Effect of surgery wait times on post op pathology.

Posted by shalom7777777 @shalom7777777, Sep 26 7:55pm

Hi, I am trying to gauge the effect of wait time from Biopsy to surgery on post operative pathology (compared to Biopsy findings) Would like to hear from people who think their wait times affected their outcomes...Can you tell me how long you waited for surgery after your biopsy and if it did affect the outcomes. Thanks in advance for taking the trouble to reply!

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Profile picture for northoftheborder @northoftheborder

The majority of prostate cancer is slow-developing, so a few months shouldn't usually matter: as someone else mentioned, if you see a different Gleason score post-op, it's typically because the biopsy needle missed something in the haystack of your prostate.

But there are exceptions. A minority of us have very fast-moving cancer that can escape the prostate rapidly. My metastasised tumour grew so fast that it compressed my spine within a month and left me paraplegic for over a yeae. Typically, you'd be seeing Gleason 8 or 9 with a cancer like that (and even most of them don't spread that quickly).

So most likely, the delay wouldn't matter (especially if the Gleason score in the biopsy was low), but there's always a tiny risk.

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@northoftheborder
Thank you for your insight! Wishing you all the best!

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Profile picture for jeff Marchi @jeffmarc

@shalom7777777
This does sound like a pretty safe solution. While you do have active prostate cancer, it is not real aggressive from the looks of your biopsy.

Waiting a few months is not gonna make a difference. If they find a higher Gleason score after the surgery It probably won’t be much more aggressive,.

The odds are in your favor.

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@jeffmarc
Thank you Jeff!

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This study from 2020 reported in JAMA indicated that even with localized, high-risk prostate cancer, a delay of up to 6 months has no statistically significant chance of worse outcome. —> https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2773817

This 2019 paper out of the UK indicated that initial biopsy and pathological grade matched 59% of the time, while upgrades occurred 25% of the time and downgrades occurred 16% of the time: https://bmcurol.biomedcentral.com/articles/10.1186/s12894-019-0526-9

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Profile picture for shalom7777777 @shalom7777777

@kenhorse
Thanks for sharing Ken! you lucky guy! Your decipher score is low I guess.

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@shalom7777777 I really don't know as I was never given that information. My urologist is pretty cool, I wonder if he has the info if I asked.

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Profile picture for brianjarvis @brianjarvis

This study from 2020 reported in JAMA indicated that even with localized, high-risk prostate cancer, a delay of up to 6 months has no statistically significant chance of worse outcome. —> https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2773817

This 2019 paper out of the UK indicated that initial biopsy and pathological grade matched 59% of the time, while upgrades occurred 25% of the time and downgrades occurred 16% of the time: https://bmcurol.biomedcentral.com/articles/10.1186/s12894-019-0526-9

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@brianjarvis
Thank you for the information. Our Surgeon also told my Husband (I woundn't listen) that 6 month delay will make no difference to lifespan.

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My surgeon said he does surgery within 30 days of the biopsy. Mine was 6 weeks as he waited until we got back from a planned vacation. Good luck.

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