Tumour in the Apex, positive margins and continence

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

BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 8/2/2010 8:03 PM (GMT -6)   
Another video which deals with tumour in the apical region of the prostate and its impact on continence and the risk of positive surgical margins ...... from the same people who explained nerve saving on the earlier video I posted. I do wish he would not speak so fast, although I guess the videos are aimed at urologists.

vimeo.com/13766328

Bill

lewvino
Regular Member


Date Joined Jul 2009
Total Posts : 384
   Posted 8/3/2010 2:39 PM (GMT -6)   
Thanks so much for posting the links for both videos. They were very informative. I have also passed the links on to my son who will be working on a research project at Cornell NYC Medical school starting Aug. 19th. He will be doing research on A Level 3 Alzehimer study being conducted at Cornell.
 
Larry
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
Ten month PSA - 0

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4237
   Posted 8/3/2010 4:32 PM (GMT -6)   
As a note; 51% of all positive surgical margins occur in the Apex.
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


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 8/3/2010 4:38 PM (GMT -6)   
Billy, thanks for another good and informative link
Age: 58, 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: Aug 3
Latest:  7/9 cath #6 - 41 days, 8/9 2nd corr surgery, 8/9 cath #7 - 38 days, mapped  9/9, 10/1 - 3rd corr. surgery - SP cath, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12 ,Cath #11 - 21 days,  Cath #12 - 41 days, 3/2- Corr Surgery #5, Cath #13 - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 31 days, Cath #17 - 39 days, 7/2 - Corr Surgery #6, Cath #18 - 13 days, Cath #19 - 17 days, Total Blockage, Cath # 20 - 7/19

Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3734
   Posted 8/3/2010 5:40 PM (GMT -6)   
Now you tell me. I was an Apex and both lobes guy. I wish I knew about this 15 months ago. I could have at least mentioned it to the surgeon.

Has anyone ever checked the correlation between surgical speed and the incidence of recurrence? Would spending an extra 20 minutes on the procedure reduce positive surgical margins?
Until everyone's DaVinci image data is recorded and stored in our electronic medical files, the results will be buried with the patients.

Thanks for posting
Jeff

Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1267
   Posted 8/3/2010 8:10 PM (GMT -6)   
Jeff:

"Until everyone's DaVinci image data is recorded and stored in our electronic medical files, the results will be buried with the patients."

What a cheery thought!

Bit like the old story of doctors burying their mistakes.

Makes me wonder though --- do surgeons/hosptials record the image data during da Vinci operations, and, if they do, is it kept?

Sheldon AKA Sleepless
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
From "knock out" to wake up in recovery less than two hours.  Actual surgery 70 minutes
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"
 
Oct 1st 09 -- dry at night, during day some stress issues.
Oct 31st padless 24/7 
 
First post op PSA Sept 09  less than 0.02
PSA on Oct 23, 2009 less than 0.02
PSA on Jan 8, 2010  less than 0.02
PSA on April 9, 2010 less than 0.02 
PSA on July 9, 2010 (one year) less than 0.02
  
New Topic Post Reply Printable Version
Forum Information
Currently it is Thursday, July 19, 2018 12:40 PM (GMT -6)
There are a total of 2,983,209 posts in 327,092 threads.
View Active Threads


Who's Online
This forum has 161897 registered members. Please welcome our newest member, med01.
437 Guest(s), 13 Registered Member(s) are currently online.  Details
Balladeer, 81GyGuy, Kent M., Carib_Lyme, readingmom, Dogdays, Girlie, Dmarie8, blksteeda, InTheShop, Leaker65, jenni44, NotQuiteAntonio