Doctor got back to me.

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Rick Tom
New Member


Date Joined Dec 2009
Total Posts : 5
   Posted 12/18/2009 12:16 PM (GMT -6)   
Hello Everyone,

A couple of weeks ago posted about post-op pathology report. I was concern about a positive margin.

Well I emailed my doctor and he got right back to me. I have to admit his response took a great load off my shoulders. I just wanted let everyone know who responded to my question how it all turned out. I know PC is very unpredictable but this gives a better outlook on my situation.

My doctor's response below:

Hi Rick,


A focal positive margin is not something to worry about. It means that a small focus of cancer is near the edge of what is taken out and almost never means that there is anything left behind. We are talking less than one millimeter (1/25th of an inch).


Take a look at the following: http://www.mskcc.org/applications/nomograms/prostate/PostRadicalProstatectomy.aspx and plug in your PSA, Gleason 3+3=6 and 0 months disease free. Then push calculate to see that you have about 98% chance of never having a recurrence. Then calculate again with a positive margin and I think it drops to 97% And that's a regular positive margin (potentially much larger), not a focal positive margin.


I think you are doing absolutely terrific and will continue to well with an extremely small chance of recurrence.


Thanks Again Rick

geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 12/18/2009 12:25 PM (GMT -6)   
Great news -- and thanks for sharing the information it will be a great help to others
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


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 12/18/2009 12:33 PM (GMT -6)   
Rick,

Hoping that news from your doctor will give you some real peace of mind. Always love hearing good news here.

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
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA:
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 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 in place


Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4119
   Posted 12/18/2009 1:49 PM (GMT -6)   
Rick,

What GREAT news. Thanks for letting us all celebrate with you.

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
1year psa <0.01
ED- 5 mg Cialis daily, pump daily, going to try MUSE next. Next step injections.


LuvMyDAD
Regular Member


Date Joined Dec 2009
Total Posts : 316
   Posted 12/18/2009 2:36 PM (GMT -6)   
Hi Rick,
 
Just a quick question, is that calculator based only on surgeries performed at Sloan or after RP in general? Either way, I am glad to hear of your great results!
 
LuvMyDAD

Squirm
Veteran Member


Date Joined Sep 2008
Total Posts : 744
   Posted 12/18/2009 3:34 PM (GMT -6)   
It says:
"We have updated the nomogram by extending the predictions to 10 years after RP and have enabled the nomogram predictions to be adjusted for the disease-free interval that a patient has maintained after RP. METHODS: Cox regression analysis was used to model the clinical information for 1,881 patients who underwent RP for clinically-localized prostate cancer by two high-volume surgeons. "
 
Not sure who the two surgeons are.

medved
Veteran Member


Date Joined Nov 2009
Total Posts : 1100
   Posted 12/18/2009 3:43 PM (GMT -6)   
Seems like your surgeon is a good guy -- responds promptly, and offers you not only reassurance but also evidence to substantiate his reassuring comments. Sounds like you have an excellent chance of never having to deal with this again.
Age 45.  Father died of p ca. 
My psa starting age 40: 1.4, 1.3, 1.43, 1.74, 1.7, 1.5
 

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