Perineural Invasion

Hi
Can't help you with radiation as my husband is still waiting for his first post-op PSA reading (in 2 weeks). As far as the perineural invasion goes my husband's path report stated that there was perineural invasion present, but that there was no extracapsular perineural invasion. From my understanding the perineural component (nerves within the prostate) are separate from the nerves that are spared in surgery. My husband had the right side nerves spared as the biopsy showed a left lobe tumour. The biopsy also showed negative perineural invasion. However, the post op pathology report showed that there were 3 tumours (left lobe, right posterior and apex) with perineural invasion ! I have also read many posts with differing opinions on the significance of perineural invasion. My doc said that the most significant result was that there were no positive surgical margins. That said, the docs cannot see if there has been any microscopic spread, and obviously the perineural involvement might certainly suggest the chance of microscopic spread. I hope that you get some good advice with regards to the radiation. Stay positive !

Hi Ladies,

I am a wife too.  Hubby has similiar numbers.  We are awaiting pathology.  Just want to say I understand the rollercoaster.

Best of luck to you both!

 

Thank you Alicepalace!  Hubby is recovering very, very well.  He is on the couch reading his laptop, watching the Food Network.  It is nice to see him relax, because he works so hard.  This entire episode has given him a new perspective, and that is a very good thing.  He is talking about a vacation and dinner dates.  That is something he didn't quite often take the time for before (or as much as I would have liked) :).  How is your hubby doing?  Wives club is needed, for sure.

Boogee - I just bumped the link to the ladies only links -
hugs,
Bronson

Bronson,

Welcome to the ladies club!

Since I am new, I see occasionally people state the size or weight of their prostate? What importance does it have regarding a persons stats? Not many people state their early post-op PSA's either????

Sounds like you are off to a good start with having surgery only.

Keep up the good numbers.

Good Luck!

BOOGEE

Thanks Bronson for the ladies only links - have saved them all in my favourites folder and will take a look. However, I think this forum provides the best advice and seems to be really busy.
Nice to know who all the ladies are with husbands in the same situation - it sure is a worrying time for all of us. Please make sure you all post updates on how things go.
Thanks and will all keep positive !
Alice

Boogee - I'm so sorry to hear of your husband's status. As you have found, this is a great place to get support from others. I too love the fact that wives can also have disucssions as you too are going through this emotional journey.

My RP surgery was 2 weeks ago and the pathology also showed positive perinueral invasion. We were very uncomfortable with these words and what they meant. The Surgeon and other professionals quickly put our minds at ease. They advised that is common and while anything can be an issue, it is not what it sounds like. This is the nerves internal to the prostate, so they and they cancer in them was removed in the RP. This is NOT the infamous nerve bundles that the surgeons try so hard to save. The primary concern for perinueral invasion is that these nerves can be a springboard for cancer cells getting out. Not hugely often, but is it one of the paths for cells to escape. Thus one can have positive perineural invasion and the cancer is still considered "contained" in the prostate.

One important question from your husband's pathology report is whether the margins were positive or negative? Do you have access to that information? If there were positive margins, it is important to understand where they were, as that's a potential indicator to where cancer was left behind when all the organs were removed. If all margins were negative, then positive PSA likely means some cells escaped through another mechanism. Hard to tell where they would have emplanted themselves.

I have not reached my 6 week PSA, so I'm still in that twilight zone waiting to hear. I had a 1 mm positive margin at the apex. Asserted that it will be inconsiquential, due to its location. I'm still concerned and holding on to the hope that PSA will be zero.