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What is next after a final pathology report of T3bN0MX cancer stage ?

Posted by soli @soli, Sep 9 5:04pm

The final pathology report after my prostatet surgery last week uncovered a pT3bN0MX cancer stage. I believe it means the cancer has spread beyond the prostate and invaded the seminal vescibles. I have a video appointment with my urlolgist a week from today to discuss the diagnosis and future treatment options.

What are the treatment options and side effects? Start treatment now or wait till the PSA rises? What are the pros and cons of the various treatment options? I would like to educate myself as much as possible based on the lived positive and negative experiences of my cohorts in this support group, so I can intelligently coverse with my urologist next week and ask him the right questions. So, please share your views and experiences.

Thank you.

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surftohealth88 | @surftohealth88 | Sep 10 2:30pm
In reply to @soli "Thank you @surftohealth88 for helping me better understand my pathology and diagnosis. Pathology report found acinar..." + (show)
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Thank you @surftohealth88 for helping me better understand my pathology and diagnosis.

Pathology report found acinar not cribform cancer. Then it says "all margins negative for invasive carcinoma". It also says "All regional lymph nodes negative for tumor". But they only examined 1 lymph node, so I have some questions for my urlogist about this.
I do not see IDC or aggressive fetures like cribriform anywhere in the report.
On the flip side it says: "lympho vascular invation present". "Perineural invation: present".
Also, I have a GPS genomic socre of 47 which predicts a very aggressive cancer.

So, it appears to be a mixed bag (which is often the case) that needs to be sorted out with my doctor, but any input you have on the diagnosis and treatment optionss (if needed) will be invaluable to me so I can ask my doc the right questions next week.

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That is really good that you had negative margins 👍 - that means that in theory they removed all of the cancer from your body , so whatever was seen in pathology is now hopefully out of your body. Also, since they did not see any cribriform or IDC is also great news - that means that although your genetic test showed aggressiveness, your cells still (luckily) did not reach their full potential of becoming real spooks. BUT, they were very active - they invaded a lot of spaces that they should not have done. 🧐 I am sure that your doctor will wait for the first PSA test results and go from there. You can ask for him to explain findings and those "invasions" - where they were exactly and how extensive. Treatments after RP IF needed are very straightforward - radiation or radiation with short ADT or radiation with long ADT in case of very aggressive features and positive PSA results.
All in all, there are many treatments available but it could very well be that you will not need any 🍀🍀🍀.
Keep us posted 👍 and wishing you the best of luck 😊 !

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surftohealth88 | @surftohealth88 | Sep 10 2:34pm
In reply to @topf "This is great advice, I did not know that you could make an appointment with the..." + (show)
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This is great advice, I did not know that you could make an appointment with the pathologist.

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It is not usual thing, but you can ask for it. Our surgeon was happy to introduce us to pathologist since we had so many questions, pathologist was so happy to share his knowledge and talk to actual patient, so it worked out perfectly for all involved. 😎👍
No matter how much I criticize our institution of care - each of individual care providers was outstanding once we were actually able to see him. The waiting period is horrendous though and it effects results and success of treatment so I am really conflicted 😣.

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soli | @soli | Sep 11 10:40am
In reply to @surftohealth88 "That is really good that you had negative margins 👍 - that means that in theory..." + (show)
Profile picture for surftohealth88 @surftohealth88

That is really good that you had negative margins 👍 - that means that in theory they removed all of the cancer from your body , so whatever was seen in pathology is now hopefully out of your body. Also, since they did not see any cribriform or IDC is also great news - that means that although your genetic test showed aggressiveness, your cells still (luckily) did not reach their full potential of becoming real spooks. BUT, they were very active - they invaded a lot of spaces that they should not have done. 🧐 I am sure that your doctor will wait for the first PSA test results and go from there. You can ask for him to explain findings and those "invasions" - where they were exactly and how extensive. Treatments after RP IF needed are very straightforward - radiation or radiation with short ADT or radiation with long ADT in case of very aggressive features and positive PSA results.
All in all, there are many treatments available but it could very well be that you will not need any 🍀🍀🍀.
Keep us posted 👍 and wishing you the best of luck 😊 !

Jump to this post

Thank you @surftohealth88 for your best wishes and excellent elucidation of the likely next steps given my pathology result. I will keep you all posted on what my urologist prop[oses.

On a related but different topic, yeterday was cathether removal day..yaaaaa. I will work to strengthen my pelvic floor in the coming weeks.

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