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Path report back but i'm confused

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Posted 3/10/2011 2:45 PM (GMT 0)
My post op pathology report is back however I have not discussed with the Dr. yet.  But the results showed Gleason 6, no seminal invasion but small amount spread outside of organ.  Typically what is next when this stuff spreads a little?  I'm thinking a little radiation treatment to the area.  Have others experienced this?

Typically is this curable? 

I'm more worried than ever...

 

Posted 3/10/2011 2:56 PM (GMT 0)
Viper:

Beforeyou flip out, what was the final Staging listed as in your report, that is most important to know, i.e., mine was T2C, what does yours say?
Posted 3/10/2011 3:04 PM (GMT 0)
Viper yours sounds just like mine but I had a Gleason score of 7. But I did not know what my final staging was neither.So I'm not sure what's in store for me either. My next visit is the 23rdwhen I will get my first post -op PSA count. I to am a little nervous about the whole deal.
Posted 3/10/2011 3:40 PM (GMT 0)
i did not see the final results regarding the stage.  unfortunately i have to live with the unknown for another week (my next appt).  You get all these visions of this crap spreading all over the place and taking your life away little by little.  Gleason still being post op 6 isn't too bad with no seminal invation could be worse.  I guess i'll just wait. 

darn the stress 

Posted 3/10/2011 3:42 PM (GMT 0)
If this cancer crap doesn't kill you anxiety will.
Posted 3/10/2011 3:50 PM (GMT 0)
Does the pathology report say anything about the surgical margin?  They might have found a small amount outside the organ, as it says, but still inside the surgical margin.  The surgeons remove a bit outside of the organ to make sure they get everything, even if a few cells were outside, so if your surgical margins are negative, that's a very good result.
Posted 3/10/2011 3:56 PM (GMT 0)
Viper - ask the physician for a copy of your biopsy pathology report and the surgical pathology report.

It helps to have this stuff in your possession. When you are in the doctor's office talking it is easy to forget what you are told.
Posted 3/10/2011 4:04 PM (GMT 0)
Viper:

Like most of us, your report will probably have some good and some areas of concern. The G3+3 is extremely good. Very few folks die from G 3+3.

I really doubt if radiation is in your immediat future. I had a G 4+3 with ECP AND a focally positive margin and immediate radiation was still a gray area.

Can't they just email you the report? They did for me so I have a printed and electronic copy. Call them. Maybe they will do it and you will have it right away!

Mel

Posted 3/10/2011 5:28 PM (GMT 0)
I've have one of those doctors that is highly skilled but is difficult to deal with. He will not talk with me about anything until next Thursday. I just hate to have anxiety out the roof until then. I'll see if the nurse will email me a copy.
Posted 3/10/2011 5:32 PM (GMT 0)
Viper, you have rights, to have a copy of this report as soon as its available.. Your doctor may want you to wait until you see him, but its your report. As someone else said, I would have it faxed or emailed to you, or pick it up in person if you are close enough to do that.

David
Posted 3/13/2011 6:57 PM (GMT 0)
Viper - Yes. My pathology indicated 'extraprostatic extension', but seminal vessels and lymph nodes clear. As others have stated, you need the post-surgery pathology report in your hands even if the Uro Doc explains it, so you can see exactly where you're at. This should also give you a more accurate Gleason score. Mine actually increased...but I was a nasty Gleason 9 post-surgery. I am one week into Adjuvant Radiation - Calypso IMRT. With you're current Gleason score (I assume post surgery Gleason 6), you have alot going for you. Adjunct Radiation cannot start until 8 weeks after RP if this is even your course of action. I would get the pathology report ASAP, but get through your surgical recovery and concentrate on healing. regards, <bobr>
-----------------------------
Age: 54
Routine Physical on 10-20-2010 DRE Normal
PSA 4.3, up from 0.6 5 years prior
PSA 0.6 on 10-25-2005
PSA 0.4 on 7-30-2004
PSA 0.5 on 5-9-2002
Followup with Urologist on 11/10/2010 after elevated PSA; DRE noted slight bump
November 30th, 2010 had prostate biopsy.
December 9th, 2010, Biopsy results 3 of 12 cores positive.
LLB: Gleason's 4+3=7, 11 MM Tumor Length/15MM Core Length (73%)
LLM: Gleason's 4+4=8, 12 MM Tumor Length/15MM Core Length (75%)
LM: 0.1 MM Tumor Length (1%)0.1 MM Tumor Length
RALP Surgery 12/27/2010 Released: 12/30/2010
Thunderbird Banner Hospital, Glendale, AZ
Post-Surgery Pathology: GS 4+5=9
Pathologic Staging: pT3a, N0, MX; location: Left Side; Volume: 10%
Margins: Left posterior inked margin focally involved
Extraprostatic Extension: Observed
Seminal vesicles: Not observed
Lymphatic/Vascular Invasion: Not observed
Catheter: Removed 15-days after surgery

Post-OP Followup on 1/11/2011; Catheter/Staples removed
Adjuvant IMRT 8 Weeks Post-OP.
No exercise for 4 Weeks Post-OP.

Radiation Oncologist Initial Consultation on 1/18/2011
Arizona Prostate Cancer Center

Calypso Procedure on 2/17/2011; PSA <0.1; Bone Scan Clear
341 Testosterone

CT Simulation on 2/24/2011.
Calypso IMRT started on 3/8/2011 - 40 Treatments.
Posted 3/13/2011 7:35 PM (GMT 0)
Viperguy - I agree with others, you need to get a copy of the report.

With a G6 your odds for successful cure are still very good even if there is a little extracapsular extension. See for yourself, go the to SMKCC nomogram page and plug in your own data. Adjuvant radiation is possible, you will know more when you get to talk to the doc and you can always get another opinion(s). But most important, calm yourself; your odds are still good.
Posted 3/14/2011 12:35 PM (GMT 0)
Thanks for the fantastic information. My appointment witht he doc is this Thursday (03/17/11) and I will get a copy of my pathology at that time. Seems like the Post Op Gleason 6 is probably the best thing I have going for me at this time. I keep having these horrible visions of laying there dieing a way from this crap as it spreads throughout the organs of the body. I know it sounds stupid but I can't help thinking of the worse case. I had so many bad experiences in the past month (my friend dieing in the car while taking him for his blood transfusions, and this cancer stuff etc.)

Will post results when received.
Posted 3/14/2011 1:19 PM (GMT 0)

Hi Brampy,

How is your Adjuvant Radiation going?  How many treatments are you scheduled?  Any side affects?

 

brampy said...
Viper - Yes. My pathology indicated 'extraprostatic extension', but seminal vessels and lymph nodes clear. As others have stated, you need the post-surgery pathology report in your hands even if the Uro Doc explains it, so you can see exactly where you're at. This should also give you a more accurate Gleason score. Mine actually increased...but I was a nasty Gleason 9 post-surgery. I am one week into Adjuvant Radiation - Calypso IMRT. With you're current Gleason score (I assume post surgery Gleason 6), you have alot going for you. Adjunct Radiation cannot start until 8 weeks after RP if this is even your course of action. I would get the pathology report ASAP, but get through your surgical recovery and concentrate on healing. regards, <bobr>
-----------------------------
Age: 54
Routine Physical on 10-20-2010 DRE Normal
PSA 4.3, up from 0.6 5 years prior
PSA 0.6 on 10-25-2005
PSA 0.4 on 7-30-2004
PSA 0.5 on 5-9-2002
Followup with Urologist on 11/10/2010 after elevated PSA; DRE noted slight bump
November 30th, 2010 had prostate biopsy.
December 9th, 2010, Biopsy results 3 of 12 cores positive.
LLB: Gleason's 4+3=7, 11 MM Tumor Length/15MM Core Length (73%)
LLM: Gleason's 4+4=8, 12 MM Tumor Length/15MM Core Length (75%)
LM: 0.1 MM Tumor Length (1%)0.1 MM Tumor Length
RALP Surgery 12/27/2010 Released: 12/30/2010
Thunderbird Banner Hospital, Glendale, AZ
Post-Surgery Pathology: GS 4+5=9
Pathologic Staging: pT3a, N0, MX; location: Left Side; Volume: 10%
Margins: Left posterior inked margin focally involved
Extraprostatic Extension: Observed
Seminal vesicles: Not observed
Lymphatic/Vascular Invasion: Not observed
Catheter: Removed 15-days after surgery

Post-OP Followup on 1/11/2011; Catheter/Staples removed
Adjuvant IMRT 8 Weeks Post-OP.
No exercise for 4 Weeks Post-OP.

Radiation Oncologist Initial Consultation on 1/18/2011
Arizona Prostate Cancer Center

Calypso Procedure on 2/17/2011; PSA <0.1; Bone Scan Clear
341 Testosterone

CT Simulation on 2/24/2011.
Calypso IMRT started on 3/8/2011 - 40 Treatments.

Posted 3/14/2011 2:15 PM (GMT 0)
I have a total of 40 treatments on a daily (weekday) basis. So far, I've had 4...36 to go. No side effects so far. I ran a 17k race this weekend. Worse part of this deal is getting the calypso gps markers put in my prostate bed. A little worse than a biopsy, but its only 3 of these. regards, <bobr>
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