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Posted 9/8/2011 9:28 PM (GMT 0)
Just want to give some of you some hope regarding positive margins.... I am undetectable 3 1/2 years out using a regular PSA lab test. I was a G-6, unilateral, but minor in the one lobe post surgery. I know post surgery the last thing you want to hear is the "positive margin".......... Any others have comments ????
Posted 9/9/2011 1:00 AM (GMT 0)
i also was g6 with positive margin. had rp in 2009 and completed radiation about a year ago. psa has been "undetectable" since. Thank GOD! your post is very encouraging as i still get the feeling of waiting for the other boot to drop every time i get tested. thanks.
Posted 9/9/2011 1:35 AM (GMT 0)
tigre-sorry about the anxiety - here's to a lifetime of zero's for you -

woodstock -congrats and thanks for the zero club announcement - here's to a continuing lifetime of zero's for you as well.

positive margins can be scary and it is good to hear of good news.

all the best,
Bronson
Posted 9/9/2011 1:36 AM (GMT 0)
woodstock, the most important and glowing thing, is that you are 3 1/2 years out pulling a zero. As far as the positive margin factor goes, it seems to work one of two ways most of the time. It's either hanging in the air the whole time, i.e. your journey, or else it has a negative effect fairly quickly. I, unfortunately, with one tiny positive margin, experience BCR within 9 months of surgery. I am glad for your sake, that your positive margin hasn't been a "negative" for you, and sincerely hope it stays that way for years to come.

david in sc
Posted 9/9/2011 2:49 AM (GMT 0)
I am 10 months post-RP, a G7 with positive margins. PSA is undetectable so far. It's good to hear that guys who are further along are doing fine.

Guys who get a pathology report that isn't everything they'd hoped for should absolutely not freak out. A positive margin doesn't necessarily mean recurrence.
Posted 9/9/2011 6:01 AM (GMT 0)
Great news Woodstock. Here's to a lifetime of zeros!
Posted 9/9/2011 1:32 PM (GMT 0)
Congratulations, Woodstock.  I hope you continue to have good reports.

I know when my pathology report came back, I had mixed news: a drop in the gleason score to 6 instead of 7 but with positive margins.  I had hoped I would be able to put this "life episode" behind me, but such is not the case.  Plugging my numbers into the Sloan-Kettering Nomogram for post-surgery recurrence suggests a high-probability of non-recurrence, but the thought of it is always there.

Posted 9/9/2011 1:36 PM (GMT 0)
I had negative margins but my PSA crept up a bit. So far it's remained stable but when I met with the radiation oncologist he showed me a nomogram for my chances if I needed SRT. I was happy about having negative margins until I saw the nomogram that showed my chances with SRT were worst with negative instead of positive margins. The theory is that if PSA comes back, positive margins may be the source, indicating that the recurrence remains local. With negative margins, you never know. I really hate this &(&^ disease.
Posted 9/9/2011 1:54 PM (GMT 0)
Wondering if "TIGRE" had a recurrence that led to radiation.... Did'nt say in your post above ???? As far as "SLOAN's" nomograms, they are so high in their percentages in everyone favor. I tend to not totally agree with them, although they do give us confidence and they know more about this than me.
Posted 9/9/2011 1:55 PM (GMT 0)
Congrats Woodstock! I fall into the "positive margins" group too. First PSA near the end of this month. Comforting to hear about good results.
Posted 9/9/2011 2:58 PM (GMT 0)
What is a positive margin? Alsowhy the 1 is PSA O.O1 a zero,I know it is good but does this mean a trace still exsist?I am 3 months post surgery,ed,trying pump but slow,1 to two pads a day,depending on activity!
gamms
Posted 9/9/2011 8:22 PM (GMT 0)
Positive Margins means that there are cancer cells at the edge of tissue that has been removed.    This can only be seen under the microscope, after the surgery.  Positive margins occur about 25-35%  of the time after non-nerve sparing radical prostatectomies and 35-45% of the time in nerve sparing radical prostatectomies.     Positive margins mean the chance of the cancer recurring in the surgical area is significantly greater than if the margins are negative.

An undetectable PSA is PSA 0.2 ng/ml or lower, which essentially means a “zero” PSA. PSA 0.2 ng/ml means undetectable because PSA tests are unreliable below 0.2 ng/ml.  Johns Hopkins defines it as less than 0.2 ng/ml.  The Prostate Cancer Research Institute (PCRI) defines it as "a PSA of <0.05 using a hypersensitive assay such as DPC Immulite 3rd generation PSA or Tosoh assay."  From a strict technical point of view, an "undetectable" reading is one where the equipment failed to detect the marker sought, PSA in this case.
Posted 9/9/2011 8:45 PM (GMT 0)
Move over boys cause here come another one. Welcome to the Zero Club!
Posted 9/9/2011 9:37 PM (GMT 0)
HD,

Not sure where you got the idea that .2was undetectable, but I would take exception to that.

Most assays can detect PSA levels down to .01 quite accurately. For 27 months I have tracked my PSA, and watched it track from <.01 to .03 and back to .02. The testing report clearly states that a PSA over .05 is considered abnormal.

It is true that many doctors do not begin treatment until .2, or even .5, but I believe it is incorrect to say that it is undetectable.

But hey, I'm an electrician, what do I know ?

Goodlife
Posted 9/9/2011 10:10 PM (GMT 0)
You could probably say any number (0.01) would be detectable... I, and my doctor chose the standard psa test to avoid getting to wrapped up in determining if it was back or not... We would'nt do anything till 0.2 anyway... Tell me i'm undetectable and my quality of life is great for another 6 months.... Everyone is different though and we all have different path results.
Whatever we chose is based on our own feeling... Glad to hear from some positive margins guys and see they wait some time for results to come through.... Think in years past the rush to radiation was higher..
Posted 9/9/2011 10:52 PM (GMT 0)
I had positive margins, but my surgeon said they were so small not to worry about them. Had my last PSA done on Aug 24. Still less than .1. Undetectable. That is now 22 months since surgery.
Posted 9/10/2011 12:21 AM (GMT 0)

goodlife said...
HD,

Not sure where you got the idea that .2was undetectable, but I would take exception to that.

Most assays can detect PSA levels down to .01 quite accurately. For 27 months I have tracked my PSA, and watched it track from <.01 to .03 and back to .02. The testing report clearly states that a PSA over .05 is considered abnormal.

It is true that many doctors do not begin treatment until .2, or even .5, but I believe it is incorrect to say that it is undetectable.

But hey, I'm an electrician, what do I know ?

Goodlife

Goodlife - I stand corrected.  The most widely recognized Clinical Standard for "undetectable" PSA remains at LESS THAN 0.1 ng/ml which is reported as < 0.1 ng/ml on the Standard PSA assay (1 decimal point), which reports results to the tenth of a nonogram.

Posted 10/3/2012 1:16 PM (GMT 0)
woodstock, sorry for taking so long to reply. i'm not sure if "reccurence" is appropriate for my case. "persistance" has also been used by docs. my first  psa post surgery was 0.02. per uro. this indicates cancer still was likely present. two months later, psa was 0.05. uro. said this confirmed cancer still present and scheduled radiation.
Posted 10/3/2012 1:39 PM (GMT 0)
Tigre,

That low of PSA could be an indication of benign prostate growth. When you have positive margins, there's only about a 50% chance that the cells left behind are even viable (according to Epstein). Some of the cells left behind can also be normal prostate cells, and these can produce PSA.

In one article I read, a PSA > .03 seemed to be the threshold for considering PSA to be generated by cancer cells.

Likely, your radiation oncologist already explained all this to you.

Best wishes,
Nellie
Posted 10/3/2012 4:01 PM (GMT 0)
I'm also a G6 with a positive margin. Had RP about 6 years ago and IMRT 5 months later. Maybe jumped the gun on having radiation (PSA was creeping up ever so slightly) but I've been 0.02 for the last 4 years so I have no regrets.
Posted 10/3/2012 4:49 PM (GMT 0)
Woodstock,
Congradulations. With a G6 positive margins are not as big a deal as a G8 or a G9. G6 cancer rarely matastize as the body's imune system takes care of the stray cells. This is not the case with more aggressive cancers where positive margins should be treated with radiation for the most effective chance at a cure.
Posted 10/3/2012 6:40 PM (GMT 0)
How did this old thread get resurrected? A year has passed and it's strange to see my old posts. Coming from someone still very scared and knowing comparatively little.

I'm still scared. I hope you folks are right in that my gleason 6 / PSA .03 will remain in check.

My next PSA blood draw is next week.
Posted 10/3/2012 7:59 PM (GMT 0)

Congrats,

I'm a G-7 with a positive margin also. Just got the card from the Doc's office that its time for my year 3 PSA Check on OCT 25 so I'm hoping you have lead the way and I will have a 0 also.

lewvino

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