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Medical Forum / Diseases and Disorders / Prostate Cancer / June 2007Final Pathology
Hi folks, I hadmy RLRP last week and followup visit yesterday. My pathology report's final diagnosis was as follows: a] Prostate, left base margin (biopsy): Fibromuscular tissue and nerve. No prostatic glands or carcinoma seen. b] Prostate and seminal vesicles (radical prostatectomy): Prostatic adenocarcinoma, Gleason Score 7 (3+4). The tumor is bilateral and organ confined. Perineural invasion is identified. Both seminal vesicles and all surgical margins are negative for tumor. Univolved prostate shows glandular and stromal hyperplasia. c] Lymph nodes, pelvic disection: Five lymph nodes, negative for metastatic carcinoma. I am certainly happy with the results, as this is pobably the best outcome I could hope for. I am struggling a bit in the recovery. I've had a hell of a time getting my bowels going again, and I'm still bleeding too much for the cath to come out. If anyone has any questions, I'd be more than willing to share info/experiences... Hello, Paul: That's good news about the clear margins. The report says "[p]erineural invasion is identified"; I'm assuming that's a reference to your erectile nerves. Could they spare them? After my surgery, they had me on oxycodone for pain, and I probably took it longer than I had to. It made me constipated, and I'd get a bloody discharge from around the catheter at every bowel movement. Gosh, I hated that! I took Dulcolax at bedtime every night and my bowels were much more comfortable. And as soon as that $&#**^% catheter came out, I felt fine. Good luck on the recovery. The worst is over. Now you can start ringing up those undectables PSAs. --charlie > The report says "[p]erineural invasion is identified"; I'm assuming > that's a reference to your erectile nerves. Could they spare them? "Perineural invasion" does not refer to the erectile nerves which lie on the outside surface of the prostate. Perineural invasion means there was some cancer identified within the prostate where nerves that enter and serve the prostate are located. Almost eveyone has perineural invasion and statistically it means nothing. Dave Perry On Jun 21, 1:39 pm, djperr...@sbcglobal.net wrote: > "Perineural invasion" does not refer to the erectile nerves which lie > on the outside surface of the prostate ... > Dave Perry Thanks, Dave --charlie >> The report says "[p]erineural invasion is identified"; I'm assuming >> that's a reference to your erectile nerves. Could they spare them? [quoted text clipped - 5 lines] >perineural invasion and statistically it means nothing. >Dave Perry Dave I asked my Dr. about that, and he responded that it is normal to see that. Thanks for the clarification. >Hello, Paul: > >That's good news about the clear margins. Thank you. >The report says "[p]erineural invasion is identified"; I'm assuming >that's a reference to your erectile nerves. Could they spare them? The nerves were spared. >After my surgery, they had me on oxycodone for pain, and I probably >took it longer than I had to. It made me constipated, and I'd get a >bloody discharge from around the catheter at every bowel movement. >Gosh, I hated that! I took Dulcolax at bedtime every night and my >bowels were much more comfortable. And as soon as that $&#**^% >catheter came out, I felt fine. I'm taking 100mg of Colace TID, and I wasn't just constipated, my body went into intense abdominal pain after four days. I'm using MOM to get back on track with that. >Good luck on the recovery. The worst is over. Now you can start >ringing up those undectables PSAs. Thanks Charlie. If the damn bleeding will stop, they'll pull the cath, which wil certainly make me want to celebrate. >--charlie That's really good news Paul. You're right...the best you could hope for. Perineural invasion is not considered unusual. The neg. margins, confinement and neg. lymph nodes all bode well. I had an open RP 2 years and 3 months ago and things are going well so far. I must say...most guys go home after 2 days which I can't figure out. Everything hurt like hell after 2 days, but that was me. Morphine was limited in the hospital and Toradol was used for pain (which was all that I needed)...to help with the 'bowel problems.' Stool softeners are necessary...for SURE. :-) I happened to stay in the hospital for SEVEN nights as my cath kept clogging with clots. Not the usual condition...so I had hospital care for those tough 3rd, 4th, 5th, 6th and 7th days. And I was glad that I did. Many of the great guys here wanted to get home in 2 days...and DID so. They were tough. Even a week after...I had pain getting into the car to go home. (Of course I got a ride). My doc, Dr. Catalona here in Chicago (which will be commented upon in the follow-up) kept me there to be irrigated until the clotting stopped. Your bleeding will stop as well. You're doing good...keep taking stool softeners (Colace or generic...twice a day) for the bowel problems. The update deals with the local political guy Todd Stroger...who, at a young age (early 40's), was diagnosed with PCa TEN MONTHS ago..and just had his RRP the other day. He left the hospital the NEXT DAY. (I'm sure that he has a nurse or nurses around...cuz he couldn't have felt too good.) I'm including today's article about this. When I heard that he had waited 10 months...I said to myself...that there was no WAY that Catalona could be his doc. Well, Catalona DID the surgery...but I bet he had other doctors in the past 10 months. The fact that Dr. Catalona defended the wait in the article really surprised me. Hang in there Paul. Ron B. Chicago http://www.suntimes.com/news/politics/437508,CST-NWS-stroger21.article > ... > When I heard that he had waited 10 months...I said to myself...that [quoted text clipped - 6 lines] > surprised me. > ... Maybe you're reading more into the good doctor's comment than he intended: "That kind of wait is not unusual", Catalona said. "It often takes [men] a while to educate themselves and their family," It doesn't sound to me like he agreed with the patient's decision to wait, only that he understood it. Lots of guys are terrified of treatment. Some want to see if watchful waiting is enough. It can take a while before they decide to proceed. Alan About Chicago politician Todd Stroger who recently had an RRP, Alan noted: "It doesn't sound to me like he (Dr. Catalona) agreed with the patient's decision to wait, only that he understood it. Lots of guys are terrified of treatment. Some want to see if watchful waiting is enough." That sure is true Alan. What we knew locally was that his dad (John Stroger) had had a stroke a while back and there was heavy politics going on (hey, it's Chicago ya know)...and I was just hoping that THAT didn't play a part in his decision to put off treatment. Fear...I understand all too well. Best of health to all, Ron B. Chicago >That's really good news Paul. > [quoted text clipped - 8 lines] > >I must say...most guys go home after 2 days which I can't figure out. Interesting. With RLRP, I was out the next day and my insurance co. is currently squawking about why I was even given one night, if you can believe that. >Everything hurt like hell after 2 days, but that was me. I'm healing slowly but was never in any great pain from the procedure, just my bodily functions not playing nice. >Morphine was limited in the hospital and Toradol was used for pain >(which was all that I needed)...to help with the 'bowel problems.' > >Stool softeners are necessary...for SURE. >:-) Coalce TID and I'm occasionally goosing myself along with some MOM. >I happened to stay in the hospital for SEVEN nights as my cath kept >clogging with clots. [quoted text clipped - 7 lines] > >They were tough. I wouldn't be able to quantify tough but obviously the shorter the stay, the less chance for infection.... >Even a week after...I had pain getting into the car to go home. (Of >course I got a ride). [quoted text clipped - 3 lines] > >Your bleeding will stop as well. Starting to lighten up a bit, thankfully. >You're doing good...keep taking stool softeners (Colace or >generic...twice a day) for the bowel problems. [quoted text clipped - 20 lines] > >Hang in there Paul. Thanks for the words Ron. >Ron B. > >Chicago > >http://www.suntimes.com/news/politics/437508,CST-NWS-stroger21.article > Hi folks, I hadmy RLRP last week and followup visit yesterday. My > pathology report's final diagnosis was as follows: Your post-surgical pathology report is very similar to what mine was. You will be happy to know that I haven't had any sign of recurrence for 6 years and counting. As has been noted, perineerual invasion is a common finding, it refers to nerves in the prostate, and it is nothing to worry about. You don't say how the report staged the cancer. One common thing that confuses people is that many cancers are classified as T1c because the doctor couldn't feel any thing on DRE. But the post-surgical finding will have to be at least T2a except in the extremely unlikely case that the cancer disappeared after diagnosis but before treatment. It is also common for more cancer to be found than was apparent from the pre-surgical biopsy, and if that happens, it also not something to be concerned about. > a] Prostate, left base margin (biopsy): > [quoted text clipped - 20 lines] > bleeding too much for the cath to come out. If anyone has any > questions, I'd be more than willing to share info/experiences... >> Hi folks, I hadmy RLRP last week and followup visit yesterday. My >> pathology report's final diagnosis was as follows: [quoted text clipped - 14 lines] >pre-surgical biopsy, and if that happens, it also not something to be >concerned about. Sorry Len, and you are correct. Initially staged at T1c, the final pathology placed me at T2c. >> a] Prostate, left base margin (biopsy): >> [quoted text clipped - 20 lines] >> bleeding too much for the cath to come out. If anyone has any >> questions, I'd be more than willing to share info/experiences... |
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