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Lymph node positve

Posts: 2
Joined: Oct 2013

I am eight weeks post op a robotic prostectomy. My pahtology report was worse than expected and would like to hear from anyone that has similar disease characteristics and what they are considering for further treatment. My before surgery PSA was 58 no post op is undetectable... Gleason 7 (4+3) ... lumph node positive... stage T3b tumor with extranodal involvment and extracapuslar extension into the seminal vesicles.

Posts: 194
Joined: Aug 2006

I do not understand this phrase.

Have you the pathology report? Number of nodes taken and number positive? Is all the information you post here from post op pathology or a mix of pre and post? Have you had a psa test post op?

Posts: 2
Joined: Oct 2013

Yes this is the post op pathology report. There were 26 nodes taken and 8 were positive... and PSA post op was undetectable...

lewvino's picture
Posts: 1010
Joined: May 2009

Have you spoken with your doctor about the positive nodes? They might want you to start on radiation. It is good that the PSA is undetectable so they may also just monitor you on a 3 month basis to see what the PSA does.



Posts: 194
Joined: Aug 2006


Mayo clinic has publication that says size (volume) of the infected nodes has an impact on the recurrence rate for men such as you. The psa undetecable is an outstanding result at this time. The surgeon harvested a large number of nodes so he must have been cautious in your case. It is wonderful that he went forward with the removal even if he had knowledge of the node status in the OR.You certainly managed to get to surgery at the right time. Longer would have had a worse result.

Your pre-surgery stats would be interesting to see how you arrived at surgery.

The least positive situation is that surgery can be the first in a series of multi-modal treaments for your condition. The best is that regular psa tests monitor your situation. Your healing is still continuing and I hope to hear what your surgeon recommends in due course.

You have a long time to live. Long enough that you should make yourself healthier, if possible, to avoid alternate morbidity in your extended future.

VascodaGama's picture
Posts: 2521
Joined: Nov 2010


In a situation as that of yours, doctors usual recommend earlier salvage treatment with IMRT protocols. However, the positive nodes (8 out of 26) could be indicative of existing far metastases which treatment may require adding hormonal manipulations. Radiating the prostate bed alone would not be enough.

In such aggressive case you should take into account the prejudice from the side effects caused by the therapies. You need to consult an oncologist that specializes in the overall picture of your situation and that can recommend treatments with target principles, avoiding guessing protocols.

The PSA tests will monitor the progress of the disease and should you decide in waiting for a later intervention, you could try locating the bandit with the latest ways of image studies when the time is right. Earlier interventions are linked to better longer biochemical free results but it does not relate to better outcomes in terms of survival.

Changing ways of living with diet tactics and healthy fitness programs is good to overcome the treatments effects. Nutrition in particular is followed by the many of PCa survivors, some of them with excellent reports. Avoid stress to the maximum.

Whishing you luck in your journey.

Welcome to the board.

VGama  Wink

Posts: 40
Joined: Jun 2012

To make a long story short when I found out I had prostrate cancer my psa was 110 and the doctor that did radical surgery said he would open me up if it was in my lymph nodes he would have to close me back up and only thing to do would be to go on homone treatments.My lymph nodes were fine and he removed my prostrate.This was in 2009.In2011 my psa rose to .06 and I had to have salvage radiation and today my psa is .01.Accoding to my doctor I dodnot know why he removed your prostrate if it was in your lymph nodes. Pray you do fine.

Posts: 1
Joined: Jan 2015

Any palpable (enlarged) lymph node in a patient with melanoma should be considered to be suspicious for metastasis until proven otherwise. Fine needle aspiration (FNA) biopsy is a rapid, accurate, and reliable method of confirming metastatic melanoma. If FNA is not available or results are indeterminate (inconclusive), excisional biopsy (removal) of the lymph node is performed. Patients presenting with or subsequently developing regional lymph node metastases are at high risk for distant metastases and should therefore undergo advanced imaging . In patients with cytologically (after needle biopsy) or histologically (after removal of the lymph node) proven regional nodal metastases, formal lymph node dissection (surgical removal of all lymph nodes in the region such as the neck, armpit, or groin) is performed. The development of palpable (enlarged) lymph node metastases is correlated significantly with substantially diminished survival (10 to 50%), which is influenced strongly by the number of affected lymph nodes and the extent to which the lymph nodes are involved, as well the primary melanoma thickness.

Regional lymph node dissection is not performed routinely in patients with documented distant metastases that are extensive or in those patients with large lymph node metastases fixed to adjacent structures. Significant palliation (relief of symptoms) of inoperable bulky or bleeding regional nodal metastases may be achieved with radiation therapy in such situations, which are unfortunately associated with a poor prognosis.

Best wishes,
Olivia Jane
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