Question on Pathology Info from Surgery

I had RRP surgery done one week ago on 8/16. Surgery and recovery have gone very well. I experienced very little pain -- have yet to have needed even as much as a Tylenol (let alone painkiller) and energy level good at this point. I've been walking a lot since right after surgery.

My catheter comes out Monday and Doc will go through pathology with me then. Although I don't yet have the report, I did call Doc's office to get it and office assistant gave me high level info from it which was:

- no margins
- no EPE
- no SV invasion
- no lymph node invasion
- positive for PNI
- 30% tumor involvement
- Gleason score 3+4=7 which is an upgrade from pre surgery G6

As quick background and seen in my signature, I'm 56, I was diagnosed 4 years ago and had been on AS since then. Going into this spring, I had had two biopsies -- 1st showed 1 of 14 cores G6 at <1% and 2nd showed 1 of 17 cores G6 at 6%. I had had two mpMRIs -- both were clear.

4/17 I had a 3rd MRI which showed one 19mm PIRADS 4 lesion in the Transition zone. 5/17 I had 21 core fusion biopsy which showed 5 cores positive for G6 at between 20% and 90%, all from the target lesion in TZ, and the 16 other cores taken systematically from around the prostate were benign.

My view going into surgery is that I had a good sized G6 tumor in the transition zone in the core of my prostate and not much else around the prostate other than tiny amounts of G6. The TZ cancer didn't get picked up in 1st two biopsies because that area not typically hit and the MRI may not have caught because they're not great at seeing pattern 3 cancer.

The pathology highlights sound good to me. Questions I have are:

- 30% tumor involvement sounds high but wondering if that's a function of the large TZ tumor?

- regarding final Gleason score of 3+4, is it typical to get a % amount for how much is 3 and how much is 4?

I would appreciate others perspective on this and maybe any questions that would good for me to ask?

Thanks in advance

I'll let the experts reply about the specific questions as I"m a newbie. Heading to surgery myself on September 13, I am wondering when you say you did a lot of walking right after surgery, how much? Glad to hear that pain has not been bad at all for you! That is very encouraging! Here's to a speedy recovery for you.

Thanks for the responses

MrBaseball -- I started walking as soon as I got to my hospital room from OR recovery. I tried to do 3 laps around the hospital floor every hour. A sign there said 24 laps was a mile, so 1/8 of mile an hour or so. I was released within 24 hours and since being home, I try to walk 15 minutes of every hour. My speed has improved, so I'm now covering somewhere around 4 miles a day. I'm positive walking has helped my recovey a lot. Other than the catheter which is nusance, I can honestly say I feel really good now, one week out from surgery.

MD - sounds like your situation was a lot like mine. Congrats on continued good results. The fact the some pattern 4 showed up in final pathology which hadn't up to this point, makes me feel that much better about my decision to come off AS and go for treatment.

Good advice Island time. Having no pattern 4 ever found in my biopsies that is now shown in final pathology, I definitely want to know how much was in my prostate. If my report doesn't include that info, I will seek it from JH.