PC JUST DIAGNOSED

Skippy · Regular Joined: 24 Apr 2009 Posts: 10

Combidex, an MRI contrast with superparamagnetic iron oxide nanoparticles, is not yet approved for use in Australia.
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Skippy (Australia): age at dx 53, PSA 6.0, biopsy, dx Aug 2007: T2aNxMx Gleason 7 (3+4); open RRP + PLND 01Nov2007, both bundles spared, pathology pT2aN0Mx, Gl.7 (3+4), margins negative, no perineural involvement, lymph nodes clean. PSA since surgery undetectable (below 0.04). Continence back to 100% of pre-op state within 2 mths of surgery; erection initially nil, 30% at 12 months, 70% at 18 months with regular tadalafil + sildenafil before practical attempts.

rpgilboy · New User Joined: 23 Jul 2009 Posts: 9

Three of the five positive biopsies were in the transition zone (1 gleason 6 and 2 gleason 7). The two gleason 8 cores were in the lateral peripheral zone. I have read that transition zone tumors have a better prognosis after therapy and other areas. Has anyone else heard this. One person told me that transition zone tumors are very difficult to remove because of urethea complications?? Thanks for info.

johnT · Senior User Joined: 27 Apr 2009 Posts: 177

You won't find a lot of information on transition zone tumors, believe me I have looked everywhere.
Here's what I can tell you:
They are usually non agressive and contained.
They can generate a lot of PSA because they are in the region of the prostate that creates PSA. Transition zone tumors can get up to 300 psa and still be contained.
They are very difficult to operate on because of the location close to the urethea. You have a high possibility of a positive margin or permanent damage to urethea causing incontenance. (Sardino at Slone Kettering).
Radiation, a combination of seeds and IMRT, is a good way to treat transition zone tumors because you get a very high dose with fewer side affects.
I would be more concerned with the Gleason 8, because it is agressive and much more likely to spread than the transition zone tumors.
JohnT
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psa at diagnosis 40 in nov-08
gleason 6 and 7
Treatment choice seeds and IMRT

rpgilboy · New User Joined: 23 Jul 2009 Posts: 9

I had an open RRP on 13 August and had the catheter removed today. Thank God!! My final path report upgraded my cancer from 4+4 to 4+5 "involving the right and left sides of the prostate. There is perineural invasion and areas suspicious for lymphovascular invasion but no definitive invasion is seen. Bladder neck and apical margins are negative for tumor. There is no extracapsular tumor. Lymph nodes right pelvic, excision, three negative (0/3). Tumor size greatest dimension 1.8 cm, primary tumor pT2c bilateral disease, regional lymph nodes pN, no regional lymph node metastasis. Distant metastasis pMX cannot be assesed. Margins - benign glands at surgical margin, margins uninvolved by invasive carcinoma. Extraprostatic extension absent, seminal vessicle invasion absent, venous (large vessel) invasion, indeterminate, lymphatic (small vessel) invasion, indeterminate.

I consider myself a very fortunate man to have a gleason 9 with the above report.

I am "leaking" a little but the burning at the end of urination is bothersome. What is causing it and how soon will it go away. There is no blood.

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