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Posted 8/20/2011 7:54 PM (GMT 0)
Just got a call from my surgeon two days ago.  Robotic Surgery 4 weeks ago.

I do not have the very deteailed and descriptive stats that you guys have,  not yet.... they will send me a copy of the report.

My surgeon,  very wise, very experienced says,    Tumor was very small,  Gleason 6.    All margins clear  EXCEPT,   a 1 mm segment at the neck of the bladder but he is not concerned because that area was burned by cautery....  i asked him several times if i should be concerned about that 1 mm margin....  he repeatedly said , No.   Gives me a number of 10% chance of recurrence of disease in 10 years.

I love my surgeon, trust him greatly....   but i am a dentist,  i do surgery myself....  and i know if the margin isn't clear... IT ISN"T CLEAR.

who knows how far bad cells extended past the margin... ( that was burned )....   so now i worry......

he wants to see me in 3 months for my first follow up appt.....     This wonderful man specializes in Urologic Oncology and is a Professor at a major University....   that does make me feel good .... he does know what he is talking about....    he teaches other surgeons to perform the Da Vinci Surgery.

i will post my exact stats when i gather all of the info.....

what do you fine gentlemen think ?     "Forget about it "  concentrate on getting well ???

dr nick

Posted 8/20/2011 8:00 PM (GMT 0)
I had a focal positive margin, still clean ~17 months out, a positive margin isn't any guarantee of recurrance just as a clean margin isn't a guarantee you got it all. Sadly it's a wait and see.
Best of luck to you.
Posted 8/20/2011 8:34 PM (GMT 0)
Hey Dr. Nick,

I'd say trust your doctor and relax. First of all, 1mm is very small, and if he says he cauterized it, he probably did. Even if he didn't, according to Epstein, only 50% of positive margins are even viable. Plus, with Gleason 6, even it were viable, that wouldn't mean you need to act. So wait to see if your PSA rises, and if it does eventually, see how fast it rises. It probably would be so slow that it never matters.

Wishing you the best,
Nellie
Posted 8/20/2011 10:57 PM (GMT 0)

You had surgery. Now you have to recover, get dry and start your ED treatment.

This is the most important thing you can do now. WALK WALK WALK, keep the weight down and KEGEL KEGEL KEGEL.

At 6 or 8 weeks get an ultrasensitive PSA and see where you stand. No reason to wait till the 3 or 4 month point, if it's on your mind.

If your PSA does not go to less than .01, THEN you decide what that means to you. If it does drop to nothing then you apply for the Zero Club !!!

Worrying excessively will hurt you more than the cancer! We're all in this for the long haul!

Posted 8/22/2011 10:35 PM (GMT 0)
thanks ,,, all of you.... you guys are the best ..... good advice..... i have had no real problem with continence.... even the day after the cath was removed.... use one the wife's pads..... just for protection ,,,, just in case.... there are small "squirts" as when i cough or strain hard..... that's it.... i know i am so lucky..... i am grateful for this.....
as for willy..... he has disappeared..... he is ashamed..... but we have lots of time for that......
Posted 8/23/2011 12:14 AM (GMT 0)
Aerie, enjoy life, concentrate on the future, hug the ones you love, and worry about the things you have some control over.  You have been blessed.  You have faced a terrible disease and come through in good shape.  I would trust your doctor and consider yourself "cured" until proven wrong.  Congratulations.
Posted 8/23/2011 12:22 AM (GMT 0)
Aerie, Not a bad report. Time to get on with that healing and feeling good. It is very typical to have your next PSA at the 3 months. Get on to living life to the fullest. Get busy with the willy rehab.

He needs attention or he will hide forever!

Cajun Jeff
Posted 8/24/2011 7:14 AM (GMT 0)
My very dear friend is the Sloan Kettering Prostate Cancer Nomogram:
http://nomograms.mskcc.org/Prostate/PostRadicalProstatectomy.aspx

I made some intelligent guesses based on the information given by aerie3 and plugged them into the nomogram. What came out looked very reassuring and many of the variations I tried came up suggest to me that your surgeon's prognosis is the worst case. Playing with the nomogram, it would appear that a positive surgical margin has very little effect on the overall result, maybe worsening the prognosis by 2%.

I know it's difficult but it's really best to trust your surgeon and try not to panic.
Posted 8/24/2011 7:58 AM (GMT 0)

 Hello Dr nick

well done on an excellent post surgery resuslt, continent so early, ED next hurdle, well at least sticking a needle in shouldn't be a scary thing or would it? , as for the positive margin if doc says is gone thats it gone, get on with healing. only allowed to think about it the week you give blood for PSA then forget again easy as that, nearly unfortunately we all seem to worry at PSA time, but hopefully that will pass to.

good luck to you, Ausboy

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