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Posted 5/8/2009 6:19 PM (GMT 0)

Greetings ddd49.  I just asked my wife who is a registered nurse and she says there are many reasons for lytic lesions - it can be caused from a number of things including benign reasons.  You probably want to follow up but it is good news that there is no prostate cancer.  Overall, it sounds like a very good report with an excellent prognosis for full recovery. 

Take this next month and really enjoy each other and get ready for the recovery phase.  You will both do well - it's obvious you are a big part of your husbands life and he will need you over the next several weeks more than ever.  My surgery was on Feb 4 after we got the word on Dec 24 that I had prostate cancer.  In that 6 weeks I had 3 business trips and I told my wife I needed her with me.  One of those was to a meeting of our board where I told them I had cancer.  I am the CFO and an officer of our organization so I had some obligations to make sure they were aware.  I simply needed her by my side during that time.  It was a great time for us. 

I am more grateful than I can ever express for the way she has stood beside me over the past year plus.  You are doing the same thing and I'm sure he will appreciate it more and more as time goes by. 

Please keep us posted on how things go - we want to be there for you and for him.  David

Posted 5/8/2009 10:09 PM (GMT 0)
I feel reluctant to question your doctor's good news, but in terms of realism I suggest that you go to the sloan-kettering website

http://www.mskcc.org/applications/nomograms/Prostate/index.aspx

and plug in your husband's lab results. You will see that his chances of a "cure" are very good, but not 99%.

In any case I wish you both well. Even a complete cure will still mean a number of somewhat rough months of recovery. Keep us informed as we hope for the best.
Posted 5/8/2009 10:17 PM (GMT 0)
With respect to lytic lesions, sources on the web suggest that they are mostly benign. Your scan report gives the worst case
"A neoplatic disorder such as multiple myeloma is not excluded." I'd assume that they were just covering their asses, go on and treat the PCa and then perhaps see an oncologist when things settle down.
Posted 5/9/2009 3:05 AM (GMT 0)

Thank you again for the information and the encouragement.  The doctor plans a radical prostectomy through the pelvic floor.  I  got the Walsh book on prostate cancer today.  There is a lot of information.  I think the Doctor explained why he doesn't go through the abdomen.  I hope this is the right choice.  I will take your advice CPA as my husband is also the CEO of a large organization.  He too has a few business trips including a board retreat where I assume he will tell them of the cancer and impending surgery. Thanks again.

Posted 5/9/2009 4:33 AM (GMT 0)
I know only a little about the perineal prostatectomy, but the first urologist I saw did them. He explained that this approach put him closer to the prostate and gave him a much better view of what he was doing. My impression was that this is a more difficult operation to learn but no one thought that it was inferior. If you are comfortable with this doctor, it sounds like a reasonable choice. I finally opted for the robotic operation (and my first urologist agreed that it was as good a choice) but I am an engineer and so am easily seduced by technology.

This a journey -- not one we would choose, but partnership is a positive force -- may the force be with you.
Posted 6/13/2009 8:30 PM (GMT 0)
My husband had his surgery on Thursday.  The doctor said things went well.   He said he was easily able to spare the nerves on one side but the other side was more difficult.  He said you really can't tell about ED for almost a year.  He goes back in a week or so.  They did a multilpe myloma test to rule it out beacause of the lesions on the CAT scan.  The test was negative so that was good news.  In fact I believe the oncologist did a full body scan and said everything looked good.  

My husband came home last night.  He seems restlesss and bored already so don't know how he will do staying home for long. At least this part is behind us and we will hope for good PSA results. 

Posted 6/13/2009 11:58 PM (GMT 0)
I read an interesting statistic the other day. It said that 33% of all men will face prostate cancer at some point in their lives. Of those 33%, only 1 in 35 will sucumb to it. That means the greater majority of us survive this thing! And that's good news!
Posted 6/14/2009 7:51 PM (GMT 0)
Greetings, ddd49.  Congratulations - and welcome to the other side of surgery.  We trust your husband will continue to do well and the catheter will be gone before he knows it. Please keep us posted on how things are going. Let the healing begin.  David
Posted 6/14/2009 9:11 PM (GMT 0)

Hello ddd49,

As someone who just had surgery about 4 weeks ago, the post-op recovery period is still very fresh in my mind.  I think you and your husband will find that his daily tribulations are "old hat" to the veterans in this forum.  For me, as I was going through my post-op (see my diary at "Greg's RALP"), the experiences of others that are available here were invaluable to me insofar as putting my mind at ease, during my journey to "the other side."  And it has been much easier for me to cope, knowing that I can discuss anything and everything here with my new "brothers."  Embarassment does not exist here, and that's a good thing.

Greg

Posted 6/15/2009 4:00 AM (GMT 0)

Hi ddd49,

Your being on this forum means that you care about your husband.  This fact alone will be an important part of his recovery.  Welcome to this side of healing.

DS

Posted 6/17/2009 12:35 AM (GMT 0)
Thanks for your kind comments.  We are now 5 days past the perineal prostatectomy.  His stitches, actually staples, are healing nicely.  But twice today once when he bent over in the shower quite a bit of clotted dark blood came out through the incision.  It happen again tonight when to bent over to put on his pants but unfortuately he was on the white carpet, not in the shower.   I think it is good to get it out but I am concerned that this might be unusual.  He goes back to the doctor Thursday morning.  Has any one else had  pelvic floor surgery and had this problem?  He doesn't seem worried.

Thanks,

Jeannie

Posted 6/18/2009 1:25 PM (GMT 0)
My husband had his catheter removed today and recieved the pathology report.  I asked him to let me be in there if thye had the report but he said the Doctor said no I could come in next time.  I have to say they did not make me very happy.  But the pathology report reads as follows.

Bilateral moderately differentiated adenocarcinoma ( Gleason Grades 3 + 4 = 7)

Largest measurable dimension of carcinoma on the slide is 2.1 cm. Carcinoma involves approimately 50% of the total volum of the gland.

Peripheral posterior lateral margins involved with carcinoma.

Apex and base margins are  free of neoplasia.

Seminal vesicles, no neoplasia identified.

Comment

Tumor extends to the margin, therefore the possibility of extracapsular extension cannot be excluded.  This is at least a stage T2bNX.

Gross description

Received labeled "prostate" is a prostatectomy specimen ( 19gm, 4.8 x 3.5 x 2.9 cm) with detached bilateral seminal vesicles (2.2 x 2.1 x 1.5 cm) and (3.2 x 2.7 x 1.5 cm).  Seminal vesicles are not identified grossly. The anterior/posterior orientation is identifiable using anatomical landmarks.  The bladder neck margins and apical margin are not identifiable in the state of the specimen received. The parenchyma is rubbery, tan to tan-yellow with no discrete lesion.  The seminal vesicles are off white and translucent with adjacent areas of dense fibrous tissue.

Microscopic Description

Sections reveal prostate adencarcinoma.  The Gleason grades are 3 + 4 = 7.  Multifocal perineural invasion is present.  Several sections show the peripheral margin involved with neoplasia.  No extracapsular invasion is identified. The largest measurable dimension of invasive tumor from the slide is 2.1 cm.  Carcinoma is seen in every coronal section of the prostate and involves approximately 50% of the volume of the gland.  No tumor is seen in the seminal vesicles.

END OF REPORT

Since the Doctor would not let me in to discuss the report  I am hoping someone here can explain to me what this mean.  Are the chances for a cure fair,  good, or worse.  What does the nx in the stage mean.  Any further information would be helpful

 Thanks,

Jeannie

Posted 6/18/2009 3:47 PM (GMT 0)
I think it is a shame that the doctor would not let you in to discuss the report.  Maybe time for a new doctor.  I believe that NX means that the associated lymph nodes were not assessed.
Posted 6/18/2009 6:24 PM (GMT 0)
Thanks for your reply riverbend.  I am most worried about the statement "Several sections show the peripheral margin involved with neoplasia."   Is that the same as positive margins or is it PIN?  What significance does this have in organ confined disease?  Any help appreciated.
Posted 6/18/2009 6:47 PM (GMT 0)

Neoplasm is an abnormal mass of tissue as a result of neoplasia. Neoplasia (new growth in Greek) is the abnormal proliferation of cells. The growth of this clone of cells exceeds, and is uncoordinated with, that of the normal tissues around it. It usually causes a lump or tumor. Neoplasms may be benign, pre-malignant or malignant.  (from Wikipedia)

So my guess would be that your husband will be watching the future PSA tests very carefully....any indication of rising PSA and you could be considering radiation....

Posted 7/30/2009 4:17 PM (GMT 0)
My husband got his first PSA results  .007  so that was good news.
Posted 7/30/2009 4:29 PM (GMT 0)
ddd49, that is wonderful news, that is one major Zero, congrats
Posted 7/30/2009 6:18 PM (GMT 0)
Really good news. He now qualifies for the Zero Club, if he's interested. The de facto (maybe even self-appointed) president should be around shortly. smilewinkgrin
Posted 7/30/2009 8:14 PM (GMT 0)
Great news ddd49. Here is hoping that this is just the first of a many many long string of Zeros down the road. How is he doing with the recovery up till now? It's still a long journey ahead and at times it can cause some men to become a little discouraged. So if he has questions or doubts we are here.

Take care.
Posted 7/31/2009 6:30 PM (GMT 0)
Great news.  Welcome to the zero club.  We trust this will be the first of a long, long string of zero's in both of your futures.  David

Posted 8/1/2009 2:44 AM (GMT 0)
ddd49,  we celebrate your husband's zero.

I hope the healing is going well.

Dan

Posted 2/17/2010 1:21 AM (GMT 0)
Another good PSA report of .016.  Of course looking back and seeing it was .007 last time does cause me some worry.  But the doctor seemed [pleased. Thanks for all you comments.
Posted 2/17/2010 1:39 AM (GMT 0)
a .016 is such a solid zero in the bigger scheme of things, you are doing very very well, wouldnt even be concerned with a reading that goes 3 decimal places to the right. a zero is a zero. congrats

david in sc
Posted 2/17/2010 1:52 AM (GMT 0)
Thanks!

Purgatory said...
a .016 is such a solid zero in the bigger scheme of things, you are doing very very well, wouldnt even be concerned with a reading that goes 3 decimal places to the right. a zero is a zero. congrats

david in sc

Posted 2/17/2010 1:56 AM (GMT 0)
ddd49 Yes Zero club it is...Very Happy for you guys.

Jeff T
Cajun Country
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