Post-surgery pathology report

worriedabouthubby

It took some smooth talking on hubby's part, but the uro did finally remove the catheter today. Hubby's urine is still very bloody. And his siatica is acting up.

Here's the final pathology report.

DaVinci surgery Oct. 9, 2012
Final stats- G 4+5=9 T3a N 0 M x tumor in both lobes, 3.3x3.2x2.6x tumor size , positive margins
extensive perineural invasion, extracapsular extension- yes
no lymph node involvement, no seminal vessical involvement


I think this is the best we could have hoped for. He'll have his follow-up PSA in a month. Fingers crossed til then.

Thanks again for all the support

djs123

Keep the faith
I wish you good luck, it's wonderful there is no lymph node involvement.
Stay positive. As a wife of a Gleason 9, I empathize and support you and will pray for you and your husband.

laserlight

djs123 said:

Keep the faith
I wish you good luck, it's wonderful there is no lymph node involvement.
Stay positive. As a wife of a Gleason 9, I empathize and support you and will pray for you and your husband.

Good news
No lymph node involvement, this is good, hang in there. With all that you and your hubby has been thru, take some time and go to dinner, movie, relax. and Be thankful.

Take it a day at a time, again hang in there

VascodaGama

laserlight said:

Good news
No lymph node involvement, this is good, hang in there. With all that you and your hubby has been thru, take some time and go to dinner, movie, relax. and Be thankful.

Take it a day at a time, again hang in there

Turning the page of the bad chapter of his life
I am glad to read about the results. As you comment they could be much worse.
In any case there are other important details you haven’t shared but that will be needed to access future diagnosis. For example; the size/percentage of cancer within the volume/size of the gland. Usually all the data is written in the path report, and I recommend you to keep a copy in Hubby’s file.
I wonder if the report would write the “p” before the T3 in a Davinci surgery. N0 refers to “negative lymph nodes” but the report should mention the total number of nodes removed and analysed.

Positive extra capsular extension is the “baddy” in the report. There are high rates for recurrence in G9 patients. Nevertheless there are many patients that do not experience recurrence, dying from other causes or that see it happen after many, many years of quality living.

Monitoring is important. Periodical PSA tests and image studies will provide Hubby with the means of control.

In PCa, each case is different and they should not be compared but assumed similar. Just as informative you may be interested in knowing my experience.
I had an equivalent pathological stage of pT3a pN0. Lymph nodes were negative in 9 out of nine nodes removed and cancer occupied 2/3 of the gland. The confirmed Gleason score was G6, with positive extra capsular extension and negative nodes, and SV.
Recurrence became apparent at the six month post open surgery with a rising PSA from 0.12 to 0.42. All image studies were negative too and doctors diagnosed me with micrometastases.
I was on Watchful Waiting during 6 years asymptomatic before committing to salvage radiotherapy with a PSA of 3.8.

I can understand the relief you are experiencing now. I hope Hubby enjoys life to the most and turns the page of this bad chapter in his life for good. Being active will help in the heeling process.

Wishing him complete recovery and peace of mind to the family.

VGama

worriedabouthubby

VascodaGama said:

Turning the page of the bad chapter of his life
I am glad to read about the results. As you comment they could be much worse.
In any case there are other important details you haven’t shared but that will be needed to access future diagnosis. For example; the size/percentage of cancer within the volume/size of the gland. Usually all the data is written in the path report, and I recommend you to keep a copy in Hubby’s file.
I wonder if the report would write the “p” before the T3 in a Davinci surgery. N0 refers to “negative lymph nodes” but the report should mention the total number of nodes removed and analysed.

Positive extra capsular extension is the “baddy” in the report. There are high rates for recurrence in G9 patients. Nevertheless there are many patients that do not experience recurrence, dying from other causes or that see it happen after many, many years of quality living.

Monitoring is important. Periodical PSA tests and image studies will provide Hubby with the means of control.

In PCa, each case is different and they should not be compared but assumed similar. Just as informative you may be interested in knowing my experience.
I had an equivalent pathological stage of pT3a pN0. Lymph nodes were negative in 9 out of nine nodes removed and cancer occupied 2/3 of the gland. The confirmed Gleason score was G6, with positive extra capsular extension and negative nodes, and SV.
Recurrence became apparent at the six month post open surgery with a rising PSA from 0.12 to 0.42. All image studies were negative too and doctors diagnosed me with micrometastases.
I was on Watchful Waiting during 6 years asymptomatic before committing to salvage radiotherapy with a PSA of 3.8.

I can understand the relief you are experiencing now. I hope Hubby enjoys life to the most and turns the page of this bad chapter in his life for good. Being active will help in the heeling process.

Wishing him complete recovery and peace of mind to the family.

VGama

More updates
Thanks everyone! He promised the doc he'd drink plenty of fluids and walk alot. However, his siatica (back problems) has gotten REALLY bad. He could hardly move this morning. Doc is calling in some muscle relaxer- the pain meds aren't touching this pain- . His bowels are now ok- doing well in fact. Not much control yet- but he will be doing his kegels. The hematoma on his right side is huge- that may be part of the back problems doc said- but hopefully things will get better soon. He has his first post-op PSA in 1 month, then probably every 2 months. We're going to wait on the PSA before we think about radiation.

mrspjd

worriedabouthubby said:

More updates
Thanks everyone! He promised the doc he'd drink plenty of fluids and walk alot. However, his siatica (back problems) has gotten REALLY bad. He could hardly move this morning. Doc is calling in some muscle relaxer- the pain meds aren't touching this pain- . His bowels are now ok- doing well in fact. Not much control yet- but he will be doing his kegels. The hematoma on his right side is huge- that may be part of the back problems doc said- but hopefully things will get better soon. He has his first post-op PSA in 1 month, then probably every 2 months. We're going to wait on the PSA before we think about radiation.

F-18 PET/CT
WAH,

You seem to be rightfully concerned about hubby's sciatica pain.   While his pre-tx bone scan & pelvic CT may have been negative for mets, most times those two imaging tests usually are.  With the pre & post RP tx PCa path stats you've shared here & on your many other threads, my suggestion as a layperson would be to insist on an F-18 PET/CT in order to rule out any bone issues/mets to the spine as a possible source of the sciatica.  Use your search engine to research that imaging test. Good luck.