Hi Logoslidat --
Re your post and it's title, "MRI scans! definitive proof of prostate contained or not contained Pca???"
My Dec. 5, 2014, MRI scan at Johns Hopkins Hospital was NOT definitive proof of extracapsular prostate Pca" -- what the analysis said, and then what my urologist/surgeon seemed to accept. I was told my 12/5/14 MRI showed extracapsular spread of the cancer. Which turned out not to be true! Thankfully!!
I had an MRI on 12-5-14 on the latest, newest, best MRI machine at Johns Hopkins. I think it was a 3 Tesla (3T) MRI scan. The report on my MRI stated flatly,
-- "Impression: large volume, non-organ confined disease present . . . extracapsular invasion is present on left."
That's pretty unequivocal, wouldn't you say?
My extremely well respected, nationally prominent surgeon sent me a letter 3-4 days later which
opened with. "Dear Mr. _____, The MRI of your prostate suggests that you have a large cancer with likely extension beyond the prostate." My surgeon's wording with "suggests" and "likely extension beyond the prostate" is not the same unequivocal wording of the author of the earlier analysis, but I don't read my surgeon's letter as expressing a high degree of healthy skepticism.
I based my decision to have a Radical Retropublic Prostectomy (RRP) on these two things . . . the expert's analysis of the MRI slides (or however the results are viewed) which followed the day after the MRI test, and then a couple of days after that, my surgeon's/urologist's/professor's apparent 70-80 percent (my assessment) reliance on the accuracy of the MRI analysis/report. My surgeon's letter went on to say, "I would agree with Dr. _____ that your cancer should be treated with either radiation or surgery."
Turns out post-surgery (my surgery was on Jan. 9, 2015) the Johns Hopkins pathology report, not written by Johnathan Epstein but by another very prominent and respected senior pathologist, concluded there was no evidence to support the original mistaken MRI analysis and diagnosis:
From the JH path report:
-- "Interpretation and diagnosis:
(1) Pelvic nodes, left (excision); three (3) lymph nodes and associated fibroadipose tissue, negative for tumor.
(2) Anterior fat pad (excision): negative for tumor.
(3) prostate and SV (prostatectomy): Histologic type:
Adenocarcinoma (conventional, NOS)
Gleason score - dominant nodule: 3+4=7
Tumor extent: moderate
Local extent: ORGAN CONFINED (emphasis added)
Margins: negative
seminal vesicle invasion: None
lymphatic invasion: Absent
Pelvic lymph nodes (includes all parts):
All 3 lymph nodes are negative for tumor.
Extent of invasion: pT2: Organ confined throughout
Summary margins: negative
[End JH path report]
With my surgeon enthusiastic the operation was a great success, and the post-op path report confirming that success, I never have gotten around to asking my surgeon how could the MRI analysis have been so misleading and mistaken? And how could the JH person who did the original MRI results analysis have been so wrong?
Even the best staffed, all honorable men and women, all with illustrious backgrounds, hospitals sometimes get it wrong. I give Johns Hopkins credit for at every step of the way, making sure the person they had in front of them, me, was the person they thought I was, right up to and included before they put me deep under in the operating room, I was asked a dozen times, "What is your name? Date of birth? Who is your doctor?" Nobody was cutting off my left leg that day! Only scary thing about
potential mistaken identity is the guy in the next cubicle to me in pre-op had the same last name as me. My nurse commented on it, saying "this is weird."
Thankfully I got my RRP and he got his something-or-other.
Row, row, row your boat, gently down the stream, merrily, merrily, merrily, life is but a dream. Glad my sense of humor about
these things is still intact. Fortunately for me, my prostate cancer WAS capsule contained.
Best of luck to you in all things, Logoslidat.
Bill Positive
Post Edited (Bill Positive) : 3/21/2015 6:04:27 PM (GMT-6)