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Posted 4/2/2009 11:24 AM (GMT -5)

Hi guys,

Got a copy of my post op pathology but I haven't had a chance to discuss it with the doctor yet. Appreciably worse than I thought from what I can interpret.

Tumor upgraded to Gleason 9 (5+4) occupying 80%

Apex is positive, superior margins positive, seminal vesicles positive

Apical,uretheral,posterior and bladder margins negative.

two of nine lymph nodes positive.

pT3b, pN1, pMx

We're pretty much shell shocked. The lymph node involvement really erodes your hope. Puts your fight into a different category. I assume chemo or clinical trials will be the most likely options.

Oncas (Jim)

Edited by TC-LasVegas

  Added Subject line.

Post Edited By Moderator (TC-LasVegas) : 4/4/2009 12:11:28 PM (GMT-6)

Posted 4/2/2009 11:37 AM (GMT -5)
Jim,

Sorry to hear what appears to be a pretty grim report, but remember, there is always hope, even with bad numbers and pathology reports. Surprised you weren't shown it with you dr, that's how it was with me. Please keep us posted closely, and see what kind of options you really have at this point. Now you need the help of some of the advanced fellows, they will be around soon, I am sure. My best to you, brother.

David in SC
Posted 4/2/2009 11:37 AM (GMT -5)
Hi Jim,
There is hope and don't feel there isn't. You still have plenty of options and can expect positive results with them. I am very sorry to welcome you the advanced PCa club, but it is what it is. I had the option of Taxotere and declined it hoping to get more out of ADT and radiation. You may wish to look into both. Some radiologists may back away, but there is benefit to WPRT using IMRT in stage IV cases. ADT however is a likely path right now. And there may be benefit to Chemo with an investigational drug.

If you look at the last line of my signature, you will see the best advice I can give you. I have been here over two years and have met many with similar or worse than you that are doing well at over well ten years. You will see some comparitive cases on www.YANANOW.net.

Stay with us, buddy. We will be here and I know you will get support.

Tony
Posted 4/2/2009 12:03 PM (GMT -5)
So sorry to hear your path report was worse than you anticipated.  There is a 2005 Mayo Clinic Study about T3 cancers, lymph node involvement, and surgery I think you would find useful. I'm not sure how to put link here but if you email me (I believe email address is in my profile), I will send it on to you.

Posted 4/2/2009 5:16 PM (GMT -5)
I'll try a second time here providing the link www.sciencedaily.com/releases/2005/04/050411112637.htm  

If it doesn't work, please email me and I believe I can send it as an attachment.  Certainly, I think the study results can provide some hope to you as many men with similar stats end up doing well.                                                                     

Posted 4/2/2009 1:24 PM (GMT -5)

Hi Jim,

Sorry to see your report. However, my stats are very similar to yours. (see signature) I went to Mayo for a second opinion based on the article that Wife33 recommends. I met with a Dr Blute and his assistant. In spite of my lymph node involvement the recommendation was surgery since it was the local nodes. I was told that it would probably require follow up with radiation. And hormones at some time after the surgery and radiation. I did not elect to do the surgery but I did do the radiation.(IMRT) It was a combined protocol that radiated the suspect nodes and the prostate. And I am much like the fellow who jumped off of the skyscraper who would say at each floor "so far, so good". I am about seven months post radiation and in the middle of a two year hormone course. I feel as good as I felt before discovering I had the problem. My oncologist is optimistic about my prognosis and tells me not to obssess over the PSA. Good advice. Life, for now, continues in some manner of normalcy.

My reasons for not continuing with Mayo were primarily logistical and financial as I am over 2000 miles away and uninsured. Dr Blute was quite informative in regards to my case and treatment options. Be aware that Mayo has a bias towards doing the surgery based on thier past case experience. You may want to go there for a second opinion if things permit. They were very accomodating when I called to schedule one and had me in about two weeks later.

I guess my point is don't give up. There are options and there are experienced physicians and hospitals that will take on the tough cases. Jim, I sincerely wish you the best of luck and some solution to your problem.

Best regards,

Don

Posted 4/2/2009 1:38 PM (GMT -5)
Ohio...you might want to remove your email address from the text and add it to your profile (not in your signature line) if you haven't already...prevents harvesting of email addresses....otherwise a mod can assist you
Posted 4/2/2009 2:03 PM (GMT -5)
So sorry Jim- that is a tough report but you will handle it. Stay strong and I will be pulling for you.
Posted 4/2/2009 3:35 PM (GMT -5)
Jim-
I know all too well the feeling of a devastating pathology report. My father also had a lymph node come back positive and we were absolutely devastated. The frustrating news is that most of what you will read on the internet is grim, however, pick up a copy of Dr. Snuffy Meyers book ASAP. In addition, try to keep in mind that the medical opinions are going to get even more frustrating at this point. Do your research, have faith in those close to you and believe that you will get through this. Make the best decision you can for yourself and don't look back. My father went through salvage radiation and is in his second year of HT. After his RP he didn't want to do any of it. He was devastated. IMRT was a breeze for him and he hates HT, but he manages. He looks incredible and is living again. I'm sorry you have to go into Round 2, but stay strong. You have friends here to support you and hope to hold on to. Keep us posted and let us know how we can help!
Posted 4/2/2009 4:30 PM (GMT -5)
Wow Jim, I read your pathology report and my heart sunk. And then I began to read the replies. And then I began to read the replies from guys with pathology reports very similar to yours. And I began to realize, as I know you have too, that there are a lot of very bright rays of sunshine on the horizon. Did you not come to the right place or what? Someone on this board who post pretty often has a tag line after their signature that has always inspired me. "As long as you continue to fight, you are winning." You are in our thoughts and prayers my friend, never give up!
Posted 4/2/2009 4:39 PM (GMT -5)
Greetings, Jim.  We wish you had received a more positive path report and I know you do as well.  However, as you can see there are lots of guys here who have similar reports and are doing well.  No mountain too high, no river too wide - keep the faith and seek that next level of treatment.  It's a process that we all deal with - bottom line keep up the fight.  We'll be thinking of you and praying for you.  David

Posted 4/2/2009 5:41 PM (GMT -5)

Once again I am deeply moved by the endless emotional and informational support offered in this forum. Quite honestly it has helped me put every obstacle in perspective. Truly I had some grim stats laid on me today but I am learning of others in the same arena fighting on and still alive many years later. I fully intend to join that crowd and I'll do whatever necessary to make it happen. Thanks so much to all in the fight.

Oncas (Jim)

Posted 4/2/2009 7:16 PM (GMT -5)
Jim,
Devestating news. Try to get the best Prostate Oncologist you can. Radiation and ADT3 are still good options that will give you many more good years.
JohnT
Posted 4/4/2009 7:20 AM (GMT -5)
WOW Jim you and I have almost identical pathology reports and YES YES there is much hope. I was told when I woke up from surgery that I had three positive nodes and the surgery was aborted. I went through 42 IMRT's and just got my last lupron shot. I am 21 months post op and doing great. Will the cancer come back? I am sure it will, but guess what? I am going to kick it down again and again. With the power of prayer (for me) and the love of everyone around me as well as the folks here I can do it. I have had my bought of depression, haha it took me a long time for it finally happen. Now I am up for whatever is next.
Jim, please stay in touch with us. Email me sometime and we will discuss the emotional aspects of this further. Please know I care very much.

peace and love
dale
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