Sep 18, 2013 - 9:39 pm
I am a 56 male, living in Ontario Canada, who was diagnosed with Prostate Cancer in March 2013. I had an elevated PSA (about 6.5) and my urologist suggested a biopsy. The biopsy came back showing that 5/12 needle cores were positive for cancer. The 5 were all on one side and they showed Geason 7 (3+4). I was told that I had disease in about 10% of the prostate. I managed to get my first appointment with a surgeon on May 1, but as is generally the case with Canadian doctors the wait list exceeds the available O.R. availability and so I was put on a waiting list.
Not being one to sit on my hands with a cancer diagnosis I began an extensive research program and looked at all kinds of treatment options from HIFU, to Brachy to a radical prostatectomy (both open and robotic) and at the same time I elbowed my way into a follow-up MRI (against my doctor's orders ... I may add). Well the MRI came back showing definite cancer and the possibility of "extension into the capsule".
With this new information I just could wait no longer for the Canadian medical system to smile upon me and get me into surgery (by this time I had decided on a RP done robotically) and so I called Dr. Samadi in New York and at great expense relative to what it would cost in Canada, I booked surgery with him. I had my RP surgery on September 5th, 2013 and all went well according to Dr. Samadi and I thought ... finally I have taken charge and dealt with the problem.
A week later while getting the catheter out, the nurse went over the post-surgical pathology report and I was shocked to learn that I actually had Gleason 9 (4+5) and that I had extra prostatic extension. I also found out that I had disease in 31% of the prostate. That's the bad news. The good news was that the surgeon had removed the seminole vesicles and two lymph nodes on each side and both the seminole vesicles and lymph nodes both came back completely negative for cancer (ie clean). As it relates to margin ... this is what it says ... "Tumol ertends to the left posterior capsular resection margin (slide 1M). The remaining resection margins including apex and base (bladder neck) are negative for tumor. It lists the pathological stage as pT3a, PN0.
The surgeon told me that what this means is that there was good positive margin throughout except that in one small spot the tumor approached the margin but did not actually reach it?
I have done plenty of research on Gleason 7. This has hit me like a ton of bricks. The surgeon said that he thinks he got all of it but won't be sure until I start getting my PSA tests back and that if need be I might need some follow up radiation just to "clean it up". I would appreciate any thoughts that you may have.