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Pathology report - bahhhhh :/
Ok - here we go, of course it can not be simple with us - ever !!! Sheeeeshhh ...
I mean there is nothing simple with PC, but still, having report stating "margin status can not be assessed" is just mind-blowing ... Further explanation : tumor glands focally extend very close to the inked margin, but no tumor glands are definitely identified at the true margin.
*sigh You know what - I will take it as "clear margins" LOL, I have to survive this report somehow.
Second - Gleason UPGRADED - I am not surprised, happens , especially with cribriform and IDC. Let this be warning to anybody with cribriform glands and/or IDC - you are in separate group and understand that you have very aggressive cells in your gland that multiply FAST and CHANGE fast. You do not have typical PC that moves slowly and "can take years" to advance. This was 5 mos from 4+3 to 4+5 !!!
Gleason 4+5 - Luckily, only 6% of the whole gland has that finding.
PNI - present inside the gland, nothing outside
All other tissue surrounding gland - negative
All in all, gland was taken out in the last moment, literary. I am aware that this puts my husband in increased risk for BCR , but we shell see. It is what it is... We are super happy that we had RP since the source of emitting further mets is out and because cribriform are resilient to radiation. If he ever needs some extra zapping - we will deal with that when and if that time comes.
My husband who is super optimist is happy with findings - I am bummed. Talking about Yin and Yang. XP
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I know how you feel. It was on my prostate pathology report that cribriform and IDC were first found. Not what I was hoping for, but it really made me glad I had the surgery. I was already planning to follow the recommendations for post-surgery psa testing, but having cribriform and IDC on the pathology report really "sealed the deal". I'll be watching my psa like a hawk for a long long time. Best wishes.
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5 ReactionsI’m disappointed to hear that your husband‘s case has become more aggressive. It is good to hear he is so optimistic about what’s going on. The mental attitude is really an important thing.
It might be possible to have a DVD of the prostatectomy and some tissue reviewed by another doctor to see if they come to the same conclusion about margins.
At one of the conferences I went to where they discussed cribriform they did say that it switches your Gleason to a five if large cribriform.
Have they talked about putting him on ADT, Or is he already on it? With the unknown margin issue going on ADT plus an ARSI Could give him a good amount of time without recurrence. This is something they do with a Gleason 9, In some cases.
Now it’s time to find out what his PSA is in a few months. Hopefully it becomes undetectable, and you can at least relax for a while.
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11 ReactionsNot great news, but a positive attitude like yours makes all the difference.
At least it's 4+5 and not 5+4
6% affected isn't too bad & sounds like they removed the thing just in time.
Now it's lots of blood tests to see if his PSA rises at all in the coming months.
You'll be fine.
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6 ReactionsHi Surfer, I’m sorry that you and your husband got this news. It really sucks to get news like this while in the midst of recovery when you are trying to focus on getting well. At least you have a better understanding of what your situation is. The post surgical pathology was one of many reasons I choose to start with surgery for my multi modality treatment. I also did that somatic testing that showed that I have PTEN and TP53 mutations, which I now understand that it makes PCa cancer more aggressive (but is also sort of common in GL 9). You may want to ask about FoundationOne testing if you haven’t done so already. I also agree with Jeff to ask about ADT meds. They already put me on Firmagon and I will start zytiga in a few weeks as well. I told my MO that I want my PCA to be tested every month for a while, and she agreed.
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6 ReactionsThere is supposed to be a DVD of all prostatectomies?
Very sorry to hear about your husband’s upgrade. Thankfully, you did the right thing by opting fir surgery and now have all the crucial information at your disposal.
As Jeff said, I hope that the PSA will be undetectable and that he doesn’t need RT any time soon (or ever). Sending you good vibes. 🤗🤗🤗
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5 ReactionsNow that would be worth asking for.
Kinda makes up for offering me my prostate back, then changing their mind.
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1 ReactionHi Jeff - thanks for giving me some advice for going forward 😟. Do you have any idea of how and where to send the whole gland for examination ? I guess it would be very difficult
Yes - it could be possible that cribriform made it to 5 level, and this also shows that biopsy is not so precise as we would like to think. It is often said that only when gland is out and on the table to be examined as a whole by pathologist the real and whole picture is known.
Pathology report was sent this morning without doctor's comments ( directly from pathology) so we will try to get hold of doctor tomorrow and possibly get some more info and explanation about findings.
My husband is not on any ADT , his initial findings pointed to intermediate unfavorable with no extensions and very small tumor burden. Out of 14 samples only single one had 4+3, and 2 others were 3+3 , all the rest clear. PSMA clear on everything but that one spot on the right side of prostate and he had detailed TRUS in July which also confirmed that all was contained in a gland.
We will ask about possible ADT and ARSI, thanks for telling me about that possibility.
John, Peter and Topf - love you guys and thanks so much for being here for me 🥰 !!!
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4 ReactionsThanks for the info John - do I ask my doctor to do FoundationOne test ? Is that somatic test for genetic changes in cancer cells ?