Rod's Pathology Report Was Just Called In to Us

Hi MT,
It sounds like your husband is staged at pT3b with aggressive disease. While these are serious developments, don't panic. There are many out there with good results and similar numbers. There was enough information the clinical pathology to accept that the surgical pathology would yield invasion outside the prostate. You need the medical records and a medical oncologist. A positive margin is proof that the capsule is breached, as is a bumpy DRE. So are the seminals involvement indication that the diseae is systemic. I had 4 positive margins and seminals involved. It means darn it that this disease has at least metastisized locally. But the Lymph nodes usually will show presence to be clasified as Stage IV. Like me, Rod is Stage III. And like me, he will be presented some options that will be tough to decide on what to do. He will likely be directed to consider hormone treatment. There are clinical studies and trials available but none appealed enough to me as they take away your control. Radiation will be an option but it is off protocol. That did not stop me. I've done them all. Your doctor is correct, monitor that post op PSA regularly. You are hoping for undetectable. And that is possible. Get there for us, and after you have chosen your oncologist, if you have any questions you know how to reach me and others here.

Tony

Hi, MT. I don't know enough about the pathology report to really comment. Sounds like there is some out-of-prostate involvement that will require treatment. But my reason for posting is that I wanted to comment on your husband's response to all of this -- and to you. I remember when I first learned I had PCa. I totally refused to accept it, wouldn't talk about it, got irritable if my wife and family wanted to talk about it, practically hung up on a friend who called to express her concern and best wishes, and avoided any mention of the fact that I had CANCER! "Just leave me alone -- I'm going to be fine, d*mn it!" Looking back, I know I was being naive, but it was my way of protecting myself from the hurt of knowing that I wasn't immortal, that I had come down with a serious disease and that I wasn't totally in control and needed help. Excuse me for butting in, but right now your husband needs you to be positive: "We are going to beat this thing! Sure, it's not the report we wanted, but we will get the treatment you need! I'm with you all the way!" This may not be how you feel, but to be blunt, you need to shed your tears in private and put on the brave face for hubby. He's had enough bad news. He needs a positive, upbeat partner for whatever he has to face over the next several months. And, remember, it's not a lost cause!!! Look back at the posts of guys whose post-surgery results were much worse. They're still with us and enjoying life! A wonderful anecdote: I just had dinner with Lee (Bluebird) and Buddy a couple of weeks ago. They tell a wonderful story about when Buddy first learned he had PCa. He said it made him feel like he'd been hit with a bus. Lee found a small pin she had -- a tiny pin -- of a bus. She handed it to Buddy and told him, "This is the bus. We can beat this thing!" What a great attitude! I know you're scared and feel out of control. For your husband's sake -- and your sanity -- you need to calm down and try, try to control your fear and the negative and angry feelings you're experiencing. From what you've told us, your husband is reacting just like I did. "Don't tell me about the bad news -- Tell me everything's going to be better!" Naive? Maybe. But that's his call -- give him support, not more darkness. Together you two CAN beat this thing! I apologize if I've gone over the line here. It's just that I know exactly how he's feeling . . . My thoughts, prayers and very best wishes are with you!

puget

Hang in there, girl! It's tough, but you can make a difference! My thoughts are with you both!

Dear Maria Teresa,

You and Rod have been through so much in such a short period of time.  Few of us can say we know exactly how you feel, but we can all say that we continue to support you and Rod fully!  

MT, I am not an expert in this area, but I can offer an opinion or just my 2 cents worth.  The way I look at this is that Rod took his first big step towards healing, and in that step discovered information about his cancer that he would not have had if he didn't opt for the surgery.  Considering this, I believe the surgery was a success because of the information you acquired.  In addition, it sounds like the surgeon removed other cancerous tissues.  Now, with your health care professionals, you are able build an educated plan moving forward by using the post-surgery pathology and future PSA readings.  These combined will help Rod toward further healing.

There is nothing wrong with you feeling disappointed.  Don't beat yourself up for it.  The key, like puget implied, is to find a way back up so you can get back on offense.   You have not lost a battle and you have not lost the war.  You're just digging in and building a strategy for the fight!

All the best,

MT--

Another Stage III weighing in...

Here what I was told -- Its all about the PSA from here on out.  You want it to be undectable, which my DR defined as under .04 --- it can take a while to get there --- hopefully by the 3 month mark... We starting doing PSA tests at a month out.  If the PSA rises about .2, you'll want to look at additional treatment --- IF they think the cancer is still LOCALIZED in the pelvic region, radiation is usually recommended.  If the suspicion is the disease is systemic, hormone thereapy is the norm.   A lot of docs will do both even if localized cancer is suspected (that's what I did). 

At any rate, Rod needs to heal up before they'll want to do any kind of radiation.  Hang in there, for me, the post-surgery/pre-PSA rise part of my recovery was the most difficult mentally.  Plus, you do have a shot at no PSA rise EVER!

Your husband's situation sounds similar to my uncle.  I think that he was diagnosed about 12 years ago and he is now 76 and doing well.  I will get more details from him as soon as I can.  I'm seeing Robbie or Asimov or whatever his name is tomorrow.

 Helping to keep the responses to this thread together....  quote taken from a new thread

What Rod said about your comments re the pathology report  started by mariateresa in response to the thread you are on right now.

quote:

Rod and I just read your replies together. I can see he feels much better now that he got your feedback. I wanted him to hear from those experienced so his attitude can focus on all of you and not my attitude. It was very helpful and inspired hope in him. Thank you for doing this for us and especially him!

SUSAN - Rod especially liked your comments!

So THANK YOU for helping Rod and for putting up with me!!!

And I am working on my attitude!!! Thank you for helping me to snap out of it!

Love you's,

MT

Hi Maria Teresa,
My doctor was upbeat after the surgery as well but he did say there was suspicious tissue left behind. And he was right as attested by the post op pathology. But I press on. I am certain that what all this means will be answered soon for Rod. Again he is going to have several options and will be managing this disease for a long time. And that's what he can do is manage it. JWB pretty much hits the nail on the head with his entry. I believe I may have already mentioned this book: "Beating Prostate Cancer: Hormonal Therapy & Diet" by Dr. Charles "Snuffy" Myers. I do recommend reading it as it pertains to those with our stage of this disease. Some really positive stuff in it as well. I think it will be a great "pick me up" for Rod. Also, I had a thread I started months ago on Michael Milken, the financial guy who also has prostate cancer. He got his Gleason 9, Stage IV diagnosis in 1993 and still presses on. You can read his story at www.mikemilken.com. This is stuff that brings a ray of hope. Rod also has another ray of hope...you. As you continue to stay with us, you also give him improved prognosis. I know for me that my Ruthie is by far the best encouragement I could ever want. We have prostate cancer, and I am not left alone to deal with it. I see it in all the women here at healingwell. And I know even though their men are not posting, they are very much listening to our posts. My message for Rod is that I know what he is feeling. That emptiness and loss of control is not the lasting effect that dominates my days anymore. Sure I always get nervous when it's time for a PSA test, but I have accepted that if it comes back, then that's just it. It comes back and I have to consider more treatments. I am still having fun with my family and friends and look forward to nice weekends. This weekend it's in the RV and back to Utah riding my dirt bike in the mountains. We are going with friends and will be lighting that campfire nightly for three days. I'll be thinking of you guys and I hope you'll be thinking of me. A guy who has the same stage choosing to move on. Get that book and you will better understand what you will likely need to know.  As far as your doctors advice, I believe that he should recommend an oncologist and you should be proactive and just get one.  I have never heard of a T3b with Gleason 9 not needing an oncologist regardless of the PSA going away or not.  This does not mean you need any treatments right now, but it does make you proactive and prepared should you decide to procede with HT or radiation. 

Tony