From another post from our Forum Moderator:
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.
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
I too had perineural invasion, and when I read it I literally got weak in the knees. It turned out to be insignificant and I had negative margins post surgery. Many others here will tell you the same thing.
Sorry to have to welcome you here, but as you will hear from lots of folks here too, "welcome to the club you never wanted to be part of". You will find lots of answers and support here.
The most important I learned was to take your time and educate yourself, and by all means, if you choose surgery, make sure you have a great surgeon. Many here found surgeons through referrals and research and did not go with the surgeon that diagnosed them. I know I didn't and am confident that it was a good decision.
The fear will stay with you for awhile, but don't allow yourself to make rash uninformed decisions. Your PSA is low and your Gleason score shows that you have a non-agressive cancer. You have time on your side.
Good luck on your journey and stay with us.
Gleason scores from 4 pathologies of the same biopsy with 2 of 12 cores positive for cancer (if this isn't confusing to the patient...):
1) both cores 3+4 (Weiss Memorial)
2) one 3+4 and one 3+3 (Univ. of Chicago Hosp.)
3) both cores 3+3 (Mass General Hosp.)
4) both cores 3+4 (Northwestern Memorial Hosp.)
9/17/07 - Radical Retropubic Prostatectomy Surgery at Northwestern Memorial in Chicago by Dr. William Catalona.
and the winner is...post op Gleason score of 3+4.
Good pathology report with negative margins, no seminal vesicale involvement, no lymphatic or vascular invasion, bladder and urethral free and tumor volume was 5% of 27.3g. Amazing how something so small can cause such problems!
9/27/07 - Catheter removal...let the games begin...