Positive margin

No, wait and see what the pathology says. Mine was also apical and had a positive margin, "into the orange peel but not through it" as my Rad Doc said. Might mean some rad later on after surgery heals up.

What matters most regarding recurrance is the Gleason score at the margin.  I've been quoted a study from JHU where only 1 out of ~800 Gleason 6 + margins recurred. If you have any post operative concerns about your pathology get a second opinion.  In total my slides were reviewed by 4 Doctors.  Two of them (including a relative of mine) did not even call my margins positive. 

Welcome to HW!

I also agree that you need to wait until after the surgery to be concerned about positive margins. Believe me, I worried enough after I got my path report and saw that I had a positive margin. My head was spinning thinking about additional radiation treatments, how long to wait, etc.
So far, 7 months later, I have had no signs of trouble, yet.

Be more concerned about this week coming up. Good luck to you and your husband. We are all here for you and hope you tell us how he made it through the surgery.

Bill

Hi,

If it helps to know this, I was also a G6 and had a small tumor near the apex. After my DaVinci, my doctor visited my hospital room the next morning & said everything went well. He also noted that the initial post-op pathology looked very good. He added that there was a small positive margin (at the apex).

When I asked if this meant the cancer had spread, he said no. He said that they have found that any PM that is .5 cm, or smaller, virtually never causes any problem. And he noted that mine was only a .3 cm. Turns out that the final pathology report said it was only .2 cm.

He said that no further treatment was needed and that I should consider myself cured. I have to admit that I was very relieved to hear that.

My first two post-op PSAs were both zero and the doctor says I only need to return once a year for annual PSA tests. When I saw him last, in September, he said that ALL the "numbers" are in my favor for never having any recurrence due to that PM.

As with anything, the skill of the surgeon is very important. Please tell him to be sure that his surgeon has performed a minimum of 300 surgeries so as to be beyond the learning curve.

Wishing your husband the very best! I'm sure he will be just fine.
Chuck

Resident of Highland, Indiana just outside of Chicago, IL.
July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA Sept. 2011 was 5.7.
Local urologist DRE revealed significant BPH, but no lumps.
PCa Dx Aug. 2011 at age of 61.
Biopsy revealed adenocarcinoma in 3 of 20 cores (one 5%, two 20%). T2C.
Gleason score 3+3=6.
CT of abdomen, bone scan both negative.
DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
My surgeon was Dr. Matthew Tollefson, who I highly recommend.
Final pathology shows tumor confined to prostate.
5 lymph nodes, seminal vesicles, extraprostatic soft tissue all negative.
1.0 x 0.6 x 0.6 cm mass involving right posterior inferior,
right posterior apex & left mid posterior prostate.
Right posterior apex margin involved by tumor over a 0.2 cm length, doctor says this is insignificant.
Prostate 98.3 grams, tumor 2 grams. Prostate size 5.0 x 4.7 x 4.5 cm.
Catheter out in 7 days. No incontinence, occasional minor dripping.
Post-op exams 2/13/12, 9/10/12, PSA <0.1.
Semi-firm erections now happening 14 months post-op & slowly getting a bit stronger.