Cath. out, pathology back.

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Regular Member

Date Joined Feb 2010
Total Posts : 83
   Posted 4/26/2010 5:36 PM (GMT -6)   
Hey Guys
What do you thing ?
Tumor volume %                                      9%
Gleason                                                    3+4  nearly equal amounts of each
Extraporostatic extension                        Yes, but within surgical margin
Subcapsular perineural invasion               Present, extensive
Seminal vesicle involvement                      No
Apex margin                                              clear
Base margin                                              clear
Angiolymphatic invasion                            not demonstrated
PIN                                                            Both high grade and low grade Pin are present but not extensive
AJCC stage                                                T2c N0 Mx
Most of nerve bundles gone
        Glad I did"nt take my time, on this one.  Tim

Regular Member

Date Joined Dec 2009
Total Posts : 347
   Posted 4/26/2010 5:44 PM (GMT -6)   
I'm not sure but it looks pretty good except for the nerve part. What was your gleason before?
Nice to have that rubber snake out isn't it.
Keep us posted,
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
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
11 weeks pad free
PSA 3/29/10 <0.01

Regular Member

Date Joined Feb 2010
Total Posts : 83
   Posted 4/26/2010 5:57 PM (GMT -6)   
  3+4, Yea, nerve things a drag, but I was ready for it, Doc said it was a good thing he cut wide, and I sure do'nt miss draging around that Bowling ball.  Tim

Cajun Jeff
Veteran Member

Date Joined Mar 2009
Total Posts : 4119
   Posted 4/26/2010 6:13 PM (GMT -6)   
Tim I think you are good to go. The nerve this is a drag I must say!....Best of luck buddy.

Cajun Jeff
9/08 PSA 5.4 referred to Urologist
9/08 Biopsy: GS 3+4=7 1 positive core in 12 1 pre cancer core
10/08 Nerve-Sparing open radical
Surgery Path Report Downgrade 3+3=6 GS Stage pT2c margins clear

3 month: PSA <0.1
6 month: PSA <0.1
10 month:PSA <0.1
1 year: PSA <0.1
16 month:PSA <0.1

ED - Started Cialis at 3 months, tried all 3, 6 months added pump, 9 months Tried MUSE (YUCK) Bad experience.
1 year mark Found new Urologist visit was at 14th month post surgery
Started Injections, Caverject! (Success)
17 month: ED making improvements : Oral Meds gets me 85%

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 4/26/2010 6:21 PM (GMT -6)   
Tim, all in all, not a bad surgical pathology report. You are still a confirmed Gleason 7, very unpredictible. Nothing in those numbers warrants any immediate action in my untrained opinion. You should be able to sail into the zero club at first PSA reading. THe other good number as the tumor volume of 9%%. That can work well in your favor.

Hopefully, your Gleason 7 will be the kind that is curable, and that you got many good years ahead of you. Hope the rest of your recovery is still doing well.

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, next one:  July
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- 27 days, Cath #15 - 26 days, Cath #16 - 4/23 put in

Regular Member

Date Joined Feb 2010
Total Posts : 117
   Posted 4/27/2010 12:17 AM (GMT -6)   
congrats Tim--- I am no expert but not bad!!
age 55, married, kids and grandkids
2008 psa 4.7
2010 psa 5.5
biopsy 2-10 -- 3 of 12 samples positive ca 60% 25% and 20%
perineural invasion not seen
location rt apex
negative prostascint/mri fusion for ca in body scan, pelvic scan, and neg scan in pelvic lymphs or vas def's bi-lat
DaVinci rp on 3-15-10 city of hope
Dr. Kawachi
nerves spared both sides
biopsy-- clean margins, organ confined, no capsule penetration
clean vas def and lymphs
10% total involvment
Catheder out 7 days later, 4 pads for 2 days, then 3 pads a day for a week or so
now no pads at night and one in the day trying only when i go out...getting better all the time...ED--- 50 mg viagra per day-- slight stirrings at this point, maybe a semi erection or two--- good feelings there though-----
One month psa---- undetectable... less than 0.1

Veteran Member

Date Joined Jun 2008
Total Posts : 1804
   Posted 4/27/2010 6:11 AM (GMT -6)   
Timm, except for the nerve bundles being removed, path report sounds pretty good to me especially the tumor volume. The one surprise (for me) is your stage. I thought I read somewhere that extraprostectic extension equals stage III (yours is a II). My husband had a single foci of EPE with clean margins and was upgraded to a IIIa...go figure. Just goes to show that there is still inconsistency in how this disease is viewed.

Congratulations on a good path report - may you enjoy many years of good health.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (solitary focus of extraprostatic extension). Perineural tumor infiltration present. Apex margin, bladder neck and SVs 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, March 2010 0.0. Next PSA in 6 months. Thank you God!

Regular Member

Date Joined Feb 2010
Total Posts : 111
   Posted 4/27/2010 6:44 AM (GMT -6)   
Hey there Timm...been watching the site for your return. I notice one point or "perineural invasion" that would appear ominous but seems to present for many other guys....otherwise positive post op reports. Also as quite often is the case the post ops turn out to be a tad worse then originally thought. With your numbers, as others have suggested, you should be in good shape.

74 years old / PSA 6.7 / 2 of 12 cores positive / Gleason 3+4=7 / Henry Ford robotic prostatectomy 2/10/10 / nerves spared / margins clear / no pads around home and improving day by day. Had an extremely talented surgeon, Dr. Peabody. My very enlarged prostate required a couple hours additional time to reattach (four hours total) to deal with the bladder urethra connection but still went home the following day without a penile catheter.

Veteran Member

Date Joined Jul 2008
Total Posts : 966
   Posted 4/27/2010 7:56 AM (GMT -6)   
Timm....excellant path report. I would like to understand why you were given a T2C NOMX staging with extraporostatic extension. I understand that the margin was clean, however I was under the assumption that once the cancer has protruded the capsule (EPE) then that is a stage three. Or am I misunderstanding the staging criteria.

I am sure that your upcoming PSA tests will remain undetectable for many years to come.

Best of luck to you.
You are beating back cancer, so hold your head up with dignity
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 
                 18 month April 2010   .19

Ed C. (Old67)
Veteran Member

Date Joined Jan 2009
Total Posts : 2461
   Posted 4/27/2010 8:17 AM (GMT -6)   
Your Pathology report look good. I had similar report with a higher Gleason. My doctor told me that by removing the nerve bundles he was able to go wider. So far things are looking good. Best of luck for you.
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 5 months
2 months 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 months PSA test 1/21/10 result 0.004
14 months PSA test 4/19/10 result 0.005

James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4463
   Posted 4/27/2010 9:28 AM (GMT -6)   
Tim, thanks for the update. All things considered, from before to now, a close call, but things seems to be on the plus side now.
James C. Age 63
Gonna Make Myself A Better Man
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

Veteran Member

Date Joined May 2009
Total Posts : 739
   Posted 4/27/2010 12:15 PM (GMT -6)   
Pretty good path report, if you ask me. I wouldn't worry about the perineural invasion, everyone gets that in their path report. As far as T2c with some kind of extension, I don't understand it either, but I got the same thing. So far I've been in the zero club for almost nine months, and hope you will soon join the club too.

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
Third PSA 4/1/2010 <.014

Regular Member

Date Joined Feb 2010
Total Posts : 83
   Posted 4/27/2010 2:22 PM (GMT -6)   
Thanks friends

All in all I feel pretty good about the whole thing, I'm a little bumed about the nerve lost but we all go in, knowing that's a option and i'm ready to deal with it. Thanks for all your posts, puts thing in prospective for me.

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