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Posted 7/15/2009 11:35 PM (GMT -7)
 

My surgeon called today with what he said was "excellent" news about the pathology.  Nodes clear, all cancer contained within the prostate, on two sides but largest dimension 1 cm, a Gleason 7 of 3 + 4, and nice clear margins all the way around.  He said I had a 90/95% chance that I'd never be bothered by PCa again. 

He has faxed the pathology report to me and I am looking forward to reviewing it with my urologist.

While I'd rather my Gleason be 6 than 7, which it was according the the first pathologist who read the slides, my decision to go with surgery was based on the chance it might be a 7 in which case I wanted the pathology afterwards to better know just where I stood.  As many of you know, High Intensity Focused Ultrasound (HIFU) has been approved in Canada for a number of years and the Maple Leaf clinic in Toronto has three to five year results tracking as good, or better than radical prostatectomy results.  There is also a HIFU clinic in Winnipeg run by Dr. Drachenberg.   I think there are others, but these are the two I checked out.  Of course, as HIFU has only been around for 10 years, longer term results are not available, and the third generation (I believe it's third generation) machines now in use are showing better out-of-the-box results than earlier generation machines.  If the second pathology reading had also been six, I'd likely have opted for HIFU.   The Gleason seven made no difference to the validity of HIFU as a treatment option, but knowing my nature as I do I wanted the pathology, the pathology that came in today, to know where I stood.  So, I opted for surgery. 

I know this PCa can pop back up someday, and it may, but in the meantime I'm a happy camper tonight. 

I'll probably go back to Sleepless when it's time for my first PSA test while I await the results.

Sleepless,  AKA Sheldon  

Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5

Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%

June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay

Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!

Catheter out July 9, so far, so good  

Posted 7/16/2009 3:20 AM (GMT -7)

GREAT NEWS.

Hope you get a big fat zero in 3 months.

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

05/14/09  - 4th Quarter PSA -> less then .01

Surgeon - Keith A. Waguespack, M.D.

Posted 7/16/2009 7:09 AM (GMT -7)
Sleepless, I am truly happy for you on that great pathology report. I do reflect, that I was told and thought I had one for 8 months after surgery, and only now finding out that in reality there was one positive margin. As Bro. Zufas would say, is your surgeon willing to guarantee the "90-95%" cure rate in writing, and if it comes back, the dr. would pay for future treatment?

I know that's a rethorical question, and not anything against you. Just a little cynical in general at the moment.

For you, enjoy the good news, celebrate for all of us, and like all the others, I hope and pray you get a big fat zero soon on your first post-psa test. Sincerely.

David in SC
Age 57, 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 capsule, one post. margin, clear lymph nodes 

First PSA Post Surgery   2/9 .05, 5/9 .10, 6/9 .11, 8/11 ?

Lastest 7/13 met with Rad. Oncl, they want to start radiation, 70 gray, I am still considering all options and opinions

 

Posted 7/16/2009 8:52 AM (GMT -7)
Hi David,

I thought of you when I heard this. And I had the report faxed to me. It's a three pager, not a one pager, so I hope it's the whole nine yards.

The problem with the 90/95% is that I'm already firmly in either the 5/10% group or the larger group. The doctor just doesn't know which. This doctor is very careful about not making good news statements he might have to retreat from and has always been clear that percentages apply to a large group. An individual is 100% in one camp or the other. And I had a cousin die of prostate cancer a few months ago and so I know that the 5/10% group is real people. Nevertheless, I'm pleased with the results.

Now, let's both go for some big fat zeros.

Sleepless (who slept better last night) AKA Sheldon
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5

Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%

June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay

Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!

Catheter out July 9, so far, so good  

Posted 7/16/2009 9:22 AM (GMT -7)
Sheldon, I am definitely not casting doubt on your report or your doctor, my remark was meant to be generalized and generic for sure, that's the trouble with saying what you are thinking sometimes.

I should have asked my dr. at the time, is this all there is to the report? Referring to the original one page I was shown. My mistake, at the time I wouldn't have known how many pages there might have been, having never seen one before.

You got a good report, and again, I pray and hope it stays that way for you. You have been through quite a bit yourself. Yeah, bet that Ramada Inn even if you stayed in the penthouse suite would have been cheaper than my 4 days in a regular hospital!

Best to you brother, in your healing ahead.

David in SC
Age 57, 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 capsule, one post. margin, clear lymph nodes 

First PSA Post Surgery   2/9 .05, 5/9 .10, 6/9 .11, 8/11 ?

Lastest 7/13 met with Rad. Oncl, they want to start radiation, 70 gray, I am still considering all options and opinions

 

Posted 7/16/2009 9:26 AM (GMT -7)
Great news SLeepless09. There is no better news than clear margins with no EPE. Best of luck for you.
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09 Dr Fagin, Austin TX
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Bilateral 10-20% involved
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 4 months
8 weeks PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1

Posted 7/16/2009 9:43 AM (GMT -7)
Great news on the path and the margins.  That's about as good as we can look for from a initial path standpoint.
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
21 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix .35ml 2X week continues
PSA's: .04 each 3 months

Posted 7/16/2009 10:03 AM (GMT -7)
Hi David ---- be assured I took no offense or had any problem with your comments. None, nada, zip. I didn't see it as being critical of the report or the doctor. Just a common sense comment. And, helpful.

Ed ---- thanks for your best wishes.

James --- while I know I may be in the 5/10% group that has issues in the future, I'm a happy camper right now. Thanks for your comment.

Sleepless (AKA Sheldon)
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5

Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%

June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay

Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!

Catheter out July 9, so far, so good  

Posted 7/16/2009 10:13 AM (GMT -7)
Nice work, Sheldon,
Stay well...and get some zeros

Tony
 Age 47 (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 (May 11, 2009): <0.1

My Journal is at Tony's Blog  

My InfoLink page is at Tony's Prostate Cancer InfoLink Page

STAY POSITIVE!

Posted 7/16/2009 11:13 AM (GMT -7)

Sleepless:  That is a great report.  I am very happy to see these reports.  Your stats are much like mine.  I will go for my 10th month visit in 2 wks and feel good about where I am at this time.  Your responce to David was very good. Yes we all know that we can fall in that lower group and hope to never get that but some do.  For now enjoy the great news and be greatful for where we are at this time in space.  Good luck  and happy healing.

Jeff

Jeff T Age 57

9/08 PSA 5.4, referred to Urologist
9/08 Biopsy: GS 3/4=7
10/08 Nerve sparing open RRP- Path Report: GS 3+3=7 Stg. pT2c, margins clear
3 mts: PSA .05 undetectable

 ED- 5 mg Cialis daily, pump daily,

Posted 7/16/2009 12:37 PM (GMT -7)
Tony -- thanks for your support. I'll take your advice on the zeros to heart!

Jeff --- thanks for your message. As you say it's a 'time and space' issue and PCa has made both more precious to me. Good luck and happy healing to you too.

Sheldon
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5

Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%

June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay

Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!

Catheter out July 9, so far, so good  

Posted 7/16/2009 1:19 PM (GMT -7)
Thanks Sheldon, that was my intentions all along. Now go and party for the rest of us, you have plenty to celebrate
Age 57, 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 capsule, one post. margin, clear lymph nodes 

First PSA Post Surgery   2/9 .05, 5/9 .10, 6/9 .11, 8/11 ?

Lastest 7/13 met with Rad. Oncl, they want to start radiation, 70 gray, I am still considering all options and opinions

 

Posted 7/16/2009 4:51 PM (GMT -7)
Sheldon,

I'd like to add my congrats with the rest of the crew! tongue

That is a very nice report. Like David said, go out and celebrate and enjoy your survivor-ship!

Barry
Da Vinci LRP July 31, 2007… 54 on surgery day
PSA 4.3 Gleason 3+3=6 T2a Confined to Prostate
6th PSA 06/09 still less than 0.1

Posted 7/16/2009 7:31 PM (GMT -7)
David, Barry, et al:

It is intereting, at least to me, that I am not celebrating. I am relieved, yes, but I am aware I'm just lucky to perhaps be in a sort of limbo area, or I may well be in the 5/10% who have more issues. My cousin died of PCa (some 20 years after diagnosis, by the way) a few months ago and four days after my surgery a friend died of cancer. A guy I'd spent time with less than 48 hours before my surgery and we both decided we were fed up with having cancer and we'd just get better and forget it. Another cousin, his wife has her breast cancer back. This time it's gone to her brain. Our closest friends, the lady of the couple has one more chemo for her ovarian cancer that was removed about the time I was diagnosed.

I am also keenly aware of the struggles being faced by so many here. You're not dying, but you're going through Hades (bet that word fools the Grade Two level softwear protecting us from such words!) ensuring you don't.

Relieved, yes, but I think I'll save celebrating until all of my new found friends here have path reports that are "excellent" and years of zeros to their credit.

Sheldon
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5

Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%

June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay

Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!

Catheter out July 9, so far, so good

Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"  

Posted 7/16/2009 7:55 PM (GMT -7)

Hi Sheldon,

I think that you have a great pathology report.  Look forward to future zeros.

Yes, cancer sucks. And it causes way too much pain, frustration, grief and anger.  But do take time to enjoy this moment. Your friends need to see you in a happy place, too. 

Keep healing,

Dan 

PSA 01/07 1.2, PSA 01/08 1.9, PSA 01/09 2.5

BIOPSY 02/24/09  PCa DX age 52

Right: 3+3=6, 3/6 cores 10% involved,PNI-Y

Left:  3+3=6, 1/7 cores <5% involved,PNI-N

LARP 04/09/09 nerve sparing. Final pathology:

GS 3+4=7, Margins uninvolved, 2 lymph nodes negative

Catheter out 04/17,1st no-pad day 05/03

25 mg Viagra nightly;100 mg:not ready for prime time

Followup PSA 05/28/09 <0.1

Posted 7/16/2009 10:54 PM (GMT -7)
Hi Sheldon,

Your bring up some very real concerns. I don't know how any of us square the risks of once having PCa since we are never pronounced "cured" at some future date as is the case with other cancers. I don't have just one good answer.

I have tough days and very good days. There are folks on this forum that have post treatment numbers that are very worrisome to me, yet they promote a very positive attitude by their example.

A medical site had a discussion post by a breast cancer patient where she said, "If you have been diagnosed with cancer and are reading this message, you are a cancer survivor!" That is an interesting way to think about it.

I suppose some of our brethren here with more advanced symptoms look at each day as a gift.

To give me a boost, I look at the yananow.net site and review the EXPERIENCES section. I see the great majority who are still alive and well many years after their treatment. That was the first web site I used before I got the fantastic support on this forum.

All in all, I think each of us just have to search for some kind of normalcy. The general human population are walking around with ticking health time bombs (heart problems, cancers, etc.) and don't know it. Most enjoy each day they live. I guess we've been given a little more knowledge about our morality that, at times, we'd prefer not to have.

Activity in Church and at work really helps me feel more normal. I hope and pray that you will find your "normal zone."

Remember, being a cancer patient is not your most important identifying personal feature to those who love you. tongue

Kind regards,

Barry
Da Vinci LRP July 31, 2007… 54 on surgery day
PSA 4.3 Gleason 3+3=6 T2a Confined to Prostate
6th PSA 06/09 still less than 0.1

Posted 7/17/2009 1:08 PM (GMT -7)
Hi Sheldon,
Great news on the path report!! Now just sit back enjoy life and get healed up. It takes awhile to get your head around all this stuff, or it did for myself and still does. It's just a day at a time whatever the case is anyway.

David
Age 53
Pre-op PSA 4.3
Surgery Feb. 17 2005
Post-op Path : Gleason 3+3=6
Right pelvic lymph nodes: negative for metastatic carcinoma
Left pelvic lymph nodes: negative for metastatic carcinoma
extent: right lobe 40% left lobe 10%
capsular penetration: Absent
Seminal vesicles and vasa differentia: Uninvolved
Prostate: 26 grams
Post-op PSA's <0.04 for 3 years
Feb. 08: 0.07, March 08: 0.08, June 08: 0.09 and Sept. 08: 0.1
IGRT scheduled.....November 17th....
FINISHED 01/14/09 YEA!
05/14/09
1st PSA after Salvage RT <0.04..... Another YEA!

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