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Post surgery results: Upgraded

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Prostate Cancer
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mikey1955
Veteran Member
Joined : Dec 2008
Posts : 673
Posted 6/4/2009 4:20 PM (GMT -8)
 

I had a retropubic RP in early May. Recovery is going well. Catheter removed and staples out 2 weeks later. I had pretty much full urinary control from the get-go except for a few stress squirts from a sneeze or cough. That is almost completely gone now at 4 weeks out. Nerves were spared but, at best 25-30% of presurgery erectile function. I am trying Levitra for the first time.

Pathology from surgery as follows:

1) Staging: pT3a N0 Mx...stage III prostate cancer, cancer has extended beyond prostate capsule, no lymph node involvement, metastasis (spread) cannot be determined 

2) Extraprostatic Extension (EPE): Unifocal, tumour abutting periprostatic fat, distinct bulging tumour nodule...the cancer is not confined to the prostate

3) EPE within surgical margins

4) Seminal vesicles: Clear

5) Lymph nodes: No malignancy in regional lymph nodes

6) Gleason score: Upgraded from 6 (3+3) to 7 (3+4), both lobes affected with tumours

7) Perineural invasion: Present (seen on biopsy, also)

8) Resection margins: Apical, bladder neck, radial...uninvolved with cancer

9) Additional: High grade PIN, glandular and stromal hyperplasia

Not what I was hoping for, the cancer was not confined to the prostate and Gleason is higher than presurgery biopsy, but it is what it is. Next step will be talking to a radiation oncologist specializing in PCa and waiting to see results of 3 month PSA test in August.

In the mean time, I am working on recovering from surgery and doing very well. I'm slowly starting to get back to working out, getting my fitness level improved and I'm keeping a strong and positive attitude.

I still have a lot to learn about my present staging and potential further treatment. Any comments would be appreciated.

All for now,

Mike 

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geezer99
Veteran Member
Joined : Apr 2009
Posts : 990
Posted 6/4/2009 5:50 PM (GMT -8)
Not a home run, but headed toward healing. I felt much better when I found out that 90% of extra prostatic extensions are less than 1/10 of an inch (pretty much microscopic) I'm still waiting to get to the three month test, but I'm confident that it is just a matter of time until that guy from the zeros club starts dunning us for dues.
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sterd82
Regular Member
Joined : Sep 2006
Posts : 187
Posted 6/4/2009 7:04 PM (GMT -8)
Seems like almost everybody gets upgraded post -surg. Clear margins is a nice thing to see here. At this point, its all about the PSA results. Good for you to consult with a radiation oncologist --- not that you'd leap into treatment (too soon anyway), but best to explore all the options. Nothing like throwing everything you have at the beast!

Happy healing and recovery!
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