Seminal Vesicle Involvement

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Smara
Regular Member


Date Joined Oct 2017
Total Posts : 63
   Posted 12/6/2017 6:26 AM (GMT -7)   
Hello
I would like to ask if
Seminal Vesicle Involvement (post surgery)
has more poor prognosis than Lymph Node Involvement?

Post Edited (Smara) : 12/6/2017 6:29:57 AM (GMT-7)


fiddlecanoe
Regular Member


Date Joined Oct 2016
Total Posts : 225
   Posted 12/6/2017 7:17 AM (GMT -7)   
I believe that lymph node involvement is worse.
Age: 62
Diagnosed in July 2016 with G7 (4+3) PC & PNI
Bone & CT scans clear
Surgery at Lenox Hill Hospital in NYC, 9/12/2016
Post-surgery pathology showed G7 (3+4), with SVI and PSM
Lymph nodes clear
First post-surgery PSA October, 2016: <.008
Second post-surgery PSA December, 2016: 0.01
Third post-surgery PSA June 2017: 0.05
IMRT begun: July 18, 2017 (35 fractions)
First post-SRT PSA: <.008

Break60
Veteran Member


Date Joined Jun 2013
Total Posts : 1782
   Posted 12/6/2017 7:55 AM (GMT -7)   
SVI is not good either. I had it and two years later I had lymph node mets.
Bob
DOB January 1944
8/’12 PSA 2.7; 5/’13, PSA 6.6 (actually double due to finasteride)
7/’13 Bx GS 4+5=9 , 2 of 6 cores, 10%, 40%; stage Pt1c
9/’13 ORRP, pathology GS 4+5=9, EPE and margin+ at base (4mm, GS7), BLSVIs+, 10 lymph nodes resected (clear); stage upgraded to Pt3bN0M0
11/’13 - 5/’14, PSA 0.1 to 0.3
6/’14 SRT by IMRT/IGRT (68.2 grays/38 Fx) to prostate bed, ADT (6 months Lupron)
9/’14 - 8/’15: PSA: <.1, to 1.2
9/’15 MRI, CT-PET finds two iliac lymph nodes suspicious for PCa; started 13 months of ADT3 (Lupron, bicalutamide, dutasteride) plus plus metformin, cabergoline, estradiol patches, prolia , vitamin D3, calcium. IMRT/DART (75 grays/50 Fx) to pelvic lymph nodes. Stopped ADT3 11/’16.
11/’15 - 5/’17: PSA .03 to 2.3.
2/’17: Rx finasteride added
5/’17: F-18 Fluciclovine (axumin) PET/CT scan finds 9 mm femur met. Restart ADT3; start monthly Xgeva, stopped finasteride.
6/’17 SBRT via IMRT (27 grays/3 Fx) to femur met.
6/’17 - 10/’17 PSA .3 to <.1

Tall Allen
Veteran Member


Date Joined Jul 2012
Total Posts : 8956
   Posted 12/6/2017 11:39 AM (GMT -7)   
Smara-

Please share the details of his pathology report.
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
SBRT 9 yr onc. resultsSBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.1,no lasting urinary, rectal or sexual SEs
my PC blog

Gemlin
Veteran Member


Date Joined Jul 2015
Total Posts : 620
   Posted 12/6/2017 3:44 PM (GMT -7)   
Smara,
have you been treated for PC? This is how PC progress in a man if he is not treated (it could answer your question):

PIN --> localised --> locally advanced --> N1 --> M1 --> CRPC --> death

Seminal Vesicle Involvement (SVI) - is in "the locally advanced phase"
Lymph Node Involvement (LNI) - is in "the N1 phase"

so LNI is more advanced than SVI and hence harder to treat.

Smara
Regular Member


Date Joined Oct 2017
Total Posts : 63
   Posted 12/6/2017 4:07 PM (GMT -7)   
My husband 64, post de vinchi surgery with bilateral SVI, no LNI, negative margin, extra-capsular
Gleason 4+7.
His seurgon said, no other treatment need
for now. Is this bad news? It's mean the
cancer will come back with LNI? Why no
other treatment need?

Post Edited (Smara) : 12/6/2017 4:14:57 PM (GMT-7)


ddyss
Regular Member


Date Joined Apr 2017
Total Posts : 144
   Posted 12/6/2017 4:25 PM (GMT -7)   
Smara,
its very possible that they have taken out all cancer when they did surgery so till they have any other compelling reason they are recommending no further treatment. When pathologist dissected the removed Seminal Vesicle (SV) they found cancer - hence SVI is positive and its great news that they did not find any cancer in the lymph nodes (hence LNI negative). Since you have negative margin, the hope is no cancer escaped or is remaining although it was locally advanced( it went out of the prostrate to the Seminal Vesicles).
The only way to figure out next steps is to monitor PSA regularly and hope it does not go up.

In the meanwhile based on your information you can calculate chance of recurrence using this nomogram - I dont know your initial PSA so cant do it for you:

https://www.mskcc.org/nomograms/prostate/post_op[url]
DX@ 48 Yrs PSA 03/15 4.45 DRE: Firm Right Base
04/18 Biopsy Right: Base 4+3, Middle 3+4, Apex: HPIN
Left 6 cores : -ve
5/20 MRI: Pirads 5, ECE:+ve
RALP 05/26 Mt. Sinai Miami - Dr. A. Bhandari
Path:
Gleason downgraded to 3+4 !! Stage T2C
Prostrate Size: 49grams Tumor:20%
LN/SV/ECE: -ve PNI: +ve
Cath Removed : 6/1
Full continence: 7/4
PSA History :
7/7 <0.1
10/2 <0.006

Tall Allen
Veteran Member


Date Joined Jul 2012
Total Posts : 8956
   Posted 12/6/2017 7:09 PM (GMT -7)   
Thanks for explaining. So far as you know right now, he is cured. But he has to monitor it with ultrasensitive PSAs every 3 months to make sure it doesn't come back. He has no lymph node invasion, which is good. He did have seminal vesicle invasion, which is a risk factor. That's why they have to watch closely.
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
SBRT 9 yr onc. resultsSBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.1,no lasting urinary, rectal or sexual SEs
my PC blog

Smara
Regular Member


Date Joined Oct 2017
Total Posts : 63
   Posted 12/6/2017 9:58 PM (GMT -7)   
Thanks a lot to all of you.
for the nformation and support.

Post Edited (Smara) : 12/7/2017 6:52:17 AM (GMT-7)

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