Rod Update: cath out; no path report; question re OR report; adhesions;PSA; Gleason; etc.

Hello everyone,

We just came home from the hospital. The catheter has been removed. The pathology report was not available - this troubles me. Now the nurse will have to call with the results. I think the communication would have been better if we were told the results in person and not over the phone and that we would have gotten an immediate copy. I get so easily frustrated over having to wait yet again.

We were given the O.R. report which reads Clinical stage: T1C; SHIM: 18; IPSS: 2 (0). I don't know what any of this means. And is it significant? Wouldn't the pathology report be more significant than the O.R. report? AND does it even matter what the pathology report states? I'm getting the impression that the more important factor is the post-op PSAs over the course of time. Is this accurate?

The O.R. report states that adhesions were noted along the pelvis involving the lateral aspect of the sigmoid colon and taken down sharply. Is this a normal finding?

The O.R. report states a nodule was not detected on digital exam under anesthesia. Is this a good thing?

The O.R. report also states nerve sparing performed was a left standard and right standard procedure given his history of prostatic biopsy findings and clinical exam.

When the surgeon came out to speak to me after Rod's surgery he left a very good impression that no further therapy would be needed, but then a few hours later I heard him be more cautious by saying we'd have to wait and see because the Gleason score was 8. Now the nurse said the same thing today. What is the significance of the Gleason score being 8? Does this mean it is more likely that the cancer has already spread and that Rod will need further treatment?

Last Saturday Rod started having a lot of drainage from the site that used to have the drain in it. At the same time a large hematoma appeared up and down Rod's right side. I thought the drainage was causing that and I was so worried that I had Rod call the nurse yesterday. Today when she looked at it, she said it was actually the hematoma causing the drainage and not something internally. What would cause a hematoma?

While we were waiting, one of the other surgeons in the group walked by, Rod acknowledged him with a smile and this surgeon just ignored him. This did not leave a good impression. One of the residents noticed us and came over and shook our hands so that was a much better interaction.

There was so much commotion at the hospital today and I am aggravated because they were supposed to come and get me after the cystogram, but they didn't so I feel like I missed out on information. Then I'm aggravated because the pathology report was not ready. Rod is ready to send me to the moon because my aggravation is irritating him big time (not good to make stress for a recovering patient). I'm having a pity party today because I want things to go back to normal. I can see that Rod is feeling troubled today. Today I think I stink at being a support system.

We need you guys big time!!!!!

THANK YOU!!!!!

Love,

Maria Teresa

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Husband Age 55 Maria Teresa age 44
Total PSA 8 on 05/21/07
DRE: prostate bumpy
Biopsy on 07/16/07: 5 out of 8 cores positive, Gleason Score 8 (3+4+5)**
CT of the abd/pelvis; Bone Scan; Xrays done on 08/13/07: Normal
Robotic Surgery Scheduled for September 11, 2007 - Cancelled due to anesthesia complications
Robotic Surgery September 25, 2007

**"Report to the Nation on Prostate Cancer" published by the Prostate Cancer Foundation, page 11: "In some cases, the pathologist might identify a third pattern, which is less common but that has a higher grade than either of the first two patterns that comprised the Gleason score. The presence of this third pattern might indicate that the tumor is more aggressive than the Gleason score would otherwise imply. For example, if a Gleason 4+3 tumor also has some grade 5 cells, the cancer would be considered as being of higher grade disease overall."

Maria,

MT,

You seem to be rushing things so take a deep breath and relax. The path report is the key. What you want to see on the path report is clear margins, no seminal vessel or lymph node involvement. The Gleason of 8 means that the cancer is moderately aggressive. I think what the surgeon was saying to you after the surgery is based upon his visual assessment he could not see any signs of the cancer on the prostate membrane. Do not jump to any conclusions about additional treatment. Your urologist and his team got Rod through the surgery in fine shape and they will get the information to you as soon as they can. The focus now is recovery and stress does not help that outcome. Rod is probably feeling fairly well and elated to have the catheter out.

Blessings to the both of you.

Tamu

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Diagnosed 7/6/06, 1 of 10 core samples, 40%,Stage T1c, Gleason 3+3

Maria - we are all here with you. It's normal for you as a wife to also be emotional over this whole situation. Our surgery was last Sept 27, 2006 and I didn't find this forum until mid October. I had many "pity parties" before that time and it was the support and shared experiences in here that helped me through and in turn made me a way better support system to Bob.

Just think before you know it you'll be saying . . . hey that was last year and look where we are now.

Please hang in there; don't beat yourself up; and stay with us.

;o) Linda & Bob

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Bob (61) - Laproscopic Prostate Removal Sept 27, 2006.

Dear MT,

Breathe honey!!!!! Everything that you know so far is good. The post-op pathology report will be the determining factor in how Rod is doing. Waiting for it is really hard but its not like anything has to be done right away. We all have this frustration with PCa, from diagnosis, through treatment, then waiting for PSA results. Its just something that cancer leaves us with.

Take it one day at a time Maria Teresa, and look for the bright and positive things that happen each day.

Good luck,
Jim

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Age 73. Diagnosed 11/03/06. PSA 7.05. Stage T2C Gleason 3+3.

Maria Teresa,

I remember your first posts here...

MT-

I think we are a lot a like.       I will tell you what I learned from my experience.  Be happy with the success of today.  Rod made it through surgery! That is fabulous!  Rod got his catheter out! Great news!  My dad was sooooo happy on that day!  As hard as it is for me to give him a break, they need a break to heal mentally and physically.  Waiting is the hardest part, however, unfortunately from experience, there is nothing we can do for awhile after the pathology report comes back.  Regardless of the result.  Unfortunately, part of this horrible disease is that we will never be truly comfortable.  My dad's path report wasn't the report I was hoping for and it devastated me, however, we still have to wait six weeks until his post-op PSA to start any treatment...maybe even another two weeks after that.  It has been a hard 4 weeks of waiting, but this is an important time for my dad physically and mentally.  (and for us)

The path report will come that is for sure and you will have time to soak it in and hopefully celebrate a great report!  If not, you will still have time to make your next plan of attack.  Either way...it's a waiting game.  A good friend of mine who is an Oncologist told me that I need to wrap my mind around the idea that there are no answers with cancer.  No if A then B.  You will see this from a lot of the posts.  It doesn't make sense to me why my dad's PSA of 5.5, Gleason 7 spread outside the prostate and into a lymph node, when people with PSA's of 100 didn't.  It doesn't do me any good to ask why.  We've got to "play it where it lays".  We make the best decisions we can with the information we have and don't look back.  I keep reminding myself of this. 

I am type A and I want everything done now and I am a fixer.  It's hard when I can't fix things.  I'm learning to be patient and to celebrate the litte things right now.  My dad's continence is getting a little better and his infection is feeling better after being on antibiotics for a few days.  I have to celebrate the little wins, otherwise, I will drive myself crazy. 

So, today I am going to celebrate with you that Rod is through surgery, through with the catheter and pray that his path report comes back with good news and he has a speedy recovery.  I will also continue to pray!  Cheers to your husband and all that he has been through successfully!  You guys can and will do this!  Hang in there! 

Doting

Doting - I agree with you that we are a lot alike! I can totally relate! I want things to be perfect and I want things to be black and white. And I definitely want everything to be done NOW and I'm also a fixer. I have no patience. And I don't know about you, but I am very emotional. Thank you for pouring light into my mind and heart!!!

Ray & Avis - Thank you for the links! I had no idea! Thanks for enlightening me! God bless you both!

Everyone - Thank you for helping me pull myself together today and help me readjust my attitude. I only hope in the future I can pay it forward and help others as all of you have helped Rod and I and continue to help us!

Love,

Maria Teresa

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Husband Age 55 Maria Teresa age 44
Total PSA 8 on 05/21/07
DRE: prostate bumpy
Biopsy on 07/16/07: 5 out of 8 cores positive, Gleason Score 8 (3+4+5)**
CT of the abd/pelvis; Bone Scan; Xrays done on 08/13/07: Normal
Robotic Surgery Scheduled for September 11, 2007 - Cancelled due to anesthesia complications
Robotic Surgery September 25, 2007
Post Op Gleason 4+5; Positive margin right base of prostate; tumor into seminal vesicle; lymph nodes negative
Next step is the post surgical PSA to determine need for additional treatment

**"Report to the Nation on Prostate Cancer" published by the Prostate Cancer Foundation, page 11: "In some cases, the pathologist might identify a third pattern, which is less common but that has a higher grade than either of the first two patterns that comprised the Gleason score. The presence of this third pattern might indicate that the tumor is more aggressive than the Gleason score would otherwise imply. For example, if a Gleason 4+3 tumor also has some grade 5 cells, the cancer would be considered as being of higher grade disease overall."

Post Edited (mariateresa) : 10/2/2007 3:31:46 PM (GMT-6)