Road To Recovery

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axle
Regular Member


Date Joined Feb 2011
Total Posts : 35
   Posted 2/5/2011 7:17 PM (GMT -6)   
I have been reading here for the past month or so since I was diagnosed with PCa.  I appreciate the information and experience here.
 
Although my PSA values have been steadily increasing over the past 6 years, it was really an increasingly abnormal DRE that triggered doing a biopsy.  I participated in a POPs (Prostate Onsite Project) program at my workplace.  I have to credit the POPs program for making me aware of my PCa.
 
My biopsy revealed PCa on the right side with 4 of 6 cores positive and 40% of the tissue involved (GS = 3+4).  The left side biopsy samples had only 1 of 6 cores positive and only 1.5% of the tissue involved (GS = 3+3).
 
I educated myself regarding the available options and read Dr. Walsh's book.  I pretty much decided on the da Vinci RRP for myself.  I met with another urologist for a second opinion and asked if I should get another biopsy.  He responded, "If it quacks like a duck...".
 
I had the da Vinci RRP on 1/26/2011 and the catheter removed on 2/3/2011.
 
So now I am hopefully on the road to recovery. 
 
 
Age 58; da Vinci prostatectomy on 1/26/2011
PSA History: 10/2005 = 1.7; 10/2007 = 2.8; 10/2009 = 3.6; 10/2010 = 4.9
Abnormal DRE in 2009; Increasingly abnormal DRE in 2010
Biopsy on 11/23/2010: GS = 3+4 (right side) with 4 of 6 cores positive involving 40%.
Post-OP pathology: GS=3+4; tumor = 35%; R. seminal vesical invasion; Extraprostatic extension into the R. bladder neck; margins uninvolved

Post Edited (axle) : 2/5/2011 5:28:57 PM (GMT-7)


60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2243
   Posted 2/5/2011 8:20 PM (GMT -6)   
Sounds like the surgery went well and that you did your homework before making a treatent choice. Not sure where you work but the POP program is a winner in my book. Keep us posted and hope for continued smooth sailing for you.
Michael

An38
Veteran Member


Date Joined Mar 2010
Total Posts : 1152
   Posted 2/6/2011 6:30 AM (GMT -6)   
Welcome Axle!

It sounds like you did your homework prior to the surgery. At the moment the focus should be on healing from the surgery, you are only 10 days out and there is plenty of healing left to do.

It's certainly good news that your Gleason score was not upgraded. And that the biopsy did foretell the post op outcome quite well. And that your surgical? margins were negative.

An area of concern is the involvement of the seminal vesicle and the right bladder neck. Perhaps this is something to bring up with the doctors the next time you see them.

However, for now, the cancer is on a lab bench somewhere and not in you. That is the thing to remember.

Heal well,
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 (ISUP 2005). Neg (margins, seminal vesicles, extraprostatic extension). Multifocal, with main involvement in the fibro-muscular zone. T2C.
Post RP PSA,
Lab 1: Sep10 – 0.02|Nov10 – 0.03|Dec10 – 0.03
Lab 2: Nov 10 - 0.01|Dec10 – 0.01

axle
Regular Member


Date Joined Feb 2011
Total Posts : 35
   Posted 2/9/2011 1:25 PM (GMT -6)   
Thanks for the words of encouragement and advice.  At my post-op appontment my doctor said, "I think you made the right decision.  I think we got it out just in the nick of time."  He was referring to the pathology report.
 
My post-op pathology report noted that my right bladder neck margin was within a fraction of a millimeter of being invloved.  But all margins were not involved.  So I interpret this to mean that it was close but clear and good to go.
 
I am not sure I fully understand the implications of the seminal vesical being involved.  If the seminal vesical is involved and fully removed doesn't that mean that the tumor is also fully removed?
Age 58; da Vinci prostatectomy on 1/26/2011
PSA History: 10/2005 = 1.7; 10/2007 = 2.8; 10/2009 = 3.6; 10/2010 = 4.9
Abnormal DRE in 2009; Increasingly abnormal DRE in 2010
Biopsy on 11/23/2010: GS = 3+4 (right side) with 4 of 6 cores positive involving 40%.
Post-OP pathology: GS=3+4; tumor = 35%; R. seminal vesical invasion; Extraprostatic extension into the R. bladder neck; margins uninvolved

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 2/9/2011 2:59 PM (GMT -6)   
What was your final staging after surgery, you don't list it in your signature. Glad you are on the recovery road at this point, with the surgery behind you.

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 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

axle
Regular Member


Date Joined Feb 2011
Total Posts : 35
   Posted 2/9/2011 9:18 PM (GMT -6)   
Well, I guess I didn't see the final staging at first look.  The report says "PATHOLOGICAL STAGE: Primare Tumor: pT3b".  So I guess that means T3b.  From the Dr. Walsh book this seems to mean that the tumor was palpable and into the seminal vesicle.
 
My report also references a term called "Regional lymph nodoc: pNY".  or it could say something else because the report is a scan of a FAX and that line is a little distorted.  It could say "pNX".  Either way if the lymph nodes were involved I assume the text would mention that as it did for the seminal vesicle invasion?
 
Age 58; da Vinci prostatectomy on 1/26/2011
PSA History: 10/2005 = 1.7; 10/2007 = 2.8; 10/2009 = 3.6; 10/2010 = 4.9
Abnormal DRE in 2009; Increasingly abnormal DRE in 2010
Biopsy on 11/23/2010: GS = 3+4 (right side) with 4 of 6 cores positive @ 40%.
Post-OP pathology: GS=3+4; tumor = 35%; pT3b; R. seminal vesicle invasion; Extraprostatic extension into the R. bladder neck; margins uninvolved
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