perineural invasion

   

     Have spent the last couple of days reading many of your posts.  It has been very helpful.  We have been home now for a couple of days following da Vinci Prostatectomy.  Now we are waiting for the path results on Friday.  I don't know which  is worse waiting for surgery or waiting for the test results.  Mike was 2.9 psa, 3+3 gleason 2 out of 12 positive. One less than 3% and one less than 20%. My worry is one said perineural invasion is identified.  The Dr. said that has no bearing on the outcome and is commom.  If that is so, why do they include it in the diagnoses.  Has anyone else had this on their pre treatment biopsy.  Just wondering if anyone could shed some light on this for  me.  Mike doesn't really want to discuss it at this point.  He is doing well recovering from surgery,and is finally getting rid of some of the gas.  That has been his biggest problem.  Thanks for all your help and support.    Pam

HI doting wife. My first urologist told me I had it and because of that it indicated the cancer was outside the prostate. He suggested external radiation and seed implants. I wanted surgery of some kind to get the cancer out of me. My second urologist who did my surgery told me it did not mean that it had escaped. I had negative margins and my first PSA after surgery was less than 0.01. Reading the posts from other people should make you feel better, but you never know the outcome until you get your pathology report after surgery, but think positive and trust in God and what ever the outcome we are all here for, and with you.

Mika

TC-LasVagas,Mika Thank you both for your information. I can't tell you how much this helps to be able to talk to someone about this!! I will keep reading and posting and trying to be positive. Thanks again. pam

Hi Tamu,
I posted a link above that indeed has that study at Mayo as a reference. Here it is again...

http://www.diagnosis.prostate-help.org/perineu.htm

Tony

Hey ~ Pam, Here's another bit of information that may calm your fears... until you know for sure ~ pull all the positive strength you can from all of us!!!  Continue to stay close. In Friendship ~ Lee & Buddy ** Excerpts taken from “Dr. Patrick Walsh’s Guide to Surviving Prostate Cancer” by: Patrick C. Walsh, M.D. and Janet Farrar Worthington.    Copyright 2001   This book gave us so much knowledge… and Knowledge is Power .     Page 145 ** What about Perineural Invasion? As cancers grow, they compress normal tissue, looking for “elbow room”—spaces with less resistance, where they can spread.   Nerves are usually surrounded by some empty space; for cancer, this is the real estate equivalent of a nice suburban lot with a big backyard—plenty of elbow room.   Thus, it’s not uncommon to find prostate cancer in the spaces around the nerves; this is called ‘perineural invasion.”   Because the nerves are most common close to the surface of the prostate, the findings of perineural invasion on a biopsy suggests that the cancer is close to the edge of the prostate, and may well have penetrated the capsule.   However—this is important to keep in mind— cancer that has penetrated the capsule can still be cured .   Which makes this a paradoxical finding—because, although men with perineural invaion are more likely to have capsular penetration than men without it, perineural invasion has no long-term impact on whether or not a man can be cured .   For this reason, some noted pathologists have suggested that it should not even be commented on when found in a biopsy, because it’s not worth worrying about . <end quote>

Yes TC, that is why I got a second opinion.

Mika