Apex mid and base. Sounds like top to bottom but it's the opposite. The base is nearest the bladder. The apex is closest to the penis. It is also the most common flare location for PCa. The prostate is considered two lobes. Thus left would be your left side closest to the rectum. Not sure why but there is no "capsule" in the area of the apex. I believe that it is because this is where the facia tissue integrates with the muscle tissue and the prostate. Thus this is the most common location for extraprostatic extension. The seminals which integrate through the base of the prostate are the first evidence of metastatic disease. Cancers that begin in the apex and spread to the seminals are indicative that the cancer has metastisized and no longer depends on the prostate tissue.
See Figure 1:
Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology was poor: Gleason 4+3=7, 4 positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
My PSA did drop out after surgery to undetectable. It has not returned and I will continue HT until January '08.
My Life is supported very well by family and friends like you all.