Finally pathology report

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

positional
Regular Member


Date Joined Jan 2010
Total Posts : 25
   Posted 3/4/2010 9:43 PM (GMT -6)   
Hi All,
 
Finally got my pathology report today (it took four weeks for them to produce it).
 
I've included the results to my signature.
 
Basically, Gleason was upgraded to 7 and extracapsular extension was introduced.
Those are two negatives I've noticed.
 
I've had a brief conversation with Dr. Lee about the report. He's saying that there is about 85% probability that I'm cancer free.
 
I'm still trying to interpret extracapsular extension. Anyone else got that?
 
Mark
Age - 54
Diagnosed - 09/2009
Gleason - 3+3
PSA - 6.7
4 out of 12 cores positive on the left side
MRI shows none on the left side and "cancerous" issues on the right side
RRP on 02/03 with Dr. Lee in Philly
One night stay, nerves bundles are preserved on both sides. 
After catherer removed - continent
Pathology report:
Capsular involvement: Into but not through capsule.
Seminal vesicle invasion: None
Positive margins: None
Gleason score - 7
Extracapsular extension: Yes, right anterior aspect, 27 and 33 mm from apex (blocks 1GG and 100)
 


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 3/5/2010 5:17 AM (GMT -6)   
Mark, glad to see the pathology is fairly clean, even if the upgrade had to be done.
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


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 3/5/2010 7:13 AM (GMT -6)   
Am a little confused over the path report ...

Capsular involvement: Into but not through capsule.

But,

Extracapsular extension: Yes

I'm sure I'm missing something but how can the cancer be into but not through the capsule when there is extracapsular extension? FYI: My husband had an almost identical path report except that his EPE was in the poster and was miniscule according to the surgeon.

Also, just curious whether your Gleason 7 is a 3+4 or 4+3.

Mark, all in all, a good path report. Congratulations on getting through the surgery, and may you continue to heal and be healthy.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (single small EPE in posterior left). Perineural tumor infiltration present. Apex margin, bladder neck and SV negative. Final Gleason 3+4. PSA: 0.0 til July 2009. August 2009- 0.1, September 0.3, October back to 0.0, December 0.0. Thank you God!


reachout
Veteran Member


Date Joined May 2009
Total Posts : 725
   Posted 3/5/2010 7:28 AM (GMT -6)   
I also had a strange path report. Mine said I had extracapsular extension, but it also said extraprostatic extension was negative, with the cancer less than 1mm away from the edge of the capsule. This looked to me like a contradiction, so I asked my doctor and he said he would have to ask the pathologist, but that the main thing was that my margins were negative. So even if I had some penetration of the capsule he thought he got it all out. He also said it didn't matter at this point, the main indicator from now on were the periodic PSA tests, and he was pretty sure I'd be zero. So far I've been zero for six months and have forgotten about that strange path report until I read a post like this one. So here's hoping you soon join the zero club.


Age 64 yrs
DX 5/2009
8 out of 12 cores positive
PSA 5.6
Gleason Score 3+4=7
Stage T2a
Da Vinci Surgery 08/07/2009
Upgrade Gleanson Score 4+3=7
Stage pT2c
Neg Margins and Nodes
Extracapsular extension noted but neg Extraprostatic Extention (??)
Dry immediately
Daily Cialis 5mg slow recovery
First PSA 11/3/09 <0.1
Second PSA 2/9/10 0.01

Post Edited (reachout) : 3/5/2010 6:31:11 AM (GMT-7)


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 3/5/2010 7:44 AM (GMT -6)   
I have the same question that Sephie asked. There is a contradiction in the pathology report. In any case, it is good that you have negative margins.
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
11.5 months test 1/21/10 result 0.004


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 3/5/2010 7:46 AM (GMT -6)   
Interesting...for some reason I thought that extracapsular and extraprostatic were one in the same. Guess not. Anxious to hear what some of our better knowledgable folks have to say on this. But the good news from everything I have read was that it appears to have been confined with no positive margins.

Looking forward to you enjoying membership in the zero club soon.
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 


Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
   Posted 3/5/2010 8:02 AM (GMT -6)   
LV-TX said...
... I thought that extracapsular and extraprostatic were one in the same...
 
 
Not the same thing.  The prostate capsule is the membrane that surrounds the prostate gland.  As prostate cancer advances, the disease may extend into the capsule (called extraprostatic extension) or beyond (called extracapsular extension).
 
One is into the capsule, the other is into and beyond the capsule.  If neither conditions exist, then the cancer is fully within the membrane of the capsule.
 
 
 
 
.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 3/5/2010 9:14 AM (GMT -6)   
The Gleason Upgrade is a shame, but not uncommon in a full post surgical pathology report. When you get a chance to clear your head of all this news, would be curuous as to is your gleason 7 at 3+4 or a 4+3.

Still a lot of good news to be read in your report

Good luck

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, no problem post SRT
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  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, Caths #13 & #14 same time


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 3/5/2010 9:26 AM (GMT -6)   
Casey, now I get it! I just checked John's surgical path report and he had extraprostectic extension (not extracapsular extension as noted in my signature). The exact words on the report are "tumor extension into capsule in multiple foci. Solitary focus of extraprostatic tumor extension..." Whew...glad I caught that one, and will correct my signature ASAP! Just goes to show that there's always something to learn with this disease!
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (single small EPE in posterior left). Perineural tumor infiltration present. Apex margin, bladder neck and SV negative. Final Gleason 3+4. PSA: 0.0 til July 2009. August 2009- 0.1, September 0.3, October back to 0.0, December 0.0. Thank you God!


positional
Regular Member


Date Joined Jan 2010
Total Posts : 25
   Posted 3/5/2010 10:34 AM (GMT -6)   
Hi Casey,

Thanks for your input.

The good news is Dr. Lee said he got all the cancer out including extracapsular tissue. Only time will tell if he's right...

about Gleason, I just placed a call to them asking to explain it to me since, on the pathology report, all I see is:

Gleason grade - 3

Gleason score - 7

Does it mean 3+4?

Mark
Age - 54
Diagnosed - 09/2009
Gleason - 3+3
PSA - 6.7
4 out of 12 cores positive on the left side
MRI shows none on the left side and "cancerous" issues on the right side
RRP on 02/03 with Dr. Lee in Philly
One night stay, nerves bundles are preserved on both sides. 
After catherer removed - continent
Pathology report:
Capsular involvement: Into but not through capsule.
Seminal vesicle invasion: None
Positive margins: None
Gleason score - 7
Extracapsular extension: Yes, right anterior aspect, 27 and 33 mm from apex (blocks 1GG and 100)
 


positional
Regular Member


Date Joined Jan 2010
Total Posts : 25
   Posted 3/5/2010 12:59 PM (GMT -6)   
Still waiting for the cal back from the doctor on Gleason question.

That's what I've found so far on this link:

http://www.prostate-cancer.org/resource/gloss_g.html

Gleason grade: a widely used method for classifying prostate cancer tissue for the degree of loss of the normal glandular architecture (size, shape and differentiation of glands); a grade from 1–5 is assigned successively to each the two most predominant tissue patterns present in the examined tissue sample and are added together to produce the Gleason score; high numbers indicate poor differentiation and therefore more aggressive cancer.

Gleason score: two Gleason Grade numbers are added together to produce the Gleason Score. The first Gleason Grade number indicates the Gleason Grade of the cancer cells found most commonly within the sample, the second number the second most commonly found grade. For example, a Gleason Score of 4+3=7 means that Gleason Grade 4 is the most commonly found type of cell, Gleason Grade 3 the second most commonly found, producing a total Gleason Score of 7.



Mark
Age - 54
Diagnosed - 09/2009
Gleason - 3+3
PSA - 6.7
4 out of 12 cores positive on the left side
MRI shows none on the left side and "cancerous" issues on the right side
RRP on 02/03 with Dr. Lee in Philly
One night stay, nerves bundles are preserved on both sides. 
After catherer removed - continent
Pathology report:
Capsular involvement: Into but not through capsule.
Seminal vesicle invasion: None
Positive margins: None
Gleason score - 7
Extracapsular extension: Yes, right anterior aspect, 27 and 33 mm from apex (blocks 1GG and 100)
 


Arnie
Regular Member


Date Joined Aug 2009
Total Posts : 372
   Posted 3/5/2010 1:10 PM (GMT -6)   
Hey Mark....

Good report.........I'm another Dr. Lee alumnus. My path has the same Gleason scoring. Yours is a 3+4..........I didn't have the extracapsular, but if Lee thought he got it, he probably got it. How are you feeling and coming along in the incontinence and ED areas?

Ironically, I'm headed out the door for my 1-yr checkup with Lee, and to pursue his opinion on some hormonal issues I've been having. Again, glad to hear you got a favorable pathology report

Arnie in DE

 


Age 56 (biopsy & surgery)
PSA at Diagnosis-3.9
Biposy 8/19/08--4 of 12 cores positive; 5% involvement, Gleason 6 (3+3)
 
Surgery 1/26/09-DaVinci Robotic Prostatectomy at Presbyterian Medical Center/HUP-Phila, PA
Dr. David Lee
 
Pathology Report- Adenocarcinoma, no capsular involvement, seminal vesicles clear, lymph nodes clear, negative margins, Gleason 7 (3+4), Stage T2C, NO MX, Prostate 61.8 grams, gland involvement 2-10%
 
Catheter removed after 8 days, totally dry at 3 months. ED issues continue, Viagra (via ADC) nightly (100mgs), VED use in earnest at 6 months. "Ball Park Frank" plumping at this point......ED at 10 months continues to improve, albeit slowly. Continued daily use of 100mg Viagra (ADC). Discontinued pump use; manual stimulation to varying states of erections; achieved penetratable erection on a couple of occasions----At 13 months, nocturnal erections are frequent. Still taking 100mg of ADC Viagra nightly. Libido still in the dumper, but working on it with doctors.
3 month PSA--<0.1
6 month PSA--<0.1
10 month PSA--<0.1
13 monthPSA--<0.1


positional
Regular Member


Date Joined Jan 2010
Total Posts : 25
   Posted 3/5/2010 1:22 PM (GMT -6)   
Hi Arnie,

3+4 is what I figured too.

I'm about 90% continent (1 pad per day), but ED is definitely an issue (4 weeks after surgery). I might start increasing the Viagra dosage from
50mg to 100mg. Also, yesterday, when I was in doctor's Lee's office, there was a pump sales guy who's trying to sell me his pump.
If insurance will cover it, I will buy.

Good luck with your 1 year check-up. Keep us informed.

Mark
Age - 54
Diagnosed - 09/2009
Gleason - 3+3
PSA - 6.7
4 out of 12 cores positive on the left side
MRI shows none on the left side and "cancerous" issues on the right side
RRP on 02/03 with Dr. Lee in Philly
One night stay, nerves bundles are preserved on both sides. 
After catherer removed - continent
Pathology report:
Capsular involvement: Into but not through capsule.
Seminal vesicle invasion: None
Positive margins: None
Gleason score - 7
Extracapsular extension: Yes, right anterior aspect, 27 and 33 mm from apex (blocks 1GG and 100)
 


Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
   Posted 3/5/2010 2:18 PM (GMT -6)   
positional said...

Gleason grade - 3

Gleason score - 7

Does it mean 3+4?
 
 
Yes.  Note the underlines which I added to your message...they help to put the pieces together.
 
 

keysailfisher
Regular Member


Date Joined Dec 2009
Total Posts : 346
   Posted 3/5/2010 6:41 PM (GMT -6)   
I"m glad that you seem to have a favorable report. Other than the gleason changing looks ok.
 
Neal
age 45
psa 3.09
Biopsy results 12/9
Left side base 3+3=6 21% 2/2 cores positive
Left side mid  3+3=6 100% 2/2 cores positive
Left side apex 3+4=7 88% 2/2 cores positive
Right side - 0/6
CT & Bone scan negative
Davinci Feb. 5th 2010/ cath removal 2/16
 
Gleason-3+4=7
Extent of tumor-Bilateral
Extraprostatic Extension-Absent
Seminal Vesicles-Negative for tumor
Surgical Margins-Rt apical margin focally positive
lymphovascular invasion-Suspicious in areas of capsular involvement
Regional lymph nodes-One node negative
Stage-T2c NO Mx
Incontinence-yes

New Topic Post Reply Printable Version
Forum Information
Currently it is Monday, June 18, 2018 11:16 AM (GMT -6)
There are a total of 2,972,796 posts in 326,012 threads.
View Active Threads


Who's Online
This forum has 160857 registered members. Please welcome our newest member, Mom_of_many5.
441 Guest(s), 9 Registered Member(s) are currently online.  Details
Mind body spirit, Froggy88, Kent M., Notime4lyme, mpost, lifelieswaiting, FamilyGuy, pinkroses, 1hopeful1