lymphatic invasion?

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

mountain man
New Member


Date Joined Feb 2010
Total Posts : 10
   Posted 2/11/2010 4:51 PM (GMT -6)   
First time posting, so hi to all from a HW newbie! Found the site a month ago and think it’s great. Thanks to all for contributing to such a worthwhile board.

I had robotic RRP in Oct’09, so nearly 4 months out now and have recovered well physically (except for ED). Coming up on 2nd post-surgery PSA test in a few weeks (first was 0.0!, but going to diagnostic test this time based on reading HW posts) and must say I’m nervous as hell!

Wondering if anyone out there can shed any light on “lymphatic invasion”? My path report indicated that, but my doc told me it was definitely not positive lymph nodes (which in my case they did not check due to my low clinical #s) and didn’t seem too worried about it. I’ve tried to research it, and understand it involves channels of the lymph system, but can’t find much more than that.

Does anyone know anything more about lymphatic invasion? Any info would be much appreciated.

Ralph
DX age 56 
psa 4.0
biopsy Aug 09 gleason 3+3=6; T1C; 2 of 12 cores (40%/50%)
RRP 10/20/09, B&W/Faulkner Boston, Dr Jim Hu 
path report gleason 3+4=7; T2C NX MX; 1.9 cm & 10%
perineural invasion present
lymphatic invasion present
margins & seminal vesicles negative
lymph nodes not tested
post op psa 11/23/09 - 0.0!
no incontinence after cath removal (confidence pads for 1 wk)
ED complete so far (but some signs of life)


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7084
   Posted 2/11/2010 4:55 PM (GMT -6)   
I had invasion in the lymph node channels as well, but the nodes attached were clear (they were removed and tested). I was told it just meant that if I had waited a little longer I'd have been a lot worse off.

Sorry I missed the "new" status - welcome. I've only been on the board a short time, but have also found it to be helpful. The folks here will share, consult, and console. Good place to visit.

Post Edited (142) : 2/11/2010 5:17:24 PM (GMT-7)


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4463
   Posted 2/11/2010 6:14 PM (GMT -6)   
Ralph, welcome to HW, sorry you have to be here, glad you came. Don't know the answer to your question, but I bet at least one other does. Have you considered a second opinion consult about it?
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
32 mts: PSA's: .04 each test since surgery, ED Continues-Bimix .3ml PRN or Trimix .15ml PRN


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4269
   Posted 2/11/2010 6:18 PM (GMT -6)   
Prostate cancer moves in a fairly predictable manner. It starts in the prostate then moves to the bed surrounding the prostate then into the lymphatic system then to the bones. It can also go directly to the lymph system through the seminal vesicles.
Once it is in the lymphatic system it is consider metastized and not curable, but this doesn't mean it cannot be controlled.
Ct scans are used to spot enlarged lymphnodes which are an indicator of lymp node invasion. The best scan is a Combidex MRI, only given in Holland, which can detect small lymph node involvement.
Lymphnodes can be radiated and Hormone therapy is the normal treatment.
Read Dr Snuffy Myer's book, "Beating Prostate Cancer" Hormone Therapy and Diet" Dr Myers has PC in the lymphnodes and has been living for years.
JohnT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT


60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2243
   Posted 2/11/2010 6:33 PM (GMT -6)   
Welcome aboard Mountain Man. John T.gave some good advice so I cant add anything to that. But do hope that it's a false alarm and that you will have many more years of zero PSA's.
Michael
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
Margin slightly involved
2 pads per day, 1 depends but getting better,
8/5 1 depend at night only, now none
 started ED tx 7/17, slow go
Post op dx of neuropathy
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5
Starting IMRT on 1/18/10
Great family and friends
Michael


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 2/11/2010 6:36 PM (GMT -6)   
Ralph,
This is an extremely valuable read for you...Even if there was any mets to the lymphatic system...

prostatecancerinfolink.net/2010/02/10/surgery-for-lymph-node-positive-prostate-cancer-a-second-look/

Mayo Clinic and the Munich Cancer Registry seem to agree that surgery is a good option for lymphatic invasion prostate cancer. This data is showing once more that RP and advanced cases is a great option. Mayo Clinic has argued this for years and was a pioneer in continuing RP even after discovering positive nodes prior to removing prostates. As you may already know, many surgeons will test nodes prior to performing the RP, and if found positive, they stop the procedure without completing the RP. The data in these studies have shown that is not a best practice. But rather, removing as many regional nodes as possible and completing the RP has shown excellent results.

However, it is worth noting that adjuvant radiation can also improve bFRS in these cases. You should bring this study to your doctor and ask his input on it.

Tony
Prostate Cancer Forum Co-Moderator


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 2/11/2010 6:42 PM (GMT -6)   
Ralph, welcome to HW ,sorry you need to be here, but glad you are. I agree with Tony's accessment above. I wish you well 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
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, 1/19 - Corr Surgery #4,  Caths #11 and #12 in at the same time, 2/8-Cath #11 out - 21 days


mountain man
New Member


Date Joined Feb 2010
Total Posts : 10
   Posted 2/12/2010 8:24 AM (GMT -6)   
I believe my path (which was sent for 2nd opinion) indicated "intraprostatic" lymphatic channel involvement, but given connectivity of the system don't suppose there's any way to know if any of the little suckers got out. Wish they'd checked LN's during surgery, but at clinical G6 I guess that's not the protocol.

I'll be sure to share the Mayo study and ask about LN scans when I see my doc in 3 wks. Othwise, its down to psa results I guess.

Thanks guys.

Ralph
DX age 56 
psa 4.0
biopsy Aug 09 gleason 3+3=6; T1C; 2 of 12 cores (40%/50%)
RRP 10/20/09, B&W/Faulkner Boston, Dr Jim Hu 
path report gleason 3+4=7; T2C NX MX; 1.9 cm & 10%
perineural invasion present
lymphatic invasion present
margins & seminal vesicles negative
lymph nodes not tested
post op psa 11/23/09 - 0.0!
no incontinence after cath removal (confidence pads for 1 wk)
ED complete so far (but some signs of life)


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4269
   Posted 2/12/2010 12:07 PM (GMT -6)   
Ralph,
How did your doctors come to the conclusion that lymphatic invasion was present if they didn't remove any lymphnodes? If there is any question I would highly recommend the Combidex MRI if you can travel to Holland. Drs Strum, Myers and Scholz all refer their suspected patients there. If specific nodes are identified they can be individually targeted with radiation which is better than having your entire body radiated.
JT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT


mountain man
New Member


Date Joined Feb 2010
Total Posts : 10
   Posted 2/12/2010 3:29 PM (GMT -6)   
JohnT,

"Lymphatic invasIon" was in my path report, so was only identified by the pathologist. My surgeon described it as internal to the prostate and not of great concern. Apparently lymphatic channels are present throughout the body including inside the prostate. I have had no indication of lymphatic involvement outside the prostate (including LN's), althouth again mine weren't removed/tested during my RRP. Wish they had been now.

Ralph
DX age 56 
psa 4.0
biopsy Aug 09 gleason 3+3=6; T1C; 2 of 12 cores (40%/50%)
RRP 10/20/09, B&W/Faulkner Boston, Dr Jim Hu 
path report gleason 3+4=7; T2C NX MX; 1.9 cm & 10%
perineural invasion present
lymphatic invasion present
margins & seminal vesicles negative
lymph nodes not tested
post op psa 11/23/09 - 0.0!
no incontinence after cath removal (confidence pads for 1 wk)
ED complete so far (but some signs of life)

New Topic Post Reply Printable Version
Forum Information
Currently it is Saturday, September 22, 2018 10:08 PM (GMT -6)
There are a total of 3,005,775 posts in 329,263 threads.
View Active Threads


Who's Online
This forum has 161801 registered members. Please welcome our newest member, kissel123.
281 Guest(s), 2 Registered Member(s) are currently online.  Details
Healing98, Saipan Paradise