I don't know what periprostatic lymphatic spaces are, but I do know that scans and even surgical removal of lymphnodes is a very innacurate way to discover lymphnode mets, especially with a low psa.
It is also a high probability that your doctors don't know and are just guessing (at your expense).
I would go on prostate pointers P2P and ask Dr Strum what it means. A phone consultation with Drs Scholz or Myers would also be good options. Find out from an oncologist that specializes in only prostate cancer. If PC has invaded the lymphatic system in anyway it must be considered systemic and you need to know this before you undergo another local treatment that may not be effective.
Just for you information, a CT scan can identify a large infected lymphnode at 10mm it cannot identify mico mets. Unless a lymphnode is reviewed pathologically by an expert it is very difficult to determine PC in a node. You can't do it by sight unless it is really bad. Also surgical removal of lymphnodes can identify at best 50% of lymphnode involvement as recent studies in Germany and Holland have uncovered. This is way out of any urologist or radiologist's skill level.
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.