6 Week PSA Test and Pathology Results from Vanderbilt

Hello,

I just got back from my Friday Appointment at Vanderbilt University (6 weeks post op).  I had my 1st PSA test done and it was less than .1 ng/ml.  (Undetectable).  The surgeon went over the pathology report and I got a copy.

In Summary:

Gleason score raised to 7 (3+4) versus 6 (3+3) at biopsy;

30 percent of the gland was cancer;

Extrapropstatic Extension: None Identified

Seminal Vessel Involvement: None Identified

Margins Uninvolved (Negative)

The only thing that concerned me on the report was the fact that Perineural Invasion was present.  (Is that a major cause for concern when everything else seemed very good?) I did not get a chance to ask my surgeon.  He just told me to have the PSA tested every 3 - 6 months going forward.  As long as it remains undetectable then no action required.

If anyone has any info on the Perineural Invasion issue please provide.  Happy with 1st test and proud to be part of the zero club.

Thanks

Congratulations on being in the zero club. From what I was told, all post prostatectomy pathology shows PNI. It means nothing as far as prognosis. Go out and celebrate!

That is a really great report. Congrats!

-Gedman

Thanks Everyone.  I spent several months educating myself before deciding on the best treatment plan for myself.  I met with several surgeons and radiation specialists and finally decided on surgery at Vanderbilt.  I really liked Dr. Smith at Vanderbilt and he is very experienced with robotic prostate surgery as he has done over 1,500 of them.  I have minimal incontinence and sexual function is coming back gradually. 

I am glad that my pathology report was so good and that my 1st PSA reading is undetectable.  My surgeon said that the Gleason 7 cancer I had would have eventually escaped from the prostate had I not gotten treatment when I did.

Of course I will still monitor my PSA's going forward but it looks as though I am off to a good start.

Thanks again for everyone on this board that educated me when I was 1st diagnosed.  I have learned so much and seem to know the prostate cancer lingo now. 

Hopefully I can now help others as they start their journey and let every man I know to get their PSA levels tested.

Thanks

Congrats to you ! Great report. As mentioned, GO CELEBRATE !!


Don

Great report!

Congratulations.

Andrew

Sounds like things worked for you. The upgrade of Gleason is more common than we'd like to see, but the source is the whole gland, not just those minimal biopsy samples from limited sites.

PNI seems common, but not as ominous as it seems. I had it, but also had multiple EPEs and positive margins, so I'll blame those for my issues.

Minimal incontinence and returning function? That's great news!!

kdeinv
Great results. This is one time in your life when you want to be called a ZERO.
Best of luck in the future.
RickyD

Hello Everyone,

Have not been on for a while but I have my 1st 6 month PSA test results tomorrow. Hopefully the PSA is still undetectable.

The surgeon at Vandy was very optimistic that I would not have any recurrence but nothing is guaranteed.

I guess since this is the 1st one since my 6 week post op PSA I am a little anxious about this one.

Thanks to everyone on this board for the education I received when 1st diagnosed.