1. < Prostate Cancer

thoughts on what I should do.

Posted by z1k @z1k, 2 days ago

48 years old , So How screwed am I. Dr. gave me two options radiation pellets or a Prostatectomy. Pet scan is next week. right now its panic and wait. was told if I did radiation then surgery was not an option after the fact as no dr would remove the prostate after I had received radiation first. but If I removed the Prostate and the cancer came back then I could get radiation afterword's.

SPECIMEN C: PROSTATE, LABELED AS "RIGHT APEX", CORE BIOPSY:
- ACINAR ADENOCARCINOMA, GRADE GROUP 3 (GLEASON SCORE 4+3=7)
- PERCENTAGE OF GLEASON PATTERN 4: 71-80%
- CRIBRIFORM GLANDS: NOT IDENTIFIED
- NUMBER OF POSITIVE CORES: 2 OF 2
- TOTAL CORE LENGTH INVOLVED: < 5%, 6-10%
- PIN4 MULTIPLEX IMMUNOHISTOCHEMICAL STAIN SHOWS THE ABSENCE OF BASAL
CELLS (p63 AND 34betaE12) AND IS POSITIVE FOR AMACR STAINING WITHIN
GLANDS OF INTEREST
- SEE COMMENT
Comment: The Gleason grade 4 tumor shows some nuclear stratification and
tufting suggestive of ductal features; however, the quantity of tumor
present precludes a more definitive diagnosis of ductal carcinoma.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

survivor5280 | @survivor5280 | 13 hours ago
In reply to @heavyphil "I honestly don’t think a surgeon can “see” cancer in a lymph node or not- which..." + (show)
@heavyphil

I honestly don’t think a surgeon can “see” cancer in a lymph node or not- which is why most of the centers of excellence recommend removing at least six on each side.
Imagine them on a string running from your prostate and down toward the pelvis.
The pathologist examines them sequentially, first to last; if he sees cancer microscopically in the first, he then looks for it in the second and then down the line and so on until he hopefully finds none. If he does find cells then you are usually put on ADT and offered salvage therapy or surveillance.
Not removing a larger number of lymph glands is controversial. My surgeon, for instance, only removed the closest one to the gland ( I believe it was called the “bullseye node” in the path report) and I learned later that he was sued by some patients for doing just that.
Man, was I pissed!! But after going on various forums I discovered that a lot of surgeons do this for one reason or another.
I don’t agree with it or like it, but I am not a cancer surgeon so who am I to say?

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When I say "see", he did say that my lymph nodes were analyzed and no cancer was found, it was done in real-time as the surgery occurs, by a pathologist that attends the surgery. I can even see the detailed surgical bill where each of his tests had a line item.

My surgeon did indicate that it is his usual practice to remove all lymph nodes but the analysis indicated that was unnecessary and not done because that can lead to lymphedema.

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ctl498 | @ctl498 | 13 hours ago
In reply to @survivor5280 "When I say "see", he did say that my lymph nodes were analyzed and no cancer..." + (show)
@survivor5280

When I say "see", he did say that my lymph nodes were analyzed and no cancer was found, it was done in real-time as the surgery occurs, by a pathologist that attends the surgery. I can even see the detailed surgical bill where each of his tests had a line item.

My surgeon did indicate that it is his usual practice to remove all lymph nodes but the analysis indicated that was unnecessary and not done because that can lead to lymphedema.

Jump to this post

I’m curious about how a pathologist can analyze a lymph node without it being removed first. I’d like to understand this process. Is it done by needle biopsy or similar?

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