Focal Perineural Invasion Identified?

I had perineural invasion on my biopsy but was clarified on the pathology as not penetrating the prostate wall. Here is the general definition from this web site:

"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 invasion 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."

There are also nerves going through the center of the prostate, and nerves surrounding the prostate. The location of the invasion is also important. If the invasion is within the interior of the prostate, the cancer will be removed even if penetrating into the nerves (if you are having RRP). If it is on the exterior of the prostate, your surgeon may cut a wider path. Even though shown on the biopsy, it still may not issue forth in a positive margin. Keep your chin up!

RB

Age 61
Original data - pre-operation
PSA: 5.1
T1C clinical diagnosis, Needle biopsy - 10 cores, Gleason 7 = 3+4 in 1 core (40%), 7 cores Gleason 6 = 3+3 ranging from 5% to 12%
All scans negative
Lupron administered 4/9/2008 for 4 months (with idea I would undergo external beam radiation followed by seed implants - then I changed my mind).
Robotic DiVinci surgery - Dr. Fagin (Austin) May 19th
Post operative - pathology
pT2c NX MX
Gleason 3+4
Margins - negative
Extraprostatic extension - negative
seminal vesicle invasion - uninvolved
1st Post PSA <.04

Thank you Les and RB for the info. Just hard not to think about all the details, especially since I have been laid off as a CFO for 3 months now, on top of dealing with the PC.

David in SC

I lost about 10 pounds before surgery and 10 after. for me, it was all stress related. I am almost six month post surgery and have gained it all back. Initially, I thought it was cancer related but it was all stress. Good luck with the surgery.

Ivory63, welcome to the forum, hate to see ya here...lol Your journey is just beginning, but it can be moved along more quickly if you are ready for a bunch of reading. Your stats indicate early detected contained PCa and usually easily removed. The removal process is the big decision, of course. I would suggest you take the few weeks or so to do some in depth reading here, starting with some of the material listed in the 2nd from the top subject line above. This contains links to some of the info available, as well, as some of the Journeys of our members. If you have questions, ask them on a separate thread with the appropriate subject, to catch peoples attention.