Connect
Just got my prostatectomy pathology results
It’s been a while since I last posted. I was diagnosed with prostate cancer in April of last year, Gleason 7 (3+4). PSA was 6.8 before biopsy. I contemplated active surveillance and had another PSA 4 months later and it came back at 8.9. Decided on radical prostatectomy which was performed on February 8th. Just got my pathology back a couple days ago. Gleason score remained the same. However, the following was noted: cribriform glands present, extra prostatic extension present nonfocal (right anterior, left anterior) bladder neck invasion present, multi focal positive margin present, length of margin >3 mm, margins involved right anterior, left anterior and right bladder neck. No other adverse findings. pT category: pT3a.
Surgeon’s PA went over the report with me and I have my first post op PSA draw in May with a follow up visit in June.
I’m reaching out to the forum for insight, thoughts, advice, etc. on what will/may be coming next in my future. I know the findings suggest BCR at some point and further treatment would be needed to get the last bit out. It’s not the path report I was hoping for but it could’ve been worse.
Thanks to all, in advance, for any input you might want to throw my way.
Like
Helpful
HugInterested in more discussions like this? Go to the Prostate Cancer Support Group.
Connect
Consider talking to your urologist / oncologist about a 6 week and 12 week PSA test, so that your June appointment can include a discussion about both the PSA value and any rate of increase. The information will guide you on any need for follow up treatment timing as you heal from the surgery. While 3 month post RP is typical for the first PSA, that timeline is often shortened when the post RP pathology report includes extra prostatic extension.
Thank you, @jsh327
3 month postop standard; PSA has a relevant half life after RP, so not clear what efficacy there is in PSA test sooner. Have noticed that some Drs order post RP PSA tests sooner; would defer to your MD.
-
Like -
Helpful -
Hug
1 ReactionNow to your Q:
No great answer; your PSA test will give you significant information.
If < .1, then considered undetectable.
Personally, and somewhat to jsh327's point, I would want 3 mos followup testing for 1st year because of EPE and other findings from Pathology.
If not undetectable after a confirming PSA test, then that's a problem that needs to be addressed.
My story:
RP Aug 2022 - clear margins, lymph nodes and seminal vesicules.
BUT Pathology confirmed Gleason 9 , staged pT3aN0 and identified Extraprostatic Extension (EPE).
My 1st 90 day postop PSA was a disappointing .19 (30 days later, retest confirmed .18).
Deemed BCR (biochemical recurrence).
Referral to Radiation Oncology; recommended Salvage Radiation together with a short course of ADT.
Completed treatment (tx) June 2023.
1st post tx PSA in Nov and 2d this past week both undetectable < .02
Trying to be direct and not prematurely negative.
IF you have BCR, there is treatment.
See SPPORT trial and video " Rising PSA after RP" Jan 2023 Prostate Cancer Foundation (pcf.org).
I hope and pray that your PSA will be undetectable and remain so.
Best wishes.
-
Like -
Helpful -
Hug
2 ReactionsThank you @michaelcharles, great information. Glad your PSA is now undetectable with the additional treatment. Any side effects from salvage?
There is much good input above
You just had surgery, so focus on healing and getting back to normal. If life is going to through you a curve ball, let that happen but first make sure you are recovered. Be easy on yourself, prostate cancer is generally a very slow cancer, so early detection equals lots of options.
-
Like -
Helpful -
Hug
1 ReactionAgain, I am somewhat hesitant to get the cart before the horse.
IF you were to have salvage radiation treatment, most men, and I, report nominal to mild side effects (SEs) which resolve w/in 4 weeks of treatment ending.
ADT hormone therapy has its own SE profile and seems to be very varied and individual. My SEs were mild to moderate, and substantially disappeared over a number of months.
Concurring with others, suggesting a 2d opinion and not getting ahead of yourself.
Best wishes.
Thank you, guys! Very helpful information
What are the early signs of prostate cancer?
@jeff1957 rising PSA within 12 months is typically the first point at which a urologist visit is made. The urologist performs an examination which can help you decide if you want to take further diagnostic steps.