post op visit pathology

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Mbshine
Regular Member


Date Joined Aug 2008
Total Posts : 67
   Posted 10/29/2009 12:58 PM (GMT -6)   
First I don;t really know how to navigate these threads, so I ask you all to share this note.
 
First a thank you to moderators and posters who have been guides and supporters since my DX in July 08. With a son in Iraq at the time and his own family worries, right or wrong I felt my relatives did not need to worry about my condition.
 
I returned for my first post op visit at Memorial Sloan Kettering and it was made clear that I would see the uro nurse to get the catheter removed and check the wounds. As an obese patient the "minimal" holes were not so minimal as they had a crumbly Casodex embued prostate to take out of a larger than usual whole, stiched back up with Titanium sta[les which they clipped today.
 
Unexpectedly Dr, Guillonneau who  was in the building stopped in and was totally pleased with my progress nine dys after surgery. I was forewarned that the path report might not be ready, so I said "gUESS there is no pathology report to discuss." He smiled and said, "I have the report, but nothing to discuss."
 
He handed me several pages of pathology reports from Dr. Reuter and explained there was no sign that any cells escaped the prostate, no cancer on the margins and the one lymph node taken out was clean. He explained that 13 months of quarterly Zolodex and daily Casodex made "Gleason readings impossible and meaningless." Re incontinence they gave me three bottles of water and tld me to hang around the building, and within 20 minutes I was "leaking" and actually went to the bathroom and with no straining had a fairly painless pee.   Seven hours later the one extra duty pad was only a bit damp. As for ED, "Don't expect much. Hormone therapy often takes a year to wear off and does lots of damage even when we saved the nerves." He wants me on the Caverject once a week and  1/4 Viagara six days a week and full pill once aweel. The nurse constantly fights insurance companies and said "We get supported by Viagara, we get research money from Pfizer, we got loads of samples and discounts for patients, and yet we can't prove to most companies the advantage of Cialis, Levitra, Viagra or one over the other. We have used Viagra the most with few side effects so we use  it. Everyone is different but it keeps the blood vessels open and is more likely to help you in the long run."
 
As a once normal macho male with an ego bigger than the Goodyear Blimp it is tough to admit this, but I will never, ever forgot the relief my wife and I experienced when Dr G said he was encouraged that i would be "clean" for many years. In the scheme of things--and guys--this is just me....the issues of leaky pee and Mr Woody are waaaaay down my list of truly critical concerns.
 
So...took a cushy car service into Manhattan this morning...and road the rickity subway back to a generous friend's brownstone in Brooklyn this afternoon.....hopefully back to NM in a few days.......Most of you have been down this road....many of you still have unresolved issues....but no matter what this is a powerful friendship we;ve evolved and in this case, you and James et al have eased the ride.
 
Mbshine
 

AGE 62

DX 7/08 

psa HAD GONE FROM 1.7 TO 4.3 IN THREE YEARS...DIGITAL AND ULTRA SOUND EXAM SHOWED NO ENLARGEMENT.

BIOPSY SHOWED 2 OF 12 CORES POSITIVE.

TWO TUMORS SHOWED GLEASON 4+3 AND 3+4

NO INDICATION OF ESCAPE FROM CAPSULE OR METASTASIS

STARTED CONSULTATIONS AT SLOAN KETTERING 8/09

DR GUILLONNEAU SAID NO SURGERY UNLESS MASSIVE WEIGHT LOSS.

AT DX 333 LBS, SLEEP APNEA, AND HIGH BP

BARIATRIC SURGERY RECOMMENDED.

LAP BAND SURGERY IN EL PASO, TX 1/23/09

10/1/09  276 LBS, TRIGLYC AND CHOL NORMAL, NO SIGNS OF  SLEEP APNEA, ONE BP RX REMOVED AND OTHERS CUT DOSAGE IN HALF;

 

  STARTED QUARTERLY ZOLODEX BY TAOS,NM UROLOGIST, WHO TRAINED AT MSKCC, INJECTIONS AND CASODEX 50MG DAILY 9/08

 

davinci done 10/19/09

Jackson pratt drain removed surgery plus 1 day.

Catheter out 9th day

One heavy duty pad first day without catheter.

 

PATH MSKCC DR REUTER

GLEASONS CAN NOT BE DETERMINED, HORMONES DRIED PROSTATE

NO SIGN OF ANY CANCER ESCAPING PROSTATE, OR AT MARGIN

NO SIGN OF ANY CANCER IN ONE LYMPH NODE REMOVED

 

PROGNOSIS EXCELLENT. PSA IN ONEMONTH

THEN SIX MONTHS

THEN ONCE A YEAR OR MORE

ONE VISIT PER YEAR FOR LIFE.


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 10/29/2009 1:12 PM (GMT -6)   
Thats about as good as it gets...Congrats on the path report. Next we will be hearing about those zeros you will get from followup psa tests.
You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral w/PNI - Gleason (3+3)6 Stage T1C
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (3+4) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
PSA 5 week Oct 2008 <.05
                   3 month Jan 2009 .06
                   6 month Apr 2009 .06
                   9 month Jul  2009 .08
                 12 month Oct 2009 .09 


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 10/29/2009 2:04 PM (GMT -6)   
With a report like that you are off to a great start, and seem to have "pee control" already. Work on healing and keep positive about improvements to come.

Just one word about Caverject (which is alprostadil) A some guys here have had very painful reactions to it (you might want to read about them) We hope you don't, but remember that there are other alternative chemicals so don't give up if alprostadil is not right for you.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan, Bone scan 1/09 both negative.

Robotic surgery 03/03/09 Catheter Out 03/08/09
Pathology: Lymph nodes & Seminal vesicles negative
Margins positive, Capsular penetration extensive Gleason 4+3=7
6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
10 weeks: no pad at night -- slight leakage day/1 pad.
3 mo. PSA 0.0 - now light pads
6 mo. PSA 0.00 -- 1 light pad/day


Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4106
   Posted 10/29/2009 3:27 PM (GMT -6)   
Sound like you are well on your way. Congrats.

Jeff T
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
 10th month  PSA <0.01
ED- 5 mg Cialis daily, pump daily, going to try MUSE next


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 10/29/2009 4:05 PM (GMT -6)   
great news MB, I remember when you first came to the forum. I am really pleased to see that all has worked out so well for you. way to go!
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
PSA August 09 (2 year mark), <0.01


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 10/29/2009 4:07 PM (GMT -6)   
mbshine, glad to hear of your successful after-surgery visit, and all the godd things- good path report, easy cath removal and good continence recovery. Success on all fronts, congratulations...
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 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
24 mts: PSA's: .04 each test since surgery, Bimix .3ml PRN or Trimix .15ml PRN


Mbshine
Regular Member


Date Joined Aug 2008
Total Posts : 67
   Posted 10/29/2009 4:40 PM (GMT -6)   
STAYING POSITIVE..THANKS GUYS

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 10/29/2009 5:08 PM (GMT -6)   
I Think you will find a positive artitude makes this whole ordeal much more bearable. That and an acceptance of what it is, not what it could have been, or what you wanted it to be, or what somebody else has.

With a positive attitude, and acceptance of what card swe have been dealt, and gratitude for always being better of than someone else will make this PC thing bearable, and eventually, at least for long periods of time, forgettable.

Enjoy life, enjoy your wife, and keep looking up !

Congratulations !
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks due to anatomical issues with location of ureters with respect to bladder neck.  Try 3 tubes where no tubes are supposed to be for 2 weeks !
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 10/29/2009 5:10 PM (GMT -6)   
Great going, MB, great attitude. With your path stats, you should be in line for a bunch of zeros, hoping the best for you as you continue to recover.

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: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sessions/72 gys.


Herophilus
Veteran Member


Date Joined Sep 2009
Total Posts : 663
   Posted 10/29/2009 6:25 PM (GMT -6)   

WONDERFUL....Godspeed...

jnm


Age: 51 years,
Overall Health: Excellent
PSA: 08/31/2009   6.8
DRE: 09/10/2009 "nothing really" ????
BXY: Scheduled at 08:30 on 09/24/2009
GLEASON 3+3=6
Cores 10 of 12 positive
SURG: da Vinci Scheduled for November 2 2009 
 


60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2222
   Posted 10/29/2009 6:28 PM (GMT -6)   
Great news MB. Know you will be glad to get back to NM and with a great path report to boot.
Michael
Dx with PCA 12/08 2 out of 12 cores positive
59 yo when diagnosed
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
Margins not involved
2 pads per day, 1 depends but getting better,
8/5 1 depend at night only
 started ED tx 7/17, slow go
Great family
Michael


Modelshipwright
Regular Member


Date Joined May 2009
Total Posts : 215
   Posted 10/30/2009 6:33 AM (GMT -6)   
All the best for the future... your results werre fantastic!

Keep well,

Regards,
Bill
Pre-Op:
 
Age 64. Diagnosed with Pca January 2009.
PSA 5.6, Gleason 3+3=6, T1c
 
Biopsy:
 
TRUS biopsies of prostate left adenocarcinoma of prostate involving part of 1/4 biopsy fragments, less than 10% of the surface area involved, CT scan clear.
 
Treatment choice:
 
Robotic Assisted Laparoscopic Prostatectomy - September 29/09. 
Pre-op PSA down to 5.28 which I attribute to visualization techniques and a new vegetarian diet.
 
Post-Op:
 
Robotic Prostatectomy - 09/29/09, back home 10/02/09.
 
Pathology - 10/14/09  Gleason Score remained at 3+3 = 6 as it was when originally diagnosed. There were no positive margins. Tumors were found in both lobes and involved 3-5% of the prostate. There was no Seminal Vesicle, Perineural, Lymphovascular or Lymph node involvement, and the bladder neck was also cancer free. 
 
Continence
 
10/16/09 - 3-4 pads a day and working on pelvic floor exercises as prescribed.
 
Potency:
 
10/16/09 - Zip, nada
 
State of mind:
 
Excellent - always positive.
 
 

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