Received Post Prostatectomy Pathology

Wheel

just received my post Surgery Pathology report. Lowered my Gleason 8 to unfavorable Gleason 7 (4+3). Also lowered my grade group 4 to grade group 3. At least I feel better I can call myself a 7, but there are caveat’s . The cancer had left prostate capsule. No distinct mass was identified. His initial cuts to Prostate bed to eliminate any potential unexpected margin were standard cuts to take care of any margin you were not aware or expecting. He then sent the specimens along with 5 lymph nodes (also not believed cancerous)to Pathology while I was on the table and was totally surprised when Pathology found inked positive margin. That is why the surgery extended from 4 hours to over 6 as he had to go back in and cut more and deeper. Then you are now just hoping you get it all because you can’t wait around again for another interim report and you will wait for final pathology report. The good news the final pathology report came back no positive margins in prostate bed and nothing in lymph nodes. I’am thrilled with my results, but the report does also describe the “dreaded” Cribform Glands Present. He did say that also confirms a more aggressive cancer and more likely for metastasis and progression and more resistant to treatment. He said although we did not learn earlier from the biopsy, it often directs peoples choices and surgery was the correct call not waiting any longer either. He did also say just because of those reasons even with it all out some Doctors will still call for Adjuvant Radiation and Hormone treatment to eliminate any possibility of more cancer. That at this point is not being discussed and for me I think off the table. Overall I call it a good day for the good guys.

Steve1961

hmmm wow so we are kind of in the same boat .i had cribiform and I made a horrible decision and I did radiation instead of surgery and of course cribiform is now being determined that it is radiation resistant. I sure wish to God I knew this six years ago. Apparently cribiform is being seen a lot more as of late. I had a reoccurrence after 6 years because the radiation did not kill the part of the cancer that was cribi form so I decided to do salvage surgery ..what strikes me as odd is that my surgery was only about an 1 hour and 45 minutes . They don’t actually remove lymph nodes. They remove the tissue around the prostrate and then they send that to the lab and it could have one lymph node up to 10 or 12 lymph nodes. Mine only had one lymph node in it luckily for me I guess everything came back clean, except I had Peuraneral invasion. Which isn’t good either good news is for you. You have a second chance if it happens to come back, you can do radiation with me. I got to do right to step three which would be hormone treatments hopefully in two or three months when you get your first PSA test, you will be below 0.015. I’m very lucky mine was below that, hopefully you will too take care hope for the best

Wheel

steve,

It’s interesting because I did not know that I had cribriform before surgery and I did actively look at Radiation consulting with two Radiation Oncologist’s. It seems if I had opted for Radiation like in your case it may have then been less effective. Did you know that you had cribriform before Radiation from your biopsy? I agree I am reading more about it now than in the past. As medicine moves forward they are always learning something more. My cousin had Gleason 6 , 20 years ago and it was right to Radiation no such thing as active surveillance which is a standard of care for Gleason 6. He was shocked knowing what he went through in the past and now what is offered. He said it was terrible. No offense if I happen to be late to the Radiation party. I am really glad though that I have that window open for salvage radiation

Clevelandguy

Hi,

Looks like you had a decent pathology report minus the cribriform. Just have to wait and see over several PSA tests if the cancer has returned, hopefully it won’t. You still have several tools left to try if the cancer returns so be optimistic. Good luck……..

Dave 3+4

Wheel

Thanks Dave,

Where I am at now after surgery at 71, I feel pretty good about starting the journey and being around at least 10 years plus unless something else gets me, and that is enduring more treatments if necessary.

Steve1961

https://csn.cancer.org/discussion/comment/1717560#Comment_1717560

yes i knew i had cribiform ..but for some reason back then i was pertrified of surgery ..i made a terrible mistake what upsets me is I should’ve demanded that the radiologist and the surgeon get together and both come to conclusion of what would be best for me, but I didn’t. The radiologist happened to say what I wanted to hear …..dont need surgery ….back to the pathology report after surgery the report mentioned nothing about Cribiform how odd is that?

Steve1961

i learned alot about the does and donts about radiation.. so the big facilities aren’t everything that they’re cracked up to be OK sure they may have experience which is good …i had a private practice urologist but he wasn’t very good. He didn’t give me an MRI or anything had two biopsies even the third one no MRI so I probably had the cancer for quite some time. They were just missing it, …but he sent me to go see a private radiologist who had his own practice. This is all this guy did was prostrate cancer radiation for men he told me to have surgery. I should listen to him and I should have gone to him for the radiation but ended up going to UCSF and it was horrid. It really was , lotta sidk dying people there. I was seeing a lot of very sick people every day. I had to wait quite a while most of the time and after the fourth of fifth treatment, I could not urinate had start Flomax.. after the treatment my bowels exploded after brachytherapy. I could not control my bowels and they have been messed up ever since , if I would’ve gone to private practice, I would’ve been able to pull up valet parking . Just been with men not seen a lot of sick people and would’ve been having the same radiologist every single day specialized in prostate radiation .. I have known two men that have gone to this practice and had no side effects whatsoever so there you go. It’s a learning lesson but it’s a tough one to swallow because there’s no going back. I don’t get a second chance that’s why I go on here and try to , help men because I’ve been through a lot . everybody said about salvage surgery never done blah blah blah blah blah. It’s done not done a lot but it’s done. I went in the surgery was less than two hours. I left the next morning some incontinence issues but other than that, everything went smooth.

Wheel

Steve,

It’s good you seem to have had success with your salvage surgery after your horrendous Radiation treatments. You are a fighter. One thing I even learned 20 years ago when I was diagnosed with non Hodgkins Lymphoma and had chemotherapy Doctors all have different opinions. I had three , one from UCLA, one from Mayo in Rochester and my local and they all offered different recommendations. It does seem like a crap shot at times.

on another note after my recent blood clot in my calf last week after Surgery I was supposed to take my blood thinner 2 tablets twice a day for the first week (4 a day), then 1 tablet twice a day. In my head I had it 1 tablet twice a day for the first week then 1 tablet a day. I just realized I took 1/2 dose the first week only taking 1 tablet twice a day. I guess that was why my leg hurt longer than expected. I am still here so I guess now I just continue with what planned after the first week.