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Posted 6/9/2011 12:34 PM (GMT 0)
hi everybody, my dad fouNd out he has prostate cancer last month after a raise in PSA whitch was 13. after a positif DRE, he had a biopsy whitch confirmed cancer, gleason8 he had a open surgery to remove the prostate, so he just had the reposrt from the surgeon,it says: prostate weight 32g , 4.5cm *3cm*4.5cm cancer located at the right and left side of the prostate gleason score8(5+4) tumor p t3 c N o M x the report is in frensh so it says exactly CONCLUSION : ADENOCARCINOME PROSTATIQUE PEU DIFFERENCIE ET INVASIF GLEASON-SCRORE 8 (3+5) DE LOCALISATION DROITE ET GAUCHE INFILTRANT DES VESICULES SEMINALES A DROITE ET A GAUCHE, MAIS A LIMITES D’EXERSE SEMINALES SAINES ; AVEC DEPASSEMENT CAPSULAIRE FREQUENT ET MARGES POSITIVES A DROITE ET A GAUCHE, AVEC IMAGES D’INVASION PRENEURALE ET SANS INVASION DES GANGLIONS DU CURAGE ILIO-OBTURATEUR BILATERAL..      tumeur p t3 c N o M x   i need your help to understand my dad situation   MANY THANKS
Posted 6/9/2011 12:52 PM (GMT 0)
I hope my French to English translation is good. After all I used iGoogle :-)

The above pathology translates as follows:
CONCLUSION: poorly differentiated prostatic adenocarcinoma INVASIVE AND GLEASON SCRORE-8 (3 +5) location OF RIGHT AND LEFT INFILTRATING seminal vesicles RIGHT AND LEFT, BUT LIMITS OF SEMINAL EXERSE HEALTHY, AND OFTEN WITH EXCESS CAPSULAR POSITIVE MARGINS TO RIGHT AND LEFT WITH IMAGES OF INVASION AND WITHOUT PRENEURALE INVASION OF THE LYMPH FLUSHING ILIO-BILATERAL CLOSURE ..

Tony
Posted 6/9/2011 12:58 PM (GMT 0)
lalla374
The stage is pT3c, N0, Mx or basically the same as mine. The staging guidelines used by you doctors has the pT3c designation which is still used internationally but in the US the staging manual has been revised and there is not pT3c. Today it is pT3b using the AJCC2007 manual.

I say this so that if you can't find other pT3c's they are actually pT3b's mostly these days. I am one of them and I am doing well. It was my decision to go with additional therapies in hope of a durable remission. And here's the good news ~ almost five years out I do have a remission.

Your Gleason score is more concerning than mine but you can still have good results moving forward. Stay positive and look hard at what might be a good plan moving forward.

Tony
Posted 6/9/2011 12:58 PM (GMT 0)
From what I can decipher of the French, I believe your dad has positive margins, which means the cancer has spread outside the prostate.

What this probably means with Gleason 8 is that he will most likely require radiation also. Some would advise the radiation within 4 months of surgery, or adjuvant treatment, some would say wait until the PSA rises to a certain level, and then do it, called salvage radiation.

Gleason 8,9, and 10 are termed aggressive PC. They behave differently than the other Gleasons, and will need careful attention. He should be seeing the doctor every 3 months, and getting PSA tests. If you don't feel he is getting enough attention, a second opinion from an oncologist may be a good idea.

Good luck and welcome to HW.

Post Edited (goodlife) : 6/9/2011 6:44:54 PM (GMT-6)

Posted 6/9/2011 6:09 PM (GMT 0)
Tony thanks for your help, i hope that your PSA will remain undetectable FOREVER
goodlife thanks for the clarification.

how it works after the surgery, schould my dad go for a blood test? is his situation dangerous? is he at high risk of recurrence?
thanks
Posted 6/9/2011 7:06 PM (GMT 0)
Yes,

he should get tested regularly. The Gleason 3+5=8 means that the cancer found had mostly first score slightly abnormal cells (3), it is the second part of the score- the 5 is a higher grade of cancer that might be more agressive. There is less of the 5s than the 3s in the sample  that is why the 3 comes first and it adds up to an eight. Good luck to your Father and keep us posted.

Mike

Posted 6/9/2011 7:15 PM (GMT 0)
laila374, Your dad should go for blood tests every three months and will probably get a baseline bloodtest sometime between 4-8 weeks post surgery. No one can tell from a pathology report whether he will have a recurrence, but some cases are at greater risk for that to happen. When the Gleason score is high there is a more aggressive cancer. When the tumor is not confined to the prostate or when the surgical margins are positive all mean there is greater risk for recurrence. That is why the PSA bloodwork is so important to follow up with. There are many guys with similar numbers on this forum who have done very well after completing treatment so take it one step at a time. Best of luck to you and your dad and let us know how it is going.
Posted 6/9/2011 10:45 PM (GMT 0)
The 3+5=8 and invasion of the vesicles plus positive margins means your Dad in all likelihood will require further treatment..In the States, that would be radiation and hormone treatment combined, depending on his age and overall health..

The next milestone will be his first post-surgery PSA test 6 or 8 weeks from now...Hopefully, it drops to undetectable..That's a good sign. But with your Dad's numbers, they STILL might want to continue the treatment..
Posted 6/9/2011 11:05 PM (GMT 0)
Good luck to your father, from that pathology report, its highly likely he will need a secondary treatment, in the form of radiation or radiation with hormone therapy added into the mix. PSA tests of every 3 months will be essential for some time.

Wishing you both the best.

David
Posted 6/9/2011 11:59 PM (GMT 0)
Report:
Poorly differentiated Adenocarcinoma of the prostate (Gleason score 3+5=8) is present in both hemispheres (left and right side) of the gland.
Tumour has invaded both left and right seminal vesicles to a small extent.
The prostate capsule has positive margins on both the left and right hemispheres of the gland.
There is perineural invasion present.
There is no evidence of lymph node involvement. (removed nodes are clear)

laila,
As the other members have explained the removed prostate has tumour present with tumour cells comprised of both grade 3 and grade 5 cells. Prostate cancer cells are given a grade (from 3 to 5) on how they appear under a microscope and the grade given is related to how much their structure has changed and is directly related to the aggressiveness of the tumour cells. Grade 3 is the basic grade before cells are said to be a tumour. In your father's case there is tumour in both the left and right halves of the gland and the tumour has escaped the gland (the capsule is a thin skin-like cover on the surface of the prostate gland) on both left and right. As Tony has said this is usually known as "EPE" (extra prostatic extension"). As well the tumour has invaded both the left and right seminal vesicles (which were removed along with the prostate). The presence of grade 5 cells are a cause for concern as are the positive margins. Perineural invasion is very common with all grades of the disease and is thought not to be a great concern. The good news is that cancer was not detected in the abdominal lymph nodes near the prostate. It is more than likely that given the presence of grade 5 cells and the positive margins, additional therapy in the way of radiation may be done in the future after he recovers from the operation. The aim of this is to try and kill any tumour cells that may be in the prostate bed (tissue that surrounded the prostate). His PSA at about 6-8 weeks after his operation the key, although as Fairwind has said, they may elect to go with the additional therapy as a precaution without waiting for obvious signs that surgery did not remove all the tumour..
Bill

Post Edited (BillyMac) : 6/9/2011 10:03:02 PM (GMT-6)

Posted 6/10/2011 11:05 AM (GMT 0)
thnaks guys for you answers. i would like just to understand if the opeation was successful or not, is a positif margin means there is cancers cells left behind? if yes, why waiting for PSA test? is there any chance for his PSA to be undetectable?
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