Just found this group tonight and have found the postings really helpful.
Thanks to all who are willing to share their experiences!
Here's my situation and question: 54, RRP on 12/12/2003, pre-op I was T2a,
Gleason 6, PSA 3.8. Surgery went fine, am now 4 weeks out, feeling pretty good,
fairly dry when lying and sitting, but leak like crazy when walking/moving
around.
Pathology report showed all margins, seminal vesicles, etc.negative, but
Gleason went to 7 (3+4), and report showed extracapsular extensions in 2
places(max penetration 0.5mm). How significant is this? Dr was vague, but said
the obvious, namely that he would have preferred not to see any extensions! I
had kinda figured that!
Also, i see from other posts references to nomograms for statistically
predicting the chance of recurrence. Where do I find these?
Thanks for your help!
Fred
dale.j. - 09 Jan 2004 09:43 GMT
> Just found this group tonight and have found the postings really helpful.
> Thanks to all who are willing to share their experiences!
[quoted text clipped - 17 lines]
> Thanks for your help!
> Fred
I think as long as the margins are clear then you're ok. I'm just a
patient myself and this is what Dr. Walsh said in his book if I remember
right. Looks like you're doing fine.
Check here to perhaps answer your other question: http://urology.jhu.edu/Partin_tables/
Dale J.

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Email: dalej2@mac..com
c palmer - 09 Jan 2004 11:11 GMT
hi fred - the leaking is common at this stage of the game. you have
passed through the first two stages, laying down and sitting, so you're
ahead of the game. you will start drying up as time passes. be sure to
walk as much as you can. it seems to help.
if the surgeon didn't pull your lymph nodes, then i would say the
penetration wouldn't be that much. the gleason score will jump up after
they get to take a closer look at the path table, so don't be alarmed by
that. and the gleason of 7 is 3 + 4, not 4 + 3.
now, the waiting game begins on the psa draws and praying they will stay
undetectable. we are all in the same boat as far as the RPer's, but
there doesn't seem to be any reason for who gets the recurrance and who
doesn't.
hope this has helped.
~ curtis
knowledge is power - growing old is mandatory - growing wise is optional
Leonard Evens - 09 Jan 2004 16:40 GMT
> Just found this group tonight and have found the postings really helpful.
> Thanks to all who are willing to share their experiences!
[quoted text clipped - 15 lines]
> Thanks for your help!
> Fred
Try Sloan Kettering at
http://www.mskcc.org/mskcc/html/10088.cfm
You can download the program or run it from the website. I just checked
your case, but I wasn't sure which choice to make for "Prostate Capsule
inv". Using all the choices, your chances of being PSA free at 7 years
are between 78 percent and 91 percent. If your cancer had been confined
to the prostate, the chances would have been over 95 percent, so you are
still doing pretty well. There is some chance that PSA recurrence will
occur after 7 years, but it is not common.
The nomograms are based on solid research from a database of patients
treated at large medical centers in the US and elsewhere.
Unfortunately, not all surgeons are equally proficient, but these days
more and more are well trained. If your surgeon was trained in a good
residency and has lots of experience doing the procedure, chances are
these statistics are reliable for you.
Also, Walsh gives some statistics on p. 296 in Guide to Surviving
Prostate Cancer. You would be in his Group II since your cancer was
specimen confined. He gives your chance of being PSA free at 10 years
as being over 72 percent.
There are some other nomograms and calculators out there on the web
which are not nearly as accurate since they are based on much smaller
patient data bases and may not use the best statistical tools available.
It doesn't make sense to spend much time worrying about whether your
cancer will recur. In your case, the chances are that it won't, and in
any event, worrying won't help prevent it. Worrying will cause you
anguish. So it is best to assume it won't happen.
Now if I could just follow my own advice. ;-)
NDaviesruckRND - 09 Jan 2004 17:18 GMT
leonard and everyone else who responded:thanks!...ran the nomogram myself and
got the same results as you did. I think i'm on the lower end of the range,
since the path report indicates "extracapsular extension: established" but even
a 78% chance sounds pretty good... at least for a poker game!
Your advice about worrying is right on target I know, but ....anyway, I will do
my best! Think for me it's a matter of getting the info, and then letting go.
Thanks again guys!
Fred