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Pathology/Surgery Question

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Prostate Cancer
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Posted 10/10/2008 1:38 PM (GMT 0)
Not sure if anyone could anser this but going to throw it out their since it has been on my mind and dont see doc for another two months... I noticed on my post op pathology report the doctor took a sample from the left apex of my prostate, and left base of my prostate during the operation with a frozen sample to be looked at during operation. Which he  said to me he was going to do samples during operation to ensure he got everything. They both were negatve. He is also took a sample of my right lynmph node and the took out my entire left lymph node. My biopsy beforehand showed all the cancer in my right prostate lobe. In postop pathology showed majority cancer in right and some in left. Why didnt he take a froxen biopsy of my right side apex and base, not my left and take my right entire lymph node since that was were the side of the cancer was?  Also do you know when during surgery can the doctor see the tumor inside your prostate? So fo me that he could see it was predominately on my right lobe?? My margins were clear which I thank God every day but I was just curious if he mistakenly thought everything was on the left during the surgery or did he see this and was ensuring the left was clear.... Thanks!
Posted 10/10/2008 3:12 PM (GMT 0)
SHU93....I maybe wrong, but it sounds like your surgeon was looking for spread of cancer, knowing that the right side from the biopsy would be checked during the final pathology. Much like a my surgeon that tested the lymph nodes on both sides at the beginning before moving forward with the removal of the gland. Just take it as he was looking around and becoming familar with your cancer before doing any cutting to make sure he could get clean margins. As far as being able to "see" the cancer...good question, but I think it can be felt easier than seen if it is large enough. With robotic that tactical feel isn't there. Most PCa is multiplicity which means more than one tumor is present in either lobe. PCa is not generally one mass but made up of several smaller ones. That is why the biopsy won't catch all of the cancer locations and is why the pathology is usually different than the biopsy when it comes to the amount of PCa and the grade and sometimes stage.

Great news on being zero and here's hoping for a lifetime.
Posted 10/10/2008 4:17 PM (GMT 0)
In my opinion, the only negative with the Da Vinci is that the surgeon might not be able to get all the lymph nodes he/she would like. Therefore, in your particular case, he might have wanted to get more on the right side, but couldn't get the angle. The surgeons are not always able to see the cancer, that is why they send the slides to the pathologist. Like Les said, he was probably looking for spread, which is normal and it is fabulous news that your results were negative!! Have a great weekend!
Posted 10/10/2008 8:58 PM (GMT 0)
SHU,

There was no indication for the surgeon to remove nodes. He checked the close nodes and removed just one, leaving the rest (you have many) after finding a clean pathology. He did pretty much what all good surgeons will do...checked before doing more than he needed to. He's the kind of Doctor I can respect.
Lookin out for his patient :>)

Swim
Posted 10/11/2008 12:38 AM (GMT 0)
That is standard procedure SHU, I had 13 lymph nodes removed during surgery, for me though the cancer had spread and the surgery was aborted. Be thankful the surgeon checked like he did. Sounds to me like all went well and you are on the road to recovery. How are you doing physically and emotionally?

peace and grace
Dale
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