Help understanding fathers discharge summary

Hello Anthony,

If I understand things correctly it sounds like he had a modest upgrade in his risk category after surgery as opposed to what his biopsy showed. It sounds like he did well with the surgery but his doctors will, at the very least, want to watch him closely, and depending on how aggressive your father and his doctors wish to be, they may simply monitor his PSA or they may plan for additional treatments (radiation) to reduce the chances of a recurrence.

I assume, by the way that you meant to type Gleason 7(3+4) since Gleason 7(3+7) doesn't make any sense.

See inline below for translation:

" ... patient tolerated the procedure well. Peri/post operative period was uneventful."
** nothing went wrong in the surgery or recovery.

" Drain was 90 cc on POD 3."
** they check for fluid draining from the abdominal cavity through a small tube they leave in, to make sure everything inside has sealed up properly. It has.

" HPE of specimen showed adenocarcinoma with GS 7 (3+4)"
** they examine the prostate "specimen" after they remove it, and this confirmed that the grade of the tumor is Gleason 7, with more G3 than g4. This is on the favorable end of the intermediate range. Fairly good news.

"..for involving 50% of gland"
** more than 50% of the prostate consisted of cancerous tissue, which is on the high side.

"...BN margin and apical margins - positive..."
** the place where they snipped the prostate out leaves two cuts, the bladder neck margin and the apical (apex) margin, and both of these margins were positive, which means that some cancer cells were remaining at the cut. Not good news. This may mean that he needs additional treatment, but it is too soon to tell. The doctor will discuss this with you at the first follow up visit.

"...perineural inv. Present."
** they found what is called "perineural invasion". This means that some of the prostate cancer cells were in the process of creeping outward along the space around the nerves. This is fairly common and while it is not good news, it is not a particular concern.

" No tumor emboli "
** Tumor emboli in this context means deposits of cancer in small blood vessels in or near prostate that could take the cancer to other parts of the body. None found. Good news.

"and no periprostatic spread...."
** There is no evidence that the cancer has spread outside the prostate, or has broken through the surface of the prostate. Good news.

"LN - negative."
** No cancer was found in the lymph nodes. Good news.

"Now stable condition and is being discharged."
** Time to go home.

All in all a pretty good report. Most factors are favorable. The fact that there is no peri-prostatic involvement and no lymph node involvement is great. The positive margins and 50% involvement are not favorable, but not terrible either. Somewhere in the middle. The doctor will discuss with you whether to begin any other treatment in the near future or simply wait and monitor the PSA.

Post Edited (proscapt) : 11/29/2014 12:44:59 AM (GMT-7)

Proscapt, impressive and time consuming research/translation, unless you had that knowledge of the top of your head, which would be more impressive.

Doctor has suggested for radiotherapy. Can u tell on the basis of above report. How long he needs to go for it?

He had the operation on 24th Nov. he has been asked to start the therapy from February 2015.

I hope it will be fine.

Do you think that after radiotherapy he will be completely ok...

Anthony,

Can I ask where your dad is receiving his treatments? It is somewhat unusual for the post-op pathology information to be included in the "release" report since most patients go are sent home before the full pathology report is finished. (HPE = histopathological examination.) Your dad's doctors seem to do things in a different order which makes me wonder if they are in a different part of the world.

In any event, the pathology information is a bit sketchy. Is there a more-detailed report available? Is one expected? While your questions can't be answered with 100 percent certainty by anyone, certainly not by us here on this forum, we could tell you more about your dad's odds if we knew more details of the positive margins that his release summary report mentions.

But, like the other commenters said, he will be OK. But what kind of OK will depend...