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perineural invasion

PawPaw J
Posts: 34
Joined: Jul 2011

OK guys,uro said do not worry about this but....I have read numerous topics about whether pni has any connection to the chance of recurrance of pca. Most say it does not but then I find where it is usually connected with more aggressive tumors and is like a pipeline to the outside of the prostate. Now I'm not sure what to believe. Short hx and pathology report.....53y/o psa 3.3 free psa 14%. Biopsy done 6/28/11 1 of 12 core pos with less than 5% of tissue involved. Gleason 3+3=6. NO PERINEURAL INVASION or any other type of invasion. Stage t1c.. Open rp on 8/9/11. Pathology report as follows: Lymph nodes negative, Gleason still 3+3=6, Total tumor involvement 2-3%, tumor size 6mm x 3mm, extraproststic extension not identified, seminal vesicle invasion not identified, margins uninvolved, lymph -vascular invasion not identified, perineural invasion PRESENT, Tumor stage pt2a pno, focal high grade prostatic intraepithelial neoplasia. Well differentiated carcinoma....Any comments or suggestions from what ya'll have learned? Thanks,Johnny

VascodaGama's picture
VascodaGama
Posts: 1568
Joined: Nov 2010

Johnny

Your pathologist report is complete and indicates optimum status. PNI may indicate that your surgery was done at the proper timing. Meaning that; it exists but with no confirmed “invasion”. Only time can tell the contrary. Relax and celebrate. Do not allow anxiety to take over your success.

In this reliable study they say this; “…the prognostic impact of PNI on risk for progressive prostate cancer is actually much lower than has been assumed in the past…”

You can read details here;
http://prostatecancerinfolink.net/2010/06/23/the-prognostic-implications-of-perineural-invasion-at-the-time-of-surgery/

Hope for the best.

VGama

PawPaw J
Posts: 34
Joined: Jul 2011

Thanks for the web site. I also saw 2 new articles that confirmed the first findings. It seems that the relationship of aggressive cancers and pni are only if the pni is extraprostatic and not intraprostatic. Also if the invasion is found in needle biopsy and not in post rp pathology report. Two good facts for me. I have always been a worrier and my wife gets on me all the time for that but that is a hard habit to break. Regardless, I am satisfied with my choice of treatment and happy so far with the side effects.(Still dry after 2 days and burning stopped last night.)Its so reassuring to have knowlegeable guys like you(those who have actually "been there, done that" and who have done way more research than us newbies to have to ask questions to. Thanks again, Johnny

VascodaGama's picture
VascodaGama
Posts: 1568
Joined: Nov 2010

Johnny

May I suggest you use that “worrier” energy in researching on diet and change of habits so necessary in your continuing journey of your case?
Some things will be not the same and you may have to adapt to the newer “looks”.

I raise a glass of my red-wine to your success.
Wishing you the best.
VGama

PawPaw J
Posts: 34
Joined: Jul 2011

Thanks to this site I have started that transformation. Starting decaf coffee this week, hardly any milk,and will cut down on red meat. This is only a start but being in the DEEP south we love to eat all the things not that great for ones health and to top it off we pour on the cajun spices. We will get there though.
Johnny

lewvino's picture
lewvino
Posts: 1007
Joined: May 2009

I'm still constantly struggling on my diet changes! I have not had red meat in almost 30 months now. THought it would be harder to give up then it was. I never cared much for coffee so that was no issue.
However I still struggle with ice Cream and Cheese.

Lewvino (larry)

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