How to read pathology report?

Too tempting to answer since you have got not replies so far. I guess, it is still early at your side of the Atlantic. Consider that I am not an expert and my answer is purely based in googling. As other say, essentially I do not know what I am talking about.
T3a means that they detected cancer outside what are considered to be the limits of the prostate, negative margins means that there is not cancer in the limits of what the surgeon has removed so that probably he has taken it all out. There are contradictory statistics but, in average, positive margins or T3a show similar prognosis. It means that you are classified as high risk (or borderline) from the surgery features though, again, you will find different definitions. T3a is definitely better than T3b according to all opinions.
Perineural invasion is another feature that increases risk, but it is not generally a statistically independent predictor. It means that it probably does not add much to your T3a status.
With respect to your PSA increase, you need some more tests to be sure if it means something or not. Good ultrasensitive tests gives usually three digits after the point; therefore maybe your test has an intermediate precission between "normal <0.1" and uPSA and your rising is simply be a fluctuation. You could ask your surgeon about the usual fluctuation observed in other patients taking the same test. Or just ask directly to some of them if you can.
We are not in the same ship, but in similar ones. I do not have any worrying surgical outcome but I have a higher pathological Gleason grade. And I am also getting ambiguous two digit PSA test results.

To expound on Robs comments, PIN is the presence of cells that are atypical, but not cancerous. It is, in a biopsy, often a pre-cursor to cancer. Now that is out of your body, it’s irrelevant. It means more on biopsy pathology than surgical pathology

T3a – Penetration of prostate capsule on one or both sides.

Means the tumor was localized and extended outside the prostate.

epe - Extraprostatic Extension, they found a localized tumor extending out of the prostate.

Not the best news. If you're next PSA test is up again, you'll need to talk to an RO about SRT and possibly a few rounds of HT.

In your place I'd ask for a retest in 3 months.
Andrew

the gleason score of 4+3 puts you in a higher risk group. If the rising PSA pattern holds that's an indication that something is still there. If it's still in the prostate bed, then SRT+HT will clear it up.

Andrew

oldbeek,

I agree with fiddlecanoe.

Even some of the best PCa surgeons still hold to the old .2 protocol, but current research indicates that the threshold should be lowered to .1. I too was pT3a, my PSA rose post-surgery from undetectable to .09, my surgeon was convinced he "got it all" and wanted me to wait till .2, but after consulting with three ROs I pulled the trigger earlier. We'll never know whether I would have done just as well waiting longer, but the odds seem to favor taking action at .1.

Thanks guys. I am old and trying to enjoy the rest of my life and don't need more SEs. My next test is in January. If that is over .1, I am seeing an RO. If still under .1, I most likely will wait 3 months for another PSA test.

:thumbs up: