icemanldg said...
Is it possible to have positive margins but the PSA is undetectable? I get my pathology report tomorrow and the surgeon has already stated that I was a good candidate for positive margins. Has anyone had positive margins but PSA levels stayed undetectable.
What was your Gleason score after the surgery?
As one of us noted, the Gleason score can have a bearing on recurrence with positive margins. I did have one very small positive margin, but my Gleason score was a 6, which is low risk. At 2 years out my PSA is still zero and I've only needed annual PSA tests since the completion of my first year, post-op.
It is also believed by many doctors that Gleason 6 prostate cancer cells cannot survive outside of the prostate and quickly die if they get out.
Johns Hopkins did a survey a number of years ago that involved 17,000 Gleason 6 patients who underwent RP. The study was to see how many had cancer that had spread to other parts of the body. The number was ZERO.
I don't recall if the study involved mets at the time of the surgery or down the road after the surgery, but it still bodes well for the prognosis of Gleason 6 patients.
Good luck to you!
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.
Pathology showed Gleason 3 + 3, pT2c, N0, MX, R1
adenocarcinoma of the prostate.
Prostate 98.3 grams, tumor 2 grams. Prostate size 5.0 x 4.7 x 4.5 cm.
Abdominal drain removed the morning after surgery.
Catheter out in 7 days. No incontinence, occasional minor dripping.
Post-op exams 2/13/12, 9/10/12, 9/9/13 PSA <0.1. PSA tests now annual.
Semi-firm to firm erections now happening 2 years post-op.