PNI found during biopsy

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

88CC
New Member


Date Joined Sep 2010
Total Posts : 11
   Posted 9/29/2010 11:18 AM (GMT -6)   
Hello all. I'm a new member recently diagnosed. My wife and I have been getting a crash course in PCa. So far, I've meet with 4 out of the 6 doctors I am planning on interviewing (with various specialties). But none of them think PNI in two of my biopsy cores is significant. Yet, in the literature, there seems to be a strong correlation between PNI and "metastatically capable" cancer; i.e., it gets out. The likelihood of the cancer penetrating the capsule may influence my decision for treatment.

So here's my question: Have any of you had PNI in your biopsy before RP? Did the pathology report confirm the PNI?

Any information would be appreciated. Thanks in advance for your help.

Cheers,
Age 55; living in Seattle area
PSA = 5.1 on July 19, 2010; no long term history
Bx on Aug 25, 2010; ultrasound showed 88cc volume (due to BPH)
Dx on Aug 31, 2010; 6 out of 20 cores positive
PNI in 2 cores
G = 6 (3+3); Clinical stage = T2a
No treatment yet; still researching options.

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7078
   Posted 9/29/2010 11:27 AM (GMT -6)   
From a non-physician, mind you -
 
I understood that PNI is very common, and it was indicated in my biopsy.
 
It was explained to me as one of many indicators, to be seen as a part rather than a single red flag.
 
I did have Surgery (DaVinci), and the PNI was shown on the path report as well.
If it shows on the biopsy, I can't imagine that it would not show up in the path report as well, unless they excised the only example -
 

Post Edited (142) : 9/29/2010 10:31:18 AM (GMT-6)


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 9/29/2010 11:28 AM (GMT -6)   
Grey area in PCa as to significance here is what is supposedly means:
within your biopsy a blood vessel or means of cells escaping the prostate capsule is found within the biopsy, it doesn't mean that PCa cells escaped for any certainty(LOL- the prison guards don't get to make a bed count, either on these guys), some docs believe it as no big deal....what is fact vs. fiction??? In patients whom had surgery with clear margins, clear nodes etc., maybe this is the factor for recurrance issues??? (maybe)- PCa has various rules and one of the coined rules in PCa.....is there are no rules).  From what we have seen in various patients, this factor might not be worth alot of worry, gleason scoring and type of PCa found and sample amount and volumes is perhaps a better place for our attention.

PNI- Perinueral Invasion
PIN- is about the discussion about how the cells appear
HG-PIN - this grading can be a precursor to PCa appearance seen in the cells
Dx-2002 total urinary blockage, bPsa 46.6 12/12 biopsies all loaded 75-95% vol.; Gleasons scores 7,8,9's (2-sets), gland size 35, ct and bone scans look clear- ADT3 5 months prior to radiations neutron/photon 2-machines, cont'd. ADT3, quit after 2 yrs. switched to DES 1-mg, off 1+ yr., controlled well, resumed, used intermittently, resumed useage

Post Edited (zufus) : 9/29/2010 10:34:52 AM (GMT-6)


proscapt
Veteran Member


Date Joined Aug 2010
Total Posts : 644
   Posted 9/29/2010 12:31 PM (GMT -6)   
PNI isn't good, but it's just one among many factors. In my case, the first reading of my biopsy slides was rated 3+3 with focal PNI, and then when I took them to a leading cancer center they said that because some PNI was present they would rate me a 3+4=7. So, it matters. But PNI internal to the prostate is common and not that big a deal, I'm told. If you're trying to estimate the probability of capsule penetration see the MSK nomograms; there's a nomogram that covers this. Also, my doc used doppler ultrasound to check whether the tumor was out prior to deciding on surgery; the ultrasound said it was fully contained and the path report later confirmed this. So you might to explore that option as well.

88CC
New Member


Date Joined Sep 2010
Total Posts : 11
   Posted 9/29/2010 3:04 PM (GMT -6)   
Thank you all for responding to my question. I just got back from yet another consultation. This time the doctor explained that the nerves that show up in a biopsy are internal; they are not the nerves that are close to the capsule. (That makes me feel a little better.) So he pretty much confirmed what you all said.

Thanks again for your help.

Cheers,

88CC
Age 55; living in Seattle area
PSA = 5.1 on July 19, 2010; no long term history
Bx on Aug 25, 2010; ultrasound showed 88cc volume (due to BPH)
Dx on Aug 31, 2010; 6 out of 20 cores positive
PNI in 2 cores
G = 6 (3+3); Clinical stage = T2a
No treatment yet; still researching options.

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3887
   Posted 9/29/2010 3:50 PM (GMT -6)   
Have you read 'Guide to Surviving Prostate Cancer" by Dr. Patrick Walsh? Or any of the other excellent books out there?

Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 9/29/2010 6:45 PM (GMT -6)   
88, PNI is a very common finding on both biopsy and surgical pathology...don't sweat it (too much).
New Topic Post Reply Printable Version
Forum Information
Currently it is Wednesday, September 19, 2018 8:17 AM (GMT -6)
There are a total of 3,004,570 posts in 329,153 threads.
View Active Threads


Who's Online
This forum has 161744 registered members. Please welcome our newest member, Deep_sleep.
328 Guest(s), 5 Registered Member(s) are currently online.  Details
alltheway, Dogdays, RJD76, Sherrine, Pratoman