Was your pathology report after RP , RALP upgraded, downgraded or stayed the same

Upgraded from 3+4 to 4+3........Glad I made the decision to remove it.

Feeling almost 100% after 3 months since surgery. Dry and ED is a work in progress.

Berk

Gleason stayed the same but Positive margin gleason was 7 vs 9 and I have EPE and SVI.
Bob
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DOB January 1944
1981: prostatitis
2000-2013 BPH treated with finasteride & tamsulosin; low T treated with androgel
PSA History:
Pre 2009 0.4-.6
11/2011 2.2
8/2012 2.7
2/2103 5.5
4/2013 6.1
5/2013 6.6
11/2013 0.1
1/2014 0.2

6/2013 Bx:PCa Gleason 4+4=8 (Bostwick), 4+5= 9(Johns Hopkins), 2/6 cores, 10%, 40%, DRE neg. (Stage PT1c)
7/2013 bone scan and pelvic MRI negative
9/7/13 open RRP, Johns Hopkins, Ted Schaeffer MD PhD.
9/9/13 Pathology: 33G, both nerves spared, SVI, EPE and 4mm pos. margin at base (Gl7), Stage PT3bN0M0)
9/20/13 Foley and staples removed
Continence: one pad per day for 13 weeks, now none. ED pre and post op.
Watchful waiting until next PSA May 1, 2014

From 3+4 on two cores, and one core 3+3 and no PNI on biopsy to pathology: single teeny tiny tumor and a G6 no spread...still don't quite understand it all. I guess G7's are on the fence and their cancers can really go either way from what I read.

BTW, I saw someone post their staging went from T1c to T2a... My understanding is post op you can NOT be anything but a 2 at the very lowest.

I was 3+4=7 at pre-op and that was adjusted down to 3+3=6 post-op. I definitely don't feel cheated.

turpT1a said...
Inchoation,

You are mostly right about the post op staging. The one exception is the stage pT0, which occurs when no residual cancer is found. As we discussed before, you would be kicking yourself a lot more if your Gleason 7 turned into a Gleason 0.

I find it interesting how we deal with life psychologically. Consider two cases:
1. a clinical pre-operative G6 followed by a G7 after surgery
2. a clinical pre-operative G7 followed by a G6 after surgery

Anybody in his right mind would prefer to be in case 2. However, the person in case 1 feels that he dodged a bullet by undergoing the surgery, while the person in case 2 feels cheated.

I'm the rare guy who can find the one cowpie in the beautiful meadow. Had I been case 1, I would be horrified. I'd be thinking that all the while I thought I had some benign cancer but wanted it out because of the word "cancer". In having it out, I would be terrified that the fact it was a 7 and worse than feared meant a much higher probability of micrometastasis.

It's ironic you posted those two scenarios. I struggle with which way to feel about the whole ordeal. Should I just be thankful that I went from 7 to 6 believing I'm done with all of this, or should I feel cheated I was unable to choose AS due to the 7? I battle that from time to time but most of the time I'm on the side that is thankful I was "better than expected". I realize it could be far worse, it always can be, but as a guy who strives for perfection in most things, but is trying to recover from that sickness, nothing will ever be good enough.

Mine went from G7 (3+4) to G6 (3+3).

I "improved" my score from 4+5 from biopsy to 5+4 after surgery. Still a perfect 9.