Can T staging change T1c=>T2c with path results?

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mountain top high
Regular Member


Date Joined Mar 2009
Total Posts : 22
   Posted 4/24/2009 9:25 PM (GMT -6)   
My urologist staged my PC when he diagnosed it (from my second biopsy pre-surgery) as T1c (couldn't detect it with a digital exam, but found with the biopsy after suspicious PSA numbers). I noticed that the path report after surgery said T2c, which I understand means it was able to be felt digitally. I assumed that was a typo since the uro couldn't find it digitally. Can the staging really change from T1c to T2c based on path results though?
Mountain Top High, Age 43
PSA 1.6 (2006), 1.9 (2007), 6.0 (6/2008), 3.9 (7/2008 after 30-day Cipro course)
8/08 biopsy--high grade PIN
11/08 biopsy--Dx (age 43), Gleason 7 (3+4), T1c
Da Vinci RP 2/9/09 (Dr. Abaza, Head of Robotic Uro, James Cancer Center @ Ohio State)
Path--PCa 9%, 39.5 grams, contained in capsule, margins & lymph nodes clear
Catheter 1 week, no nighttime incontinence
@ 6 wks: ~4-5 pads/day, since 7 weeks out 1-2 pads/day with regular ab/core exercises
Complete ED, pump twice daily, fighting with insurance for Viagra


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4823
   Posted 4/25/2009 3:47 AM (GMT -6)   
I don't recall ever getting a "stage" number...But my Gleason score went UP from the post surgery path report. I believe this to be very common.

Age 54   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
 
06/25/08 - Da Vinci robotic laparoscopy
Catheter in for five weeks.
Dry after 3 months.
 
10/03/08 - 1st Quarter PSA -> less then .01
01/16/09 - 2nd Quarter PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.
 


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 4/25/2009 5:47 AM (GMT -6)   
I believe the staging T2c in this case means that the tumour was confined but within both lobes of the prostate.
Bill
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


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 4/25/2009 7:33 AM (GMT -6)   
Mountain, that is very common indeed to the have the staging upscaled like that. I never had a positive DRE in 7 years, originally it was assumed to be a T1, but after surgery, it was a T2.
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 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, 6 month on 5/9
 
 


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 4/25/2009 10:11 AM (GMT -6)   
Good advice and wisdom gentleman. This is common and Bill you are correct in how to read the staging. Now that you are on the other side of surgery you can begin to enjoy your new lease on life and see and do things that might have been otherwise taken for granted. Thanks for sharing and please feel free to join in the conversations.

peace and love
dale
My PSA at diagnosis was 16.3
age 47 (current)
My gleason score from prostate was 4+5=9 and from the lymph nodes (3 positive) was 4+4=8
I had 44 IMRT's
Casodex
Currently on Lupron
I go to The Cancer Treatment Center of America
Married with two kids
latest PSA 5-27-08 0.11
PSA July 24th, 2008 is 0.04
PSA Dec 16th, 2008 is .016
PSA Mar 30th, 2009 is .02
Testosterone keeps rising, the current number is 156, up from 57 in May
T level dropped to 37 Mar 30th, 2009
cancer in 4 of 6 cores
92%
80%
37%
28%
 


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 4/25/2009 10:12 AM (GMT -6)   
Yes.
Under AJCC (2007) tables:
T1c is defined as positive needle biopsy after an elevated PSA test.
T2c can be defined if the biopsy is positive on both sides of the prostate.

I'll bump my staging post for your reference...
http://www.healingwell.com/community/default.aspx?f=35&m=1290567
Tony


Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 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!

Post Edited (TC-LasVegas) : 4/25/2009 10:21:33 AM (GMT-6)


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 4/25/2009 10:29 AM (GMT -6)   
If anybody noticed, I changed my answer above.  I've seen too many AJCC (American Joint Council on Cancer) references...lol.  I linked AJCC2002 for this description but if I used 2007 it would state the palpability of the tumor.  The current table in use is AJCC2007.  From my experience, the tables are reviewed every 5 years.  Very subtle changes.  The last major change was 1997 when T3c was dropped from staging.  However some doctors still use that table.  Confuses me as to why. (both why doctors don't all use the current tables, and as to why they changed it eyes )
 
It depends on which tables your doctors use.
 
Tony

Post Edited (TC-LasVegas) : 4/25/2009 10:38:08 AM (GMT-6)


mountain top high
Regular Member


Date Joined Mar 2009
Total Posts : 22
   Posted 4/25/2009 8:18 PM (GMT -6)   
Ok. Thanks for the info, guys!

Mountain Top High, Age 43
PSA 1.6 (2006), 1.9 (2007), 6.0 (6/2008), 3.9 (7/2008 after 30-day Cipro course)
8/08 biopsy--high grade PIN
11/08 biopsy--Dx (age 43), Gleason 7 (3+4), T1c
Da Vinci RP 2/9/09 (Dr. Abaza, Head of Robotic Uro, James Cancer Center @ Ohio State)
Path--PCa 9%, 39.5 grams, contained in capsule, margins & lymph nodes clear
Catheter 1 week, no nighttime incontinence
@ 6 wks: ~4-5 pads/day, since 7 weeks out 1-2 pads/day with regular ab/core exercises
Complete ED, pump twice daily, fighting with insurance for Viagra, ordered from alldaychemist, 4/23 started 100mg nightly 


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 4/26/2009 12:00 AM (GMT -6)   
T2c is new newer name for bilateral tumor in general. T2b is a term used to describe tumor found bilaterally with half or more the lobe involved and / or can be felt by DRE. Pathologists wanted a way to just say both lobes so they added T2c to the list.
 


kcragman
Regular Member


Date Joined May 2008
Total Posts : 240
   Posted 4/26/2009 6:08 AM (GMT -6)   
MT High:

You can see my stats. My only comment is that I was told the "p" means that the staging was upgraded (progressed?) from a lower stage.

Good luck,

kcragman
Age: 53; 52 at DX
March 2006: PSA 2.5
Dec 2007: PSA taken for insurance application. I did not see the results until late
Jan '08 - after I was rejected. Their lab said PSA 4.5.
Feb 2008: PSA 3.7.
March 2008: Biopsy. Gleason 7 (4+3) 12 cores taken. 5 on the left side were
cancerous and the 6th was suspect.
May 5, 2008: Da Vinci robotic laparoscopy at GW Hospital, Washington DC.

Post op: Gleason 9 (4+5). 15% of prostate involved. Stage: pT3a. Negative margins. Lymph node and nerve samples taken, and appeared to be cancer free.

July 2008: PSA at 7 weeks was undetectable.
August 2008: PSA at 14 weeks (3 months) was undetectable.
Nov 2008: PSA at 6 months was undetectable.
Feb 2009: PSA at 9 months was undetectable.


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 4/26/2009 7:56 AM (GMT -6)   
kcragman, et al,
p ~ as in pT3b like mine ~ indicates a port operative stage. Without the p you have a clinical stage.

Tony
Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 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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