Pam,
I would bet that almost 70% here had PNI. The presence of PNI and its effect is contraversial. Most with PNI are never affected by it. PNI is an indication that there is a path from inside the prostate to escape. Thus if you don't have positive margins, then it was still posible that cells escaped the prostate through the nerve lining. It is unlikely, however as the most common way cells begin to escape is through positive margins. After talking to several oncologists, it is moot in my case. I had four positive margins so the PNI does not matter. Below is a web description.

http://www.diagnosis.prostate-help.org/perineu.htm

Tony

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Age 45 (44 when Dx)

HI doting wife. My first urologist told me I had it and because of that it indicated the cancer was outside the prostate. He suggested external radiation and seed implants. I wanted surgery of some kind to get the cancer out of me. My second urologist who did my surgery told me it did not mean that it had escaped. I had negative margins and my first PSA after surgery was less than 0.01. Reading the posts from other people should make you feel better, but you never know the outcome until you get your pathology report after surgery, but think positive and trust in God and what ever the outcome we are all here for, and with you.

Mika

Hi Mika,
Every doctor and oncologist I have spoken with would not make the same assessment that your first urologist has made. And since most with PCa have it and most never develop those stated results I would have to agree with your second urologists opinion. But certainly Amen on the rest.

Tony

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Age 45 (44 when Dx)

TC-LasVagas,Mika Thank you both for your information. I can't tell you how much this helps to be able to talk to someone about this!! I will keep reading and posting and trying to be positive. Thanks again. pam

I read somewhere recently that the Mayo Clinic has stopped reporting PNI on biopsy results because they do not believe that it has any impact upon the type of treatment that is chosen.

Tamu

Hi Tamu,
I posted a link above that indeed has that study at Mayo as a reference. Here it is again...

http://www.diagnosis.prostate-help.org/perineu.htm

Tony

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Age 45 (44 when Dx)

Ditto, I had the same thing on mine.  The doc explained it just meant the cancer had spread to the center of the lobe, internally, and had nothing to do with margins and such.  So, I'd say relax.  Sounds like a clean surgerical removal to me.  lol

Hey ~ Pam,

Here's another bit of information that may calm your fears... until you know for sure ~ pull all the positive strength you can from all of us!!!  Continue to stay close.

In Friendship ~ Lee & Buddy

**Excerpts taken from “Dr. Patrick Walsh’s Guide to Surviving Prostate Cancer”

by: Patrick C. Walsh, M.D. and Janet Farrar Worthington.   Copyright 2001

 

This book gave us so much knowledge… and Knowledge is Power. 

 

Page 145

**What about Perineural Invasion?

As cancers grow, they compress normal tissue, looking for “elbow room”—spaces with less resistance, where they can spread.  Nerves are usually surrounded by some empty space; for cancer, this is the real estate equivalent of a nice suburban lot with a big backyard—plenty of elbow room.  Thus, it’s not uncommon to find prostate cancer in the spaces around the nerves; this is called ‘perineural invasion.”  Because the nerves are most common close to the surface of the prostate, the findings of perineural invasion on a biopsy suggests that the cancer is close to the edge of the prostate, and may well have penetrated the capsule.  However—this is important to keep in mind—cancer that has penetrated the capsule can still be cured.  Which makes this a paradoxical finding—because, although men with perineural invaion are more likely to have capsular penetration than men without it, perineural invasion has no long-term impact on whether or not a man can be cured.  For this reason, some noted pathologists have suggested that it should not even be commented on when found in a biopsy, because it’s not worth worrying about.

<end quote>

 

bluebird,and others thanks again for the information. This site has been a God Send!!! pam

Yes TC, that is why I got a second opinion.

Mika

Count me among those that had perineural invasion, but negative margins. My urologist said he doesn't think info about perineural invasion should be included in post-surgery reports anymore, and is more of a vestige of past thinking about how prostate cancer spreads, rather than anything definitive.

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____________________

Prostate cancer diagnosed: May 15, 2006 (age 40)
Gleason score: pre-surgery 3+3=6; post-surgery 3+4=7
daVinci radical prostatectomy: July 25, 2006
size of tumor: approx 1.1 inches; negative margins from surgery

- number of pads/day at 3 months after surgery: 3 to 5
- number of pads/day at 4 months after surgery: 1 to 2
- number of pads/day at 6-12 months after surgery: 0 to 1

- 1st post-surgery PSA: 0 (Nov 2006); 2nd post-surgery PSA: 0 (Feb 2007)
- 3rd post-surgery PSA: 0 (May 2007); 4th post-surgery PSA: 0 (June 2007)

The search for timber: took Viagra/Cialis approx. every other day, ErecAid once a day, injections. Peyronie's diagnosed 7/5/07. Now on Cialis, L-arginine and pentoxyfylline, ordered to be celibate for 6 weeks.

- PGE1 batting average: .364 (4 for 11)
- Bimix batting average: .500 (4 for 8)
- Trimix batting average: .500 (1 for 2)

"Lost in the valley without my horses, no one can tell me what my remorse is..."