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Medical Forum / Diseases and Disorders / Prostate Cancer / January 2005

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Pathology report

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Bob Anthony - 28 Dec 2004 22:05 GMT
Hi All:

It's been 2 weeks since my robotic laparoscopic surgery on 12/14 at the
Cleveland Clinic in Florida. The surgery was done by the head of urology
there. The catheter was taken out 12/22 and I had full control of my bladder
with no need for pads. Still have some aches and pains in abdominal area
when I sit for extended periods, but I guess that is to be expected. Some
swelling at the incision site (about 2 inches on the left) where they
removed my prostate, but it appears to be going down. This was the largest
incision by far. The final pathologic diagnosis results are:
Gleason 4+3 (Clinical was 3+3)
pT2c             (Clinical was T1c)
PSA 7.4
Focal perineural invasion is seen.
Focal extension into the prostatic apex is identified.
No vascular invasion is noted.
No extension beyond the prostatic capsule is identified.
The bladder neck and seminal vesicles are free of tumor.
There is extensive high grade PIN, both adjacent and away from the invasive
adenocarcinoma.
The non-neoplastic prostatic tissue shows fibroglandular hyperplasia.

Conversationally, my surgeon was a bit challenged. But a guess all that
matters is that he is just a good surgeon and that it appears that the
surgery was successful. I  was diagnosed at age 52 August of '04. Other than
the diagnosis, I felt like 30 before the surgery and exercised both with
weights and aerobically since I was in my teens. I am looking forward to
doing it again soon!
Comments (support & reassurance is what I really want I guess) is
appreciated!!!!
Leonard Evens - 28 Dec 2004 22:30 GMT
> Hi All:
>
[quoted text clipped - 7 lines]
> incision by far. The final pathologic diagnosis results are:
> Gleason 4+3 (Clinical was 3+3)

It is not unusual for the postsurgical Gleason score to go up.  Mine was
7=3+4 both before and after, so I guess I was lucky in that respect.
Yours is a bit worse than mine but still a 7.  The Sloan Kettering
nomogram for post RP recurrence doesn't distinguish between 3+4 and 4+3,
and if you believe them, your likelihood of NONrecurrence within 7 years
is over 90 percent.

> pT2c             (Clinical was T1c)

Postsurgical pathology will show at least stage 2 except in the rare
event that there was not actually any cancer in the prostate.  T1c is a
presurgical staging which means the doctor can't feel anything.  2c
means there was cancer on both sides of the prostate, and this is not at
all  unusual.  The important thing is that, in any event, the cancer
appeared to be confined to the prostate.

> PSA 7.4
> Focal perineural invasion is seen.
My postsurgical pathology report showed this also.  It is my impression
that it is quite common, and it is not of great significance.

> Focal extension into the prostatic apex is identified.
> No vascular invasion is noted.
[quoted text clipped - 12 lines]
> Comments (support & reassurance is what I really want I guess) is
> appreciated!!!!

Any one of us can always have a recurrence, so you will be nervous
before each of your follow-up PSA tests.  But the chances are pretty
good that the cancer has been excised, and you should live your life
from now on as if you believed that.

Good luck.
Glassman - 28 Dec 2004 22:42 GMT
> Hi All:
>
> It's been 2 weeks since my robotic laparoscopic surgery on 12/14 at the
> Cleveland Clinic in Florida. The surgery was done by the head of urology
> there. The catheter was taken out 12/22 and I had full control of my bladder
> with no need for pads. Still have some aches and pains in abdominal area

 Congrats... sounds like you're cured to me!

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JK Sinrod
Sinrod Stained Glass Studios
www.sinrodstudios.com
Coney Island Memories
www.sinrodstudios.com/coneymemories

MH - 28 Dec 2004 23:24 GMT
Hi, Bob....

Sounds like your surgeon got it all to me.  It's not unusual for the post-op
path numbers to be a bit different from the numbers going in.  Any of us, no
matter how low our numbers, could have a recurrence.... but the likelihood
is very small.  It's the same for you.  Yet, I can promise you, as you
approach each PSA test, there will be trepidation.  It's just goes with the
territory.
Hang in there and concentrate on your recovery!  You have every reason to be
very optimistic!

Take care!
MikeH :)

> Hi All:
>
[quoted text clipped - 29 lines]
> Comments (support & reassurance is what I really want I guess) is
> appreciated!!!!
James A. Honeychuck - 29 Dec 2004 08:04 GMT
What a terrific success story this is.  You are the poster boy for
making the right decisions, catching a potentially dangerous case early,
and coming through it with flying colors.

Congratulations!  And on with life.

jimhoney
standard RRP age 52, cured, no significant aftereffects,
but definitely had a rougher time of it than Bob did

> Hi All:
>
[quoted text clipped - 26 lines]
> Comments (support & reassurance is what I really want I guess) is
> appreciated!!!!
GregL - 02 Jan 2005 10:01 GMT
Hang in there Bob

I had RP in June 1995 aged 42 and still kicking.
I'm pretty active with golf, tennis and my morning run for the newspaper.
Can't root without an injection but that was the risk.

I am due for my annual PSA test (I usually get it done after xmas, don't
want bad news before xmas) so I always get a bit nervy at this time.

Last result <0.01
Good luck with your recovery

cheers
greg

> Hi All:
>
[quoted text clipped - 29 lines]
> Comments (support & reassurance is what I really want I guess) is
> appreciated!!!!
 
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