Pathology Report back..

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Fairwind
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Date Joined Jul 2010
Total Posts : 3740
   Posted 9/9/2010 1:46 PM (GMT -6)   
Two R-docs warned me this would happen, they were right..Positive margin in one 6mm spot..microscopic invasion in one seminal vesicle, Gleason 5+4=9

So, it looks like HT & RT for the Holidays!

Surgeon said we will wait and see how that first PSA comes back at 6 weeks. If it goes to zero, maybe we can wait a while before further treatment...

Post Edited (Fairwind) : 9/9/2010 11:40:22 PM (GMT-6)


Tony Crispino
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Date Joined Dec 2006
Total Posts : 8128
   Posted 9/9/2010 1:51 PM (GMT -6)   
Sorry for the results. But keep your head up. You can still do very well.

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
RALP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino

Steve n Dallas
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Date Joined Mar 2008
Total Posts : 4829
   Posted 9/9/2010 2:45 PM (GMT -6)   
Yeppers. Just toss those lemons in the blender and make some lemonade.
 
Keep us posted.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 9/9/2010 3:35 PM (GMT -6)   
sorry about that pathology, you are now in that advanced case category, but there is still lots to hope for. i agree with your doctor, to wait on that first psa test, or perhaps a couple of them, some men with your numbers don't have reccurance for some time, and some men with lesser stats end up with reccurance faster.

enjoyed you on the chat last night. hope to see you again.

you would also want to have any incontinence issues and a a jump on ED matters before you jumped into radiation/HT, unless your doctors advised you differntly.

good luck and keep us posted

david in sc
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 ?
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, on Catheter #21, will be having Ileal Conduit Surgery in Sept.

compiler
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Date Joined Nov 2009
Total Posts : 7203
   Posted 9/9/2010 4:02 PM (GMT -6)   
oH, man -- I feel for you. I know my pathology report hit me like a ton of bricks (the surgeon said all looked good). Hopefully yours will not re-occur.
 
Now you can join those of us waiting to exhale (ie: awaiting PSA tests).
 
Mel
PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (PSAf: 24%), PCA3 =75 .
Biopsy 11/30/09. Gleason 4+3. Stage: T1C. Current Age: 64
Surgery: Dr. Menon @Ford Hospital, 1/26/10.
Pathology Report: G 4+3. Nodes: Clear. PNI: yes. SVI: No. EPE: yes. Pos. Margin: Yes-- focal-- 1 spot .5mm. 100% continent by 3/10. ED- in progress. First post-op PSA on 3/10/10-: 0.01. PSA on 6/21/10--0.02. Next PSA late Sept.

compiler
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Date Joined Nov 2009
Total Posts : 7203
   Posted 9/9/2010 4:05 PM (GMT -6)   
Fair:
 
I meant to add one thought.
 
I never went through the "why me" stuff. I mean, this is part of life. Almost all of us go through this with some disease or another.
 
However, one thing that really bothered me: I dutifully had my annual physicals, which included the PSA. Still, somehow, I got a PC of G 4+3 and the other pathology.
 
It looks like you were doing the same thing, and you still got a significant PC.
 
Ticks me off!!
 
OK, that's my vent for you (and me)
 
Mel

daveshan
Regular Member


Date Joined Jan 2010
Total Posts : 363
   Posted 9/9/2010 4:08 PM (GMT -6)   
Sorry about the path' report.

You can see my stats in my sig'. With G-8 and tertiary 5, seminal vesicle invasion and a positive margin I was expecting the worst but as of my last test am still <0.04 and my Dr is holding off on radiation for now either 'till I get as much function back as possible or we see a bump. She strongly feels that when radiation starts recovery stops at least if not gets knocked back a bit.

For now just concentrate on healing

Hoping for the best
Dave in Durango CO
Diagnosed 12-09 age 55
07-06 PSA 2.5
01-08 PSA 5.5 (PCP did not tell me of increase or schedule follow-up!!!!)
09-09 PSA 6.5 Sent for consult with Urologist
11-09 Consult, scheduled for biopsy, found out about PSA from '08 (yes I was pissed)
12-09 Biopsy, initial Gleason 9 (4+5) later reduced to 8 with tertiary 5, ain't much but I'll take it.
01-10 Bone Scan, "appears negative"
03-01-10 RRP in Durango CO by Dr Sejal Quale and Dr Shandra Wilson, no naked eye evidence of spread, Vesicles and lymph nodes taken for microscopic exam.

03-16-10 Removal of cath' and pathology results of samples.
Multifocal carcinoma with areas of Gleason pattern 3, 4 and 5, Overall Gleason grade 4+4 with tertiary 5, Bilateral involving 21% of left lobe, 3% of right lobe, Invasion of left Seminal vesicle, Tumor focally present at left resection margin, 9 lymph nodes removed all negative, Tumor staging pT3b NO MX

04-23-10 PSA <0.04....... 06-07-10 PSA <0.04..... 08-03-10 <0.04
05-03-10 1 week without pads
06-28-10 ;-)

LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 9/9/2010 4:09 PM (GMT -6)   
Hmmmm....6 mm margin is quite large

I would agree with you about the upcoming holidays...but get the ducks in a row and follow your gut feelings.
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 
                 18 month April 2010   .19

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 9/9/2010 4:33 PM (GMT -6)   
to dave in CO: i think that is good advice your dr is giving you on the waiting time, especially with the .04 reading. good luck
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 ?
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, on Catheter #21, will be having Ileal Conduit Surgery in Sept.

howard l
Regular Member


Date Joined Aug 2010
Total Posts : 152
   Posted 9/9/2010 5:17 PM (GMT -6)   
Fairwind so sorry for the path report.
 
Mine was almost exactly like yours. Wait for first PSA report before you decide anything. I went 7 months of zero before it went to
.5. Then did 39 rt. When I started RT PSA was 1.5. My first PSA after RT 2 weeks ago was .47. So their is hope and I want you to have it.
 
FIGHT ON
DX age 58
PSA 5.4
Gleason 5+4 = 9
City of Hope Clinical Trial (punch protocol). 6 sessions textore every 3 weeks + lupron
PSA .1
RP Oct 2009. Seminal Invasion positive margins. Lymphnods clear.
1 month PSA post op undetectable.
4 month PSA undetectable.
7 month PSA .5
Bone scan and CT scan negative. Prosticint scan mild activity in prostate bed.
EBRT May 2010. 39 sessions 70gy. On number 37.

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3740
   Posted 9/9/2010 5:51 PM (GMT -6)   
Thanks guys, I haven't thrown in the towel yet, that's for sure..I was hoping for a hole in one but now we will have to do it the hard way..I knew this going in, the Pardin tables only giving me a 28% chance that surgery alone would provide a cure..Some of the newer tables bumped it up to 50-50 but the Gleason 9 is a real game breaker...Fight On we shall do...
Age 68.
PSA at age 55: 3.5, DRE negative. Advice, "Keep an eye on it".
PSA at age 58: 4.5
PSA at age 61: 5.2
PSA at age 64: 7.5, DRE "Abnormal"
PSA at age 65: 8.5, DRE " normal", biopsy, 12 core, negative...
PSA age 66 9.0 DRE "normal", 2ed biopsy, negative, BPH, Proscar
PSA at age 67 4.5 DRE "normal"
PSA at age 68 7.0 third biopsy positive, 4 out of 12, G6,7, 9
RRP performed Sept 3 2010

tarhoosier
Regular Member


Date Joined Mar 2010
Total Posts : 486
   Posted 9/9/2010 6:07 PM (GMT -6)   
Read the trial of SWOG 8794 and it is free from the J of AMA with a more recent update. Adjuvant radiation in men of your condition was significantly related to improved response. I give you 90 days to regain continence and best healing and then go get 'em.

Galileo
Veteran Member


Date Joined Nov 2008
Total Posts : 697
   Posted 9/9/2010 6:24 PM (GMT -6)   
Fairwind,
I'm sorry to hear about your pathology. You went into this knowing you were high risk, but I'm sure you were hoping for much better news.

I'll be watching for your posts going forward, as you do battle with the beast.

Best wishes.
Galileo

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NX MX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) Jan-Mar 2007
PSA 9/2007 and thereafter <0.1
pcabefore50.blogspot.com

An38
Veteran Member


Date Joined Mar 2010
Total Posts : 1148
   Posted 9/9/2010 7:01 PM (GMT -6)   
I am so sorry about the path report. I do hope that the post op PSA test comes out to zero and you have some time before launching into HT, RT.

An
Husband's age: 52. Sydney Australia.
Family history: Mat. grandfather died of PC at 72. Mat. uncle died of PC at 60. He has hereditary PC.
PSA: Aug07 - 2.5|Feb08 - 1.7|Oct09 - 3.67 (free PSA 27%)|Feb10 - 4.03 (free PSA 31%) |Jun10 - 2.69. DRE normal.
Biopsy 28Apr10: negative for a diagnosis of PC however 3 focal ASAPs “atypical, suspicious but not diagnostic” for PC. Review of biopsy by experienced pathologist, 1/12 core: 10% 3+3 (left transitional), 1/12 core: ASAP (left apex)

Nerve sparing RP, 20Aug10 with Dr Stricker. Post-op path: 3+4. Neg margins, seminal vesicles, extraprostatic extension. Multifocal, with involvement in the peripheral, apex, fibro-muscular and transitional zones.

Old Sailor
Regular Member


Date Joined Aug 2009
Total Posts : 208
   Posted 9/9/2010 7:01 PM (GMT -6)   
Fairwind, so sorry about your path report. I have always said that a Gleason 8-10 is a different ball game.  I don't understand why the Uros don't do a saturation biopsy when PSA is rising with negative regular biopsies and normal DREs.  I had two ten core biopsies before the saturation biopsy which found the cancer.  Had RRP, was undetectable for about 7-8 months then had SRT when PSA reached .27  I just read Dr. Myers book "Beating Prostate Cancer with Hormonal Therapy etc."  Great read and will give you much hope as it did myself.  Seems that HT in conjunction with RT is the way to go if your PSA starts to rise and hopefully it won't.  Old Sailor   

Dx 07/09 Age 67 - 28 core saturation biopsy w/5 positive (2 gleason 8, 2 gleason 7, 1 gleason 6)
RRP 8/13/09 Mayo Clinic Jacksonville

Path report upgraded gleason to 4+5=9

Negative margins/extraprostatic extension/seminal vessicles/ lymph nodes but perineural invasion present.

Two month post surgery PSA 0.022

Five month post surgery PSA 0.081

Seven month post surgery PSA 0.190

Eight month post surgery PSA 0.217

Started 38 sessions IMRT at Mayo Jacksonville on 4/12/10, completed 6/4/10. Few side effects except urinary urgency and frequency during the day and some rectal discomfort near the end of therapy.

rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1131
   Posted 9/9/2010 7:40 PM (GMT -6)   
Sorry to hear the news.

Old Sailor, I was a Gleason 8 with a PSA under 4. Also being 48 at diagnosis there was not much testing before my PSA went from 2.7 to 3.8. I now know that I probably had PC when my PSA was over 2. The doctor said if it is under 4 it is in the "normal range".
 
Age 48 at diagnosis
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
Robotic Surgery May 9, 2008 - houston, tx
Pathology report -gleason 8, clear margins
22 month  PSA <.04
continent at 10 weeks (no pads!)
ED is still an issue

Ed C. (Old67)
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Date Joined Jan 2009
Total Posts : 2458
   Posted 9/9/2010 8:06 PM (GMT -6)   
Sorry about the bad result. You can still fight this beast. Hang tough.
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
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

Cajun Jeff
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Date Joined Mar 2009
Total Posts : 4106
   Posted 9/9/2010 8:19 PM (GMT -6)   
Fairwind, I just want to chime in with the rest. Tough break but hang tough you can do this. I enjoyed chatting with you on Wed night in the Chat roon.

Know we are here for you.

Cajun jeff
9/08 PSA 5.4 referred to Urologist
9/08 Biopsy: GS 3+4=7 1 positive core in 12 1% cancer core
10/08 Nerve-Sparing open radicalSurgery Path Report Downgrade 3+3=6 GS Stage pT2c margins clea
r3 month: PSA <0.1
19th month: PSA <0.1
Only issue at this time is ED

TryingToStayCalm
Regular Member


Date Joined Aug 2010
Total Posts : 53
   Posted 9/9/2010 9:21 PM (GMT -6)   
HI Fairwind,

I am so sorry to hear the report was not as good as we had all hoped. You know M is virtually in the same spot. I am hoping your recovery from the surgery is going well. Our doc said the same - probably combo HT and Radiation with the wait due to the incontinence and ED. HE also said that there is a very recent study that indicates that even if the first PSA read is good we should begin as long as all other things are looking good at that point. We are making an appt tomorrow to see an Oncologist to get her take and probalby will have the slides re-read by Memorial Sloan Kettering where she works.

We are in the same boat and will keep our outlook positive and our life vests ON. You are in our thoughts and prayers.
Judy
Husband DX on 6/30. Age 56. PSA b/fore surg. 7.9. Biopsy 6/12 positive 5=50%/90%, 1/10%. PNI present. Gleason 7 (3+4). Robotic RP Mt Sinai. NYC. 8/26. POST SURGERY PATH: Extensive bilateral involvement. Gleason 7 (4+3) w/ some 5 patterns. 70% of slides contain tumor. 42g. Extends beyond capsule into tissue and left seminole vesicle. Extensive Intra & Extra prostatic PNI w/tumor. Lymphs neg. pT3b

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3740
   Posted 9/9/2010 9:33 PM (GMT -6)   
You guys are all great, just great..You can be sure I'll be working on regaining continence as soon as possible...I started to look back,,stopped, said "No no, don't go there, just keep pushing forward.." Never look back..Again, I can feel you all standing behind me. It feels good..Thank you so much..

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 9/9/2010 9:42 PM (GMT -6)   
judy - sounds like a good plan in place for the next step for your husband.

fairwind - we still stand behind one another here, even when opinions go amuck sometimes. the bottom line, we are all in the same PC boat fighting the same monster. we fight different battles on different days. you can always come here to vent too, one of the great bennies of being in the brother hood, sometimes it feels so good to let it bounce around the room and off the ceiling.

david
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 ?
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, on Catheter #21, will be having Ileal Conduit Surgery in Sept.

Sancarlos
Regular Member


Date Joined Feb 2010
Total Posts : 242
   Posted 9/9/2010 10:19 PM (GMT -6)   
Fairwind,

Sorry about the pathology report. Unfortunately there are not many good rolls of the dice for the Gleason 9 guys and as one of those I feel your pain.

But definitely take some time to get stronger before doing any radiation therapy. But you might want to start the HT as soon as possible to weaken the PCa for the eventual radiation.

Sancarlos
Age 66, PC diagnosed 7/2009 at age 65
Stage: T2c, Gleason: 9 (4 + 5), 6 of 6 cores positive
Bone, CAT and MIR scans negative

Treatment: brachytherapy (103 palladium), 100 gy, 11/2010 + hormone therapy (Lupron + Casodex) + IMRT on Novalis, 45 gy, 3/2010.

PSA: 7/2009, At time of diagnosis -- 11.9
10/2009 -- 5.0
12/2009 -- 0.56
5/2010 -- 0.15
8/9/2010 -- 0.06

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3740
   Posted 9/9/2010 11:09 PM (GMT -6)   
Hormone Therapy....I'm REALLY looking forward to that....Give me a few days and I'll get my act together again..It's fasten your seat-belt time...

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3800
   Posted 9/9/2010 11:33 PM (GMT -6)   
Fairwind -- you'll be fine on HT.  it's some vile stuff for sure but you're a survivor.  i get my last shot next tuesday so maybe we can compare notes smilewinkgrin .
 
F8
age: 55
PSA on 12/09: 6.8
no symptoms, no prostate enlargement
12/12 cores positive....gleason 3+4 = 7
ADT, brachy and IGRT

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3740
   Posted 9/9/2010 11:38 PM (GMT -6)   
Yup! Just a walk in the park!
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