Pt3b N0 Help

It’s too bad you didn’t mention what the Gleason score is. That is very important, especially when you have an advanced prostate cancer problem like seminal vesicle invasion. Yes, that is something to worry about it can cause you to have a reoccurrence sooner.

A high Gleason score (over 7) plus Seminal vesicle invasion gives a high probability of reoccurrence.

You should ask the doctor to get a decipher test. That will determine the probability of reoccurrence.

Was anything else found in his biopsy like intraductal, cribriform, EPE or ECE.

@jeffmarc
Sorry here is the report.
Diagnosis/Comments:
Radical prostatectomy :
- Adenocarcinoma, Acinar.
- Modified Gleason score : 3+4=7.
- Prognostic grade group -2.
- Tumour constitutes - 11-20% of the entire prostatic tissue.
- Percentage of pattern 4 constitutes 21-30% of the tumour component.
- Tumour involves both the lobes of prostate.
- Perineural invasion is identified.
- Lymphovascular invasion is not identified.
- Extra prostatic extension is identified, non-focal, at right posterior, Right posterolateral region with modified Gleason's score of 3+3 =6, Grade group- 1.
- Right seminal vesicle is involved by tumor, left seminal vesicle is negative for malignancy.
- Bilateral vas deferens are negative for malignancy.
- All margins of resection including apex and base are negative for malignancy.
Lymph nodes :
- Fifteen lymph nodes identified, negative for malignancy (0/15).
Pathological stage :pT3b N0

Thanks much for the reply @jeffmarc
Do they remove Seminal vesicles with Radical Prostatectomy? If yes, does it invasion still a concern? While Lymph Nodes and All margins of resection being Negative.

That would be a localized cancer, which requires more treatment, but is usually receptive to additional therapies. It does have a higher risk or recurrence than pT2. Radiation therapies are available after a RARP. Hoping for the best for your father.

Memorial Sloan has a free database where you can answer a few questions and they'll give you some statistics of reoccurrence based on their database:
https://www.mskcc.org/nomograms/prostate/post_op
Best wishes.

@dave27
One thing that is very aggressive was found, Besides seminal vesicle invasion

Non-focal extraprostatic extension" (EPE) describes prostate cancer that has spread beyond the prostate gland into the surrounding tissues in a widespread, extensive manner rather than a limited, pinpoint area. This finding, typically made after a radical prostatectomy (surgery) or potentially seen on imaging like MRI, indicates a more advanced stage of the disease (pT3a) and is a significant risk factor for poorer outcomes and cancer recurrence.

So not only do you have a pT3b but also pT3a

It does say all margins are negative, which is good, but the likelihood of reoccurrence is very high with the two different things that are the shown.

I would definitely want to see a decipher test after this biopsy.

You might discuss this with your doctor and ask what they think about your chance for reoccurrence.

Your father has somewhat increased chance for recurrence but nothing is written in stone.

There are statistics that show increased risk, but nothing is guaranteed in either direction. It is VERY good that you are doing your research and continue to do so since in case of PC it is very important. PC has many forms and many stages as well as many , many treatment options if and when they become necessary. . 👍🍀

Try to concentrate on good findings - negative margins are a huge help. Also his EPE is in low gleason area. His tumor burden is low. They did not find any features that point to aggressive and fast spreading cancer like "big cribriform glands, or intraductal carcinoma ".

Your father should concentrate to healing from surgery and before the first PSA level is checked one can not know more but there are good chances that PSA might come back undetectable. IF it is not, he will have some radiation in that area combined with short course of ADT and that protocol still has very good curative rates.

Don't forget that your father has one of the most important factors - YOU 💗😊 by his side and with your support, good nutrition and exercise he will heal fast and overcome recurrence if it ever happens.

Wishing your father super fast recovery and undetectable PSA 🤗🍀 !

@dave27
Because of the two things that were found It is very likely that the cancer has spread to the prostate bed. Only time will tell. The fact that EPE Was so extensive could mean it is also in your bloodstream.

@surftohealth88
Thank you so much for the detail. If PSA level comes undetected post surgery does it mean we are good and might not need any radiation?

@jeffmarc
Thank you! 🙏
Sure will discuss with doctor in our next appointment. We were told to get PSA and Rectal Profile tests done.