb 9th
Surgeon: Dr. Randy Fagin, Austin TX.
12 sections tested 2 with cancer
Left Medial Apex 4.0 mm. Gleason score 8 (4+4)
Left Lateral Apex. 2.0 mm Gleason score 8 (4+4)
Negative CT scan and bone scan done on 1/16
PSA 3.5
Post op Pathology report: Bilateral with perineural invasion
Gleason 4+4
both nerve bundles removed,
pT3c Nx Mx
Negative margins
Lymph nodes: uninvolved
seminal vesicles clean


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 2/17/2009 10:22 PM (GMT -6)   
Yes if there is still residual disease the PSA may show it. But not necessarily yet. But try not to worry about it. (easy said). There was no doubt in my case but I am doing well. And if you get that undetectable, rejoice. That is great stuff. Always think the good things. You can and will do well.

Tony
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!

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