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Positive Margins and Seminal Vesicle Involvement, T3b

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Posted 12/10/2009 1:19 PM (GMT 0)
Hi,

My Dad recently got his pathology report back from his prostatectomy and it showed he has T3b prostate cancer with seminal vesicle involvement, positive margins, but thankfully no lymph node involvement. I was wondering if anyone else had this diagnosis and what/if any follow-up treatment did you do? How soon did you have your post-surgery PSA, if you started radiation, how soon after surgery?
It would be really great to hear from someone who has gone down this road already. Looking for any comforting words- thank you very much.

Have a good day,
Pauline
Posted 12/10/2009 3:17 PM (GMT 0)
Hello and welcome to HW, Pauline.

Another daughter watching out for her day, I always love to see that.

His pathology report does have a lot of seriousness to it. One of two things will probably happen next. They will either watch his post surgery real close, and if they verified reaccurance, then they would want him to have Radiation Treatments. Or, with his report, they may reccomend that he start Radiation as soon as he's well enough from his surgery.

I had my first PSA exactly 3 months after open surgery.

If you could put his stats at the bottom of your posts, it would help. Go to "Control Panel" at the top of the screen and set up his profile info. It would make it easier to understand his journey so far.

Please keep us posted and ask as many questions as you need.

Several of us have had radiation after our surgeries, I just completed mine 2 weeks ago.

David in SC
Posted 12/10/2009 4:36 PM (GMT 0)
The most current studies say that if adjuvant radiation is begun within 4 months after surgery, the chances of success is much higher.

On the downside, if the patient is not continent when the radiation starts, he most likely will not improve.  Same for ED.

Goodlife 

Posted 12/10/2009 6:27 PM (GMT 0)
Pauline,
If there was seminal vesicile invasion there is a high probability of lymphnode involvement. The lymphnodes sampled during surgery are not the lympnodes that are most likely to be involved through seminal vessicle invasion as there are two lymphatic paths that PC can take. Most doctors don't know this as it was just discovered in a large study just released in Germany and Holland. You didn't mention his pre surgery PSA or his Gleason grade or % involvement. All of these have a bearing on what his next steps should be.
I would definately be looking for another opinion from a good prostate oncologist as he is better able to guide you through your next steps. You must determine if the PC is still contained in order to have an effective salvage treatment or your Dad will just add to his side affects without any befefits. From what you have discribed salvage radiation will have a very low probability of success.
JT
Posted 12/11/2009 12:12 AM (GMT 0)
Hi Pauline,

Sorry that your Dad has to walk this path. Please check my stats below. They will give you the dates and timeline of my pT3b diagnosis. I saw my urologist/surgeon, a medical oncologist/hematologist, and a radiation oncologist. The consensus was that I needed to start Adjuvant Combination Therapy as soon as possible. My positive margins were fairly extensive at the base, and the seminal vesicle involvement was the clincher for doing both Androgen Deprivation Therapy (Lupron) and IMRT. 1st Lupron injection was on Oct 20. IMRT will begin on Jan 12. My 1st PSA was at 1 month and was undectable at <0.01. 2d PSA at 2 months gave the same result. With pT3b, you don't want to wait for a rising psa to start salvage radiation therapy. Hope this helps.

Roger

Posted 12/11/2009 12:31 AM (GMT 0)
Not to change the subject, but i just signed up yesterday. Opa n Dr.Tortora is also my uro, how do you feel about him? I just found out 12/9 that i have Pc. How was the procedure? I also see that you were a GC. I have my own little home improvement business. Nice to see someone in this area. Maybe i should of started a new thread. sorry
Posted 12/11/2009 1:39 AM (GMT 0)
Keysailfisher:

I sent you an email so we can be off this thread.

Roger

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