How much actual truth do you wish to hear? It boils down to best guess scenario in all treatments....no way of knowing if you have micro mets in any particular region of your body, even with clear margins, clean surgical pathology...some get BCR or found uncured...because of the huge unknowns in PCa...it is a best guess assessment. Scans today are lacking in what they can do. To many imprecise variables even in pathology although this area of expertise is rapidly getting better with recent technologies.
PNI- perinureal invasion is possible blood path for PCa to travel anywhere from your gland...doesn't mean it did travel..but could...you can have had your pathology found with PNI and be a cured patient and vice versa...remember biopsies can miss plenty of areas in the gland..those could harbor not only different Gleason grades/scores, but different PCa variants potentially and PNI issues. Thus it is over the top complex and never simplistic...however since we look to experts as to what to do...this is the land of simplistic choices we currently have, as what you can see as choices. It is going to get down to more of the genetics, genomes and celluar level as to how to attack the PCa using new technologies and way better pathology. Right now we get to deal with best guess...crapshoot mentality for treatments.
How many doctors know this: www.yananow.net/24Variants.pdf
(you might be shocked) Or look at some pathology prior 18 variants known: www.webpathology.com/case.asp?case=23
(photos on pathology)
Plenty of people believe PCa is just one type and all the same...no way.
Not sure how many doctors will tell you this kind of information, as it doesn't promote alot of confidence. My onco-doc is straight forward on the totality of PCa which is refreshing to see.
Dx-2002 total urinary blockage from PCa emergency room, bPsa 46.6,
12/12 biopsies all 80-95% vol., Gleasons found 7,8,9's, scans appeared clear, ADT3 prior to Neutron & Photon radiations, DES since 2004-5.
Post Edited (zufus) : 4/13/2011 6:22:37 AM (GMT-6)