Final pathology report just in...

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RickyD
Regular Member


Date Joined Dec 2009
Total Posts : 163
   Posted 4/15/2010 2:07 PM (GMT -6)   
I have updated the signature with the final pathology report from Vanderbilt.  I received this report just this afternoon.  Dr. Smith pointed out the positive margin at the apex and stated he "believes I am cured" but we will watch the PSA tests.  He further stated that their research indicates only slightly elevated risk of BCR with apex positive margin.  I have quickly read a few papers and it seems there is evidence on both sides.  Apex positive margin is the most prevalent of the positive margins. 
So some good news mxed with a small "concern".  I will take this as an overall good news scenario and move on while knowing that should BCR prove out there are therapies to address it.
Rick


Age 55,  PSA = 4.97 on 11/17/09, DRE negative,
Biopsy 12/2/09: 1 of 12 cores positive with less than 5% volume
Gleason 3 + 3 = 6
Prostate Size Estimate on 12/2/09 = 28 cc
RALP performed on 4/7/10 at Vanderbilt University MC with Dr. Joseph Smith (3000+ RALPs)
Final Pathology on removed prostate:
Prostatic Adenocarcinoma present bilaterally from apex to base and extending to inked margin at right apex.  Gleason 3 + 3 = 6, stage pT2c
Prostate Size  = 59 grams, Tumor 5% of total prostate volume.
SV negative, EPE negative, PNI present. Lymph nodes - not checked
 
 
 

Post Edited (RickyD) : 4/15/2010 3:18:32 PM (GMT-6)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 4/15/2010 2:14 PM (GMT -6)   
Still a lot of good news in that report, Rick. Tumor is only 5% and still a Gleason 6. Hope it stays in remission for you. Hopefully your first PSA test will be a good one and get you in the zero club.

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, 4/8 .04
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, 3/6 Cath #13 out - 4 days, Cath #14 out - 27 days, Cath #15 - 3/29


BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 4/15/2010 2:35 PM (GMT -6)   
Path report looks really good Ricky. No worries.

Dx with PC Dec 2008 at 56, PSA 3.4, Biopsy: T1c, Geason 7 (3+4)

Robotic Surgery March 2009 Hartford Hospital, Dr Wagner
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes negitive
nerves spared, no negitive side effects of surgery

One night in hospital, back to work in 3 weeks

psa Junl 09 <.01
psa Oct 09 <.01
psa Jan 10 .07 re-test one week later .05
psa Mar 10 .28 re-test two weeks later .31


tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2842
   Posted 4/15/2010 2:43 PM (GMT -6)   
ricky - congrats on the good pathology report - here's to your first of many zero club PSA results - keep us updated -

hugs
BRONSON
.................
Age: 54 - gay - with common-law spouse of 13 years, Steve - 60
PSA: 04/2007- 1.68 - 08/2009 - 3.46 - 10/2009 - 3.86
Confirmation of Prostate Cancer: October 16, 2009 - 6 of 12 cancerous samples , Gleason 7 (4+3)
Doctor: Dr. Mohamed Elharram -Urologist / Surgeon - Peterborough Regional Health Centre
Radical Prostatectomy Operation: November 18, 2009 , home - November 21, 2009
Post Surgery Biopsy: pT3a- gleason 7 - extraprostatic extension - perineural invasion - prostate weight - 34.1gm -
ED Prescription: Jan 8/2010 - started daily 5mg cialis - girth back to normal -but not much length - will go for trimix in April when I see doc
Incontinence: Feb 2010- 3-5 pads/1-2 clothes changes/day- March 3, 2010 - week 14 after surgery -finally seeing improvement - March 29- incontinence better - 1-2 pads a day - one pad at night
location: Peteborough, Ontario, Canada
Post Surgery-PSA: - April 8, 2010 - 0.05 - I am in the ZERO CLUB - hooorah!
............


medved
Veteran Member


Date Joined Nov 2009
Total Posts : 1096
   Posted 4/15/2010 2:53 PM (GMT -6)   
Looks pretty good -- especially the 3+3 holding post-surgery. As you know, it often doesn't. One interesting note about your path report is the disparity between the prostate size etimate and the actual prostate size. That is probably of very little (or no) significance, but quite a difference.
Age 46.  Father died of p ca. 
My psa starting age 40: 1.4, 1.3, 1.43, 1.74, 1.7, 1.5, 1.6
 


lewvino
Regular Member


Date Joined Jul 2009
Total Posts : 384
   Posted 4/15/2010 2:56 PM (GMT -6)   
Ricky
 
I also had Dr. Smith at vanderbilt back in Aug 2009. Also had positive margin. So far been pulling 0's on my PSA tests. Just keep up on them as I'm sure Dr. Smith stressed. Looks like yours came out better then mine. I had Gleason 3+4 7 post surgery. Also Doc had to take some of my erection nerves on the one side but Levitra is working pretty good for me.
 
Get them from all day chemist unless your insurance happens to pay for them.
 
Larry Chattanooga Tn.
 
 
Age 55 / age at diagnosis 54, PSA 5.1
Robotic surgery 08/12/09 at Vanderbilt, Nashville TN. 
Final Path report:
20% of the prostate Involved
Tumor graded at T2C
Overall Gleason 3+4 (7)
Lymph Glands Clear, Positive Margin Noted in Right Apex
 
First post Surgery PSA - 0
Six month PSA - 0


keysailfisher
Regular Member


Date Joined Dec 2009
Total Posts : 346
   Posted 4/15/2010 4:33 PM (GMT -6)   
Looks good no change in gleason that is a plus.
 
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/ Down to 1 pad at 6 weeks out
PSA 3/29/10 <0.01


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 4/15/2010 4:44 PM (GMT -6)   
take your good news where you can find it. Congrats on all the news and results so far....
James C. Age 63
Gonna Make Myself A Better Man www.youtube.com/watch?v=a6cX61oNsRQ&feature=channel
4/07: PSA 7.6, Recheck after 4 weeks Cipro-6.7
7/07 Biopsy: 3 of 16 PCa, 5% invloved, left lobe, GS3+3=6
9/07: Nerve Sparing open RRP, 110gms, Path Report- Stg. pT2c, 10 gms., margins clear
32 Months: PSA's .04 each test since surgery, ED continues: Bimix- .3ml PRN, Trimix- .15ml PRN


Sharp18
Regular Member


Date Joined Mar 2010
Total Posts : 78
   Posted 4/15/2010 5:06 PM (GMT -6)   
It is actually pretty good report.  Congratulations...

Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 4/15/2010 5:26 PM (GMT -6)   
Congrats!!! Hope and believe the best until notified otherwise ;) Cheers to you!!!
Father's Age DX 62 (now 64)
Original Gleason 3+4=7, Post-Op Gleason- 4+3=7,
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin, One positive node. T3a N1 M0.
Bone Scan/CT Negative (Sept. 10, 2007)
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07, Lupron beg. Dec 03, 2007 2 yrs
Radiation March 03-April 22, 2008- 8 weeks 5x a week
July 2, 08 PSA <.02
Oct. 10, 08 PSA <.02
Oct. 9, 09 PSA <.01 Last Lupron Shot
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 4/15/2010 6:53 PM (GMT -6)   
I would say with a Gleason 6, that you do have some great odds on beating this thing even with a positve apical margin.

Again, one of the very positive thngs about surgery is that you and the doctors know. You will be watching careully, and not be lulled into a false sense of security. Regular PSA testing every 3 months for a while will tell the rest o the story.

Good luck, and keep us in the loop on your progress.
Goodlife
 
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01


60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2222
   Posted 4/15/2010 7:10 PM (GMT -6)   
Ricky,
I am not sure what tomorrow will bring but today your present was a pretty good path report and a Gleason 6, so if even a BCR ocurrs you still have good odds of knocking out the rest of the PCa. Enjoy.
Michael
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed, 61 yo 2010
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
2 pads per day, 1 depends but getting better,
 started ED tx 7/17, slow go
Post op dx of neuropathy
T2C left lateral and left posterior margins involved
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5
Starting IMRT on 1/18/10, Completed 39 tx at 72 gys on 3/12/10
Great family and friends
Michael


ChrisR
Veteran Member


Date Joined Apr 2008
Total Posts : 825
   Posted 4/16/2010 2:14 PM (GMT -6)   
First, let me be clear, I am not saying you don't have a positive margin.  But......Dr. Walsh says sometimes positive margins are not always a positive margin.  When the prostate is disceted (sp) the scalpal slides across a cancerous area dragging some cells to the margin.  Therefore, what is reported as a positive margin is not actually one.  I don't think there is anyway to determine that this actually happened to a person, only he states that it does.  It seems very logical to me that this can happen.  So, maybe you really don't have a positive margin.   Let's hope....Even if you do and your PSA rises you can be pretty confident that it is a local recurrence and radiation should take care of it.
Dx 42
Gleason 6 (tertiary score 0)
OPEN RP 10/08  Johns Hopkins
pT2 Organ confined Gleason 6
PSA Undetectable as of 10/15/09
Next PSA 10/15/2010


gold horse
Regular Member


Date Joined Nov 2009
Total Posts : 360
   Posted 4/17/2010 5:40 AM (GMT -6)   
Rick that is a great report,even with a positive marging most people on your position get cure let be happy.tongue
DIAGN=46 YEARS
GLEASON=3+3
FATHER HAD PC,THEN I THEN MY BROTHER STILL HAS TWO BROTHER PC FREE.
MARRIED,TWO CHILDREN.AGE 13 AND 8.
LAPROSCOPY SURGERY 6/2005
PATOLOGY REPORT.
GLEASON=3+3
TUMOR VOLUME=5%
LYMPHOVASCULAR INVASION=NEG
PERINEURAL INVASION=POSI
TUMOR MULTICENTRICITY=NEG
EXTRAPROSTATIC INVASION=NEG
SEMINAL VESICLES BOTH=CLEAN
MARGIN ALL=NEG
PT2ANXMX
DEVELOP SCART TISSUE AND NEEDED A SECOND SURGERY BECAUSE COULD NOT URINATE,
PSA 6/05=0.04,0.04,0.04,6/06,0.04,0.04,0.04,6/07,0.04,0.04,0.04,6/08,0.04,0.04,1/09
0.04,10/09,0.04
 

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