Biopsy vs Surgery Results

@ireland1964 Yes, of course! My post-surgery pathology report results were exactly the same as my biopsy results, which in my book was good news. Pre-surgery, I had been told that my staging likely could go up because the location of my tumor was hard to sample via a transrectal biopsy (I didn't initially have the option of a transpereneal biopsy at my first doctor...midway through, I switched surgeons to a major center rather than local hospital).

I started out as 3+4=7 and ended in that same place. When I asked the surgeon about my post-surgery pathology report, he told me that it is as good as it gets.

Still, I get very anxious and nothing is a sure thing. Hoping that time lets this anxiety fade....

•••••••••••••••••

Here is the condensed post-surgical 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).

@fritzo
Definitely good results from the biopsy.

It sounds like you’re going to be one of the people that doesn’t need to come back here, because nothing ever comes back. You had a very minor case of prostate cancer that got caught early.

@fritzo I think what was initially most beneficial to me was in the mid-1990s coming across newspaper articles (like the two I’ve attached).

From those I became aware of the importance of early and annual PSA screening. Starting in June 2000 (at 45y/o), I began annual PSA tests and monitoring this just as I would any other blood assay.

Over the next decade, I watched my PSA slowly creep higher each year. So, it wasn’t a big shock to me in April 2012 (at 56y), that my urologist told me that my biopsy showed low-grade, localized prostate cancer: Gleason 6(3+3).

I think that over those 12 years I became somewhat comfortable with PSA results - just as with my cholesterol, LDL, HDL, triglycerides, etc. results - No reason to panic or worry that my spouse would be widowed. Simply take it in stride and look for the next diagnostic test.

One important option developed during the time that I was on active surveillance - and I mention this humorously as well as seriously - is the development of rectal spacers for radiation treatment in 2015. Prior to that they used endo-rectal balloons that were inserted and removed at every radiation session - while still leaving the anterior wall of the rectum fully exposed to radiation. (Sounds pleasant doesn’t it?) Today, the rectal spacer is injected just once, lasts through the entire treatment, and reduces radiation to the rectum by up to 70%.

Technology-wise it was the development of Pencil-Beam vs. Passive Scattering systems. Being able to apply proton beams layer-by-layer, delivering a highly conforming dose that matches the exact shape of the tumor, and protecting adjacent healthy organs better than the older scattering methods (taking further advantage of proton’s Bragg-Peak characteristics).

I’m glad I waited…..

@brianjarvis Amazing that you still have those news clips. It's the power of good information from reliable sources and then you taking action. Sadly, people now can source their information from places that may not be as accurate as news of the past. (I'm biased, worked in the news industry for a good long time).

I hope I can get used to regular PSA tests and get past that anxiety (just took one today). You know the drill....it's just new for me.

Endo-rectal balloons. Yikes-sounds like something out of a Johnny Knoxville video.
https://ew.com/movies/johnny-knoxville-recovery-from-jackass-penis-injury-variety/
Interesting note; my wife was diagnosed with a very rare lung disease (PHA) in 2000 with few treatment options. Since then, they have come up with so many new treatment options (but no cure). So, if her current treatment starts failing, she has so many more options.

OK-I had not heard of Bragg-Peak characteristics in Proton radiation. I explored Proton vs Photon treatment briefly, but the Proton centers were both 2 hours away, wasn't sure insurance would cover.....and it looked like study results so far hadn't shown a big improvement in outcome/side effects.

But, I guess if the day comes that I need it, hoping they figure it all out. Buying all the time I can.

Thanks for the share!