I wonder if it has anything to do with the physical fat that has to be
gotten through just to get to the walnut-sized prostate.  I'm still amazed
the my doc got to mine.

A total of 731 men with organ-confined disease and negative margins were
included in the analysis.

Compared with normal weight men, moderate and severely obese men were
four times more likely experience PSA failure after prostatectomy (p =
0.035).

This elevated risk fell slightly after adjusting for the higher
pathological Gleason grades seen among obese men.
=========================

my comments - first - it is a small sampling, and as with any sampling,
you will get some skewing one way or the other.

i know that the gleason score plays a big role when factoring in post RP
risk assessment of recurring cancer.

the skill of the surgeon also plays a big role in the RP and obesity.
when you have a high BMI body on the table, there are other variables
that have to be considered that have never been discussed at the
newsgroups.

first,  what is the position of the prostate gland?  

   a.  is it in front or further back in the body?

   b.  how deep into the body is the prostate embedded?

   c.  are there other factors involved that is not listed.

now, let's discuss these items i've mention.

the positioning of the prostate gland.  if it is more toward the front
and what they call "riding high"  it is a lot easier to remove than one
that is in back and riding low.

the deeper the prostate is located in the body the harder it is to see
and remove.  look at a cabinet of food.  the food that is at the edge is
easy to pull out that the can located in the very back.

and what about the "smoke netting" and other physical factors that show
up at the prostate site that one doesn't see until they arrive on the
table.

case in point.  my prostate was up high and riding in front.  the
surgeon said it would be a "piece of cake" to remove.  however, getting
a DRE was like he was going to china.  his comments on that was that he
had to push so hard inside to get to the back of the gland due to the
forward position.    i had nerve sparing.  again, he said it was a text
book case and no problems whatsoever.  path report took my preop status
from T1c, to T2c but still gland contained.  and i'm overweight so i
qualify for this mention article.

but, i got a phone call from a patient who my surgeon had given him my
phone number.  his psa was almost the same as mine, about the same
weight and he wanted nerve sparing.

so, we have stabilized EIGHT variables in this case,  we have the same
surgeon, and the same hospital with the same staff, operating on two men
who are the same age, and had the same T1c preop status, and almost the
gleason score and almost the exact same  psa and weight.  but the
results were totally different.

when they opened him up, my surgeon said they could not do nerve sparing
on him.  that his prostate sat too deep in his body and there was a
smoke netting surrounding the prostate - which he said he hasn't seen
but wasn't going to take the chance.  the surgeon also made the comment
that because of the BMI, it was more difficult to make sure he got
everything and not leave something to chance.  so, it was gland
contained, negative margins, with no nerve sparing.

already, our two lives are on different paths from here on.  granted we
both have undetectable psa's for right now, but it is the luck of the
draw from here on.  

if there were a bunch of men with my condition and my results in this
published study, would the results be the same as compared to a group of
men with the second patient's condition and results?

my final decision after reading this article - i'm going to have to
think about it.......

~ curtis

knowledge is power - growing old is mandatory - growing wise is optional    
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."