Replies to You are correct. PNI Does not mean it has spread outside the prostate. It does, however,…

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Prostate Cancer | Last Active: 4 days ago | Replies (74)

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@jeffmarc

You are correct. PNI Does not mean it has spread outside the prostate. It does, however, seem to mean the cancer is aggressive. I see multiple statements about PNI, from NIH and others, that are similar to this.

“Prostate cancer has a propensity to invade and grow along nerves, a phenomenon called perineural invasion (PNI). Recent studies suggest that presence of PNI in prostate cancer has been associated with cancer aggressiveness.

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Replies to "You are correct. PNI Does not mean it has spread outside the prostate. It does, however,..."

heavyphil | @heavyphil | Dec 8 6:56am

Jeff, I wish I wasn’t so bad at copying and pasting! The gist of Dr Barsky’s article is that PNI is NOT associated with post surgical Gleason upgrading. And that PNI offers - in a perverse way - a clearer look into the actual “Gleason-ness” of the original presurgical biopsy.
In my own case I had PNI in perhaps six cores out of twelve. I was diagnosed with Gleason 4+3 unfavorable. My surgical pathology report remained the same - no 5’s detected.
Of course, here I am 5 yrs later having salvage radiation so my cancer was obviously more aggressive. My doctors at Sloan however, ascribe this more to the surgeon’s laxness at doing complete lymph dissection than pure aggressiveness.
So the spread of the cells toward the neural sheath -PNI- does, in fact, point to a more aggressive type of cell but not one that has necessarily escaped into the surrounding tissues.
Best

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