Perineural Invasion

From another post from our Forum Moderator:

Bluebird said...

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>



I too had perineural invasion, and when I read it I literally got weak in the knees. It turned out to be insignificant and I had negative margins post surgery. Many others here will tell you the same thing.

Sorry to have to welcome you here, but as you will hear from lots of folks here too, "welcome to the club you never wanted to be part of". You will find lots of answers and support here.

The most important I learned was to take your time and educate yourself, and by all means, if you choose surgery, make sure you have a great surgeon. Many here found surgeons through referrals and research and did not go with the surgeon that diagnosed them. I know I didn't and am confident that it was a good decision.

The fear will stay with you for awhile, but don't allow yourself to make rash uninformed decisions. Your PSA is low and your Gleason score shows that you have a non-agressive cancer. You have time on your side.

Good luck on your journey and stay with us.

Hi   ~ Bootheel ,   Welcome to the Forum!   You have made a great choice to reach out to others in this forum.   Members of this forum have the ability to help your journey to healing become a little better and brighter.   In turn, your discussion and comments help all of us further develop our personal understanding and compassion.     HealingWell will always be here for you…!   You are now part our forum family ~ a group of wonderful individuals who are willing to share and to care .   We’d like to hear and respond to anything you’d like to express.   So please, keep posting.     My thoughts and prayers will be with you, as you make important, personal choices toward healing.   Kindest regards,, IdahoSurvivor ~ Barry

Thanks for the good sound advice.  It has already made my stress level go down.  I am a little older than you but I still have good erections.  I can be happy with any results as long as I am alive, although  it would be a bonus to regain potency. Reading my post you know that my PSA doubled in one month.  I think it was the result of a biopsy (16 needles) about three weeks ago.  My PCP had my wife and I scared to death saying that I should have surgery immediately.  I think he should leave that decision up to my Uro.  I think his statement was based on opinion and not fact. We are still in shock over his comments.

Thanks again for the advice 

 

Bootheel said...
Thanks Barry for the warm welcome.  I read your reply to Chas036 about removal of one nerve bundle during surgery and ED probability.  My diagnoses is similar to yours.  Did you have perineural invasion as part of the diagnosis.  I just assumed that it meant removal of that nerve bundle during surgery.

Hi Bootheel,

My pre-surgery biopsy did not indicate perineural invasion.  My post-surgery pathology indicated that the tumor was contained in the prostate.  I was fortunate to find that the tumor post-surgery was smaller than expected from the pre-surgery biopsy results. 

Typically, doctors would like you to have surgery within four months of diagnosis when there is a chance of taking the tumor self-contained.  Considering how long it may take to get surgery set up with the hospital, and following the 6-8 week required delay after biopsy, your doctor may be considering "right away" to be inside this four month period.

Do you have a second opinion in mind?

Kind regards,

Thanks for the clarification.  I am newly diagnosed and not familiar with all of the medical terms yet.  I feel a little more at ease knowing that there isn't a connection.

Thanks for your input