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Post RALP Pathology
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
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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).
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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.””
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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.
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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.
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