Brought up from below, new member: soulmate 101 first post

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Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 1/22/2010 11:15 AM (GMT -5)   
I just found this forum and it is so wonderful to read this great news. Your relief is palpable.


Husband, age 57, diagnosed in December 09, Gleason 4+3 = 7 stage T2c, laparoscopic nerve sparing Da Vinci robotic radical prostatectomy 1/13/10, clear surgical margins no lymph node or seminal vesicle involvement.
Let the healing begin...

geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 1/22/2010 1:29 PM (GMT -5)   
Welcome -- all of us here know the importance of a supportive wife/partner.

Your husband went from biopsy to surgery in near record time. Both of your heads must be spinning The pathology report sounds very good. If you haven't seen them, the Sloan-Kettering nomograms let you plug in your husband's stats and see the liklihood obeing PCa free for 5 and 10 years
. His odds will be very good.
www.mskcc.org/applications/nomograms/prostate/PostRadicalProstatectomy.aspx

Any way, keep in touch. We are here for information AND support
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


soulmate 101
Regular Member


Date Joined Jan 2010
Total Posts : 57
   Posted 1/22/2010 4:39 PM (GMT -5)   
Thank you so much geezer99. You said it correctly, the time from diagnosis to treatment was phenomenal but we had a number of caring professionals around us whom we trusted and decided to go with their advice without too much back and forth. I am the information gatherer of our couple, and tend to obsess over the research and books etc. etc., whereas my husband is very easy going and in particular trusted in our doctor.

Thank you for the link. I have one question that comes up in reading his pathology report. Even though he had negative surgical margins including the bladder base , lymph nodes and seminal vesicles, he did have "perineural invasion identified." What significance does this have? Is this another thing I should worry about?

the cancer was in both sides of the prostate, about 10% volume and extended within .1cm of the apical margin. .1cm doesn't seem like much of a distance to me and it made me all the more glad that we did not delay in having the surgery done.

geezer99, I would also like to add that your follow up results look so very good! congratulations, yes?
Husband, age 57, diagnosed in December 09, Gleason 4+3 = 7 stage T2c, laparoscopic nerve sparing Da Vinci robotic radical prostatectomy 1/13/10, clear surgical margins no lymph node or seminal vesicle involvement.
Let the healing begin...


soulmate 101
Regular Member


Date Joined Jan 2010
Total Posts : 57
   Posted 1/22/2010 4:39 PM (GMT -5)   
Purgatory, thank you for starting this thread for me!
Husband, age 57, diagnosed in December 09, Gleason 4+3 = 7 stage T2c, laparoscopic nerve sparing Da Vinci robotic radical prostatectomy 1/13/10, clear surgical margins no lymph node or seminal vesicle involvement.
Let the healing begin...


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 1/22/2010 4:49 PM (GMT -5)   
No problem, didn't want you to get lost in the stack.
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: 1/10 .12
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 43 days, 1/10 - Corrective Surgery #4, and Caths #11 and #12 in at the same time


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 1/22/2010 6:01 PM (GMT -5)   
Soulmate 101 PNI is quite common in path reports and sometimes found on biopsy. I wouldn't be too concerned about it as your surgeon won't be either. PNI is the space around the tiny nerves inside the prostate. Because of the tiny spaces, the cancer finds room to grow in that space...open real estate if you would with no other cells crowding the cancer growth. It is considered a pathway for the cancer to leave the prostate, but has never been confirmed to be fact.

They normally won't indicate this on pathology reports because it is so common. So I am a bit surprised they noted it on yours.
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 


soulmate 101
Regular Member


Date Joined Jan 2010
Total Posts : 57
   Posted 1/22/2010 7:34 PM (GMT -5)   
Thanks for the elucidation, LV-TX.
Question: If PNI is found, do negative margins still indicate the cancer has not spread beyond the prostate?
I suppose, even with all the stats, nothing is 100% predictable at any given point and one must simply live your life, in the here and now.
Husband, age 57, diagnosed in December 09, Gleason 4+3 = 7 stage T2c, laparoscopic nerve sparing Da Vinci robotic radical prostatectomy 1/13/10, clear surgical margins no lymph node or seminal vesicle involvement.
Let the healing begin...


zachattack
Regular Member


Date Joined Dec 2009
Total Posts : 97
   Posted 1/23/2010 6:14 AM (GMT -5)   
Welcome to the club,best wishes.

Zach
age 55dx 12-2008,psa at biopsy 8.6
biopsy 12/12 gleason 3+4=7
da vinci surgery 6-09 nerve sparing by DR. John W. Scott (my hero)
Hospital 3 days cath 7days still leaking from cough(bad lungs)
still have ed may be the hormones.
9-09 psa 2.2 hormone inj
10-09 nuclear bone scan no results yet I will have gold markers placed 12-29-09
start rad 1-10-10
organ confined
extracapsular seminal vesicle involvement
lymph node involvement


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 1/23/2010 9:31 AM (GMT -5)   
Soulmate,
My cancer escaped the prostate capsule (Extra Prostatic Extention) and yet I had negative surgical margin. My doctor told me that he removed tissues beyond the prostate that didn't contain cancer.
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
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm in circumference.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
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
8 months PSA test 10/9/09 result <0.1


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 1/23/2010 10:25 AM (GMT -5)   
Welcome soulmate, hope you find what you are looking for and will hang with us...
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, ED Continues-Bimix .3ml PRN or Trimix .15ml PRN


soulmate 101
Regular Member


Date Joined Jan 2010
Total Posts : 57
   Posted 1/23/2010 11:56 AM (GMT -5)   
Ed, am I right to be encouraged by your psa levels after these number of months, even with the extra prostatic extension?

James, thank you for the welcome. I think I'll try to stick around for a while. Glad you all are around.
Husband, age 57, diagnosed in December 09, after PSA velocity increase from 2.71 to 4.34 over one year prompted a prostate biopsy.
Gleason 4+3 = 7 stage T2c, laparoscopic nerve sparing Da Vinci robotic radical prostatectomy 1/13/10, clear surgical margins no lymph node or seminal vesicle involvement.
Let the healing begin...

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