Pathology Report

MichaelF1002 · October 2013

Well, it looks like surgery was the right choice for me. The Pathology Report shows that my initial Gleason 3+3 score remained the same, involving less than 5% of the total prostate volume; the stage was T2A. Although it was a small tumor, and my urologist thought I would be a good candidate for watchful waiting, the tumor extended to less than 1 mm of the margin. I may have dodged a bullet. If I had waited a year or two, who knows? Another reason to be happy today: my catheter was removed. I am sitting here in my new diapers doing my Hegel exercises

Here is the rest of the report:

Tumor involves right posterolateral quadrant and measures up to 8 mm

No evidence of extraprostatic extension

Bilateral apical and bladder neck margins negative

Bilateral seminal vesicles negative for tumor involvement

Mild glandular and stromal hyperplasia

Prostate weight - 49 g

Lymph Node Sampling - No lymph nodes present

Extraprostatic Extension - Not identified

Seminal Vesicle Invasion - Not identified

Margins - Margins uninvolved by invasive carcinoma

Lymph-Vascular Invasion - Not identified

Perineural Invasion - Not Identified

Regional Lymph Nodes (pN) - Cannot be assessed

Distant Metastasis (pM) - Not applicable

Additional Pathologic Findings - Nodular prostatic hyperplasia

I’m thankful to God and my surgeon for what may have been a life-saving operation.

Also many thanks to all here for being so willing to share your knowledge.

Regards,

Michael

hopeful and optimistic · October 2013

I wish you a speedy

I wish you a speedy recovery.

Did you and your surgeon discuss what needs to done to avoid long term ED?

VascodaGama · October 2013

Excellent Pathology Report

Michael

Congratulations on the results.

Your doctor was right when judging your status last April. You were a good candidate for Active Surveillance.

I believe all RP survivors would like to receive an excellent path report as that of yours. You got now the peace of mind you so were looking for. I hope things keep well and that you recuperate from the surgery side effects the soonest.
In fact these are the problems we all confront when deciding on a major treatment for PCa. Some guys prefer to get rid of the bandit and risk to become incontinent or less sex active. Others wouldn’t mind to sleep with the bandit to keep the QoL.

May I ask you to share details of your case and recovery progress to the many reading and following your story with PCa?

Let's celebrate.

Best wishes.

VGama

MichaelF1002 · October 2013

VascodaGama said:
Excellent Pathology Report
Michael

Congratulations on the results.

Your doctor was right when judging your status last April. You were a good candidate for Active Surveillance.

I believe all RP survivors would like to receive an excellent path report as that of yours. You got now the peace of mind you so were looking for. I hope things keep well and that you recuperate from the surgery side effects the soonest.
In fact these are the problems we all confront when deciding on a major treatment for PCa. Some guys prefer to get rid of the bandit and risk to become incontinent or less sex active. Others wouldn’t mind to sleep with the bandit to keep the QoL.

May I ask you to share details of your case and recovery progress to the many reading and following your story with PCa?

Let's celebrate.

Best wishes.

VGama

updates

Thanks for the kind words, VGama. I have an appointment in 8 weeks and will get my first post-surgery PSA test at that time. I'll update as things happen. In the meantime, it might be good for folks who are planning to undergo surgery and are concerned about the pain to know that, at least in my case, there actually was none. I have not had to take a pain killer since I was discharged. In the hospital, I asked them to stop giving me the pain medication because the little pain I had (from the gas pumped in during the robotic laproscopic surgery) was very manageable without it. Currently, I am experiencing the initial incontinence problem but nothing that wasn't expected and I'm learning how to handle it. Hopefully things will improve over the coming weeks and months. As far as ED is concerned, that's a distant worry in my mind right now.

lewvino · October 2013

Congrats to you and looks

Congrats to you and looks like you will have some PSA of 0 coming up!

lewvino

MichaelF1002 · October 2013

hopeful and optimistic said:
I wish you a speedy
I wish you a speedy recovery.

Did you and your surgeon discuss what needs to done to avoid long term ED?

Long-term ED

Thanks, Hopeful. The doctor talked about how long it could take to get relief from ED and that there are options such as medications or surgery if needed. But other than that, no. I knew the risks. Radiation held similar risks.

Michael

MichaelF1002 · October 2013

lewvino said:
Congrats to you and looks
Congrats to you and looks like you will have some PSA of 0 coming up!

lewvino

Zero PSA

Thanks, Lewvino. That's what I'm hoping for!

Michael

hopeful and optimistic · October 2013

MichaelF1002 said:
Long-term ED
Thanks, Hopeful. The doctor talked about how long it could take to get relief from ED and that there are options such as medications or surgery if needed. But other than that, no. I knew the risks. Radiation held similar risks.

Michael

pump and daily ED drugs(viaga, cialis)

as a prevrentive measure to bring blood to penis. This is done to limit chance of ED.

MichaelF1002 · October 2013

hopeful and optimistic said:
pump and daily ED drugs(viaga, cialis)
as a prevrentive measure to bring blood to penis. This is done to limit chance of ED.

Preventive measures

Yes, he mentioned medication as well as the pump, but I didn't take it as an SOP for prevention but as an "in case you need it" type of thing. I'll have to check with him on that one. Thanks.

Michael

VascodaGama · October 2013

Atrophy of Penis

Michael

I think that RP guys should give more considerations to ED and Incontinence initiating a program for recuperation, done from day ONE once the catheter is out.

In my case (50 years old at op) there was a sex specialist doctor in the team who operated on me from whom I got advices. ED problem was far in my mind at the time and I wonder “why this guy should be included in the team”. I experienced erection sensations while with the catheter but the reality was up on the day that it was withdrawn. The willingness was there but no “shaft” to get it up, as usual.
I used the pump frequently and soon my erections improved in terms of “elevation” and “hardness” but it never returned to previous standards. The penis was also about one inch shorter (the portion they cut off with the prostate) and I only managed to get back an half of that. Some guys report problems in peeing because of the contracted Glans (head of penis) hidden deep in the foreskin.

Masturbation, using pumps, medication or other means to get hard erection is needed even if it seems odd or even if the purposes are not due to sex. Atrophy of the penis should be avoided as much as we can.

You will get it back. For the moment enjoy the occasion and celebrate the RP outcomes.

I like Esporao red wine, how about you?

VG

MichaelF1002 · October 2013

VascodaGama said:
Atrophy of Penis
Michael

I think that RP guys should give more considerations to ED and Incontinence initiating a program for recuperation, done from day ONE once the catheter is out.

In my case (50 years old at op) there was a sex specialist doctor in the team who operated on me from whom I got advices. ED problem was far in my mind at the time and I wonder “why this guy should be included in the team”. I experienced erection sensations while with the catheter but the reality was up on the day that it was withdrawn. The willingness was there but no “shaft” to get it up, as usual.
I used the pump frequently and soon my erections improved in terms of “elevation” and “hardness” but it never returned to previous standards. The penis was also about one inch shorter (the portion they cut off with the prostate) and I only managed to get back an half of that. Some guys report problems in peeing because of the contracted Glans (head of penis) hidden deep in the foreskin.

Masturbation, using pumps, medication or other means to get hard erection is needed even if it seems odd or even if the purposes are not due to sex. Atrophy of the penis should be avoided as much as we can.

You will get it back. For the moment enjoy the occasion and celebrate the RP outcomes.

I like Esporao red wine, how about you?

VG

Penis talk

Hi VG,

Thanks for the encouragement. Where else can guys talk about their penises so matter of factly?

No wine for me. I'm strictly a coke/pepsi guy (caffene free these days).

Regards

Michael

mrspjd · October 2013

MichaelF1002 said:
Penis talk
Hi VG,

Thanks for the encouragement. Where else can guys talk about their penises so matter of factly?

No wine for me. I'm strictly a coke/pepsi guy (caffene free these days).

Regards

Michael

Dr Mulhall

Hi Michael,

Most folks recommend reading Dr. John Mulhall's book "Saving Your Sex Life, A Guide for Men With Prostate Cancer." Mulhall is a well known medical expert in the field of ED. In his book, he outlines a proactive post-RP rehab program with the goal being to get oxygenated blood flowing to the penis soon after RP.

Here's a brief video of one of his lectures:

http://www.mskcc.org/multimedia/penile-rehabilitation-after-treatment

Best wishes for a full and speedy recovery.

MichaelF1002 · October 2013

mrspjd said:
Dr Mulhall
Hi Michael,

Most folks recommend reading Dr. John Mulhall's book "Saving Your Sex Life, A Guide for Men With Prostate Cancer." Mulhall is a well known medical expert in the field of ED. In his book, he outlines a proactive post-RP rehab program with the goal being to get oxygenated blood flowing to the penis soon after RP.

Here's a brief video of one of his lectures:

http://www.mskcc.org/multimedia/penile-rehabilitation-after-treatment

Best wishes for a full and speedy recovery.

Dr. Mulhall

Thanks. I will look into that.

Michael

lewvino · October 2013

MichaelF1002 said:
Dr. Mulhall
Thanks. I will look into that.

Michael

I will second the motion on

I will second the motion on purchasing the book. I've read it and having great results four years post surgery. I'm in IMRT radiation (THIS IS THE LAST WEEK) and doing ok so far.

lewvino

MichaelF1002 · October 2013

lewvino said:
I will second the motion on
I will second the motion on purchasing the book. I've read it and having great results four years post surgery. I'm in IMRT radiation (THIS IS THE LAST WEEK) and doing ok so far.

lewvino

Book

Hi Lewvino,

Thanks. Already purchased the Kindle version from Amazon. I watched the video, too. With only one kidney, I'm a bit hesitant about using medications. And the needle gives me the shivers. Hopefully the pump will do the trick. But I'll have more info on which to base a decision after I read the book. Glad to hear you're doing well after the radiation treatments. I'll bet you're glad they're just about over.

Michael

lewvino · October 2013

MichaelF1002 said:
Book
Hi Lewvino,

Thanks. Already purchased the Kindle version from Amazon. I watched the video, too. With only one kidney, I'm a bit hesitant about using medications. And the needle gives me the shivers. Hopefully the pump will do the trick. But I'll have more info on which to base a decision after I read the book. Glad to hear you're doing well after the radiation treatments. I'll bet you're glad they're just about over.

Michael

I've not had to use the

I've not had to use the needle but from what I hear its very smal gauge similiar to a diabetic stick. There is a website at www.franktalk.org which has man to man talk about various issues following prostate cancer. They have a section on using the needle if you want more info.

Being frank it also gives me the shivers but if I ever need to then perhaps I'll try.

Lewvino

Pathology Report

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