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outside the prostate but not outside the margin

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Posted 12/3/2013 6:00 PM (GMT -5)
Just had the chat with my surgeon about the prostate pathology report. I understand most of it but one thing that confuses me is that he said the cancer had grown out of the prostate but not outside the margin.

What does that mean?
Posted 12/3/2013 6:06 PM (GMT -5)
could you possibly share some more of the overall pathology report? might make it easier to answer the question.

david
Posted 12/3/2013 6:12 PM (GMT -5)
It means that while the cancer had extended outside of the prostate, your surgeon cut wide enough that the margins were clean. The hope is that he got it all.
Posted 12/3/2013 6:14 PM (GMT -5)
It would be my understanding that he means even though the cancer had broken through the prostate capsule, he cut out a little further so that the margins of what he removed were clear. That is a good thing. What was your Gleason and PSA? Clear margins are a definite positive.

Tom
Posted 12/3/2013 6:26 PM (GMT -5)
Yes it was outside the prostate, but specimen contained, i.e., the big lump of junk the pathologists cut to slice and dice to see if they got it all. A very good thing! In Pca and most cancers, it is never known whether they got it all, which is why you are monitored for a recurrence. Your pathology make a recurrence less likely
Posted 12/3/2013 7:19 PM (GMT -5)
Havenon, my husband had a similar situation. I think this is called EPE (extraprostectic extension). In my husband's case, the surgeon cut a very wide margin around that area and all margins were clear. My husband is 5 years out from surgery with a Gleason 3+4 and 40% involvement and he's doing just fine PSA wise.
Posted 12/3/2013 7:41 PM (GMT -5)
I was in the same boat. I'm about 2.5 years out with undetectable Psa. Good luck!
Posted 12/4/2013 12:22 AM (GMT -5)
This may not be for the squeamish but, when the lab processes your prostate after it is removed, the first thing they do is to paint the outside with multi-colored ink -- one color on the right side and one on the left. Then they slice it like a loaf of bread and examine the slices under a microscope. Anything that is covered with ink is part of the "margin". If the surgeon cuts wide at a particular point -- because he doesn't like the look of it (robotic) or it feels funky (open) -- then the cancer can have grown out of the prostate but not out far enough to get inked.
Posted 12/4/2013 12:26 AM (GMT -5)
Havanon

I was/ am in kind of the same situation. Surgery in oct 2007
T3a Gleason 3+4=7 EPE 5% involvement clean margins
First psa was .005 now it is .039 at 74 months out-rising but still undetectable- maybe facing SRT- re-test in six weeks
Keep us posted
Posted 12/4/2013 12:47 AM (GMT -5)
My margins were outside the prostate and outside the surgical margins at multiple points, even after the surgeon went back and took more tissue after a preliminary review. That is bad.

Your results were very good, in a contorted way, since they could have been some much worse.
Posted 12/4/2013 5:48 AM (GMT -5)
Mine was "into but not out of the orange peel".
Posted 12/4/2013 4:51 PM (GMT -5)
Thanks all.

Uro told me he's seen only one prostate more bunged up than mine and the man is alive ten years later with undetectable PSA. So there is hope, but it is too early for celebration. My girlfriend read my horoscope that said 'Trust in the cosmos!" I said, "It's the cosmos got me into this!"

So yes. It's a crap shoot.

My continence is ok unless I'm drinking, and I even woke up with a semi-semi! This is good, right?

Three weeks in I've taken some Cialis. It doesn't seem to do much.

Thanks again to all of you. You support helps.
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