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@perrychristopher

Hi, my name is Perry and I had a Radical Prostatectomy (RP) last week (8/4/22). I am sitting on my chair with a catheter and foley bag. Yuck. I just turned 60 and have been dealing with this since my Feb 22 PSA came back at 2.99. That flagged a Urology visit and a second PSA in March 22 that was at 3.46. This flagged a Trans Rectal Ultrasound that came out with a mass being detected. All the DREs I had were fine. This caused a Biopsy to be performed in May 22 which showed a Gleason 7 (4 +3) in 2 of 12 cores and a Gleason 6 (3+3) in two other cores. No perineural invasion etc. After this I had a bone scan, abdominal scan, and a prostate MRI. My urologist/surgeon wanted a PSMA PET Scan but my insurance would no approve it. Great...... Anyway, I had some incidental findings on the abdominal scan but nothing to worry about I was told. Bone scan clear. MRI on prostate showed an area of EPE. Anyhow, I decided the RP was best for me and had it last week. One night stay in hospital. Pain not too bad and came home next day. IMO 2 nights should be standard not one. Today I received my pathology report and I read it. My appointment with surgeon is in two weeks (busy man). No signs of seminal vesicle, bladder neck, or lymphovascualr invasion which is all good I assume. Also, the cancer was still graded a Gleason 7. Tumor is PT2. 15 lymph nodes removed and no tumors present. They were also listed as pN0 which is no signs of microcell cancer in them which I am very thankful for. The EPE detected on the biopsy had no signs of cancer in the margins which was good, but unfortunately the report stated in another area (left lateral) there was a 1 mm length of invasive carcinoma present at the margin. Not sure what this means but I think that means I have positive margin in one area. This has got me down as I was hoping I would not need any further treatment (radiation) and only would have to keep an eye on my PSA over whatever interval is prescribed by the doctor. Now, I am not so sure. Does anyone have thoughts on this margin issue? Thank-you, Perry Christopher. Also, there was no mention of Perineural Invasion on the pathology report.

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Replies to "Hi, my name is Perry and I had a Radical Prostatectomy (RP) last week (8/4/22). I..."

My first thought is they shouldn't make it available till you can get to your doc for an explanation! (I've been where you are on this one...) mine was some Perineural invasion though. Not to mention sitting in the situation you are in, somewhat limited in what you can do to take your mind off it, carrying the bag around and all, makes it a little worse. That part will be over before you know it!

It is a shame you have to think about this for 2 weeks, but, a mm being as small as it is, my GUESS is that it's likely that the margin is longer than that? It would've been nice if they told you how much clean margin there was after that 1 mm, my guess is only the doc will be able to tell you that after comparing the path report to his surgical notes. There may be a standard those more learned on the subject here may know.

I would be surprised if the doc sent you immediately for more treatment. You're likely going to be playing the PSA waiting game like the rest of us do for a while. If you do have to go back for radiation, at your age (just a little younger than I) assuming other good health, you'd most likely tolerate it pretty well. I'm having my last one tomorrow. (yay!). Back to the PSA waiting game LOL. Hopefully , you will not have to.

Best of Luck to you!
Mike