i have posted my post pathology report in my signature
i have my second opinon next week with oncologist.
it looks like radiation for me, and psa right now 0.45
i don't think waiting is an option.
so what do you think?.
had rectal exam and found prostrate nodule detected.
psa was .097 before exam.
referred to urologist and also rectal exam , but couldn't feel anything.
we discussed about biopsy to be on safe side.
Final Diagnosis of biopsy
specimen is received in formalin in 8 parts labeled A-H.
A-G ------ no atypia or malignancy found.
H---- prostrate needle biopsy, left anterior horn: Adenocarcarcinoma,
gleason score 3 + 4= 7, 4 mm in greatest linear dimension, involving approximately 20% of tissue from this site. less than 1ml cancer and less 1% of gland involved.
prostrate surgery done 7/29/2009 -- radical perineal surgery.
robotic was out of the question due to previous surgeries, hernia repair,gall bladder,had mesh put in.
before surgery , psa was at 0.97.
09/2009 psa ---- 0.55
10/2009 ----- 0.39
11/2009 ------- 0.45
10 days with foley cathereter
drain tube for 2 days
hospital stay--- 2 1/2 days
had trouble with bowl movements constipated due to pain meds .
on stool softners
after cath was out 2 pads a day
6 weeks later just 1 pad a day.
slight leakage , when lifting, sneeziing
post op pathology report
specimen type - radical perineal prostatectomy
specimen is intact
pre op psa level 0.97/ng/ml
other organs-seminal vesicle(s)
microscopic --tumor site-1 nodule
nodule#1- involves left lateral mid and left lateral
dimensions--0.6 x 0.2 x 0.6 cm
Histologic type------ Adenocarinoma
primary pattern is-grade 3 : single acini of variable size and seperation , cribriform and papillary patterns
Secondary pattern is: grade 4 : irregular masses of acini and fused epithelium , can show clear cells
gleason score (primary + secondary) = 7 : Moderately poorly differentiated
preportion of prostrate involved by tumor =<1 %
estimated tumor volume(% involved by tumor x prifixation vol) =< 1 ml
extraprostaic extention - absent
seminal vesicle invasion- absent
perineural invasion - absent
blood /lymphatic vessel invasion --absent
extent of invasion : pT2a: tumor involves < one half of one lobe
regional lyph nodes: NX; cannot be assessed
margins involved by tumor : anterior left lateral mid
margin involvement is extensive (> 1 HPF)
beingn prostatc acini are present at margins , not in area of tumor