Non focal EPE

Posted by someoneelse @someoneelse, 18 hours ago

Hi guys,

I got my pathology report back from last weeks RARP and at first I was excited. Then I looked up what non focal EPE means. Not good.

I haven't talked to my doctor yet. What am I facing here and what should I ask my doctor? FYI my decipher score was 6.0

I have attacked the report PDF

Thanks

Shared files

Final Diagnosis (Final-Diagnosis.pdf)

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jeff Marchi | @jeffmarc | 17 hours ago

The Decipher score goes from zero to one. You can’t be six it’s impossible. It has to be below one. .99 is real high .5 is in the middle. Are you a .6? You have some chance of recurrence.

Yeah, the non focal EPE is pretty significant. While your report says the margins are clear that EPE could very well be beyond the prostate area completely. Something to talk to your doctor about. See what his impression is. Maybe they actually did get it all, But it already spread outside before the surgery so it could be in your bloodstream, Another thing to ask the doctor about.

It seems your decipher score is not too high, That could be positive.

someoneelse | @someoneelse | 16 hours ago

In reply to @jeffmarc "The Decipher score goes from zero to one. You can’t be six it’s impossible. It has..." + (show)

@jeffmarc .6 sorry

surftohealth88 | @surftohealth88 | 16 hours ago

Although your extension is pretty long (26 mm) and it is in the place where tumor is present, the fact that your margins are negative and that you do not have any aggressive features such as cribriform and IDC , and your gleason is 7 favorable, I think that you are in good place. 🍀🍀🍀

Your first PSA test will give you additional information about the whole picture. Yes, not ideal scenario but not very bad either . Only time will tell, unfortunately. Try to concentrate on healing now 👍😊 and the fact that BCR can happen to everybody regardless of "ideal" pathology. We can all just take one day at the time 🌺.

Wishing you super fast recovery and no BCR ever 👍✨🍀 !!!

michaelcharles | @michaelcharles | 2 hours ago

My layman understanding is that EPE is a negative finding that statistically could increase the risk of recurrence.
My post-op pathology confirmed G 9 (never had a Decipher) with clear margins, lymph nodes and seminal vesicles. Also identified EPE.
My 90 day post-op PSA was .19, not undetectable and labeled "persistent PSA". Repeat PSA 30 days later confirmed .18
Led me to Salvage Radiation Treatment with short term ADT.
That's the "bad news" of my story.
The good news is that I have been undetectable < .02 uPSA for 2 years following Salvage Treatment.
My understanding is that BCR rates post RP are in the 25 - 35% range. I have not seen any direct prediction of recurrence based solely on EPE, but there may be info available.
As with all of us, only time will tell. Hopefully your other Path report results will portend an extended PCa free time period for you
Best wishes.