Talked to Doc, Initial Path

Doctor called w/ Bob's path results. I was trying to write it all down so don't have all the info but will tell you guys what I know so far. Stage T2C, final Gleason 6. Cancer found in both lobes grown into the uretha (doc says he got all that), on the left side cancer is to the edge, that he had extensive cancer on the left lobe through the wall 2mm area near the edge. (Or he may have said edge of margin not sure on that). Will check PSA at 4 weeks, said we may be looking at low dose radiation depending on PSA. So does it sound bad? It sounds bad to me.

Good report. Not great but I'd say he's likely got it all and you're looking at recovery and monitoring the PSA for awhile.

It's likely the doctor was being cautious when he talked about radiation follow up. When you get cells close to the margins, there is always the worry about if you've got it all. It's not bad, many guys have to get that, but I going to guess you won't have to. If you do, no big deal. The most difficult part for you will likely be getting to and from the hospital for the daily treatments. The treatment itself isn't a big worry, side effects are not bad and don't last long.

but for now that is very far in the future and all speculation. Wait and see what the PSA does. For a G6, the urgency of SRT, follow up radiation, is very low and unless you see rising PSA post surgery, you're good.

Hang in there, you've been through a rough time. Rest, recover and put the future stuff out of your mind for awhile.

Andrew

Did the doctor tell you he might need radiation our was that your assessment based on your limited knowledge from the forum. My reading of your post is that the surgeon was relaying to you what he saw during the surgery. He may have contacted pathology for an initial report, but I suspect not. I think he meant " from the edge '" of the specimen removed which " suggests negative margins. Without the full pathology report he would be remiss in his area of expertise to say any thing more. The full pathology will tell the story. Please be advised there are many things in your post, that to another reader would indicate your fears. I could be totally wrong in everything I just wrote. There is much in your post, that is very positive even if your fears of the margin be come real. I won't get ahead of the cart, but will wait , with you for the full pathology report. When it comes post it. If you could get as much information from the surgeon as to what it means. I would suggest you get one of the small recording devices, advise the surgeon you will tape it as , memory is not precise. He will have no problem with it but be sure to advise him. bottom line there is " more gravy than ghost " in that initial report as reported by you. That is a good thing, not bad. Know this!

Oh one more thing, so as not to confuse you, Edge of the specimen would be the same as edge of the margins. Thru the wall means he would have extra prostatic extension meaning it escaped the prostate and the protective capsule around it. The effect of this is negated if he does have negative margin. From what you posted, the narrative suggests that he will have EPE, but with negative margins.That with a confirmed gleason 6 is an excellent path report. Put the radiation possibility out of your mind for now. The horse before the cart stick. I suspect if he did mention radiation, it was to comfort you from any anxiety. A little " low dose radiation" indicates just that. I am quite sure your surgeon went home feeling he cured your husband or at the least, but you in a position for some "low dose" rad to mop up, well to mop up the operation. Your case will be a classic example of what we say in the "trade" "a bump in the road. " the bump referring to a bump the doctor might feel in prostate prior to biopsy. Enjoy the holidays it's really good news. A rough ride to be sure. celebrate or save it for after the path report. Even any {bad news} will be short lived.

Tell your husband to chill there is zero zip nada there to be devastated about. Trust me on that one. You went in with a 4.1 psa. No way it will be 4. Unless some data points are missing, which I seriously doubt. He got all the cancer in the urethra. At the most this may mean a longer than normal time to continence, but even this is not a given. You tell your husband to settle down , he is not going to die from Pca, and he causing you unnecessary stress. Well maybe not the last part, Im way out of my pay grade on that advice. But yes it is assuredly not a death sentence by any stretch. Surgeons love cases like yours, it makes them look good. Again my caveat is I say all this based on the information you have given Oh and don't angst if you didn't get every jot and tittle or even if you got it all wrong. I t will all work out. Good golly you are not a secretary, you are a concerned loving wife. Don't beat yourself up. Its just a season, honest!!

Thanks logo.

Prato, in spite of the grief you might have gotten from us and possibly still do. Your draw with us is that in a sense, you are an everyman.

Don't trouble trouble till trouble troubles you - you're thinking too much tonight. I know it's difficult but now is not the time to think of that stuff. Plenty of time later, if the PSA results come back bad. Which they won't.

Get off the internet and get some rest.
Go do something to distract your brain from all this for a few hours, days, weeks...
Andrew

Your surgeon would not reconnect a cancerous urethra. I know, what if…… My dear daughter, you can what if till the cows come home. The danger in that is the cows may grow weary and look for greener pastures. Having said that, if you give living water to your pasture, they will return with bells on.

Miki,

This is a good report. So first things first - remain calm! Remember that 6 year old is watching and listening.

Tell Bob from all of us - THIS IS NOT A SENTENCE.

You should have an appointment for the removal of the catheter - right? At that time, the surgeon should go over the printed report with Bob and you. GET A COPY! If you have not already, put together a folder or notebook with all of Bobs test results and lab work. Up in the front, create a list of questions with a bunch of space between each question for you to write down the surgeons answers. Be sure BOTH Bob and you go into this meeting. (My wife even watched them take out the catheter! ) I am sure that BOTH of you have questions so be sure to get them on your list. You had the opportunity to know what the pathology "kind of says", so you guys have a better opportunity to ask better questions than we did.

The stuff you should have heard was that the prostrate was removed. Like me, the Gleason score was reduced to a 6 - time to party! That it is T2C (maybe pT2C - the p means pathological observation) He had to get good tissue for the anastomoses of the urethra. He would not have left in a cancerous tube.

Much like my two infiltrations, you need much more information in front of you guys to understand what it means. If he said that the margins were clear, then you are worried for nothing. If there was some infiltration in the margins, then there would be a lot more said in the pathology report. You don't have that information. Again, nothing to worry about right now. You simply do not have the information and it is a G6.

Like logoslidat said (he said this to me as well) that being graded a G6 is a TOTAL win. As he said to me - Even if there were some cells that escaped in the vascular system, they have no prostrate tissue to call home. I "think" that Bobs Dr. is most likely covering himself with the "low dose radiation depending on PSA." Take that as what he says. If the PSA goes up (unlikely I believe) you guys MAY do some RT to kill off whatever is around. it is something to ask think about 3 months from now - not to worry about right now.

Remember that PC is something that Bob has taken action against. You guys are not taking this as something like a cold or taking out his tonsils - but as something to fight. You now get to help Bob recover from a MAJOR surgery. Remember that those 5 or 6 little holes are only the outwards sign of having a major male organ being removed. PC is something that you will need to keep an eye on and a chance to educate others about. I was totally surprised about how many guys had no idea what a PSA test was all about and why it is needed. What does Bob think of that?

Bob is going to be around to help educate other men about how important it is to get tested. This is the #1 of all cancers and education and research is really needed. [Off soap box.]

I am just another guy with PC - unlike the others here with all sorts of knowledge and experience. Peter said it best in less words than I used. I love his potato example. When I got my pathology report, my Doc. said something like that only in medical terms. (I understand them better than most.) Anyway - I am just giving you what I know from what I went through. Please take it for what it is worth to you and Bob.

DonC

Miki,

Bill from Florida woke me up. Your surgeon said that it was staged as T2c. This means that it has not got out of the prostrate and was seen on both sides of the prostrate. So I am unsure that you heard him correctly about it getting through the margins. That would usually make it a stage 3 cancer. Did he say anything about the lymph nodes? Usually staging is like pT2c pN? M? where the ? have a number. The pN? is the node score - hopefully pN0.

If I am wrong about that, I am sure that the group will chime in and set me straight.

DonC

He didn't take any lymph nodes. I asked about this twice (once at hospital then on the phone when he called w/ the path report). He said surgery protocol on someone w/ hubby's numbers (PSA and gleason) was not to remove lymph nodes (this was after he had told us at pre-op appt. that he "may" remove lymph nodes). He also stated he found nothing indicative of a spread during surgery (the stickiness he has mentioned numerous times, was not there). I can't wait to get my hands on the path report so I can post it here. As far as was it margin or still in the wall I am going to type exactly what I wrote (but remember I was writing as he was talking). Here's what I wrote as he was talking on the phone (this is from the surgical path report he got back) Stage T2C, gleason 6...grown to urethra got all that.....left side cancer on edge....extensive cancer....2mm area near edge through wall.....

Great report. Don't get much better.

My vast experience and 15 minutes of medical training predict a fast recovery and a very long life without further PC troubles.

I prescribe periodic PSA tests and a nice vacation somewhere fun.

Andrew