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Path Report After RP Some Deciphering Please

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Prostate Cancer
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Posted 11/21/2017 11:52 PM (GMT 0)
Hi guys wondering if you cans can let me know what my prognosis looks like, surgeon feels i will get an undetectable reading on my psa test in 2 months.

From my knowledge i guess i am at a higher risk of recurrence.Also if it does come back undetectable, does that mean i am cancer free for the time being?

Thank you all for taking the time to look at this.


Index Tumour Left PZ (anterior horn) apex to mid
Tumour Type Adencarcinona acinar type
Gleason Score 3+4 (10%)=7 (grade group 2)
Tumour Volume 2.7%

Other Tumour foci Right apical type
Gleason score 3+3=6
Tumour Volume 0.1cc

Perineural Invasuion Present multifocal
Lymphovascular invasion Not Identified
Intraductal carcinoma (IDC-P) Not Identified
Prostatic intraepithelial neoplasia Not Identified

Extraprostatic extension Present non focal :left apex 12mm in linear radial extent radial extent not assesible as tumour extends to the margin at this point

Seminal vesicle involvement Not Identified

Pathological resection margin status Positive left apex up to 3mm Gleason pattern 3 at margin

Lymph nodes Not performed

CONCLUSION

Robotic Radical prostatectomy-- Bilateral prostate adenocarcinoma, index tumour left peripheral zone apex to mid (anterior horn), Gleason 3+4(10%)=7 (Grade Group 2),
extraprostatic extension (left apex 12mm) with associated postive margin (3mm),
no involvement of seminal vesicles and pathological margins clear.
Patholical stage--pT3a
Posted 11/22/2017 12:26 AM (GMT 0)
Undetectable means you host the party and I'll have a beer.

You should start your party planning now as the good venues fill up fast and two months isn't a lot of time to plan a party of that size.

I predict that in six months you'll be wondering why you were worried.

You're going to be fine, rest, heal, live, love, and do fun stuff.
Andrew
Posted 11/22/2017 12:29 AM (GMT 0)
Omg in the shop if you are correct I'll buy you a keg my friend.
Posted 11/22/2017 12:56 AM (GMT 0)
5 gal or 15.5 gal
Posted 11/22/2017 1:08 AM (GMT 0)
I'll treat the whole crew on here you all just need to come to Australia.
Posted 11/22/2017 2:18 AM (GMT 0)
I don't usually recommend sending prostatectomy specimens for a second opinion, but there is an equivocal aspect here that you may want more assurance about. The GS 3+4 tumor in the left apex extended into the surrounding fossa. Your surgeon cut around it, but there was still a focal positive margin of 3mm that, fortunately, appears to be only grade 3. I think that is hard to assess accurately with only 3 mm, but maybe you want another pathologist (Phillip Stricker's lab?) to take a look.

As of right now, as far as anyone can know, you are cured. I'm a big believer in focussing on what you have before you in the present moment. Who can say what the future will bring? As long as you follow up with ultrasensitive PSAs every 3 months, you have done as much as you can do.
Posted 11/22/2017 2:30 AM (GMT 0)
Thanks Tall Allen.I thought my path report was pretty bad, guess it's not as bad as I conjured in my head. January 11 I'll know what my psa is going to be, it will be a big day if it shows up undetectable.
Posted 11/22/2017 1:28 PM (GMT 0)

Big Tasty said...
I'll treat the whole crew on here you all just need to come to Australia.

And I hear that the weather "down" there gets rather nice this time of year. Up here in the upper Rust Belt, we are readying the snow blowers.
Posted 11/22/2017 1:52 PM (GMT 0)
I wonder why the surgeon didn't excise a few lymph nodes?
Posted 11/22/2017 3:13 PM (GMT 0)
No idea why I'll ask when I see him in January with my first psa.
Posted 11/22/2017 3:34 PM (GMT 0)
Summer is a week away Paxton and boy it's warm already we are in for a hot one.
Posted 11/22/2017 11:00 PM (GMT 0)
Greetings Big Tasty! From another Melbourne forum member! Hang in there - you're doing GREAT! Peter Mac also have (and can probably recommend) excellent pathologists if you're seeking a re-check after TA's suggestion.
And you're right - it's been a super hot week here already, and we're bracing for more. BRING IT ON!
Happy snow season to the rest of you.
Jaybee&GG
Posted 11/22/2017 11:10 PM (GMT 0)
Hi Jaybee yep and another hot one today.
Posted 11/23/2017 3:36 AM (GMT 0)

John_TX said...
I wonder why the surgeon didn't excise a few lymph nodes?

Would it be because my bone scans were clear no cancer in them.
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