"Focally Positive" Pathology Report

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New Member

Date Joined Oct 2009
Total Posts : 2
   Posted 10/20/2009 2:54 PM (GMT -6)   
My husband's post surgical pathology report included a statement that the part of the bladder neck included as a speciment was "focally positive".  His surgeon said that this could be an "artifact" of the the way the sample was taken.
Can someone translate what this means?  We've searched several sites and found the term "focally positive" used, but never a definition of the term.

Regular Member

Date Joined Jul 2009
Total Posts : 384
   Posted 10/20/2009 3:01 PM (GMT -6)   
I'm anxious to hear also...I just talked to my Doctor yesterday about my Path report. Mine state Focally positive Type 5 cells. The Doctor explained that to me as even though my Gleason Came out as 3+4 There were some scattered type 5 cells.

I would assume it means that perhaps some cancer cells were found on the bladder neck?

Age at diagnosis 54, PSA 5.1
Biopsy 04/08 12 cores, 5 positive
Gleason 3 Cores at 4+3=7, 2 Cores at 3+4=7
Perineural Invasion Noted on biopsy

Robotic surgery 08/12/09 at Vanderbilt, Nashville TN. 
Post Surgery - Dr. Spared 100% of Nerves on the left side.
Estimated that 50 - 70% of the nerves were spared on the right side.
Final Path report
20% of the prostate Invovled
Tumor graded at T2C
Overall Gleason 3+4 (7)
Lymph Glands Clear
Positive Margin Noted in Right Apex

Steve n Dallas
Veteran Member

Date Joined Mar 2008
Total Posts : 4849
   Posted 10/20/2009 3:06 PM (GMT -6)   

For peace of mind and 100% accurate info - call your DOCS back.

Its very possible someone here will tell you excatly the right information but - when in doubt make your doctors work for you.

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.

Ken S
Regular Member

Date Joined Nov 2006
Total Posts : 120
   Posted 10/20/2009 3:21 PM (GMT -6)   

Focally positive means there is a very small positive margin. I read somewhere several months ago that focally positive was anything under 3 mm. A positive margin means that the prostate and the tissue removed was found to have cancer cells right to the edge of the specimen.

The doctor and pathologist have no way of knowing if there were cancer cells left behind or not so the report may state cancer contained within the prostate with a positive margin. Perhaps T2C.

Many of us here had positive margins and we're doing very well. Some have opted for adjuvant radiation therapy (radiation treatments soon after surgery, but before PSA rise) and some have taken a wait and see approach and if there is a slight PSA rise then have the radiation treatments (salavge radiation therapy).

With today's medical advances positive margins, if there is a PSA rise, can be treated very successfully.

Age 54 (2006) PSA: 2005 - 3.2, 2006 - 3.7
Biopsy 8/06, Gleason 6 (3+3), T1c
Radical Retropubic Prostatectomy 11/3/06 Post-Op Biopsy, Gleason 6 (3+3), T2c, right apical margin positive
CT Scan 1/07, tumor discovered on right kidney (unrelated to PCa)
Partial Nephrectomy 3/9/07
IMRT (37 Treatments) 4/23/07 - 6/14/07
PSA: 6/09 - 0.03

New Member

Date Joined Oct 2009
Total Posts : 2
   Posted 10/20/2009 3:26 PM (GMT -6)   

Thanks very much.  This is very helpful.  Are there any sites you would recommend to help us translate the rest of the pathology report?


Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 10/20/2009 4:02 PM (GMT -6)   
Mia, as clever as we are here at HW, I would strongly reccomend that you get your husband's doctor to explain the detailed wording on his pathology report. The devil is in the detail and the verbage.

Good luck to him.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/09 met 2 rad. oncl, 7/09 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 - out  38 days, 9/14/9 - met 3rd rad. oncl.agree to start radiation, mapping on 9/21/9, 9/24 - mtg with uro/surg, 9/29- pre-op, 10/1 - 3rd corr. surgery - suprapubic cath/hard dialation, 10/5 - began IMRT SRT - 39 sessions/72 gys.

Veteran Member

Date Joined Mar 2009
Total Posts : 739
   Posted 10/20/2009 4:26 PM (GMT -6)   
Mia, this may explain some of your questioning..........................Cheers Kev
Age 51yrs
DX 11/11/08
6 out of 8 cores positive 3 X 60% / 3 X 10%
Gleason Score 3+4=7
Stage T1c
Robotic Surgery 24/12/08
Upgrade Gleason Score 4+3=7 Gleason Differential 60%/40%
Stage T2c
Three small foci total volume <10%
Neg Margins and Nodes
Nil - Extraprostatic Extentions
Dry less than 1 week.
ED- taking Meds- Its been 9 mnths now getting some action ! yah
PSA 1/09  .03
PSA 2/09  .03
PSA 5/09  .03
PSA 9/09  .03
"Everyday in Everyway I get better"

Veteran Member

Date Joined Aug 2009
Total Posts : 2448
   Posted 10/20/2009 5:41 PM (GMT -6)   

Nice article man thanks for the post.

61 years old
PSA 11/07 3.0
PSA 5/09 6.4
Diagnosis confirmed July 9, 2009
12 Needle Biopsy = 9 clear , 3 postive
<5%, 90%, 40%
Gleason Score (3+4) 7 in all positive cores
CT Organ Scan - negative
Nuclear Bone Scan - Negative

da Vinci 9/17/09 Dr. Mani Menon Henry Ford Medical Institute

Post Surgery Pathology:
Gleason: Changed to (4+3) = 7
Stage: T3a
Tumor Volume 12.5%
Margins: focally positive right posterior mid level
Perineural Invasion: present
Seminal Invasion: absent
Venous Invasion: absent
Angiolymphatic Invasion: absent
Left Internal iliac lymph node: reveals zero
Right Internal lymph node: reveals zero

Veteran Member

Date Joined Sep 2008
Total Posts : 744
   Posted 10/20/2009 6:33 PM (GMT -6)   
That's an interesting article, I see it was written in 1997. At the end of the article it was noted that if margins are positive, radiation treatment can be used on the prostate bed, to hopefully kill any remaining tumor cells.

I didn't think they did salvage/adjuvant radiation back then...I guess they did. I was under the impression that adjuvant radiation has only fairly recently (perhaps the past several years) been used as additional treatment.

Regular Member

Date Joined Oct 2009
Total Posts : 23
   Posted 10/20/2009 7:41 PM (GMT -6)   
Nice article. I forwarded it to my dad. Thanks for the post.
Daughter worried about dad
Locally advanced prostate cancer
CT scan negative
PSA 7.9
Gleeson 7 (3+4)
Age 54
1 postive margin (seminal vesicle)
Robotic nerve sparing surgery Oct 2009
Scheduling for radiation

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