Waiting for lymph node test...

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New Member

Date Joined Jan 2009
Total Posts : 10
   Posted 2/25/2009 4:49 AM (GMT -6)   
My farther had the lymph node operation yesterday, and he must now wait to the 13th of march to get the answer...
I'm really so afraid that the test does not come out clear... What are the risk that the cancer has spread to the lymphs (He has no symptoms, PSA 11, and a clear bone scan)

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 2/25/2009 9:24 AM (GMT -6)   
Don't have a reply to you on that, lots of variables and more stats pathology would influence the risk factors of course. Did doc explain that there is some risk or possible side effects from doing this proceedure, I looked into it back in 2002 and my stats were so bad that it may not even been worthy, I chickened out with mentioned side effects that could effect your legs and such, not saying anyone else should chicken out of such, just find out what can be known.
Can you tell us more about the details on this proceedure, and how many samples and/or where are taken in his case???

John T
Veteran Member

Date Joined Nov 2008
Total Posts : 4269
   Posted 2/25/2009 5:24 PM (GMT -6)   
Even if the lymph nodes are sampled it does not mean that they are clear. Usually samples are taken from only one lymphatic path. In 40% of the cases when the 1st path is clear the 2nd path is infected, especially if there is seminal vessel invasion. Why did the doctor do an operation when his PSA was only 11? Was his gleason socore high?
A Combidex MRI is much more effective and much less risky and costly compared to a lymph node dissection.

I had a psa of 4.4 in 1999 and steadily increasing psa every 3-6 months before reaching 40 in 5-08.Free psa ranged from 16 to 10%

I had biopsies every year, 13 total in all. I saw 5 different doctors, all urologists or urological oncologists at Long Beach, UCLA, UCSF and UCI and had an MRIS at UCSF in 2007. All tests were negative and I was told that because of all the biopsies I most likely didn't have PC, but to keep getting biopsies every year.

in Oct 08 my 13th biopsy of 25 cores indicated 2 positive cores, gleason 3+3 less that 5% in 2 cores. Doc recommended surgery.

2nd opinion from a prostate oncologist, referred by my wife's oncologists said cancer found wis indolant and statistacally insignificant, but PSA histor was a major concern and ordered a few more tests.

Color Doppler ultrasound with targeted biopsy found a transition zone tumor 18mmX16mm, gleason 3+4 and 4+3. CT and bone scans clear, but Doc thinks that there may be lymph node involvement (30% chance) because of my high PSA, and referred me for a Combidex MRI in Holland, currently scheduled for Feb 14.

Changed diet and takiing supplements while I wait. The location of the tumor plus the high psa make surgery an unlikely option. I'm still evaluatiing all treatment options and will make a decision once I get the results of the Combidex scan.


Veteran Member

Date Joined Feb 2008
Total Posts : 1858
   Posted 2/25/2009 7:28 PM (GMT -6)   
Going back to your original post I see that your father's PSA was 11 and he had 8 of 10 cores positive but I cannot see the Gleason score mentioned. This is a very important part of his diagnosis and is a major factor in his ultimate decision on treatment. We cannot stress enough that your father (or you on his behalf) obtain copies of all test results and learn what all the terms mean (plenty of help here with that task). You will be surprised how knowledgeable you can become in a fairly short time. If there is one thing I've learned in my journey it is how important it is to be very pro-active and involved in your treatment ......... if a doctor recommends an action then know why he thinks that particular action is best for you. There are many doctors, some good, others bad, some compassionate, others distant. To some you are simply a patient not a person. Many are biased toward a particular treatment because that is their field. It is important that you get a second doctor's and even third doctor's opinion on the best course of action ( see a radiation oncologist as well as a medical oncologist). Did your father's recent operation involve removal of lymph nodes or a needle biopsy of the nodes. I believe it would seem a little unusual to have lymph nodes removed for testing at this stage. Try to relax a little with this disease........... your father's not going anywhere for a while yet.
If you want to attach a signature in your posts ( that's the details of your journey....as is in blue below this post) go to "control panel" in the blue band at the top of this page, then to "edit profile" on the page that opens up. Scroll down to "signature" at the bottom and type the details in the box. When done , press "submit" and the details will come up with each of your posts. I hope the lymph node test goes well for your father.
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07
4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August 08 <0.001 undetectable (disregarded due to lab "misreporting")
Post-op pathology rechecked by new lab:
Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September 08 <0.01 (new lab)
PSA February 09 <0.01

Post Edited (BillyMac) : 2/25/2009 6:23:20 PM (GMT-7)

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 2/25/2009 8:46 PM (GMT -6)   
Billymac excellent and unbiased and objective, and heads up for new patients to wrap their minds around.
Well said and I also atest to the value of second opinions on anything major done to your body. You can get second(s) opinion(s) on all kinds of PCa things, or second testings to verify, always good.

Also John T just got the combidex scanning method, you may want to discuss such with him, it seems it outperformed the 4 scanning methods he had done here in the USA. 


Post Edited (zufus) : 2/25/2009 6:50:18 PM (GMT-7)

New Member

Date Joined Feb 2009
Total Posts : 18
   Posted 2/27/2009 7:51 AM (GMT -6)   
Newly diagnosed Psa 2.3,biopsie report 3+3 left base,4+3 mid lat,surgeon suggest davinci radical,waiting to get second opinion from radialogical oncologist on Mar 18,good health,any suggestions,oh my prostate is 61.5cc,first urologist suggested 2yrs hormones and seed implants,I dont like side effects of hormones,nixed that thanks ,richienofear

richienofear (and others), I created you your own thread so you and your Journey won't get lost inside this thread. The link to it is:


Post Edited By Moderator (James C.) : 2/27/2009 8:11:14 AM (GMT-7)

James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4463
   Posted 2/27/2009 10:11 AM (GMT -6)   
richienofear (and others), I created you your own thread so you and your Journey won't get lost inside this thread. The link to it is:

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

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