opinions please

mikem · New User Joined: 14 Jul 2006 Posts: 1

Hi to all,

I just discovered this forum and am hoping that I can get some feedback based on your knowledge and/or experience on the status of my PC.

I was diagnosed with PC on 3/28/06 and had a Da Vinci RP on 6/27. I am 57 years old. I am trying to come to grips with my diagnosis and understand my prognosis. Any insights into my prognosis based on the following information will be appreciated.

I had my biopsy done on 3/27/06 after a rise in my PSA to 5.3. The pathology report found adenocarcinoma on both sides. Ten cores were taken. One core on the right involved 2% of the tissue. Gleason 2-3 (5). One core on the left involved 2% of the tissue. Gleason 2-2 (4).
Stage T1c.

The post operative pathology report is what I do not understand. Also, I was shocked at the difference in the pre and post-op reports:

"Adenocarcinoma, conventional type, Gleason score 6 (3+3), bilateral.
Minimal Focal Margin involvement, left posterior lateral, Mid-base. (see comment)
No evidence of extra prostatic extension or seminal vesicle invasion.
No evidence of Angiolymphatic invasion.

Comment: Approximately 40% of the right lobe and 50% of the left lobe are involved by Gleason score 6 tumor. Close to the margin in the left lobe, three or four glands are touching the inked surface.

Pathologic staging is pT2c, pNX, pmx."

Based on the pathology report from my biopsy, it seemed that I had a very small, contained cancer. The size of the actual involvement based on my post operative report is disturbing. Based on the post operative report, has the already cancer spread, or is it probable that it has?

Thank you in advance for you insights. I look forward to contributing to this forum.

Michael

johnw100 · Posted: Mon Jul 17, 2006 11:32 pm Post subject: opinions please

Michael,

I often suggest the book "Prostate Cancer Prevention and Cure" by Lee Nelson, which has a wealth of information on stage, treatments, prognosis, lifestyle etc.

My understanding is that Stage T2 is confined, while T3 is advanced.

It's very common for the pathology report to upgrade the previous boipsy reports which are usually based on a limited number of needle samples.

For most men with early stage diagnosis, gleason 6 is a very common score which is not the most agressive cancer, and your 5.3 PSA wasn't overly high.

A small minority experience a PSA rise after surgery which can indicate future additional treatment.

The book sets out various risk factors like PSA, stage, gleeson, positive margins, seminal invasion, cure rates, all of which your urologist can also discuss with you, but apparently the only way to really know if one is "cured" after surgery is the regular PSA testing.

Good lifestyle changes to exercise, diet, supplements are thought to have an impact on overall health and prognosis.

John

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