Reading my Pathology Report Correctly

Rick, hellow and welcome to HW Prostate Cancer. You being fresh out of surgery guarantees your membership here is paid in full. Hope you are recovering well.

Your final staging is just like mine.. Yes, that one positve margin may or may not prove to be a problem in the future. There are men here with positive margins that never do anything, and men without them that have reoccurance regardless.

Right now, you need to continue your healing process. Are you walking a lot, how are you doing on the Incontinence front. It will be an anxious wait of course till that first post surgery PSA, but you got all the holidays ahead of you to distract you.

The important thing is that you are still a Gleason 6 after the surgery. If you had been upgraded to a Gleason 7 or higher, that would be a more serious matter.

Good luck to you, and you have any other questions ,please feel free to ask away.

David in SC

41? That makes you the youngest or next to youngest here if I remember. Good news on incontinence front, that's a big help.

On the ED side, did they do a nerve sparing operation, or non-sparing, or did they leave one nerve bundle to work with?

David in SC

Rick Tom said...
Hello All,

I'm new to this forum. I had RRH five weeks ago by DaVinic. The Dr. said it went as expected but did not elaborate to much on the Pathology report. I just want to make sure that I'm reading the report correctly. Below is what my report says.

Gleason 6 (same score as biopsy)
Tumor involved in both lobes at almost all levels
Apical and Bladder Neck resection margin is negative for tumor
Peripheral resection margin focally positive for tumor (very worrisome)
No definite evidence of extraprostatic extension seen
Seminal vesicle negative for tumor
Lymphatic invasion not seen
AJCC: pT2c (upgrade from biopsy pT1c)

My real worry is Peripheral positive for the tumor. I will be having my first PSA done in Feb. 10.

Thanks Rick

Focally positive means a few cells (less than 5 if I remember right?) were found at the margin. It may never be of any concern..so think positive. T2c is the new fangled way of saying bilateral with less than half of either lobe involved.

All in all...a promising pathology.

Rick,
Welcome to the forum.
Fellow member "John T" posted an interesting link in another thread a couple of days ago. It actually dealt with the question of positive margins . A focally positive margin involving a Gleason 6 (i.e. grade 3 cells at the point of extension) has only a slightly worse chance of relapse than a clear margin. It states among other things :

"For patients with low-risk disease, those with positive surgical margin had a bio-chemical progression free survival of 94.9 percent vs. 99.6 percent for those with negative margins.

Here is the link:

prostatecancerinfolink.net/2009/12/10/7398/

My best wishes for a zero PSA result
Bill

Thank you everyone. You all have made me feeling much better about my situation. I have message in with my doctor about my positive margin. I'll update everyone on our discussion.

Thanks again everyone. I also would like to wish everyone luck in all their future PSAs.

Rick

Good luck Rick. 

Lots of good info in the post above.  I’m going to talk to a pathologist on Monday about reports like this because I just dont understand... What tissue are we talking about when we see this issue of “focally positive” in the presence of negative seminal vesicles negative lymphatic evaluation, and no prostatic extension. I just don’t understand what specific tissue we are talking about. Your report is like several others that I have seen and are confusing. I’d be concerned also. Again best to you.  Oh and welcome....

 

 

Hero,
There is some pathology reading here. A little heavy but some explanations.

www.uscap.org/newindex.htm?iap2006/longc02-7.htm

Bill