← Return to PSA detected after salvage radiation and prostectomy

Discussion
Comment receiving replies
Profile picture for rlpostrp @rlpostrp

Did your husband's post-surgical pathology report reveal and detail any of the following:
1. Extraprostatic Extension (EPE) where the tumor broke through the membranous "capsule" of tissue that surrounds the prostate?
2. Surgical margins where cancerous cells were viewed microscopically right up to the edge (margin) of the tissue? That means that the cancer extended beyond what was removed...the urologist couldn't have know it, but (s)he left some cancerous tissue in your husband's body.
3. Seminal vesicle invasion of one or both seminal vesicles. Both were removed along with both vas deferens, but when the cancer is found in the seminal vesicle(s), it instantly takes you to the pT3b tumor classification, independent of the lower risk Gleason of 3+4=7. I know, because this was my reality. A pT3b cancer has a 25-50% probability of recurring "within" the first five years post op. My urologist said that in his practice 1 of 3 (33%) of his pT3b patient have recurrence "within" five years. I am hoping, praying, and counting on being in the 2/3 that don't have the recurrence.
The real pivot point for prostate cancer seems to be Extraprostatic Extension. Once the tumor breaks through the capsule, all bets are off because you don't know where it is spreading. The likely places are the seminal vesicle(s), and that is why they are removed in cautionary surgical practice. Sometimes the cancer spreads to the bladder neck, or lymph nodes that are close by.
I'll look for your reply. Good luck to you and your husband.
Hopefully there will be enough prostatic tissue for a PET Scan to see radioactive isotope (Gallium) uptake and where it is. Prostate cancer grows so slowly (most of the time) that your PSA can be detected, but there may not be enough cells to take up the Gallium isotope for the PET Scan to detect it.
Please reply back with whether your husband had any of the above (1-3).

Jump to this post


Replies to "Did your husband's post-surgical pathology report reveal and detail any of the following: 1. Extraprostatic Extension..."

@rlpostrp 1. No; 2 margins were clean. Have to check our notes for 3. Will get back to you on that when I can.