Post RALP Pathology

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Rob.Ski
Rob.Ski Member Posts: 155 Member
edited March 2022 in Prostate Cancer #1

Here's pathology after RP. Could be better, could be worse. Tertiary pattern 5 is concerning. Previous 2 biopsies showed 3+3.

Procedure Radical prostatectomy

Tumor

Histologic Type Adenocarcinoma (conventional, NOS)

Histologic Grade 

Gleason score (dominant nodule) 3+4=7

Percent Pattern 4 20-30

Tertiary Pattern 5 Present

Grade Group 2

Gleason score (secondary nodule) 3+3=6

Tertiary Pattern 5 Not identified

Grade Group 1

Extent

 Size Tumor dimension (greatest dimension) 15 mm

Location, dominant nodule Right ; Posterolateral, Posterior ; Mid, Base

Location, secondary nodule Left ; Posterolateral, Posterior ; Mid, Base

Extraprostatic Extension Not identified

Seminal Vesicle Invasion Not identified

Lymphovascular Invasion Not identified

Intraductal Carcinoma Not identified

Comments

  • Old Salt
    Old Salt Member Posts: 1,407 Member
    edited February 2022 #2
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    Congratulations on 'getting it out'. I hope that your recovery will be without hiccups.

    Let's hope that future PSA readings will all be very low or 'non-detectable' and that no further treatment will be necessary.

    PS: I find it surprising that the prior biopsy appears to have missed the dominant nodule (with Gleason 4 and 5).

  • Rob.Ski
    Rob.Ski Member Posts: 155 Member
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    Well last biopsy was in May 2021 so, it's been 9 months. Guess it could have been there back then but, maybe it progressed?

  • centralPA
    centralPA Member Posts: 309 Member
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    The whole bunch of "Not Identified" is good news. Best on your recovery!

  • Rob.Ski
    Rob.Ski Member Posts: 155 Member
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    Waiting on the call from the doc to review but, I think "Not Identified" means it was not evaluated. No samples taken in those areas. Someone here probably has the answer to that, can chime in.

  • centralPA
    centralPA Member Posts: 309 Member
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    Pretty sure it means they looked but didn’t see it. From a doc on pathology reports…

    ”Negative findings are usually reported as “not identified” rather than “absent” along the line of the statement that “absence of evidence is not evidence of absence” and acknowledging the insight that in medicine the latter can rarely be provided. Of note, biomarkers for which the positive result reflects the normal situation are reported, for example, as “Intact nuclear expression” versus “Loss of nuclear expression” rather than “positive”/“negative.”

    Different responses to one data element are usually designed not to differ only by a single word, which might be accidentally omitted and thereby invert the intended meaning, e.g., “not identified” rather than “not present.” Also, there is a tendency towards some degree of redundancy, such as in the case of grading, i.e., “G2, moderately differentiated” rather than just “G2.””

  • Rob.Ski
    Rob.Ski Member Posts: 155 Member
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    Today is day 11 since RP. I pulled catheter day 9. So far, I'm fully continent. I went all day yesterday without depend or pad. Made it through the night completely dry (got up once to go in middle of the night). Even sneezed several times without a drop. Haven't done a stress where lift something heavy, still on the 10lb lifting restriction. Also, was able to get an erection without the blue pill. Very encouraging results so far.

  • eonore
    eonore Member Posts: 182 Member
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    Boy Rob, that is terrific! Together with the good pathology report, hopefully you are totally on the other side of this thing.

  • VascodaGama
    VascodaGama Member Posts: 3,692 Member
    edited February 2022 #9
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    It looks very good. The time you took to make a decision had its value. I recommend you to be active in the sex department. 😜

    Hopefully the PSA comes out in remission levels. That is a successful story.

    Congratulations.

  • lighterwood67
    lighterwood67 Member Posts: 384 Member
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    Great news. Always glad to hear success stories.

  • Rob.Ski
    Rob.Ski Member Posts: 155 Member
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    Thanks guys. I do consider myself extremely fortunate to be experiencing minimal side effects so far. We'll see in a few months how PSA goes. This site has been very valuable to me. I learned a lot from current and past posts and appreciate everyone's input.

  • centralPA
    centralPA Member Posts: 309 Member
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    How goes it, Rob?

  • Rob.Ski
    Rob.Ski Member Posts: 155 Member
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    Good so far. I've found I might leak a few drops if I'm walking and sneeze or cough. I'm told this is why moms will stop to sneeze. So, thats what i do. Haven't been using any pads. Haven't leaked through pants at all. Had some drinks this weekend, no issue there.

    Got about 2 months for that first PSA.