Post Surgery Pathology Report

jvancik

I had the RP on 5/3/04. I was under the impression prior to the operation that my cancer was in the very early stages since my PSA was being monitored regularly for 2 years after having a negative baseline biopsy. When the PSA took a 50% jump, I got another biopsy. This biopsy showed minimal cancer, only one of six cores in the left and none in the right and no perineural invasion and gleason of 3+3. I had the surgery 33 days later. Since I expected the best, when the surgeon told me that all went as expected after the operation I just accepted it. At a 4 month follow up PSA, I asked for a copy of the post surgery pathology report. The surgeon explained it to me then in some detail and it sounded OK at the time, but now that I have had time to actually read it and think about it, it scares the 's' out of me...Cancer involves the peripheral zones bilateraly at multiple levels of sectioning, invades capsular tissue and perineural invasion, distal periurethral prostatic inked tissue margin focally positive, right... the gleason is 3+4 with a final staging of T2c, pN0. Everything else on the report sounds OK i.e. negative for cancer seminal vesicals, vasa deferentia, no lymphatic or extracapsular invasion, peripheral inked margins negative, proximal periurethral prostatic tissue/bladder neck margins are negative...I trust the surgeon when he tells me that I am still in good shape for a cure...the 4 month PSA was 0.19 and the nadir was 0.19 which is very good...but also very early in the game...I know that the pathology is typically upgraded when the actual pathology report is done...but does anyone have a feel for whether or not my upgrade is more atypical than typical...should I ask the surgeon more questions? e.g. what's my real statistical chance for a cure given this report..I would appreciate any thoughts...thanks...

Dario

Hello Jvancik. I also had RP on 4-15-04 my PSA also took a 50% jump in a year from 2.2 to 4.2 my doctor recommended a biopsy . It show that my cancer was confined in one core and that it was a gleason 3+3 and it was a Stage 2 ( confined ) I was given the choice of either Radiation or RP, I chose the RP, for me that was a real lucky call on my part. After the operation the Doctor told me that he was realy surprised at what he found. He said that for such a young guy ( 57) and with such a low PSA reading ( 4.2 ) he never saw such spreading of the cancer outside of the prostate before. My Surgical Pathology report came back with a gleason of 3+3 as before but I was upgraded to a Stage 3 cancer .I had extencive spreading Focally extending through the capsule along the nerves and about 3 other locations. He literally scrapped and cauterized the whole area. My first 3 month PSA reading came back .2 which looked like I was going to have to have Radiation, but the Doctor told me not to worry so much, sometimes it takes time for the PSA to cycle out of your system. Well the PSA readings after that have all been " 0 " for the last two times. So cheer up. I finally ( Mind wise ) turned to another chapter in my life book and look forward to tomorrow and forget about my problems that I had yesterday.
Dario

jvancik

Dario said:

Hello Jvancik. I also had RP on 4-15-04 my PSA also took a 50% jump in a year from 2.2 to 4.2 my doctor recommended a biopsy . It show that my cancer was confined in one core and that it was a gleason 3+3 and it was a Stage 2 ( confined ) I was given the choice of either Radiation or RP, I chose the RP, for me that was a real lucky call on my part. After the operation the Doctor told me that he was realy surprised at what he found. He said that for such a young guy ( 57) and with such a low PSA reading ( 4.2 ) he never saw such spreading of the cancer outside of the prostate before. My Surgical Pathology report came back with a gleason of 3+3 as before but I was upgraded to a Stage 3 cancer .I had extencive spreading Focally extending through the capsule along the nerves and about 3 other locations. He literally scrapped and cauterized the whole area. My first 3 month PSA reading came back .2 which looked like I was going to have to have Radiation, but the Doctor told me not to worry so much, sometimes it takes time for the PSA to cycle out of your system. Well the PSA readings after that have all been " 0 " for the last two times. So cheer up. I finally ( Mind wise ) turned to another chapter in my life book and look forward to tomorrow and forget about my problems that I had yesterday.
Dario

Hi Dario....thanks for your response...that's great that your PSA dropped to 0...it sounds as though your doctor did a fine job...at my 6 month PSA, the number dropped from 0.19 to 0.17 so mine is going in the right direction at this point and I'm starting to relax a little as well...I'm 56 and sure would like to avoid any further treatment...good luck to you!