Post Surgery Pathology Report

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

Skate
Regular Member


Date Joined Oct 2010
Total Posts : 424
   Posted 1/20/2011 4:02 PM (GMT -6)   
I was going over my pathology report from my prostatecomy a while back.  Since then I have had RT and I am now on HT.  In order that I have a better understanding now I am posting the results from the report in hopes that input from you guys will help explain more clearly the data. I know that we are not doctors but there is a wealth of knowledge and experience here. All responses would be greatly appreciated with thanks. Jack
Prostate / Seminal Ves. and Vas Deferens removed
Histologic type: Invasive prostatic adenocarcinoma NOS
Histologic grade: Primary - 3 Secondary 4
Gleason:7
Prostate weight: 30 gm
Tumor approximately 10%
Extraprostatic Extension: present within one block
Absence of seminal vesicle invasion
Primary Tumor:pT3a, no regional lymph node mets
Margins uninvolved
Perineural invasion present / nodular hyperplasia and adenomatous hyperplasia - additional findings
One tumor a focus identified with extraprostatic extension 1.2 cm located right side mid area posterior
Diagnosis
Invasive prostatic adencarcinoma G& (3/4), one tumor focus with focal extraprostatic spread right side mid posterior, margins clear.
UICC pTNM: pT3 pNO (0/3) pMX
 
Those are just the highlights.

Age 59 at Diagnosis
01/08 PSA 4.17 DRE showed node
03/08 RP - Nerve Sparing, margins clear, no invasion
Continent 3 weeks post surgery / ED
06/08 until 08/09 PSA 0.01
08/09 PSA .14
09/09 RT / 36 treatments
01/10 PSA .13
08/11/10 PSA 3.44
30/11/10 Zoladex ADT

knotreel
Veteran Member


Date Joined Jan 2006
Total Posts : 654
   Posted 1/20/2011 4:55 PM (GMT -6)   
I am certainly no expert or even know what the entire report means but I would have guessed that you should have had a better outcome. I wonder if the RT was targeted to where it needed to be? I am sorry to hear that the RT didn't do as much ,so far, as one would have hoped. Hopefully, others may shed some light on this. I guess my knowledge, such that it is, does not extend into the area of oncology, yet anyway.
Ron
06-08 1st biopsy neg psa 4
10-09 psa 5.5 2nd biopsy 1/12 pos. 10%, G(4+3) age 65
12-15-09 RRP Tulane NOLA Dr Lee
Path, 1%, clr marg, no EPE, no SVI, nodes cl, G(4+3)
100% incontinent @ 12 months
ED, pre-op severe, post op total
10/10 Dr Boone, Methodist recomended AUS
AUS/ IPP performed 1/11/11 Methodist Houston
post op psa's 0.04,<0.1,<0.1,<0.01@12 mo.

Skate
Regular Member


Date Joined Oct 2010
Total Posts : 424
   Posted 1/20/2011 8:48 PM (GMT -6)   

Thanks for the info Ron.  I also was lead to believe from the report and my uro surgeon that things proved very positive.  He was shocked a year later. Obviously not so positive  from my history.

Jack


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 1/20/2011 9:06 PM (GMT -6)   
Jack,

There are a lot of similarities in our post-surgery pathology reports. My doctor was pretty confident at first, but quickly changed his mind when my one tiny positive margin turned to BCR in way less than a year. I am still waiting for the final verdict on my SRT, but the early signals are that its not working either. I am still puzzled why mine was listed as a pT2c and not stage 3 (not that I wanted it).

You had a smaller prostate than me, and less involvement and a lot lower PSA pre-treatment, but I can see your PC has a path of its own. Good luck as you continue your fight.

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 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3892
   Posted 1/20/2011 9:34 PM (GMT -6)   
Salvage radiation is always a 50-50 deal ...With men who had negative margins, it's worse than that...

It looks like your PC was out of the barn before you had surgery..But with micro-mets, it's impossible to know that. Now, it's just a matter of watching and waiting...Getting your "T" level down as low as possible is very important. Don't assume ADT has done the job. In 7% of men, it fails to lower "T" to castrate levels..have it checked and do what you have to get it down below 20..Below 10 is even better...

Hang in there brother...
Age 68.
PSA at age 55: 3.5, DRE normal. Advice, "Keep an eye on it".
age 58: 4.5
" 61: 5.2
" 64: 7.5, DRE "Abnormal"
" 65: 8.5, " normal", biopsy, 12 core, negative...
" 66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
" 67 4.5 DRE "normal"
" 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RRP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT NOW

BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 1/20/2011 11:32 PM (GMT -6)   
This is why this bloody disease is so frustrating. Here you are, gland not at all enlarged for your age, pretty good PSA at a little over 4. Op says 3+4=7 with not a large amount of tumour (10% of the gland). The prostate is sliced into blocks and just the one block shows a focal extension (Skate is 1.2cm correct or should that be 1.2mm------1.2cm is rather large to be called "focal") It looks as though 3 local nodes were taken and these were clear as were the seminal vesicles. I wish when these docs speak of "margins" they would be more specific when they mention them ------ sometimes they mean margin of the prostate (the "capsule") and other times they are speaking of the surgical margin which often is further out. For example you can have the capsule margin breached focally but the surgical margin clear. Perineural invasion (invasion of the nerves within the gland not the separate nerves attached to the surface which control erection) is very common post surgery, even in a successful operation. All in all you would say that meant a very pretty good prognosis. Then despite this the disease only plays fair for a year and a half before raises its ugly head again and needs zapping with radiation. The current PSA would seem to indicate that radiation did not get it all but you should see a good response with ADT. Here's to knocking it back down again.
Bill

brampy
Regular Member


Date Joined Jan 2011
Total Posts : 42
   Posted 1/20/2011 11:41 PM (GMT -6)   
Sounds like I have some similarities. I just visited the radiation oncologist this week and he was somewhat indifferent about me doing followup radiation right away however he did state that IMRT has better results soon after RALP. I am leaning toward radiation...I still need to do my 6 week followup with my urologist and will probably get my PSA tested.

Bobr
__________________________

Age: 54
Routine Physical on 10-20-2010 DRE Normal
PSA 4.3, up from 0.6 5 years prior
PSA 0.6 on 10-25-2005
PSA 0.4 on 7-30-2004
PSA 0.5 on 5-9-2002
Followup with Urologist on 11/10/2010 after elevated PSA; DRE noted slight bump
November 30th, 2010 had prostate biopsy.
December 9th, 2010, Biopsy results 3 of 12 cores positive.
LLB: Gleason's 4+3=7, 11 MM Tumor Length/15MM Core Length (73%)
LLM: Gleason's 4=4=8, 12 MM Tumor Length/15MM Core Length (75%)
LM: 0.1 MM Tumor Length (1%)0.1 MM Tumor Length
Urologist recommended robotic removal using da Vinci method.
RALP Surgery 12/27/2010 Released: 12/30/2010
Thunderbird Banner Hospital, Glendale, AZ
Post-Surgery Pathology: GS 4+5=9
Pathologic Staging: pT3a, N0, MX; location: Left Side; Volume: 10%
Margins: Left posterior inked margin focally involved
Extraprostatic Extension: Observed
Seminal vesicles: Not observed
Lymphatic/Vascular Invasion: Not observed
Catheter: Removed 15-days after surgery

Skate
Regular Member


Date Joined Oct 2010
Total Posts : 424
   Posted 1/21/2011 8:51 AM (GMT -6)   

Bill,  I checked the report and it does state:

"One tumor a focus identified with extraprostatic extension 1.2 cm, greatest tumor dimensions on one slide."

Thanks for the responses guys. keep them coming as I can now see my path more clearly.
Jack
Age 59 at Diagnosis
01/08 PSA 4.17 DRE showed node
03/08 RP - Nerve Sparing, margins clear, no invasion
Continent 3 weeks post surgery / ED
06/08 until 08/09 PSA 0.01
08/09 PSA .14
09/09 RT / 36 treatments
01/10 PSA .13
08/11/10 PSA 3.44
30/11/10 Zoladex ADT

Skate
Regular Member


Date Joined Oct 2010
Total Posts : 424
   Posted 2/5/2011 8:58 AM (GMT -6)   
Bump...

Newporter
Regular Member


Date Joined Sep 2010
Total Posts : 225
   Posted 2/5/2011 12:35 PM (GMT -6)   
Sorry about your outcome. Hope you do well with salvage treatments.

Though you had EPE, "Margins uninvolved" meant your surgeon did a good job, took everything out and you had negative margin.

billye
Regular Member


Date Joined Nov 2009
Total Posts : 24
   Posted 2/5/2011 3:33 PM (GMT -6)   
seminal invasion or not? 

Skate
Regular Member


Date Joined Oct 2010
Total Posts : 424
   Posted 2/5/2011 3:43 PM (GMT -6)   
Absence of seminal invasion.

Age 59 at Diagnosis
01/08 PSA 4.17 DRE showed node
03/08 RP - Nerve Sparing, margins clear, no invasion
Continent 3 weeks post surgery / ED
06/08 until 08/09 PSA 0.01
08/09 PSA .14
09/09 RT / 36 treatments
01/10 PSA .13
08/11/10 PSA 3.44
30/11/10 Zoladex ADT

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3892
   Posted 2/5/2011 7:44 PM (GMT -6)   
When you get your next PSA test, ask for a "T" level test too...
Age 68.
PSA at age 55: 3.5, DRE normal. Advice, "Keep an eye on it".
age 58: 4.5
" 61: 5.2
" 64: 7.5, DRE "Abnormal"
" 65: 8.5, " normal", biopsy, 12 core, negative...
" 66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
" 67 4.5 DRE "normal"
" 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT NOW

Skate
Regular Member


Date Joined Oct 2010
Total Posts : 424
   Posted 2/5/2011 8:29 PM (GMT -6)   
As a matter of fact I go in Tuesday for my PSA and T level.  Will get my results when I go in for my second injection of Zoladex later in February.
 
Jack
 
New Topic Post Reply Printable Version
Forum Information
Currently it is Sunday, September 23, 2018 1:53 AM (GMT -6)
There are a total of 3,005,798 posts in 329,264 threads.
View Active Threads


Who's Online
This forum has 161803 registered members. Please welcome our newest member, nadadot.
228 Guest(s), 3 Registered Member(s) are currently online.  Details
Hibee, fighter87, NotQuiteAntonio