That is a serious problem, but you can increase the milage on your shoes by
applying some glue over the heel worn spots with a hot glue gun.  You must
repeat this every few days, as it wears away, but it adds very many miles.

Kidding a little of course.  No joy, but a warm welcome to the club anyway.  
No, the biopsy is not sufficient to declare no cancer outside the prostate.    
"No perineurel invasion is identified" just means the bioposy samples did not
identify any at the limited locations of the cores.  However your case of one
core with Gleason 6 is relatively low grade, which probably does means about
99% chance of none outside yet, according to the Partin tables (books below,
and online too).  That is the good news, you have time to cure this thing.

First thing to do is to make sure your doctor got a second opinion on the
biopsy lab work.  I'd assume that is pretty standard, to be sure it is
accurate before planning action based on it.   Second thing is to read at
least a couple of Prostate Cancer books, Walsh or Dummies for example are
excellent.  Only after you acquire some understanding do you decide a plan.

I didnt understand most of the words in your report, but the pathololgy report
after RRP surgery will be greatly more accurate.   The report wont get any
better after they get it out to look at it (all they can do is find more).  
But they can actually see and test all of the margins then, which will be
meaningful.  And you will know then it is gone.

My own case was very similar, age 66, PSA 4.3, one of 12 cores with Gleaon 6.  
Pathology reported two palatable tumors after they got it out.  Nothing
palatable via DRE.   The side effects of RRP are far from trivial, but I'm
glad the cancer is gone now.

Wayne

Hi, Michael, and welcome (although we all wish you didn't have to be
here).  Surgery is not the only option for this disease, although it is
highly favored in this NG, especially for "victims" of your age.  At 62
with a Gleason score of 6 and 10% cancer in one core, lesser amounts in
two others, I opted for brachytherapy instead and am pleased with the
results so far. You'll have to decide what treatment option is best for
you, and as you probably already know, it's not an easy decision to
make.  As the previous respondent said, take some time and read, then
ask questions.  See a surgeon and a radiation doc, and ask pointed
questions about their experience, expertise and success rates. Then
make your choice, say a prayer, cross your fingers, and hang in here
with the rest of us.

Good luck.

Ron Carter

"Perineural invasion" means the cancer is spreading along nerves within
the prostate; it doesn't tell you anything about whether it has
extended beyond the prostate capsule. Recent studies by some of the
best in the field suggest that this very common finding is meaningless.

Biopsies can never tell you that there is definitely no cancer outside
your prostate. They usually cannot tell you even if there is. Only
surgery could give you any reasonable indication about that (and even
then, the cancer might have metastasized to a different site, though
that seems very unlikely in your case).

The inflammation and atrophy are very common and don't mean anything at
all in respect of cancer.

For future reference, "prostatic intraepithelial neoplasia" = PIN.
Generally considered to be precancerous, but might not become so for
many decades.

All-in-all, that is pretty good pathology, given that it is positive at
all. But get a move on and choose a treatment plan - you can't ignore
this.

As others have said, a second opinion on the pathology from a top-rated
centre might be illuminating.

 Consider yourself a lucky guy! How's that for a positive spin on things?
You got yourself diagnosed early, and there's a very good chance you'll die
of getting hit by a truck before you croak of PCa. Read and absorb all your
options. My personal and slanted advice is to find the best experienced
surgeon and hospital in your area and have an RP.  I'm 55 and 3 years post
surgery. I'm very pleased with where I am in life now. Good luck!

Hello Michael, welcome to the "family".  This is without a doubt the best ng
that I have ever seen.  You will find a wide range of topics here.  Do not
be put off by the humor when it presents itself.  There is also frank
discussion that some find offensive, and we have unfortunately lost members
over some of it.  Do not be afraid to ask any questions here.  We are all
here for information and support.  You will no doubt run into a lot of
practical problems as you progress through this experience.  There are a lot
of resources available to help you educate yourself, e.g., the phoenix5 web
site.  Take a look at Joe's recent post, "1300 Page Prostate Cancer
Website".  There is a wealth of information there.

On your numbers, you appear to be in good shape.  I was PSA 5.0, PSA Free
6%, Gleason 6 (post surgery path report reported Gleason 5), 6% in two of
ten biopsy specimens, prostate 30 grams.  They told me that there was almost
no chance that the cancer had spread when I was diagnosed, and after the RRP
the path report showed organ contained disease, clear surgical margins, and
lymph nodes clear.  I wish you the same!

Good luck.

Thank you.
David S.

Hi, Michael.

Did the report mention your Stage (T1a, T2b,...) or your overall Gleason
score (3+3=6, 3+4=7, ...)?

The "last sentences" merely means that the biopsy did not identify any
escape from the capsule.  You won't know for sure until and unless your
prostate is removed and biopsied on a lab table.

Welcome from a less-than-a year member.  You have come to the right place,
with knowledgeable, intelligent, and, above all, very caring and sincere
people.  Being here has made an enormous difference to me as I have dealt
with PCa--I only wish I had known of it earlier.  But true support is here
and, as I have gratefully learned, some very real and important helpful
suggestions.  By the way, as I read your information, I believe that you
have every reason to be  very optimistic.  But, of course, you must make a
treatment decision and take care of your PCa.  The very best of luck to you.