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Pathology Report- feedback please

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Prostate Cancer
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Posted 6/6/2016 10:06 PM (GMT 0)
Hello all,

Got my stitches out and catheter out...... won't miss that.

Summary from surgeon - Lymph nodes negative, cancer 3+4, glesson7 and 7% involvement. Cancer was outside prostate on left side but within margins. Doctor says glass is half full, has seen many outcomes like this with no recurrence. Mentioned T3.....which from the intro thread on this site says high chance of recurrence but he says he is not concerned. Looking for undetectable on next PSA.

If I m understanding this right, the cancer was outside the prostate however he was successful in removing it all. The risk is that while it was outside and untreated it had the opportunity to spread?

Is there anything specific on the pathology report I should be paying attention to?

Some highlights and no idea what they mean:

Extraprostatic extension - present - non focal (established, extensive) - left posterior
Margins uninvolved by invasive carceinoma
Primary tumor PT3a Extraprostatic extension or microscopic invasion of bladder neck

Thanks in advance for your input.

Greg
Posted 6/6/2016 11:31 PM (GMT 0)
So now it's just a waiting game until that first PSA test...Until then, it's all speculation for better or for worse...It could go either way but I think the odds are on your side..So work on your recovery from the surgery, worry about the here and now not something that's 4 months down the road..
Posted 6/6/2016 11:36 PM (GMT 0)
The 7% involvement is the best thing you have going post-surgery, that's fairly low, if that is all there was. See how you do after the next 2-3 scheduled post PSA tests.

I wish you the best as you wait.
Posted 6/6/2016 11:47 PM (GMT 0)
The only thing to pay attention to is the next PSA test - that's the proof. You pathology report is an interesting data point, but for the moment nothing to take action on - just pure speculation.

and remember the glass is always full - half water, half air...

Andrew
Posted 6/7/2016 12:23 AM (GMT 0)
It's a good idea to get an ultrasensitive PSA test. You can get some meaningful readings at 6 weeks, although 3 months is more typical.

- Allen
Posted 6/7/2016 12:29 AM (GMT 0)
The others are saying what I"m thinking: all in all, not a super bad pathology report. The extracapsular extension is a concern, but with negative surgical margins, it certainly suggests they got it. I know it's hard to hear, but pay attention to your surgeon. The key is what your PSA does, and it usually takes up to 3 months to get a clear indication of what the future holds. It's highly likely you'll be joining the zero club...which is the best club of all.
Posted 6/7/2016 12:49 AM (GMT 0)
Negativie margins are negative margins...to worry if it spread while it was out side the prostate is silly... it did spread while it was out side the prostate... cancer will do that everytime... the point is... with post op pathology reporting negative margins the specimen{ prostate and and cancer infested flesh outside prostate}was removed...and outside of inked margins was free of detectable cancer under a microscope.. that is exactly the same as having prostate contained cancer. Could micromets have escaped 6 mos ...a year even before surgery...Yep...thats why they do psa tests...prognostically there is no difference..I don't care what the dialectical arguments{studies} say... they are at best... simply that... edumacated guesses in a quest for knowledge...no more ..no less.. As shredder said in tmnt..." go... play...have fun"...life is to short for angst...at any age...in any situation!!
Posted 6/7/2016 12:29 PM (GMT 0)
Thank you for your response and well wishes. Knowledge is power and I appreciate your sharing.

I did some research and PT3a means that there was some microscopic cancer cells identified on the bladder neck. This can result in some cancer returning down the road but looks like 5 years post op without recurrence averages 98% so that is a good number. (If I read things right). The doctor said that he felt I was 90% positive outcome and at least 75%. I have more knowledge now to take to my next appointment in a couple of months and will have the first PSA test by then. Thinking about zero's.

On a positive note, although it has been less than a day, I seem to be having good fortune on the continence front. No leakage in the night, no urgency. A little red urine to start the flow but clears up right away. I am wanting to have a few drinks by the pool with my wife but don't want to go there just yet. Maybe on Saturday.

The doctor gave me a 6 month supply of some daily use cialis and a prescription for viagra and cialis if needed. I am going to wait until the weekend to start taking the daily doses if all continues to go well and start working things after week 4. I am wanting to make sure everything is healed before there is a lot of activity.

Plan your work and work your plan.........I hope it makes sense........

Greg
Posted 6/7/2016 9:07 PM (GMT 0)

newtopc said...
I did some research and PT3a means that there was some microscopic cancer cells identified on the bladder neck.


Not exactly, pT3A means Extraprostatic extension OR microscopic invasion of the bladder neck. You have the EPE, not the bladder neck invasion. Good for you.

BTW, you can be a member of the pT3 club
www.healingwell.com/community/default.aspx?f=35&m=3482343
Posted 6/7/2016 9:26 PM (GMT 0)
Your stats are pretty similar to mine. I'm 5 years out with no problems except some ED.
Posted 6/7/2016 9:32 PM (GMT 0)
Nice catch Gemlin
Posted 6/9/2016 2:41 PM (GMT 0)
Thanks Gemlin, I reread the report and you are correct, it doe say OR.........so I take it EPE is better. What exactly does that mean and what impact could occur in the future?

Thanks in advance

Greg

ps. I am going to join the PT3 club, thanks for letting me know about it.
Posted 6/9/2016 8:11 PM (GMT 0)

newtopc said...
...EPE is better. What exactly does that mean and what impact could occur in the future?


With EPE there is a higher risk of BCF (as for positive margins) but unfortunately also some higher risk for metastasis (which is not the case for positive margins only). The higher Gleason of the EPE the higher risk for mets. I think that if EPE was G3 is much better than if the EPE was G4. The extent of the EPE is also a factor.
Posted 6/10/2016 12:28 AM (GMT 0)
good move...my apoligies...it will not happen again
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