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Posted 9/15/2017 5:46 AM (GMT 0)
My surgical pathology says pT3a Extraprostatic extension of microscopic invasions of bladder neck. Additional pathological findings: High-grade prostatic intraepithelial neoplasia.
Post RT 6 weeks, First PSA next week. ? What am I looking at? What questions to ask if any?
Posted 9/15/2017 7:42 AM (GMT 0)
pT3a Extraprostatic extension of microscopic invasions of bladder neck means that the risk for biochemical progression is a bit higher. Maybe you could ask about the risk.
High-grade prostatic intraepithelial neoplasia is a pre-cancer of the prostate which could have turned into prostate cancer over time if you hadn't had surgery.
Good luck with the first PSA, hopefully it will be undetectable. Tell us the result. How is your recovery going, continence? ED?
Posted 9/15/2017 12:41 PM (GMT 0)
I was T3a after surgery nearly ten years ago. At the 8 year mark my PSA had risen to .06. My urologist as well as RO said I should pull the trigger on SRT. I had 35 treatments for a total of 70 g's. No real side effects. My PSA has remained constant at <.006. I am completely happy and thank the Lord and the great medical team I have had. I wish you the best outcome possible. I hope you are a big fat ZERO! If not, there are many things that can be considered for you.
Posted 9/15/2017 1:06 PM (GMT 0)
I was also a pT3a six years ago. With my low PSA, age and surgery results etc, my Dr chose no other treatment and I have been getting undetectable PSA ever since. However there was no bladder neck invasion present. Best of luck!
Posted 9/15/2017 1:30 PM (GMT 0)
I'm pT3aN1 - I'm assuming the positive node was the automatic trigger for ADT and then ART (Lupron, radiation.) I wouldn't be a bit surprised if your Doc doesn't follow the same track that I had.
Posted 9/15/2017 1:38 PM (GMT 0)
I had RRP surgery last month and had negative LN, SV and margins but positive EPE found on a second opinion read by John Hopkins (missed on original pathology). I don't know what your Gleason score was but mine was 3+4 (an upgrade from just G6 across three biopsies). Based on the MSKCC nomogram, with my pathology and 3+4, odds of remaining recurrence free are:

2 years - 95%
5 years - 88%
7 years - 84%
10 years - 78%

I had 10% pattern 4 involvement which I assume is on the lower side of 3+4, so maybe my odds are a little better than those shown but that's just a guess.

Hope this helps and that your recovery is going well
Posted 9/15/2017 5:26 PM (GMT 0)
oldbeek-

You didn't include a signature with your details. What was your Gleason score - especially near the bladder neck?
Posted 9/15/2017 5:43 PM (GMT 0)
Not know how to attach signature. Gleason 4+3 all lesions were in the lower quadrants. They removed all nerves and nodes. No cancer in nodes.
Posted 9/15/2017 7:33 PM (GMT 0)
Did they tell you if it was a 3 or a 4 at the margin?

We too have a margin at the bladder neck and the pathologist said the Gleason there is 3 so I'm hoping and praying to remain undetectable.
Posted 9/16/2017 8:31 PM (GMT 0)
oldbeek, my husband is stage pT3a, with EPE and positive margin at the bladder neck (gleason 7, 3+4). He has been undetectable for a little over 3 years (next PSA test is later this month).

Hang in there and best of luck... let us know how things go with your first test.
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