Just found this place - checking in

Hi Guys;

Just found this place a couple of weeks ago, and checking in.

I was diagnosed with a PSA of 34.2 in May at age 53 - no symptoms of anything. That started the dance of the urologists. TRUS biopsy of 14 cores, 9 positive. Of those 4 were 4+3 and involved 90% of the core, and the other five were 3+4 involving 5% to 80% of the core. These were read by Urology Consultants of North Shore, and Lahey Burlington (MA) with the same results.

Changed urologists to get into the Lahey Burlington (MA) Institute of Urology - very experienced RA RP group. Went ahead with abdominal CT - didn't show much; bone scan - negative, more blood work, and an MRI pre-surgery - no surprises in any of it. Decided on RA RP vs. radiation as this would give a definitive staging of the cancer. And when discussing with both old and new urologists (old urologist is about to retire, and doesn't do surgery any more, but was willing to consult with me), both used the same argument that the worst case scenario with surgery is better than the worst case scenario with failed radiation (salvage surgery, 50/50 chance of permanent incontinence).

Had the RA RP on August 24, the surgery went well, and I'm healing well (some drainage that started 10 days after surgery - a bit odd, but not unheard of). Surgery at Lahey Burlington with Dr. Canes (4,000+ RA RP surgeries and very well regarded in the "industry").

Went back on this past Friday and got the catheter out, met with Dr. Canes to discuss the case, next steps and the final pathology report. Final pathology was a surprise to both him and me, and not very good news:
- extraprostatic extension through the capsule (Surprise!)
- 4 of 8 pelvic lymph nodes positive for metastatic cancer (Surprise!) (i know metastatic can be argued as they are still in the pelvis)
- One positive margin in the posterior of about 5 mm (Surprise!)
- Invasion of the seminal vesicles - both sides
- Cancer on both sides of prostate
- The Gleason was the same as the biopsies
- So that makes me T3b N1 M0
- Partial nerve spring on right side, none on left
- Stress incontinence; ED

So not a great set of outcomes, now I wait for 7 weeks for a PSA which will determine what we do next. Most likely HT and ART.

Any and all thoughts and opinions are welcome.

Cheers!

Rob

I'll echo what Hero says: What a bummer! You seem much more well-informed than I was at your stage. The big question at this point is whether the cancer has spread beyond the pelvis. If it has, ART probably can't help. I waited ten months after my surgery to begin radiation. I started SRT as soon as I regained continence. Good luck.

Hi Rob, no that's not really the post rp report u really wanted I'm kinda surprised your Gleason wasn't higher. I had a pre Gleason of 7 after Rp
They changed it to 9 you can see from my signature the rest of the story going back October 11 meeting with RO after psa check probably start SRT the next week he likes to wait at least 6 months after surgery to start radiation. Hoping to hold off on ADT for a while. Hang in there and hope for a non detectable #

Larry

Rancher Dave are you being treated at the mayo in Rochester?

Welcome to HW.

Not the best report. Still you've plenty of options.

That PSA will tell. Now just rest and heal for awhile.

Andrew

welcome to this not so lonely place on the lonely planet. Its a miracle we are here and it sucks that our own body is whats trying to hurt us. We have to be gladiators and keep fighting.

Hi Guys;

Just got my post-op PSA 0.13 Right in the middle of wait and see and do something. Not the result I was hoping for.

I see the doc on Friday and we'll see what he says. I already know he is on the more aggressive side of treatment, so likely he will recommend HT and SRT due to the lymph node involvement.

I guess I'm a full fledged member of the pT3 club at this point.

Rob