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Medical Forum / Diseases and Disorders / Prostate Cancer / November 2006Update
Larry had his first post-op RP appt. this afternoon. Pathology report as follows: Prostatic adenocarcinoma, unilateral (right side) Gleason score 8 (4+4) Right lateral peripheral zone 1.5 cm in greatest dimension Tumor volume - 15% Capsular invasion (L2) present Perineural Invasion present Left and right seminal vesicles free of adenocarcinoma Margins free of adenocarcinoma High-grade prostatic intraepithelial neoplasia Dr. Miles said the cancer was much more aggressive than originally thought. The Gleason score before surgery was 7 (4+3). There is an 85% cure rate and the reason that it's not higher is due to the possibility of the cancer getting in the capillaries and spreading that way. BUT ... 85% chance that all is well vs. 15% chance that it's not are pretty good odds. The doc is thrilled with Larry's post-op progress, especially the fact that there's no leakage problem. However, there is an ED problem. So, hubby is now on 100 mg. Viagra, cut into quarters, four days per week and then a whole tablet one day per week, with two days off. Not sure how long he has to continue this regimen. Dr. Miles did say he expects Larry to get back to 'normal' soon. A PSA was done today and we'll have the results back on Friday. Will let you all know. Thanks, Jean (and Larry too) > Larry had his first post-op RP appt. this afternoon. Pathology report as > follows: [quoted text clipped - 9 lines] > Margins free of adenocarcinoma > High-grade prostatic intraepithelial neoplasia Did you give you a post operative stage? Gleason is a damned shame. G7 is better than G8. However, the seiminal vesicle and margin news is great. > Dr. Miles said the cancer was much more aggressive than originally > thought. The Gleason score before surgery was 7 (4+3). There is an 85% [quoted text clipped - 11 lines] > A PSA was done today and we'll have the results back on Friday. Will let > you all know.  SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05, 2/06, 6/06 PSA .07 .05 .06 .09 .08 .132 .145 Casodex added daily 07/06 PSA <0.04 Non Illegitimi Carborundum Hi Steve, Yes, Stage II. > Did you give you a post operative stage? > > Gleason is a damned shame. G7 is better than G8. > > However, the seiminal vesicle and margin news is great. > Hi Steve, > > Yes, Stage II. Good. I guess I should have guessed that from the biopsy results. Hello Jean and Larry, Healing takes time as well as nerve damage. You seem to have great prognosis... Congradulations...... Expect some time for healing.....either incontinece, and ED. I suggest a pump.....sorry for the description, and maybe injections Viagra works.....after 2 years for me.... Nothing works too. A male does not have to have an erection to have an orgasm. Work with the Dr. It took me 2 years to get an erection. I used pump, (rejoyn) and tried viagra (failed) used injections...Worked, finally after 2 years i got nerves to connect... Yep 2 years,,,,,,Use all the things that you are given...and then some. Walk, run, keep trying. I think you are on a good track! Keep trying..... Prostate Cancer 1999 age 49 Messed me up, but 7 years survivor... John Loomis > Larry had his first post-op RP appt. this afternoon. Pathology report as > follows: [quoted text clipped - 29 lines] > > Jean (and Larry too) Hi Jean, The 85% cure rate is a very positive note. Also sounds like Larry is doing great on recovery. I need to look back..when did Larry have surgery? I thought psa test were done at 3 months out? Paul and I go back next Wednesday for path report and then return in 3 months for psa test. Thanks for sharing. > Larry had his first post-op RP appt. this afternoon. Pathology report as > follows: [quoted text clipped - 16 lines] > > Jean (and Larry too) Hi Lisa, Larry's surgery was Sept. 19 so we're at 8 weeks post-op. We're a little concerned that the Gleason score went from 7 at the time of biopsy to 8 at the time of surgery. (Less than 3 months.) It was most certainly a very aggressive cancer. It's also a little scary knowing that since Larry's PSA was so low, and only jumped .07% that a lot of docs wouldn't have sent him to a urologist. Many would have suggested watchful waiting, if that. We are very thankful that our family doc was on top of this!! Apparently the criteria says an increase of .07% is the 'cut off' number to suspect a problem. Forgot to add in my original post that Larry doesn't have to do the kegels anymore and he is thrilled!! Since there has been no incontinence there's no need. The ones at bedtime didn't bother him but the ones in the morning were tough. He kept falling back to sleep while he was doing them. :o} Hope all is going well for Paul! Jean > Hi Jean, > [quoted text clipped - 3 lines] > back next Wednesday for path report and then return in 3 months for psa > test. Thanks for sharing. > We're a little concerned that the Gleason score went from 7 at the time of > biopsy to 8 at the time of surgery. (Less than 3 months.) It was most > certainly a very aggressive cancer. Jean, Not to diminish the aggressiveness of the cancer, but I would say that it is aggressive because it is an 8, not because it went from 7 to 8. With needle biopsies, the lab only has small samples to determine Gleason. When they have the whole thing in front of them on a lab table, they often find more 4s or 5s than they saw inside the needles. > It's also a little scary knowing that since Larry's PSA was so low, and > only jumped .07% that a lot of docs wouldn't have sent him to a urologist. > Many would have suggested watchful waiting, if that. We are very thankful > that our family doc was on top of this!! I'd recommend a magnum of Merlot to the doc. He may have saved Larry's life. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05, 2/06, 6/06 PSA .07 .05 .06 .09 .08 .132 .145 Casodex added daily 07/06 PSA <0.04 Non Illegitimi Carborundum >> It's also a little scary knowing that since Larry's PSA was so low, and >> only jumped .07% that a lot of docs wouldn't have sent him to a urologist. >> Many would have suggested watchful waiting, if that. We are very thankful >> that our family doc was on top of this!! STRONGLY concur. Mine ignored two successive years in which my already-high PSA increased by more than 100% -- it DOUBLED -- each year! Make sure you lavish praise on that doc! I.P. |
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