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Posted 1/25/2009 3:30 PM (GMT -5)
If anyone can explain the couple of "positive" results in post op pathology report and how they fit in with "specimen confined" description I would appreciate it. The doctor said it was a good "negative" report but I still don't completely understand.
Posted 1/25/2009 3:56 PM (GMT -5)
Let me ask this simplistic question, I didn't do surgery and don't know all the parameters enough, why can't you get a written copy of this, just like we can for pathology report. Then you can have someone else review what it says and/or means. Myself I insist on verifying anything the docs tells us and it is with good reasons.
Posted 1/25/2009 4:05 PM (GMT -5)
Hi Tobmeister,

It means that there were no positive surgical margins identifiable but that the cancer had begun to spread and was no longer confined totally within the prostate.

It is a good report, pathologists do not like to play with this, if there was a questionable surgical margin they would have said so.

Organ confined totally within the gland, speciman confined totally within the mass of excised tissue.

I am sure your Dr. will explain this to you completely on your followup to have the Foley removed.

Good report, continued well wishes for a speedy recovery. Scott
Posted 1/25/2009 4:41 PM (GMT -5)
The description seems consistent with the staging, T3aN0Mx.

T3a the cancer is growing outside the prostate but has not spread to the seminal vesicles.

N0 means that the cancer has not spread to any lymph nodes.

Mx means that tests to detect distant cancer spread have not been done.

I copied the above from a brochure from the American Cancer Society, picked up at my hospital.

My layman's interpretation is that while the cancer has spread beyond the prostate boundary (capsule), it hasn't gone very far, and seems to be limited to the chunk of tissue that the surgeon has removed. Sounds pretty good.
Posted 1/25/2009 6:06 PM (GMT -5)
Anything other than "confined" will be roudned up. PNI is the only exception I've seen to this rule.

Swim
Posted 1/25/2009 6:21 PM (GMT -5)
OK thanks, that helps. I guess the main thing I didn't understand is the difference between organ and specimen confined. But I do so that makes sense.

I do have the written report but just didn't totally understand what it was saying and you know you never have time to ask the questions you think of later.

By the way, once I had my catheter out 1-15 I was pretty much dry from day one. I wore a pad for precaution until yesterday and went the last two days without a pad and no significant leaks to report!

Thanks all for your responses.
Posted 1/25/2009 6:48 PM (GMT -5)
Really happy that you are dry...The Tobemeister is Dry!! ....That is just great. Pete has not been dry for two years.....Count your blessings! D
Posted 1/25/2009 7:44 PM (GMT -5)
Tobe, congrats on you going so dry sometimes, like everything else with PC, you never know what you are going to draw out of the hat. Good luck to you
Posted 1/25/2009 7:45 PM (GMT -5)
Hey Tom,

Great that Foley is gone from your life and I hope forever.

And even better news that your continance issue is not an issue.  :-)

Scott

Posted 1/25/2009 9:08 PM (GMT -5)
Tom,

I just re-read your sig, and I see you're one of the fellows whose post surgery Gleason was actually lower! Seems like things are going well for you. Good luck on your April test; you'll likely do just fine.

DJ
Posted 1/26/2009 8:28 AM (GMT -5)
Tom, your path report is virtually identical to my husband's. I too had difficulty understanding the definition of local vs. regionally local disease. My husband's PCa had a "miniscule" (pathologist's word) extension into the prostate capsule which put him at stage T3a (clinical stage was T1c). All margins were clean as were the bladder and seminal vesicles. The urologist explained that once the cancer leaves the prostate proper and enters the capsule, it becomes regional rather than local regardless of how small or large the extension is. His path report clearly stated that the cancer was found in the capsule but not outside of it - which is what is most important. Perineural invasion is very common and means that cancer cells were found around the nerves (in my husband's case, this was noted on his original biopsy report so no surprise there). Husband's PSA pre-surgery was 6.3 with fPSA of 11. His DRE was negative and his prostate was ever so slightly enlarged but considered normal for a man his age (he was 58 at dx). Had robotic surgery in March 2008 and his PSA hit 0.0 seven weeks post op and has remained there.

The "normal" check-up is a PSA test every 3 months for the first year, then every 6 months for years 2 through 4, then annually starting in year 5. Urologist told me that he's thinking of keeping my husband on a 3 month schedule for the first 2 years just to be safe because the cancer had escaped the gland (the actual prostate) and moved into surrounding tissue (the capsule).

The bottom line is that 2 urologists we work with both felt that the path report was good and that my husband's chances at a "cure" are excellent. Of course, nothing is guaranteed but the odds are definitely in his - and your - favor.

I wish you a speedy recovery and nothing but zeros in your future!
Posted 1/26/2009 1:19 PM (GMT -5)
Tobmeister:

I was a pT3a and the way my doctor described it was - it had bulged out, but not necessarily broken out. Everything around the prostate was negative, and as far as I can tell - I'm good to go PCa wise. I hope you are the same. But you are kicking my butt in the incontinence department. Good for you.

Every day above ground is a great day!
kcragman
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