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Biopsy of left seminal vesicle reveals lesions
My RO ordered a biopsy (done this morning) to determine with better precision / certainty whether my left seminal vesicle was involved in PCa. Initial finding from the biopsy is of "grossly lesional appearing" cores. I have not discussed this yet with my RO, who will obviously provide more insight and recommendations. But in the meantime, I'm interested in hearing from others who have had SV involvement. What has been your experience with this - treatment mode(s), immediate and lasting side effects, etc.?
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Hey @guybe, what treatments have you had so far? I know you’re on Orgovyx and Abitarone; was your primary tx surgery or radiation?
Pretty sure that seminal vesicle involvement is similar to EPE, lymph gland involvement, etc. Another clue that the cancer escaped the gland.
I don’t think it changes treatment insofar as radiation is concerned; they will probably add a little more ‘juice’ to the SV’s when treating you. Best,
Phil
I had left SV metastasis too. After 28 RT visits with ADT: it was gone. I told my MO : that I felt the growth fall off the vesicle while I was lying in bed. He just looked at me. I m <.01 for over two years now- PSA. I felt the radiation cooked it dead. lol
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2 Reactions@heavyphil Thanks. Orgovyx and Abitarone is correct, started that in February. Original RO's idea, based only on PET scan hot spots, was to charge ahead and radiate two lymph glands, until a second RO wasn't sure about the second supposedly involved lymph gland. So I had further CT and MRI scans, and now the biopsy has confirmed his suspicion: on the left side it's not a lymph gland, but a seminal vesicle. (That first RO is now out of the picture, BTW.)
So onward, with much better info than we had before. I was just concerned that the biopsy's finding of SV involvement might change my treatment goal from "cure" to a lifetime on Orgovyx or whatever else comes along. Anyway, as I said: Onward.
@ecurb Bravo, and congratulations! This is encouraging news, thank you.
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1 Reaction@guybe It is never quite a cure if it has escaped the prostate, but it is much better if it is still local. The lymph node is likely to spawn more metastasis than the SV. In either case they will be hit with radiation in the treatment plan.
SVI Is not something to be taken lightly
Seminal vesicle invasion (SVI) indicates that the cancer has extended outside the prostate into the seminal vesicles. It is a high-risk, adverse prognostic feature that significantly upgrades the tumor stage and generally requires a more aggressive, multi-modal treatment approach
@guybe So did you have any PRIMARY treatment yet? You still have a prostate but did you have IMRT before this proposed SBRT? Sorry, I am just confused as to what stage of treatment you’re at. Thanks again,
Phil
@heavyphil IMRT (I think) to the prostate itself in 2022. Steep rise in PSA six months ago (suddenly from 1.0-1.5 to 5.9) prompted a treatment plan for the metastasis. After PET, CT, and MRI I began on ADT. Two lymph nodes were believed to be involved. Radiation was imminent, until the original RO's machine broke down. I went to a new, more skeptical and less hasty RO at Johns Hopkins, who had a new CT and MRI done, and now the biopsy. This has positively identified the left SV (NOT a left lymph node). Looking forward to the better aim, I believe I've dodged a bullet to my rectum.