Hi samster, - I had prepared a rather complete and lengthy explanation in a reply but it suddenly disappeared, from my page, just before Posting, simultaneously with TC's Postings, who is the forum moderator and whose control of the forum than regular members. It takes me a considerable amount of time (hours) to prepare the comprehensive explanations that I try to Post and so this does not make me particularly happy, although I know it was not intentional.
I always hesitate to comment on results that are taken out of context, since the missing information could help clarify some questionable areas. Depending on your stated information, however, I will say that, over all, your report is relatively favor, except for the identification of a limited amount of more aggressive Gleason GRADE 4 in the samples.
Although Tony has presumed this to be a post-surgery Pathologic Report, however, I believe this to be in error and that it is actually a Biopsy Report, because of the structure of the information reported. I make this judgment, assuming that the Pathologist adhered to the recommended Reporting changes in 2006 by a specially appointed, prestigious panel of Pathologists who were members of the American College of Pathologists (ACP) and which were subsequently adopted by ACP and other standard-setting organizations across the world. If he did, it denotes Biopsy findings.
The stated, “Negative lymph nodes, margins, seminal, Vas deferens,” are all favorable factors improving the statistical probability of organ confinement of the disease. This means that the effectiveness of “localized” treatment such as surgery and radiation also have improved prospects of effectiveness and enhance the statistical odds of successful primary treatment. These are the two most often employed treatments for localized disease, but there are other, less proven, options that should be considered to ensure an INFORMED treatment decision is made.
Let me specifically address the presence of the Gleason GRADE 4 that is reported to be present in the Report. Obviously, it would be better if it was NOT there, but it appears to be of limited presence and before that 2006 Reporting change, you MIGHT have been considered a Gleason SCORE of (3+3)=6, rather than the present (3+4)=7, depending on the actual percentage identified.
The finding of High Grade PIN, which is thought by many to be a precursor to PCa, has little clinical significance once PCa has been identified and diagnosed, as is the case here. All and all, it APPEARS that you likely have organ-confined disease with an excellent chance for permanently effective primary mono-therapy treatment. Good luck and I wish you the best in your decision making process. –
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