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Posted 1/29/2010 11:22 PM (GMT -5)
 

I had surgery for prostate cancer on Wed the 27th.  The doctor said that everything went well and he would get with me on what was found with the prostate.  All tests before surgery indicated that the cancer was confined to the right lobe with a gleason score of 3+3=6.  I had a 12  core bio a couple of months ago that came up negative and the latest which was 18 core which showed a very small amount of cancer in two cores which were on the right side of the prostate.  The doctor just called and told me that my gleason score was now 4+4=8 and the bio of the prostate showed most of the left side with cancer with none on the right.  In checking my MRI records they indicated cancer on the right with no mention of cancer on the left side of the prostate.  Is it possible that all of their tests could be so far off?  What are the chances that there could be a mix up or misreading of the slides?  The doctor did indicate that there was no indication of cancer in the nodes and it appeared to be all contained in the prostate.  I have went from a little worred to a lot worred!

Thanks,

twotall

Posted 1/30/2010 12:29 AM (GMT -5)
Twotall,

MRI's are not great at visualizing PC. Most men don't have them. I suppose the radiologist could have gotten left and right mixed up, but doubtful.

As far as the upgrade from a 6 to an 8, that's a jump, but the good news is the contained as far as we know. We can tell more when you put your pathology on your signature.

Of course, there can be mix-ups, but with path slides it is pretty rare. I would say that once you know you have clean margins, you can breathe a little easier, and see what the PSA tests say.

Not a lot you can do at this point, and worrying won't make it any better, Just concentrate on getting the leaks stopped, recovering from the surgery, and being thankful for all the good results.

Tomorrow is another day.

Goodlife
Posted 1/30/2010 12:32 AM (GMT -5)
Twotall. Wow that is quite a jump from 3+3 to 4+4. The good thing is that it seems that it may be organ confined. I guess when you see the Dr. he will want to watch you PSA Close. Time will tell how successful the surgery was. There is no reason to worry about the what if's. It will not change a thing. Live each day to the fullest and be thankful for each day.

Jeff T
Cajun Country
Posted 1/30/2010 6:10 AM (GMT -5)

Twotall

Glad to hear that you are on this side of the surgery.  It appears that your recovery is coming along well.  That is certainly good news.

Also good news that the PCa appears to be organ confined.

Sorry about the upgrading of your Gleason score. 

Goodlife and Jeff T offer good advice about worry.  I can only echo their words.

Skeener 


Posted 1/30/2010 9:05 AM (GMT -5)
Twotall,

You might call the Dr's office Monday and ask about the change from right side to left side to see where the mix up occured. The good news is the containment and the not so good news is the upgrade on the Gleason Score. But sounds like you have a lot to be happy about and as others have sugggested focus on that. And yes, that  is easier said than done, but worrying only does you good if you get up and do something about the problem, so call Monday to clarify your Dr's report. The best to you and hear's hoping a string of zeros on your PSA.

Michael

Posted 1/30/2010 9:08 AM (GMT -5)
My biopsy was a 3+4 and post surgery I am an 8 (4+4). I would talk to the doctor.
Posted 1/30/2010 9:18 AM (GMT -5)
Two tall,

I had a 4+4 and all contained so that is your biggest issue. They should tell you beyond a doubt from the pathology where the cancer was contained. It has a predictable progression so if the cancer was contained in the margins and had not spread to the nodes and vascular bundles before that, then you should be good to go. Mine was contained, and that is the beauty of surgery over radiation. Then you'll get a psa blood test and it should read a very low number as in undetectable. Sounds like some one took some bad notes or had the film upside down.
Posted 1/30/2010 9:46 AM (GMT -5)
twotall,
Sorry about the upgrade to Gleason 8 from 6. The key is for the cancer to be organ confined and get negative margins. hopefully your next PSA will give good news and peace of mind.
Posted 1/30/2010 10:14 AM (GMT -5)
Two Tall, glad you are on the other side, you are now in the recovery mode. Sorry about the upgrade from the 6 to 8, you must all rememember, that a biopsy is just an estimate, they are only seeing a small section of your prostate and none of the surrounding area. An upgrade like that is not uncommon, just unfortunate. It's more important, as time and future psa tests will tell, that the cancer was contained to the prostate. Good luck, you have made it this far, the gangs all here for you.

David in SC
Posted 1/30/2010 11:07 AM (GMT -5)
 

Thanks everyone for your thoughts, you have helped me step back and see the bigger picture.  I guess I was not expecting such a big jump in the gleason score and went into a tail spin for a bit.  When I talked to the doctor he indicated that he would have the slides double checked and get back with me.  My doctor will be out of the country when I have the cath. removed Wed, but I will ask for a copy of the bio report and post some of it then.  Every thing else is going about as expected, my wife and I learned a bunch about what to expect from reading the forum before we started what we are calling our "grand advanture".  Thanks again for the help and surport,

twotall

Posted 1/30/2010 11:22 AM (GMT -5)
twotall

I also had problems with the Gleason score biopsy said 4+4 post op score 3+3 then when my PSA started to rise they relooked and said it was 4+4.  I advise sending the slides to John Hopkins for a second opinion just to be sure, they all make mistakes.

Good luck and get well.

Jerry1

Posted 1/30/2010 12:34 PM (GMT -5)
twotall, I think the key is what your post-op PSA test results are. You can look at statistics and nomographs all you like, but for you, specifically, if your PSAs are non-detect, that's all you are looking for. Conversely, if your Gleasons are 6 but post-op PSA continues to be detectable (and consequently rising), the Gleasons won't help you.
Posted 1/30/2010 11:01 PM (GMT -5)
Twotall,

I'm in exactly the same situation as you are.

Biopsy showed cancer on the left side, MRI shows cancer on the right side and none on the left. Even, in my opinion, biopsy is the primary indicator, I'd still go with the worst case scenarion which is you (and me) might have cancerous cells on both sides.

One of the reasons I chose surgery. It's scheduled for the next Wednesday.

Good luck with your recovery.

Mark
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