Prostate Cancer Sucks-But good to celebrate victories big and small

Posted by fritzo @fritzo, May 20 8:59pm

I just had my post-surgery pathology consult with my doctor today after my radical prostatectomy surgery four weeks ago. Talk about apprehension and worry.

The doctor entered and asked if I had read my pathology report, which posted on MyChart earlier. I said I had, but didn't know if I was reading it correctly.

With a big smile he said, "This is as good as it possible could be." Negative margins, tumor was organ confined and seminal vesicles are negative for carcinoma.

So, a huge sigh of relief and a huge hug for my wife, who has been amazing through this journey. She admitted that she felt like she might able to breathe again.

I was also worried that my post-surgical PSA wasn't as close to zero as I hoped (it was <0.064). But, he said not to worry and that anything under .1 is a great place to be. I haven't been able to figure out what specific lab is actually processing my PSA results (used to be Abbott, but it looks like my local clinic has changed vendors).

I know I’m incredibly fortunate and I feel so indebted to everyone on this forum who has helped me navigate the emotional tsunami, as well as help me make a decision on what treatment path to follow. And then, the surgery recovery period has been a real adventure. So much advice. I feel so connected to everyone.

Things I'm still sorting out; stress incontinence, which is definitely an ordeal. I got a referral for Pelvic Floor therapy...so hoping that helps.

I also had a pre-existing inguinal hernia that definitely feels bigger post surgery. So, still looking for advice on how not to make that any worse than it is.

Prostate cancer sucks. I've had small victory moments....figuring out how to navigate catheters, overcoming rolling waves of intense abdomen pain, post-surgical bowel issues that were a big challenge, huge emotional turmoil about my surgery decision when a support group moderator (not a doctor but calls himself a doctor because they have a phd) who pushed me hard not to cancel my surgery (just four days before my surgery date),....or figuring out how to overcome intense muscle aches induced by Tadalafil,....and more.

But, I'm going to celebrate because this one seems like the big one. Feeling very grateful!

What was a surprise to me was that my staging didn't change at all. I was pretty convinced that it would come up worse because my final surgeon said the earlier trans-rectal biopsy under-sampled (even though they took 24 cores) because the location of my tumor was in a position that the trans-rectal probes couldn't reach.

I was also surprised that since my Decipher score was .61 that the pathology didn't show more serious cells than the "Prostatic adenocarcinoma" in the report. This topic is probably more complex than my limited knowledge.

Here is a section of my pathology report:
Final Diagnosis
A. Anterior fat pad, excision:
One lymph node and mature adipose tissue, negative for carcinoma.
B. Prostate, radical prostatectomy:
Prostatic adenocarcinoma
Gleason score 3+4=7 (Grade group 2, with 30% Gleason 4 tumor).
Tumor is on the left as a 1.2 cm dominant nodule.
Tumor involving 2% of prostate tissue examined.
Tumor is organ-confined.
Both seminal vesicles are negative for carcinoma.
All surgical margins are negative for carcinoma.
Benign prostatic hyperplasia, weighing 66.9 grams (including carcinoma).

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

surftohealth88 | @surftohealth88 | May 21 12:25am

CONGRATS Fritzo !!! 🙌😃 YEAYYYYY
Those are most wonderful news and may you stay undetectable forever !!! : ))))
All the rest will correct itself sooner or later.
Enjoy your summer now and stop by occasionally ; ) to say hello : ))) !

heavyphil | @heavyphil | May 21 6:22am

Fritzo, I hear you, man!
After going thru surgery and all the crap that went with it, I realized one day, “Hey, I made it - I did that!”
Especially when you’ve never needed more than a band aid in your entire life, you are suddenly thrust into a hospital drama where YOU have the starring role…really frightening and disorienting.
So congrats on your results and take more than a moment to savor this victory, which you never even wanted in the first place!😉. Best,
Phil

jayhall | @jayhall | May 21 7:54am

Many Many Congrats to you! 🙂 Go celebrate with some ice Cream! 🙂

tuckerp | @tuckerp | May 21 8:04am

good job. So far you have had to take what you were handed. Make lots of decisions. Lets hope your Dr did his job well. Now its time for you to do your part. I was an emotional mess after getting to this point and took 5 years off. None of that helped with the next two phases. ED and INC. Some are lucky enough its no big deal but best to keep after it . Great news.

melvinw | @melvinw | May 21 8:41am

Glad to hear that all is going well, and that the cancer was organ confined. The Odds are with you!

I also had a pre-existing inguinal hernia going into my RARP in April 2015. I maxed out my insurance OOP from the prostatectomy, so in consultation with my urologist, I scheduled a hernia repair surgery for six months after the RARP. Cost me nothing, and improved my life tremendously. Another multi-week recovery, but by 2016 I was fully back to normal physical activities.

Regarding the stress incontinence: even after PT and all the Kegels, I was still going through 1-2 pads per day. My urologist offered urethral sling surgery early on, but it wasn’t until 2023 that I had the procedure. Pretty simple outpatient surgery. Instant and 100% continence as a result. Again, QoL took a huge upturn. Even after my salvage radiation last year, I am still getting by without pads. Perhaps very slightly more drippy than before, but as my 50-something urologist said, I’m doing better than him (I’m 73). So, take heart that if the stress incontinence persists, there are ways to fix it.

Now go forth and enjoy the day!

Mel

mjp0512 | @mjp0512 | May 21 8:57am

This is pretty good stuff. Relax and get back to life. 👍

Jeff Marchi | @jeffmarc | May 21 11:02am

Definitely time to celebrate.

You could very well be one of those people that never needs to come back to a forum like this because you’re cured.

A real positive biopsy result.

fritzo | @fritzo | May 21 12:03pm

In reply to @surftohealth88 "CONGRATS Fritzo !!! 🙌😃 YEAYYYYY Those are most wonderful news and may you stay undetectable forever..." + (show)

@surftohealth88 Oh yes, I will not be a stranger. I'm a part of this family....just hoping that I'm in the phase where my house isn't on fire anymore.

You've been such a godsend! Your husband is an incredibly lucky to have you by his side.

Yep, working out sorting out the after-surgery symptoms...but that was the package deal. Super relieved!

fritzo | @fritzo | May 21 12:07pm

In reply to @heavyphil "Fritzo, I hear you, man! After going thru surgery and all the crap that went with..." + (show)

@heavyphil Oh yeah, hospital drama and a starring role! Things we never wanted for sure.

You helped so much during this crazy journey. So glad for all your good advice. I also read a lot of your comments on lots of other posts...keep on keepin on.

fritzo | @fritzo | May 21 12:10pm

In reply to @jayhall "Many Many Congrats to you! :) Go celebrate with some ice Cream! :)" + (show)

@jayhall You know-I did exactly that! I've been avoiding bladder irritants in this stress incontinence chapter....but dang, but on the drive home, we stopped at Culvers and I got mustard/pickle on my burger, fried cheese curds for the side and chocolate cookie custard cup. So, yeah, vinegar foods, fried food and chocolate that has caffeine in it. Screw it-it tasted great!