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pT3b Prostate Cancer - where are you now post-op?

Posted by rlpostrp @rlpostrp, Aug 27 11:15am

I'd like feedback from folks who are diagnosed as a pT3b cancer, the definitive criteria being that you had cancer invade one or both seminal vesicles. Please offer the following:
1) How long ago was you RP your surgery?
2) Did you have "surgical margins" with cancerous tissue left in you?
3) How long was it after surgery that your PSA increased to 0.2 ng/ml or higher?
4) Knowing you were a pT3b, did you start radiation before or after your PSA hit 0.2 ng/ml or higher? If you started before an elevated PSA, what did your urologist say that justified to them to start radiation?
5) If diagnosed as such, how long after RP surgery did your urologist or RO tell you that your cancer has fully returned, if it did (first year post-op, second year, third year...???), since pT3b has a 30-50% recurrence within the first five years post-op?
6) Besides radiation, what else is your urologist doing to treat you?
Thank you

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Profile picture for surftohealth88
surftohealth88 | @surftohealth88 | Sep 18 10:53pm
In reply to @rlpostrp "That is the limitation and fallacy of a biopsy...it can't tell your urologist anything beyond Gleason..." + (show)
Profile picture for rlpostrp @rlpostrp

That is the limitation and fallacy of a biopsy...it can't tell your urologist anything beyond Gleason Score and perineurial invasion that nearly everyone has (my urologist wasn't concerned about it...he literally said "everyone has perineurial invasion.").
The only way you find out about all the rest of it is when they remove your prostate and do a gross- and micro-examination of all of the prostate and seminal vesicle tissue. That is when Extraprostatic Extension (EPE), seminal vesicle invasion, Cribriform glands, bladder neck involvement, surgical margins, etc., are discovered and change "everything."

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Yes - biopsy is about 1 % of the WHOLE gland. Pathologist showed us slides - it is almost laughable how little it is : /. I wonder how many men go to radiation thinking that they have 3+4 or 4+3 and they are actually 8 or 9 😳 !!! Than protocol is much lower in intensity and no wonder that some RTs fail 🥺.

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surftohealth88 | @surftohealth88 | Sep 18 11:52pm
In reply to @thmssllvn "Let's not forget the value of PSMA PET CT scans in the process." + (show)
Profile picture for thmssllvn @thmssllvn

Let's not forget the value of PSMA PET CT scans in the process.

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There is a value, but it can miss things, especially micro mets and small EPE etc. It does not see everything.

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manutebol | @manutebol | Sep 19 6:32pm
In reply to @rlpostrp "Brettiqutte - thanks for your reply. What may I ask is "n1" and "r1"? I have..." + (show)
Profile picture for rlpostrp @rlpostrp

Brettiqutte - thanks for your reply. What may I ask is "n1" and "r1"? I have not seen that terminology with or without relation to the pT3b status. Nice to hear you are undetectable one year later, especially after a 9.4 ng/ml PSA six weeks post-op. Have you recovered full urinary continence and sexual function one year later, or still a battle?
Thank you.

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I believe R1 refers to a margin being positive.

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daveandoneita | @daveandoneita | Sep 21 6:58pm
In reply to @daveandoneita "been clean for 10yrs with radiation lest then .01 psa knock on wood. but my orgasm..." + (show)
Profile picture for daveandoneita @daveandoneita

been clean for 10yrs with radiation lest then .01 psa knock on wood. but my orgasm has gone.

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keep posting on this. I post some time back on my orgasm never came back. still waiting on some help on this subject. it has been 10 years since my radiation treatments. doing good 0.1 psa. Thanks, and good luck

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