Post-Radical Prostatectomy Pathology Results

Angstromm

I'm 4 weeks out from a radical prostatectomy and just received my post-surgery pathology report and it's indicating that cancer's a bit more advanced than pre-op biopsy/pathology/scans/etc. indicated.

What I'm wondering is if anyone has experienced a similar situation and if further treatment was required. I'm having to wait about a month to talk with my oncologist about the report and, well, would like to understand a bit more, if possible, about my results, especially in terms of potential further treatment(s).

Initial path report, etc., indicated stage 2b cancer. This current report indicates a likely stage 3b cancer that typically requires radiation and hormone therapies. But I've yet to come across any viable info on how re-staging this cancer post-prostatectomy may impact further treatment.

Here's the pith of the current path report:

pT3a, pN0, pM0.

Clear margins.

No seminal vesicle involvement.

Gleason Score 3+4=7.

11-20% of the prostate gland is involved by tumor.

Extraprostatic extension (EPE): Present, non-focal.

Perineural invasion: Present.

To be clear, I understand that anything others choose to share doesn't represent informed medical advice and that's not what I'm asking for—only my medical team knows all the ins/outs of my situation. I'm just asking for shared, similar experience.

Thank you!

Steve1961

hmmm ..this really needs to be discussed with your oncologist…i dont know why hormone treatment needs to be involved.u havent even done your post psa test yet I mean you be under 0.1 easily .personally inthink they are jumping the gun..i am personally waiting for my pathology report after salvage surgery ..they told me 7-10 days and my surgeon oncologist is calling me with the results to go over them ..i dont know why it took a month to get yours and anither month to meet with him .. somi take it no perineural invasion or EPE was seen on the biopsy …how long was it from biopsy to surgery ….what was your psa at biopsy ..was the mri clear..did you have a psam scan done im sorry but it looks like EPE non focal means it has left the prostate …next step is definitely another PSMA scan

jc5549

It looks as though you are T3a, I think they are going to follow your PSA.

Old Salt

Your prostate is gone and so is a significant amount of the cancer. The follow up consists of regular PSA tests. Hopefully they will not show disease, but if the PSA rises to a significant number, the origin needs to determined.

There will be therapies if that happens, but I will stop now.

eonore

Your pathology and post surgery Gleason score are essentially the same as mine. On advice of my surgeon, I elected to wait with PSA tests every three months. My PSA remained undetectable for ten months after which it started to rise. After three straight rises at six week intervals, and after a Pet scan, I proceeded to six months of hormone therapy and salvage radiation. Thank God I have been undetectable since. In June it will be five years, knock on wood.
Eric

Angstromm

Thanks all for the responses, very appreciated!

eonore: Glad to hear that you PSA remains undetectable all this time! I've yet to have a follow-up PSA test. That comes in about 3 months. And have an apt to go over path report in 3 weeks. Did the hormone treatment impact you much? My bro.-in-law had to go through 2-years of ADT therapy and side-effect were devastating (major loss of muscle mass, extreme fatigue/low energy).