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Double Whammy's picture
Double Whammy
Posts: 2824
Joined: Jun 2010

I see there was some data loss and unfortunately  all of mine.  Sigh.  My sons surgery (robotic prostectomy)was the 23rd and all of his paraphernalia was removed on the 1st.  He is recovering quite well and I will go home on the 6th.  I live 600 miles away.  His pathology report after surgery was Gleason 7 (3+4).  He was a 6 on biopsy samples and his surgeon did not remove any nodes because he was Gleason 6 on his biopsy and his policy is not to sample any level 6.  So we will never know about any node involvement unless he recurs which upsets this mom because of his family history.  His first cousin was also Gleason 6 and did have node removal and 2 nodes were positive.  He starts radiation in 2 months.  His Dad is currently almost done with radiation for prostate cancer and his paternal grandfather died from it.  My son did have perineural involvement .  My son is only 48. Being a cancer survivor I know how easy it is for you mind to go to the dark side.  His PSA will be monitored every 3 months.  Yes, I know it is still a low grade (2) and slow growing but I hate his surgeon for not taking any nodes.  

Clevelandguy
Posts: 409
Joined: Jun 2015

Hi,

I was a 3+4 with perinural involvement and they did not any of my lymph nodes.  From what my doctor(surgeon) told me they like to leave them in if they look good during surgery as a first defense.  I am going on 5 yrs. cancer free(no dectable psa) So I hope they knew what they were doing in my case. Just have to wait and see with future psa tests to check for any re-occurance, hopefully none will show up.

Dave 3+4

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3207
Joined: May 2012

Double,

I was Gleason 6 going in to surgery, Staged at I.  The pathologist analyzed the gland and changed it to Stage II, but the Gleason reamined 3+3.  My surgeon, who had done 900 DaVincis at that time, also did not remove any nodes.

Get a paper copy of your son's pathology report and the surgeon's report for future reference. Get it before you leave town, because the longer you wait, the harder they are to get.

The only thing worrisom that you report above was the perineural involvement.  The pathology report should state whether there was apparant glandular escape via the perineural path or not.  It will also mention positive margins and should state the condition of the Seminal Vesicals, whice in the last decade or more are almost always removed in R.P.

Surgeons get a preliminary pathology report from the lab before ending the surgery, which will effect the decision to remove nodes or not.  Most likely, the surgeon made the same call most surgeons make today, and it was medically sound.

max

hewhositsoncushions
Posts: 253
Joined: Mar 2017

Worth checking to see if it is PNI or extraprostatic PNI.

I had the former but not the latter which is hopefully a bit better.

Double Whammy's picture
Double Whammy
Posts: 2824
Joined: Jun 2010

Thanks so much for the feedback.  We have the path report and margins were clear.  I feel so much better with your comments.  He will feel better in time as I well know but he will need that time and something else to keep him occupied in the meantime.  He was laid off work after 10.5 years and a few days after telling his boss he needed time off for surgery.   Thats another story....

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