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Veteran Member

Date Joined Jun 2007
Total Posts : 789
   Posted 7/24/2007 8:24 AM (GMT -6)   
Hi have been told that when the surgeon starts RP, he takes the lymph nodes out first, and if the cancer is evident in them he does not remove the prostate, any feedback on this?
Regards Mal.
age 66 PSA 5.8 DRE slightly firm Rt
Biopsy 2nd July 07 5 out of 12 positive
Gleason 3+4=7  right side tumour adenocarcinoma stage T2a
Extraprostatic spread Not identified
Itraductal Carcinoma Not identified
RP on 30th July

Regular Member

Date Joined Apr 2007
Total Posts : 66
   Posted 7/24/2007 9:47 AM (GMT -6)   
In Curt's case, the Dr. removed the prostate and "extra lymph nodes" due to the volume of cancer on one side. It turned out that the nodes were clear as were the margins.
Age 52
Diagnosed 2/19/07
10 of 24 cores positive
Gleason 3+3=6 Changed to Gleason 3+4=7 after surgical pathology
DaVinci Prostatectomy May 11, 2007 at Univ. of Mich. Hospital
Stage: T2b
Pathology: May 16 - Cancer confined to prostate, Margins, Lymph & Seminal Vesicles all CLEAR!
Father and Uncle had prostate cancer
First PSA after surgery- July 5, 2007 = <0.01 !!!!!!!

Veteran Member

Date Joined Apr 2006
Total Posts : 1732
   Posted 7/24/2007 10:01 AM (GMT -6)   
Yes and no...

Doing a node biopsy seperate from an actual prostatectomy used to quite common. It is still true that IF, obvious cancer can be seen once the surgeon has opened the patient, the standard of care is to close the patient backup and change treatment modes. That standard may be changing a bit as more and more evidence suggests removing the organ even under advanced conditons has an advantage. Times are definately changing.


Regular Member

Date Joined Oct 2006
Total Posts : 411
   Posted 7/24/2007 5:59 PM (GMT -6)   
I am not sure, but in our case, the lymph nodes were left behind. I think they said they would do a lymph node biopsy if necessary when going in, but then they said it was totally not necessary? I don't think they even did a biopsy of lymph nodes, and just let them be?
Age: 63
Diagnosed: 10/30/06
PSA: 3.7 (2005: 3.4, 2004: 4.0)
Biopsy: 1/10 cancerous, 5% of one core, right apex.
Gleason: 3+3=6
Da Vinci: April 10, 2007, Denver CO
Path results: 1% of prostate involved. Very small tumors on both right and left apex. Negative margins, negative seminal vessicles, lymph nodes left intact. Gleason upgraded 3+4=7.
1st PSA Results: May 11, 2007 <.01

Veteran Member

Date Joined Nov 2006
Total Posts : 1464
   Posted 7/24/2007 6:02 PM (GMT -6)   
They did a lymph node biopsy while I was in the OR. They came out clean so they went ahead with the RRP. Doc told me that if they had been affected, he would not have removed my prostate. I don't know what kind of treatment I would have had in that case.


Age 73. Diagnosed 11/03/06. PSA 7.05. Stage T2C Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Pathological stage: T2C. Gleason 3+4. Cancer confined to prostate.
PSAs from  1/3/07 - 7/18/07 0.00. 
Next PSA on 10/17/07

Regular Member

Date Joined Nov 2005
Total Posts : 154
   Posted 7/24/2007 10:14 PM (GMT -6)   
Hi Maldugs,

I haven't heard that before and it doesn't sound right to me. If cancer is present in lymph nodes and the prostate is removed then perhaps all of the cancer is removed as well. Can you get a second opinion?


Regular Member

Date Joined May 2007
Total Posts : 234
   Posted 7/26/2007 12:01 AM (GMT -6)   

Hi Mal,

My doc said that once they open me up they do a quick freeze and test the lymph nodes, if they have cancer they stop and try a different treatment. My lymph nodes were negative so he continued the surgery. The next thing to worry about are the margins. You will find out about this after the surgery from the pathologt report.

Good Luck



Rick & Diana
Diag: 2-14-07 Gleason 8 Stage T1c PSA 5.09
Bone Scan 3-1-07 Clear
Radical retropubic surgery 4-2-07  Post surgery Gleason 9 Stage T3a Positive margins
4-29-07 PSA 0.02
6-9-07   PSA 0.02
7-6-07   PSA 0.03

Regular Member

Date Joined Sep 2006
Total Posts : 187
   Posted 7/27/2007 7:15 AM (GMT -6)   
As others have noted, my understanding is this is pretty standard procedure unless they really think they've caught everything very and opinions differ on what to do if they find cancer in the lympth nodes.   I was told that if they find cancer in the nodes, they'd sew me back up and spare me the morbidity of the operation--- however, as Swim noted, there are differing opinions on this....
I have a little story on this to share....prior to my surgery, I explained to my wife that the procedure ought to be 3-4 hours.  If they come to get her really early, brace herself because it would mean they found enough cancer in the nodes to scrap the full RP--- and that would be a bad thing.
about 20 minutes after they took me in, my wife, who was in the waiting area with her sister and my sister, gets called up to the desk, where the nurse cheerfully chirped that I was all done, and the doctor would be in to see her shortly.  She starts freaking out, as does my sister.... the nurse can't figure out why everyone's upset.   My wife's sister is the one that smells a rat, and they tell the nurse to double check -- that I shouldn't be done just yet.   Sure enough, it was some glitch on the notification system.
My uro, who's a bit of a bad-ass, was not pleased when he heard this story later --- I'm sure some poor nurse got chewed up on that..... my nodes were clear and we proceded as planned....weird stuff!
Age 47
Initial PSA march of 2006: 28
PSA May of 2006: 39
8 of 12 cores malignant
Open Radical Prostatectomy 6/9/2006
Pathological Stage T3a, Positive Surgical Margin
Gleason 3+4
Post surgury PSA fluctuated between .04 and .09
PSA rose to .24 in November of 2006
6 month hormone therapy initiated December 1. 2006
36 sessions of IMRT Ended Feb 1, 2007
PSA as of May 25, 2007 undetectable
Next PSA November, 2007

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