about 5 weeks ago my husband was diagnosed with prostate cancer, 55 yrs - PSA 84 in Oct 2019 then PSA 94 beginning of Feb and it has been a whirlwind time during which I’ve spent so much time googling and reading - the forum has proved both an encouragement and a source of wisdom for which i’m so thankful. We are meeting with the consultant this Saturday to go over my husbands histology report following his da Vinci robotic prostatectomy almost three weeks ago. His Gleason grade has remained at 4+3=7 but he has been upgraded to T3b from T2c. My husband doesn’t want to google and look up information as he is apt to panic so prefers me to and i’d value people’s thoughts ahead of our meeting with the consultant as regards the report - we are in the UK but blessed to have private health insurance through my husbands work - I dare say if we’d have used the NHS we wouldn’t have got to see the histology report which perhaps would have been a good thing as i’m going in circles studying information on lymphovascular invasion for starters. From my studying I would imagine that John will be offered adjuvant RT - he is hoping for a “it was a success - all clear” although I do keep reminding him his PSA check in 11 weeks time will be the deciding factor for the consultant also remind him that his Consultant has never used the words “all clear” rather “adequate cancer control” - I have lost several family members to cancer over the years and my Uncle died of PC at 69yrs whereas my husband has no experience of loved ones going through this disease. I’m so sorry for the rambling message it’s just i’m trying to remain positive and cheerful for my husband and children’s sake yet am secretly worried that this could have spread despite the radioactive choline PET scan prior to surgery being clear - the surgeon felt it best not to remove the lymph nodes nearby as clear in the scan !!!! Thank you so much !!!!!!!!
Adenocarcinoma present: Yes, acinar
Gleason score: 4 + 3 = 7
Tumour size and distribution: 47mm, widely involving the entire prostate
Extraprostatic spread: Yes, focal, right anterior, right lateral and
left lateral (up to 8mm in width, 2mm in depth)
Bladder neck invasion: no
Seminal vesicle / vas invasion: yes, bilateral
Lymphovascular invasion: yes
Perineural invasion: yes
Apical margin involved: yes, bilateral
Base margin involved: yes
Circumferential margin involved: No
Urothelial neoplasia present: No
Pre-prostatic fat: Not involved
Lymph nodes: Not submitted
Prostate, robot-assisted radical prostatectomy:
Acinar adenocarcinoma, Gleason score 4 + 3 = 7
Staging (TNM 8th ed.): pT3b pNx
Lymphovascular invasion means the pathologist saw cancer cells in blood vessels or lymph vessels or both. With pT3b the cure rate at 10 years less <22%. With a pre surgery PSA of >80 it is unlikely your husband will be undetectable after surgery or remain undetectable very long. Given his age, I would try to get into a definitive (cure) clinical trial.
There is another at John Hopkins and Rosewell Park.
Post Edited (Duck2) : 3/11/2020 8:25:28 AM (GMT-6)