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Post-op Path question

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Posted 7/8/2014 1:38 PM (GMT 0)
Good morning,

 Had my surgery June 14 (MSK with Eastham) and am feeling pretty good. Incontinence seems more a nuisance now (2 pads a day). Havent attempted anything with the wife yet as still a bit sore around the middle and been pretty tired. Hoping for some "activity down there" soon. Taking 25mg Viagra daily right now

Just read the path report and was a bit concerned. Gleason confirmed 7 (4+3) which was pre op score . Lymph nodes, bladder neck negative as well. Final AJCC staging though was pT3a due to extracapsular extention. Margins were negative

Should I be concerned about the extracapsular extension even though margins were negative? Do I have a higher chance of recurrance? I go back July 30 for first PSA. Being 46 Im a bit worried that I am in danger of a recurrance

Thanks

hatter

Posted 7/8/2014 2:02 PM (GMT 0)
My understanding is that ECE is a risk factor for recurrence but not a particularly dire one in the absence of positive margins. It adds a few percent to the odds that you will recur but it also adds to the chances that any recurrence will be local to the prostate bed and treatable with radiation.

Because of your ECE you will probably be seeing your doctor for PSA tests more often since he/she will want to watch you.
Posted 7/8/2014 2:03 PM (GMT 0)
Good Morning hatter,

MSK with Eastham...one of the best!

Did he show you the online MSK nomograms?  Go here:  http://nomograms.mskcc.org/Prostate/index.aspx

Then, select the Post-Radical Prostatectomy (Recurrence After Surgery).

You might also get some anecdotal replies in this thread, like "Here's what happened to me...," but at this point what's meaningful to you is the big picture about what happens to large populations of men like you.  Or more specifically, what's the likelihood (statistical probability) of recurrence in men like you.

Try out it out...  You can toggle back and forth different inputs to see what the differences are with and without EPE.

Posted 7/8/2014 10:16 PM (GMT 0)
It sounds like your surgeon was able to cut around the EPE and leave no positive margin which sounds great. Ask your surgeon if he thinks he got it all based on the report. Good luck!
Posted 7/9/2014 1:08 AM (GMT 0)
Hatter, re ED, stimulation appears to be the key, taking the pills "allow" things to happen. Try a little massage in the shower...worked for me!
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