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It's Official I have Prostate Cancer
Prostate Cancer | Last Active: 4 days ago | Replies (40)Comment receiving replies
I like you had my RP performed 1/27 My Gleason score was 9 grade 5. While My surgeon told me that he got clear margins, truth is he did not. The Pathology showed that I have a T3a that has invaded outside the prostate. I am working on restoring my continance 3 weeks post op with little success although I am trying to do the kegels. I feel as if I have no control over my voluntary urinary flow as if I am paralyzed but am told this is normal at this time. I am told to wait 45-90 days for a post op PSA to determine whether my levels are detectable or not. My problem is that my pre-op PSA was 2.4 and the PSMA pet scan pre RP showed no evidence of spread yet the Gleason 9 and my T3a suggests metastatic disease so I don’t know how a PSA blood test is going to guide further treatment since I am one of those prostate cancer patients that do not produce a lot of PSA as a marker so I plan to consult with GU oncologists that will think outside the box as I have the wait.
Replies to "I like you had my RP performed 1/27 My Gleason score was 9 grade 5. While..."
Hey Mish, sorry about those results, but today’s treatment options turn a once lethal disease into a manageable chronic one.
You will probably be placed on ADT as you heal before undergoing salvage radiation. As you correctly point out, PSA does not supply a good basis for treatment in your case, so no matter how low your post-op PSA is, you cannot wait IMO for the magic .2 before initiating salvage treatment.
Also, be sure your RO is including the pelvic lymph nodes and not just the prostate bed - something like 35% of failed salvage rad. occurs in the nodes. Best
Phil
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How interesting that we both got our RP done a day apart! Given that, though, how can you know he didn't get good margins so soon after surgery? In a span of ~2 weeks I would think it unlikely that the spread hadn't already happened prior. With Gleason 9 grade 5 that's pretty serious PC, the chance it spread seems like it would be high regardless of margins.
I attribute my continence to two things: the technique my surgeon used on my urethra and hammering my core and pelvic floor for three months religiously before surgery. I may have been fine regardless, but I hedged my bets.