How serious a threat is a 3+4 tumor close to the apex?

By threat, I am referring to post-treatment Mets. And, and any Gleason tumor lying near the Apex.

I have not found any significant research on this topic yet hear it sighted from time to time on this forum. Would be most greatful for any clinical studies or other related evidence.

Browntrout, I'll let some of the smarter guys correct me if I'm wrong, but I think the issue with your cancer being at the apex is more of an issue with surgery than brachy like you had. The seeds cover the whole gland so I don't think the specific location is as important.

BTW, sure looks your PSA is going in the right direction.

I had a large tumor in the apex and that's why I had combo LDR/IMRT instead of surgery. Psa from 40 and has been <.1 for 6 years.

I will try to bump this forward one time beep cause others hav also expressed an interest. I have tried the blackle trail and the search function shows people making statements about the seriousness about this issue but nothing inthe way of referenced reading.

Even pointing a finger in the right direction would be most appreciated.

Why would a tumor at the apex be any more serious than a tumor at the edge of any point of the prostate when the margins are negative. Negative margins are a good thing. A contained cancer in the prostate is a good thing. I knew apex tumor was a risk factor[preop} for positive margins, but if the margins are negative???????

Prato, I don't think that's accurate. Wouldn't be a capsule if it was "open" anywhere. The only "opening" near the apex is where the urethra exits the prostrate and enters the penis. And that is not an opening in the sense you're describing.

Cheers, Doug

The capsule surround the prostate to my knowledge. On your other point, think you meant negative margins, but ich mach nix, that issue really is another subject altogether. I won't go into why, You are not ready...grasshopper! clue... anything is possible some things are not relevant to issue at hand. Relevance is relative!!!

It seems there is the highest amount of cancer discovered in the apex hence in proximity to the erectile nerves being close can create, via internal prostate nerves{ there are many leading here and there within the prostate] some of which can lead to the erectile nerves. PNI peri{around} neural{nerves}…. Cancer cells, like humans, will take the path of least resistance. In the prostate the resistance is the least in the space peri the neurals. So When the cancer is identified in the apex, that danger is real. The cells will routinely grow in that space, actually leaving the nerves them selves alone.Eventually they will get em tho as the empty space disappears. Empty space is easier to travel than nerve fibers. Hokay. this is why in a preop biopsy PNI is prognostic for epe. But once the prostate is gone postop path done and negative margins are identified, the prognostic value is gone. Now the point of PNI being prognostic post op{ some argue this} is based on the theory that something is creating BCR in folks with excellent post op pathology. Hardly a scientific genitor! I personally do not dismiss that argument, I just need more evidence than a lazy mind. This would be easy to do. What I will say about it is that if there was as many BCR"s as there is PNI reported{ some do not even report it , {tho that number is decreasing at an increasing rate}, on Post op Path, Id be a little more sympathetic. 2 more points that are relatives to this discussion, but some what adrift to the {t}issue.tee hee. 1. the bad news of the apex sitiation is hand and hand with the good news that apex cancer is generally the only location that a urologist can feel the cancer via a dre., hence earlier diagnosis. 2, The misinformation that is exhibited here due to getting some knowledge piecing it to gather with other knowledge and coming to the wrong conclusion is inherent in any organization, group, anywhere a bunch of humans are interacting, It can only be eradicated with evolution and sincere egoless effort. It happening, its happening, but we are still a long way from that. All I can do is , If not me?, Who!…. If not now ? …When! thanks for your time. I hope the lack of editing is not to confusing. If and when I get serious about really good writing I will hire an editor.