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Pathology Report

MichaelF1002
Posts: 54
Joined: Mar 2013

 

Well, it looks like surgery was the right choice for me.  The Pathology Report shows that my initial Gleason 3+3 score remained the same, involving less than 5% of the total prostate volume; the stage was T2A.  Although it was a small tumor, and my urologist thought I would be a good candidate for watchful waiting, the tumor extended to less than 1 mm of the margin.  I may have dodged a bullet.   If I had waited a year or two, who knows?  Another reason to be happy today: my catheter was removed.  I am sitting here in my new diapers doing my Hegel exercises Laughing

Here is the rest of the report:

Tumor involves right posterolateral quadrant and measures up to 8 mm

No evidence of extraprostatic extension

Bilateral apical and bladder neck margins negative

Bilateral seminal vesicles negative for tumor involvement

Mild glandular and stromal hyperplasia

Prostate weight - 49 g

Lymph Node Sampling - No lymph nodes present

Extraprostatic Extension - Not identified

Seminal Vesicle Invasion - Not identified

Margins - Margins uninvolved by invasive carcinoma

Lymph-Vascular Invasion - Not identified

Perineural Invasion - Not Identified

Regional Lymph Nodes (pN) - Cannot be assessed

Distant Metastasis (pM) - Not applicable

Additional Pathologic Findings - Nodular prostatic hyperplasia


I’m thankful to God and my surgeon for what may have been a life-saving operation. 

Also many thanks to all here for being so willing to share your knowledge.

Regards,

Michael

hopeful and opt...
Posts: 1278
Joined: Apr 2009

I wish you a speedy recovery.

Did you and your surgeon discuss what needs to done to avoid long term ED?

MichaelF1002
Posts: 54
Joined: Mar 2013

Thanks, Hopeful.  The doctor talked about how long it could take to get relief from ED and that there are options such as medications or surgery if needed.  But other than that, no.  I knew the risks.  Radiation held similar risks. 

Michael

hopeful and opt...
Posts: 1278
Joined: Apr 2009

as a prevrentive measure to bring blood to penis.  This is done to limit chance of ED.

MichaelF1002
Posts: 54
Joined: Mar 2013

Yes, he mentioned medication as well as the pump, but I didn't take it as an SOP for prevention but as an "in case you need it" type of thing.  I'll have to check with him on that one. Thanks.

Michael

VascodaGama's picture
VascodaGama
Posts: 1511
Joined: Nov 2010

Michael

Congratulations on the results. KissLaughingCool

Your doctor was right when judging your status last April. You were a good candidate for Active Surveillance.

I believe all RP survivors would like to receive an excellent path report as that of yours. You got now the peace of mind you so were looking for. I hope things keep well and that you recuperate from the surgery side effects the soonest.
In fact these are the problems we all confront when deciding on a major treatment for PCa. Some guys prefer to get rid of the bandit and risk to become incontinent or less sex active. Others wouldn’t mind to sleep with the bandit to keep the QoL.

May I ask you to share details of your case and recovery progress to the many reading and following your story with PCa?

Let's celebrate.Smile

Best wishes.

VGama  Wink

MichaelF1002
Posts: 54
Joined: Mar 2013

Thanks for the kind words, VGama.  I have an appointment in 8 weeks and will get my first post-surgery PSA test at that time.  I'll update as things happen.  In the meantime, it might be good for folks who are planning to undergo surgery and are concerned about the pain to know that, at least in my case, there actually was none.  I have not had to take a pain killer since I was discharged.  In the hospital, I asked them to stop giving me the pain medication because the little pain I had (from the gas pumped in during the robotic laproscopic surgery) was very manageable without it.  Currently, I am experiencing the initial incontinence problem but nothing that wasn't expected and I'm learning how to handle it.  Hopefully things will improve over the coming weeks and months. As far as ED is concerned, that's a distant worry in my mind right now.  Smile

lewvino's picture
lewvino
Posts: 1004
Joined: May 2009

Congrats to you and looks like you will have some PSA of 0 coming up!

 

lewvino

MichaelF1002
Posts: 54
Joined: Mar 2013

Thanks, Lewvino.  That's what I'm hoping for!

Michael

VascodaGama's picture
VascodaGama
Posts: 1511
Joined: Nov 2010

Michael

I think that RP guys should give more considerations to ED and Incontinence initiating a program for recuperation, done from day ONE once the catheter is out.

In my case (50 years old at op) there was a sex specialist doctor in the team who operated on me from whom I got advices. ED problem was far in my mind at the time and I wonder “why this guy should be included in the team”. I experienced erection sensations while with the catheter but the reality was up on the day that it was withdrawn. The willingness was there but no “shaft” to get it up, as usual.
I used the pump frequently and soon my erections improved in terms of “elevation” and “hardness” but it never returned to previous standards. The penis was also about one inch shorter (the portion they cut off with the prostate) and I only managed to get back an half of that. Some guys report problems in peeing because of the contracted Glans (head of penis) hidden deep in the foreskin.

Masturbation, using pumps, medication or other means to get hard erection is needed even if it seems odd or even if the purposes are not due to sex. Atrophy of the penis should be avoided as much as we can.

You will get it back. For the moment enjoy the occasion and celebrate the RP outcomes.

I like Esporao red wine, how about you?

VG  Wink

MichaelF1002
Posts: 54
Joined: Mar 2013

Hi VG,

Thanks for the encouragement.  Where else can guys talk about their penises so matter of factly? Laughing

No wine for me. I'm strictly a coke/pepsi guy (caffene free these days).

Regards

Michael

mrspjd
Posts: 688
Joined: Apr 2010
Hi Michael,
 
Most folks recommend reading Dr. John Mulhall's book "Saving Your Sex Life, A Guide for Men With Prostate Cancer." Mulhall is a well known medical expert in the field of ED. In his book, he outlines a proactive post-RP rehab program with the goal being to get oxygenated blood flowing to the penis soon after RP. 
 
Here's a brief video of one of his lectures: 
http://www.mskcc.org/multimedia/penile-rehabilitation-after-treatment
 
Best wishes for a full and speedy recovery. 
MichaelF1002
Posts: 54
Joined: Mar 2013

Thanks.  I will look into that.

Michael

lewvino's picture
lewvino
Posts: 1004
Joined: May 2009

I will second the motion on purchasing the book. I've read it and having great results four years post surgery. I'm in IMRT radiation (THIS IS THE LAST WEEK) and doing ok so far.

lewvino

MichaelF1002
Posts: 54
Joined: Mar 2013

Hi Lewvino,

Thanks.  Already purchased the Kindle version from Amazon. I watched the video, too.  With only one kidney, I'm a bit hesitant about using medications.  And the needle gives me the shivers.  Hopefully the pump will do the trick. But I'll have more info on which to base a decision after I read the book.  Glad to hear you're doing well after the radiation treatments.  I'll bet you're glad they're just about over.

Michael

lewvino's picture
lewvino
Posts: 1004
Joined: May 2009

I've not had to use the needle but from what I hear its very smal gauge similiar to a diabetic stick. There is a website at www.franktalk.org which has man to man talk about various issues following prostate cancer. They have a section on using the needle if you want more info.

Being frank it also gives me the shivers but if I ever need to then perhaps I'll try.

 

Lewvino

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