T3b Prostate Cancer with Seminal Vesicle Invasion

Posted by Tom @tom86, Dec 13, 2023

I was wondering if anyone had the diagnosis of T3b Stage PCa and had a Prostectomy where Seminal Vesicle Invasion was found. What was the post op treatment, BCR, and prognosis? Thank you.

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I have Gleason 9 aggressive CR PC surgery with seminal vehicles invasion, 13 months of ADT and Erleada and in a clinical trial. My surgeon gave me 4-5 years, the clinical trial evidence is that I may have 41 months before an actionable event and about 60 months survival. I have placed myself on a strict plant based diet and hope to beat the above projections I think that the CR and aggression are the most relevant things and not the seminal invasion. My surgery indicated that the cancer had not spread to the lymph glands.

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@hbp

I have Gleason 9 aggressive CR PC surgery with seminal vehicles invasion, 13 months of ADT and Erleada and in a clinical trial. My surgeon gave me 4-5 years, the clinical trial evidence is that I may have 41 months before an actionable event and about 60 months survival. I have placed myself on a strict plant based diet and hope to beat the above projections I think that the CR and aggression are the most relevant things and not the seminal invasion. My surgery indicated that the cancer had not spread to the lymph glands.

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If you don't mind my asking; what was your PSA when you went in for surgery? Post surgery PSA? With all the new treatments and advances, I am surprised they would give you a specific prognosis.
It is good news your lymph nodes are clean. Did they suggest adjuvant radiation? In my case they left it up to me, however, it was discussed.
Thank you for your response. I wish you all the best.

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As I recall, my PSA was 9 or maybe 11 and it had increased a couple of points each of the prior years. My survival prognosis was made easier by the thousand of guys, in my situation and were in the Erleada clinical trial. It was the castration resistant, aggressive Gleason 9 diagnosis that got me in the clinical trial and that enabled the survival prognosis. What the doctors told me was in line with the stats in the trial. That was the bad news that I am fighting and hoping to prove them flat ass wrong and I hope to have a longer run. Had surgery 18 months ago and was on ADT and Erleada for 13 months, but off of all meds for the last 12 months and PSA has been .01 since the surgery. The cancer had only spread to the seminal vehicles, none in the lymph glands. Nevertheless, a poor prognosis but I feel OK.

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@hbp

As I recall, my PSA was 9 or maybe 11 and it had increased a couple of points each of the prior years. My survival prognosis was made easier by the thousand of guys, in my situation and were in the Erleada clinical trial. It was the castration resistant, aggressive Gleason 9 diagnosis that got me in the clinical trial and that enabled the survival prognosis. What the doctors told me was in line with the stats in the trial. That was the bad news that I am fighting and hoping to prove them flat ass wrong and I hope to have a longer run. Had surgery 18 months ago and was on ADT and Erleada for 13 months, but off of all meds for the last 12 months and PSA has been .01 since the surgery. The cancer had only spread to the seminal vehicles, none in the lymph glands. Nevertheless, a poor prognosis but I feel OK.

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I have been in different support groups over the past 3 years (ANCAN) and UCSF) and there are quite a few success stories for advanced stage cancer. My father in law was diagnosed 30 plus years ago with aggressive cancer and he is now 93. He initially had radiation at age 62 and it came back after 10 years and had the surgery at Mayo. It was a tough surgery. The surgeon told him at the time, if I can get it all, I can give you another 10 years. That was quite awhile ago. He is active and doing great. Everyone is different. The .01 is very positive! Attitude is everything.
Keep the faith!

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Tom thanks. That is a wonderful story and I am hopeful but I realize that there is much out of my control.
Best of luck to all.

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I just have to say, there are many examples out there. Please join a support group if you have not already done so. I am sorry (at your PSA level of .01) they are not more encouraaging to you. The more you learn from others. the more I feel you will see hope. Tom

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@tom, back to your question...8 months ago, I had radical prostatectomy with pathology findings of 4+3=7, 15% involvement, no cancer seen outside the prostate except seminal invasion. Lymph nodes negative. Dr. (and I) said, "No treatment now until we see the PSA post -op." So far @ 6 weeks, 3 & 6 months, it's undetectable, so no further treatment for now.

In my research of this issue, I found the paper I've linked below. It proposes that T3b is too broad a category, and those with ONLY seminal vessel invasion fare better than those with bladder neck. I found it reassuring. I also think, since the seminal vessels were removed, that following the PSA is the right course. Even without that involvement, I still would be at risk for future recurrence, so my attitude is not worsened by the path report.

https://meridian.allenpress.com/aplm/article/146/5/619/476351/The-Clinical-Impact-of-pT3a-Lesions-in-Patients
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@trusam1

@tom, back to your question...8 months ago, I had radical prostatectomy with pathology findings of 4+3=7, 15% involvement, no cancer seen outside the prostate except seminal invasion. Lymph nodes negative. Dr. (and I) said, "No treatment now until we see the PSA post -op." So far @ 6 weeks, 3 & 6 months, it's undetectable, so no further treatment for now.

In my research of this issue, I found the paper I've linked below. It proposes that T3b is too broad a category, and those with ONLY seminal vessel invasion fare better than those with bladder neck. I found it reassuring. I also think, since the seminal vessels were removed, that following the PSA is the right course. Even without that involvement, I still would be at risk for future recurrence, so my attitude is not worsened by the path report.

https://meridian.allenpress.com/aplm/article/146/5/619/476351/The-Clinical-Impact-of-pT3a-Lesions-in-Patients

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Great article! Thank you for sharing it.

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Mri worrisome for vascular bundleinvolvement.Not entirely positive.Having 5 day sbrt.

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@vshirley

Mri worrisome for vascular bundleinvolvement.Not entirely positive.Having 5 day sbrt.

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MRIs are not always accurate from my experience. I had them done at 3 different locations including center of excellence and they all missed by PCa which was fairly extensive.

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