Like you I was looking for negative margins but my pathology report came back with 2 focal positive margins... But the Doctor's explanantion to me was that in my case, focal point meant than only a couple of cells were touching the edge and that maybe only 1 cell or so was "outside". I also read a John Hopkins report (Epstein) about
positive margins and how many really do not indicate any need to worry as many times a cell or two outside end up dying anyway just due to the surgical trauma. The overall article and nomogram I got relieved many of my serious concerns.
My final pathology diagnosis was T2c which suggests "organ confined". The good thing were that it was still a Gleason 3+3 (6) and was not "upgraded", and seminal vesicles and lympth were also OK. The nomogram for my final pathology indicates a 95% chance of no re-occurence for 7 years. Doctor also indicated no further treatment indicated at this time. We will just monitor my PSA like most of us on this board will be doing for the rest of our lives. My signature has most of the statistics of my journey so far.
Read up on pathology reports and margins (I did a lot of googling) before your appoinment for discussion with the doctor and write all your questions down so when you are there, you can go over all your concerns. You can also request a copy of the actual report. With my questions and his answers resolving them, I left the office much more at ease as this overall journey can really spin you up.
Take care and God Bless!
Age 59 y/o
Last 3-4 years of annual general health checkups - PSA 5-6 but Free PSA Ratio 21-24%, suggesting "benign" so I did not seek immediate followup urologist referral
3/7/2007 - Went to urologist -No DRE abnormalities but scheduled screening biopsy
3/13/2007 - 12 point biopsy - Left OK Right Core Gleason 3+3
Consisting of single less than 1mm focus at tip of 1 core. Diagnosed as T1c
4/24/2007 - DaVinci performed at Virginia Mason hospital in Seattle
5/2/2007 - Catheter Out! Got copy of pathology report:
Gleason 6 T2c Nx Mx approx 20% of prostate involved
Positive margin, but 2 places where a focal point of only 2 cells were touching edge, the right apex and right posterior. Perineural Invasion present. Seminal Vesicle and Lymphatic/Vascular not identified. Doctor was not concerned about that at all and Final Diognosis of T2c "suggests" organ confined. Stats for no re-occurance are 96% for 5 years and 95% for 7 years. No further treatment other than PSA watch.