disappointing pathology--what's next
MZB
A Gleason 3+4 became a 4+3.
Lymph nodes and seminal vessicles were clear but there was perineural
invasion, extracaps. penetration, and one small positive focal margin (0.5
mm).
That has really bummed me out. They are not advocating adjuvant radiation.
My first post-op PSA will be 3/1. When it gets to 0.2 (or, I guess, if I get
a series of greatly increasing PSAs) we talk about radiation.
Has anyone had positive margins and then NOT gone on to radiation in the
near future?
Mel
Geo
Sorry to hear you had a pin hole penetration. Your case is very similar
to mine. I had no lymph node or seminal involvement with negative
margins. The Gleason score was 4+3=7 on both sides with 17% involvement.
But I did have a tiny encapsulation penetration in one spot so no home
run. My surgeon recommended a wait and see on the radiation. Happy to
report that so far (2.5yrs) PSA remains <0.1 and everything works fine.
As a precaution I took 200ug Selenium for 1 year until the government
study indicated it had no effect. The Se appeared to raise my Glaucoma
test readings which returned to normal a year after I stopped taking the
Se supplement. I don't recommend taking Se.
I take Vitamin D3 and soak up the sun every day walking 2 miles to beef
up my immune system. The penetration was not obvious to the surgeon and
was only found in the slice and dice pathology inspection. I believe the
D3 helps your immune system kill off bad cells. I only take 600mg D3.
Everything is good. I never leaked a drop after the catheter was
removed. Erections are normal again but I think your mind or something
gets traumatized for about a year.
Best of Luck
Geo
Claude
"MZB" <m...@noway.prudigy.net> wrote in message
news:hkqpcs$8im$1...@news.eternal-september.org...
X-no-archives:yes
X-no-archives: yes
Mel, sorry about the diagnosis. I had a similar post RP diagnosis to you in
2002, except my Gleason was 3+4. Also cancer cells were found in adipose
tissue outside of the prostate. My PSA stayed "undetectable" (>0.1 and then
>.05---I guess the labs changed. Never had "ultrasensative" results.). I
did not go on to radiation after surgery though I thought of it. I now
would not consider it because of some unrelated proctitis that the radiation
would probably only make worse. I am continent and have erectile function
(one nerve spared). To make a long story short, my PSA is still
undetectable. I am 72 years old.
mel
Thanks. That is very encouraging.
My first PSA will be 3/1.
I am leaking, which is VERY annoying. I've been told I am doing better than
most and this should improve (I use 1 pad during the day and 1 at night for
security although I am dry at night and I am about to dispense with the
night pad).
The more active I am the worse the leaking gets. Ditto regarding drinking.
Very frustrating!
Mel
"Claude" <cla...@nospam.com> wrote in message
news:hkrr95$pd$1...@news.eternal-september.org...
Steve Kramer
news:hkqpcs$8im$1...@news.eternal-september.org...
> A Gleason 3+4 became a 4+3.
-- skramer remarks
There was one needle as I recall in your initial biopsy with 4+3, so it
didn't really change.
> Lymph nodes and seminal vessicles were clear but there was perineural
> invasion, extracaps. penetration, and one small positive focal margin (0.5
> mm).
>
> That has really bummed me out. They are not advocating adjuvant radiation.
I know just how you feel. I went in with a 16 PSA, but T2 and high hopes.
After surgery, he told my wife he was 'pretty sure' he got it all, but it
was much more aggressive than he thought it would be. Before I was released
from the hospital, I found that I had SVI. T3. Kick in the ass! I hope
you handle it better than I did. I went straight to denial for about a
year.
> Has anyone had positive margins and then NOT gone on to radiation in the
> near future?
At first, we were thinking SRT, but when my 1st (2nd and 3rd) PSAs came back
< 0.1, we decided to put it off. Actually, my uro made the decision because
I still had my head up my ass. I'm glad we put it off. I think (with
little scientific proof) that the longer we put these things off, assuming
we hit it hard and early when the PSA starts going north, the longer we
live.
So, my advice to you is keep your head out of your ass and let the data lead
you.
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32 PSAD 0.56 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.40 years
Casodex added daily 07/06
PSA undetectable since. Next Assay 02/04/10
Illegitimati non carborundum
MZB
My original biopsy report from Umich was 4+3. Then Ford Hospital reread it
and it became 3+4.
Mel
"Steve Kramer" <skr...@cinci.rr.com> wrote in message
news:hksnp2$goj$1...@news.eternal-september.org...
frank curtis
> Has anyone had positive margins and then NOT gone on to radiation in the
> near future?
>
> Mel
Sure, I did. Also had 2 lymph nodes removed and post op psa was 1.37
only 2 months later. Went on lupron for 9 months and it went down to
undetectable. Been off it for 1 year and last psa was .02
This newsgroup is great but there's the danger of believing every
anecdote you read will be true for you as well. If I've learned
anything at all, it's that every case is unique.
Steve Kramer
> Steve:
>
> My original biopsy report from Umich was 4+3. Then Ford Hospital reread it
> and it became 3+4.
Oh. Okay. My mistake.
Steve Kramer
news:79f0b6fe-20b8-4fc0...@x22g2000yqx.googlegroups.com...
> This newsgroup is great but there's the danger of believing every
> anecdote you read will be true for you as well. If I've learned
> anything at all, it's that every case is unique.
-- skramer remarks
Timely qualifier, Frank. At best, anecdotal evidence can show what it
possible or can disprove a theory. And, only then, if you trust the poster.
Always be a Skeptic.
J
> To be very brief, I had my surgery 2 weeks ago.
> A Gleason 3+4 became a 4+3.
> Lymph nodes and seminal vessicles were clear but there was perineural
> invasion, extracaps. penetration, and one small positive focal margin (0.5
> mm).
http://www.malecare.com/surgery_page_5.htm
Margins
It is the goal of surgery to remove all the cancer. A positive margin means that
the pathologist notices that cancer cells are at the very edge of the prostate
touching the ink that was applied during initial processing of the prostate
gland. The pathologist will note the number and location of any positive
margins. Those patients with positive surgical margins are at an increased risk
of cancer recurrence. Patients with more than one positive margin are more
likely to have cancer recur compared to those with a single positive margin.
Patients with an extensive positive margin (large area where the cancer is in
contact with the edge of the prostate) are more likely to have recurrence of
their cancer compared to those with a very small area (focal positive margins)
where the cancer just touches the edge.
It is important to note that most patients with positive margins are cured.
Depending on the number and extent of margins your physician may recommend
post-operative radiation to decrease the risk of recurrence.