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Sagittarian
Veteran Member


Date Joined May 2011
Total Posts : 546
   Posted 5/10/2011 10:45 AM (GMT -6)   
In a previous post I had mentioned that if a lymph node is positive, the surgery stops.
That use to be common, but no longer.  I discovered with research outcomes were better on having the prostate removed, vs not, on positive lymph nodes.  I went to the hospital today (pre surgery screening) and found out that was also true with me.  A lymph node, along with the prostate will taken to be examined.  A lymph node are not always taken, but will be in my case.  It is usually done if the Dr feels there is a risk for lymph node invasion.  According to predictive models my chance of lymph node invasion ranges from 1-3 %.  I stand by the Dr on that decision.
 
Several places I have read about shaving prior to surgery at home,  I recommend you  don't do it.  I base this on the the literature given to me by the hospital today.  The literature said, if you scratch, cut, or shave burn where they need to operate, the surgery will be postponed.  This is due to the increased chance of infection.  I guess if your hairy you could mow the lawn a bit.  I have very little if any hair, so its of little concern to me. 
Age = 53
PSA = (2011)-JAN 4.8, FEB 4.7. MAR 4.2
Biopsy = April 2011
12 Core, 4 POS, 2 (3+3), 2 (3+4) All Left Side
Percetage on Positive Cores = 2 (40%) 1 (70%) 1 (90%)
PNI = Not Ppresent
Da-Vinci Surgery = 23 May 2011

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 5/10/2011 11:18 AM (GMT -6)   
I think the concept that the disease is "too advanced" for surgery is going extinct. In fact the intermediate and high risk groups are now being tagged as the best cases for surgery while the low risk group is best tagged as active surveillance candidates. We are seeing paper after paper with follow ups past 20 years showing that high risk cases with high amount of lymph node dissection do far better than previously thought. In fact the more nodes dissected the better. There are side effects associated that can become a problem but they can typically be treated well. For me I had ten nodes removed and they were all clean. But in the papers I'm reading it does not matter if they are positive or not there is still survival benefit to removing them.

Make sure you ask your surgeon about this. You are an intermediate case in the clinic but if your case follows mine you can be switched to a high risk case post surgery.

Tony
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:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

Sagittarian
Veteran Member


Date Joined May 2011
Total Posts : 546
   Posted 5/10/2011 11:40 AM (GMT -6)   
Our pre surgery stats are similiar, exept PSA.
I guess we on each others Radar now.
Age = 53
PSA = (2011)-JAN 4.8, FEB 4.7. MAR 4.2
Free PSA = 7% (yes 7)
Biopsy = April 2011
12 Core = 4 POS, 2 (3+3), 2 (3+4) All Left Side
Percentage on Positive Cores = 2(40%) 1(70%) 1(90%)
PNI = Not Ppresent
Da-Vinci Surgery = 23 May 2011

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 5/10/2011 11:43 AM (GMT -6)   
Sagittarian,
I am on four years without a relapse. Pretty advanced case too.

Good luck to you in the coming weeks.


Tony
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:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

Sagittarian
Veteran Member


Date Joined May 2011
Total Posts : 546
   Posted 5/10/2011 11:46 AM (GMT -6)   
You had 4 out of 8, I had 4 out of 12.
I am closely comparing our stats.

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 5/10/2011 12:04 PM (GMT -6)   
Both sides, too. But that could have been a "lucky" jab for me. 25% of my prostate was cancerous. I had a pretty large positive margin that had to be scraped to the rectum. The doc's surgical report stated that he felt it was likely spread into the rectum. The pathologist concurred. In fact my stats compare well to ralfinaz. Ralph was originally treated in 1994 I believe and has been working as an advocate ever since. He is proof that stage 4 is not the end of all things.

Stay positive.

Tony
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:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 5/10/2011 12:15 PM (GMT -6)   
Definitely no "pre-shaving" any area prior to surgery, they will do that for you in pre-op.

There's a lot to be said if you are having surgery, even with more advance PC, by de-bulking the largest source of the cancer.
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 margin
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, 2/11 1.24, 4/11 3.81
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 9/10

HD_Rider
Regular Member


Date Joined Apr 2011
Total Posts : 414
   Posted 5/10/2011 1:08 PM (GMT -6)   
Sagittarian - Best of luck to you on your surgery.  I just received my pre-op packet in the mail from my hospital.  I'm just supposed to call them a day prior to surgery to go over the details (June 8th).
 
Take care and I hope to read about your positive outcome.
John (HD_Rider) - Wichita, KS
Age: 49
PSA: 3.5, 6/07
PSA: 4.5, 3/11
Biopsy, 12 cores: 04/13/11
Dx: 04/19/11
Gleason: 3 cores at 3+3=6 and one core at 3+4=7 (primarily on right side with <5% on left side)
DaVinci: scheduled for 06/09/11, hoping and praying for the best
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