Just received pathology report from surgery

Usually the bone scan is done with the original diagnosis, not sure why they did not do that then and should certainly be done now to see if it has progressed passed the positive margins.

Happy Holidays to you and your hubby !!!

Hi I was always told that g=6 with at least one positive margin the chance of cure are very good.good luck.

First thing you should do is talk to your doctor for his recommendation on the next steps to take. IMO you have time to wait for your first couple of PSA tests to indicated it any of the PC has was left behind. G6 is not as aggressive as G7 or higher but your doctors may recommend some  RT to clean out the prostate bed and get any of the PC cells that may have been left behind. You should also talk to a good prostate radiation oncologist for consultation.  Good luck to you and your husband.

Terry TWG

I, like your husband, had a gleason 6 with a focally positive margin, meaning it the was smaller then 3 mm. As Alf suggested get the pathology report and go over it with his doctor.

My surgeon and my oncologist strongly suggested that I have adjuvant radiation and for a while my PSA crept up from 0.01 to 0.04 but has settled down to 0.02 the past few years. But understand that five years ago doctors were much more aggressive than they are now, there was a lot of over treatment occurring back then.

Even after that three month PSA the surgeon may suggest waiting and if there is an uptick in PSA do RT then. It would be helpful to know what his pre-surgery PSA was. Normally us gleason 6 guys have the odds in our favor.

Enjoy the holidays.

Ken

Hey HD Rider, chill man. the <0.01 and the 0.01 are I suspect the same figure in reality - known as "undetectable". Even 0.02 on some lab measurements is put down to "background noise" in the testing and can be regarded as fine. We are all jittery when the latest set of PSA results come around even if 5 years of zeros is called to be "in remission". You never can tell with this cancer as it contradicts experience.

Tarhoosier is right imo, even before treatment, his statement is true. more medicare bucks down the drain. That tells me you have a conscientious doctor. Check out walshes book positive margin , you will like what you read. Also the best news there is it is a post op 6. You know, the prostate is very snug and warm for those gl6 cells, its cold and nasty outside,{ not literally, lets say its hostile out side }, and "usually " will not survive in that environ ment. Not so for the for the the more aggressive cells, which you do not have. Please read up on dis ease, if you haven't, it will really really help any anxiety in your situation and empower you so you need not cringe with all that others say, myself included and includes a lot of doctors. When a Doc says 50/50, imo, he really doesn't want to commit. He knows about gl6 cells. and could have told you same as I did on Gl6. I understand why he did,t in a sue happy society. Odds are better than that, imo. Morbidity { death } for gleason 6 is about < than 1 %. Google MSK nomograms, read , follow links, again you will like what you read. Some pooh, pooh them as to optimistic. MSK is a leading PCA medical center. They feel that way imo, cause when you are on forums all the time, you mostly see people that are having problems. They dont have forums for the vast majority of "cured". Why would they? Be happy, if he hangs with us as a volunteer, for give help,{ pidgin english}, he will probably have to change tag to great grandpa tim and then some. Be optimistic, your stats are worthy of optimism. No smoke! Aloha Logo

HD,

My doctors were being aggressive because of the positive margin. My PSA 6 weeks after surgery was 0.01 before it rose they ordered a cat-scan and discovered a tumor on my kidney (unrelated to PCa).

That set back the radiation a few months while I healed from that surgery. In the mean time my PSA went up to 0.02 and right after radiation to 0.04, down to 0.03 for a couple of years and now 0.02 the past 2 years.

As Kickinthebutt mentioned your PSA is "undetectable" and numbers around 0.01, 0.02 and even 0.03 are just noise. I, most likely, was over treated but I'll never know. Your docs will probably suggest just keeping an eye on it and if it starts to rise and is approaching say 0.1 then do something about it.

We will speak with doctor on January 6th concerning this pathology report. Trying to be positive but do not understand why it was not suggested that we see another doctor for radiation. Also, need to have the
pathology report explained a bit more. Take care everyone - prayers are with each of you.

Nice post Octorobo, that advice is spot on IMO, Aloha, Logo

A huge thank you to all those positive replies. I am here again this morn at computer trying to determine if we are doing the right thing. I neglected to post PSA. Oct 06 it was 2.2, Feb 09 2.6, Apr 2011 it was 3.2, July 2011: 3.6,
the doc could not understand why in Aug 2011 it jumped to 6.6 - most likely inflammation. I tried to post pathology report info but cannot find here so here goes:
32 grams, gleason 6
portion of prostate involved by tumor approx 30%
greatest dimension of dominant nodule 1.5 cm
Margins: involved by invasive carcinoma, multifocal, apical and left anterior
perineural invasion: present
staging:
Primary Turor: pT2c+ (Bilateral disease confined to prostate but present at margin

We had to wait 3 months before surgery because of ecoli infection in blood (sepsis) immediately after biopsy end of August, then again ecoli infection in urine (both requiring hospitalization) and 6 weeks of IV antiobiotic at home because of allery to sulfur drugs. Doctor does not believe that this wait was crucial to margin being positive.

I am sorry to post such a long exclamation but just wanted to give info that we possess. Thank you again for all the support - everyone have a lovely Christmas and a safe journey on visits over the holiday.

G.P. Tim's wife (Carol)