Welcome to the forum. You can put aside the size of his prostate in relation to the tumour. It is perfectly normal for the size of a man's prostate to begin to increase in size (sometimes quite dramatically) around the 50 mark ---- this often results in urination problems but is not normally related to the presence of tumour. A CT scan and bone scan are usually done as a matter of routine but often don't tell us too much even when they are. Your father is unlikely to have any evidence of spread to the bones or surrounding prostate bed tissue with a pre-op PSA of 7 ----- this doesn't mean it has not happened, it means if there were anything it would be too small to be visible. Did the post surgical report mention the status of the surgical margin? (it will be either negative which is good or positive which is not as good). The Gleason score of 8 puts him in the higher category of risk of spread but there would not be too much difference between a 7 (his initial grading) with say 90% grade 4 cells and 10% grade 3 cells present and having 100% grade 4 cells comprise the tumor. It is the normal protocol for the seminal vesicles to be removed along with the prostate as part of the surgical process. Some doctors do not remove any lymph nodes unless they see a need to do so. In hind sight, given the seminal vesicles were later found to have contained tumour, it would have been handy to have sampled at least a couple of local nodes for any evidence of spread. The next step would be to check the PSA at 6 weeks and see if the surgery has had the desired effect (PSA should drop to less than 0.01). At present he should be well on the road to recovery so I wish him well on that front and his upcoming PSA tests.
Age 59 PSA 4 DRE neg
4/10 cores +ve [Core 1 <5%; c2 /50%; c3 /60%; c4 /50%]
Gleason 4+3=7 (80% grade 4) Stage T2c; Neg extracapsular and perineural invasion.
CT scan and Bone scan neg. RRP: Aug 10th 2007 :Post-op pathology
4+4=8 unclear margin (margin "disturbed")
Focal EPE, both vascular and neural invasion presentAll subsequent PSAs <0.01
Post Edited (BillyMac) : 11/6/2012 5:46:34 PM (GMT-7)