Interesting that the C.C. calculator shows higher odds of recurrence for a 3+4 with EPE+ and margins- than for margins+ and EPE-. Isn’t that opposite of how early treatment post RP is typically...
Question on the Cleveland Clinic calculator — is Capsule Invasion Type from DRE or pathology and what is the type Inv.Capsule? You can enter that EPE is Yes but have Capsule Invasion Type as None....
As a data point, I had RRP surgery done last August at Mass General in Boston. After 3 biopsies with 52 total cores taken while on AS for 5 years only ever finding G6, my pathology from surgery...
MrB, I had RP a little over a month ago and have the same pathology as you (see my signature). Per the nomograms, the odds of recurrence for us are relatively low. A little higher with EPE but lower...
I had RRP surgery last month and had negative LN, SV and margins but positive EPE found on a second opinion read by John Hopkins (missed on original pathology). I don't know what your Gleason score...
Good report and congrats on the progress. As someone who is four weeks post RP, its helpful to hear about your experience over the first year....
Thanks and good advice. One benefit of being on AS for 4+ years, is that you become more practiced in waiting for results -- biopsies, MRI's, PSAs, etc. I've definitely gotten better at being able to...
I actually spoke with Dr. Epstein about the second opinion of EPE. Its great that he makes himself available. He said the EPE was small (presumably why Mass General missed it). He also said given my...
I'm pretty shocked by this finding -- 1) I've had three biopsies that only ever found small amounts of G6 around the prostate and three mpMRIs two of which were totally clear and all three showed no...
Just from some quick online reading, it seems as though there's some question about whether or not EPE alone with negative margins needs treatment?...
Thanks Gemlin The EPE was the right base. The biopsies never found much of anything (2 out 47 cores <5% G6) other than the fusion biopsy which went 5 for 5 at the target 19mm lesion (from mpMRI) in...
I had RRP surgery about three weeks ago on 8/16 at Mass General in Boston. The pathology report was negative for SV, LN, margins and EPE. The final Gleason was 3+4=7 vs. my three prior biopsies (see...
Thanks Pratoman. This is probably a dumb question but is the point of kegels to strengthen the pelvic floor muscles so that you will be voluntarily squeezing them to stop the leaking or does the...
Subdenis I was on AS for 4.5 years before going for surgery just over two weeks ago. I had a steadily rising PSA going from 3.9 five years ago to 7.4 this year. Going into this spring, I had had two...
I've already had improvement with incontinence since cath came out four days ago on Monday. Ive been following a daily pattern of being totally dry in bed at night (though up 3-4 times during the...
Sorry about the path report but at least you had the surgery done. With your pre op stats, you could have easily chosen active surveillance. With only small amount of Gleason 6, what prompted you to...
I appreciate everyone's advice. It sounds like not pushing the kegels too much too soon after surgery is the right thing to do. I'm ok delaying continence some if that avoids an injury/setback. I was...
I had RRP surgery on 8/16/17 and had my catheter removed today, 12 days later. The good news is that I had a good pathology report -- clear margins, negative EPE, LN and SV. Final Gleason is 3+4=7....
Good advice Island time. Having no pattern 4 ever found in my biopsies that is now shown in final pathology, I definitely want to know how much was in my prostate. If my report doesn't include that...
Thanks for the responses MrBaseball -- I started walking as soon as I got to my hospital room from OR recovery. I tried to do 3 laps around the hospital floor every hour. A sign there said 24 laps...
I had RRP surgery done one week ago on 8/16. Surgery and recovery have gone very well. I experienced very little pain -- have yet to have needed even as much as a Tylenol (let alone painkiller) and...
Guys, Thanks for the advice, experiences and encouragement. All very valuable. I'm pretty much at Go-time and its helpful to hear about other's experiences heading into this....
Fiddlecanoe and Peter - thanks for your support. I realize pelvic muscle strength only part of equation but it's one of the things I can control in trying to prep as best I can. Hoping for the best...
I'm going for a RRP prostatectomy in a little over a week and have been doing kegel exercises for past 9 weeks knowing surgery was coming. I've gone from not being able to hold the kegel at all, to...
BPC, I'm on you're exact time track. I'm scheduled for RRP surgery on August 16. Question to group on kegels -- I've been doing sets of 10-15 four x a day. I can squeeze easily enough, but can't seem...
Ddyss, Peanut butter on whole grain bread before bed at night will add weight and are reasonably healthy especially if it's natural/low sugar peanut butter. Why are you still on a PC diet if you're...
Thanks for the advice Halbert. I have started kegels but will amp those up and try to do more core training in the time I have left. Bessebo, that's a good idea on hand gripper as one thing you can...
Bessebo, I will be going in for a prostatectomy in a couple of months and most of the guys I've spoken to that have had it say one of the benefits is that eventually you can hold urine much longer --...
Jack, I think you're right on the key issue -- for purposes of AS, do I have "high volume" G6 or not? On the last biopsy, none was found beyond the tumor but the tumor was sizable. To answer your...
Good advice TA. I've already scheduled a meeting with radiation oncologist as would like the chance to learn of more options and get another opinion. I'm not taking Proscar or Avodart....
Yes Jack, your interpretation of my May biopsy is correct -- all 5 positive core were from the targeted lesion and the 16 other cores taken systematically around the prostate were benign. When my Uro...
Based on my latest biopsy results, my Uro recommends surgery. His view is that although only G6 has been found and really only in this one lesion in the transition zone, because there were 5 cores...
Given my stats, I'm inclined not to treat now but if there's risk of it growing quickly into the urethra or bladder, I'd rather avoid that. I'm anxious to hear what my uro has to say, but most of...
Thanks TA. My urinary issues are mild if at all (e.g. I'm up 1 time a night) but if the tumor has the potential to grow fast, I'd want to treat now. The only reason I'd stay on AS is because its G6...
Thanks John. That's good to know. Looks like your treatment of seeds and IMRT has worked out very well. Did you even consider surgery? As I think about my findings, it was 5 of 17 G6 positive but the...
Btw Astronut, good luck on Monday. I was aligned with your thinking that if any pattern 4 showed up for me, I was inclined to come off AS. This result is not as simple as that although still...
Thanks to all for responses. Astronut, Although my first MRI 4 years was negative, "no suspicious lesions" and "no prostate cancer seen", it did note that there were "rounded areas of T2...
Thanks Jack. I've now seen the report and its actually 5 of 17 cores G6 (the person providing results had said 2 of 17). All 5 positive cores are from the targeted lesion in the transition zone. The...
I've been on AS for four years with PSA rising from 5.8 four years ago to 7.4 at present, two previous biopsies showing 1/14 cores at <1% G6 and 1/17 at 5% G6 and two mpMRIs which were all clear....
Signature included this time...
Astronut I've been on AS for 4 years with my stats for that in signature below. Last month I had an MpMRI identify a Pirads 4 lesion in the transition zone and now waiting for results from the fusion...
The negative predictive value of an mpMRI for significant cancer is high. The studies I've seen show it to be >90%. My uro at Mass General in Boston said its assumed to miss meaningful cancer about...
Ok got it. Thanks. And probably another dumb question but even a G6 outside the prostate can cause trouble, correct?...
Ok so although the negative predictive value of a mpMRI (>90% from what I've been able to find) for clinically significant cancer within the prostate is high, it doesn't help much as to whether...
If a pre surgery mpMRI notes no sign of EPE, how reliable is that as to whether or not cancer has left the prostate?...
Yes postatitis can be hard to detect and that would seem to be a good reason not to let someone with low volume G6 only but high PSA density be excluded from AS. I'm on AS and to date have only very...
Good information by all. Take away has to be that someone with G6 is more likely to end up with G7 or higher, than someone with no G6. Seems obvious but didn't know if had been studied. Another...
Thanks for responses which are helpful. Intuitively, it would seem that if someone has a G6 he would be more likely to develop G7 (not progression from G6, but as a new and separate cancer) than...
If one is found to have Gleason 6 cancer, is he statistically more likely to have or ultimately develop clinically significant cancer, G7 or higher, than someone that does not have any G6? I believe...
Sounds great! Did you give any thought to going on AS after your biopsy results or was it clear cut to do surgery? I'm betting that once you decided to have surgery, if you could have signed up for...