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Thread: Dad recently diagnosed - please help

  1. #41
    Regular User
    Join Date
    May 2019
    Posts
    21
    Quote Originally Posted by DjinTonic View Post
    Most likely just different, but I think it might be helpful, at least in certain cases. It is curious, since the number removed and examined is readily available. My path report went on for a few pages, listing each node with its info. I'm not trying to make a big point of this, just curious.
    Hmm that's weird. This report was just one page with a lot of overview rather than specifics.
    Son posting on behalf of father.
    AGE: 67
    Diagnosis: May, 2019
    RALP: 31st July, 2019

    Biopsy results;
    Right base: 20% Gleason Score 3+4 (10%), Group 2
    Right 2: 10% GS 3+4 (30%), Gr2
    Right 3: 50% GS 4 (60%) +3, Gr3
    Right 5 20% GS 4 (90%) +3, Gr3
    Index 1 70% GS 4 (90%) +3 , Gr3
    Left 2 <5% GS 3+3, Gr1
    Left 4 <5% GS 3+3, Gr1

    Stage: T3a N0 Mx
    Prostate: 86g
    Tumor grade: GS 7 (major 4 + minor 3, 70% Gleason pattern 4, grade group 3)
    Perineural invasion: Multifocal bilateral intraprostatic
    Extraprostatic extension: 2mm foci present posteriorly in the right lower zone and right apex. Elsewhere tumour is confined.
    Surgical margins: Tumour focally extends into the surgical margins posteriorly in the right lower zone and right apex. Elsewhere surgical margins are clear.
    Distribution: left side 10%, right side 15%
    SVI-
    LVI-

  2. #42
    Quote Originally Posted by rizzoaus View Post
    Hmm that's weird. This report was just one page with a lot of overview rather than specifics.
    Ha! I was going to ask if you had a one-page summary of some kind rather than the complete report. Is the pathologist's name and signature at the bottom?

    If you want a gold star on your signature, you can move the biopsy results up: we usually go top to bottom, older info to newer. That way it reads like a mystery story.

  3. #43
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    May 2019
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    21
    Quote Originally Posted by DjinTonic View Post
    Ha! I was going to ask if you had a one-page summary of some kind rather than the complete report. Is the pathologist's name and signature at the bottom?

    If you want a gold star on your signature, you can move the biopsy results up: we usually go top to bottom, older info to newer. That way it reads like a mystery story.
    Just a name, no signature on the bottom

    Updated! hopefully that's right ha!
    Son posting on behalf of father.
    AGE: 67
    Diagnosis: May, 2019
    RALP: 31st July, 2019

    Biopsy results;
    Right base: 20% Gleason Score 3+4 (10%), Group 2
    Right 2: 10% GS 3+4 (30%), Gr2
    Right 3: 50% GS 4 (60%) +3, Gr3
    Right 5 20% GS 4 (90%) +3, Gr3
    Index 1 70% GS 4 (90%) +3 , Gr3
    Left 2 <5% GS 3+3, Gr1
    Left 4 <5% GS 3+3, Gr1

    Stage: T3a N0 Mx
    Prostate: 86g
    Tumor grade: GS 7 (major 4 + minor 3, 70% Gleason pattern 4, grade group 3)
    Perineural invasion: Multifocal bilateral intraprostatic
    Extraprostatic extension: 2mm foci present posteriorly in the right lower zone and right apex. Elsewhere tumour is confined.
    Surgical margins: Tumour focally extends into the surgical margins posteriorly in the right lower zone and right apex. Elsewhere surgical margins are clear.
    Distribution: left side 10%, right side 15%
    SVI-
    LVI-

  4. #44
    Regular User
    Join Date
    May 2019
    Posts
    21
    Just a little update.

    Dad's post-surgery PSA test (six weeks) has come back and the doctor couldn't be happier. Back in another four months for another blood test, but he did say the next two would be the most important. Does this sound about right?
    Son posting on behalf of father.
    AGE: 67
    Diagnosis: May, 2019
    RALP: 31st July, 2019

    Biopsy results;
    Right base: 20% Gleason Score 3+4 (10%), Group 2
    Right 2: 10% GS 3+4 (30%), Gr2
    Right 3: 50% GS 4 (60%) +3, Gr3
    Right 5 20% GS 4 (90%) +3, Gr3
    Index 1 70% GS 4 (90%) +3 , Gr3
    Left 2 <5% GS 3+3, Gr1
    Left 4 <5% GS 3+3, Gr1

    Stage: T3a N0 Mx
    Prostate: 86g
    Tumor grade: GS 7 (major 4 + minor 3, 70% Gleason pattern 4, grade group 3)
    Perineural invasion: Multifocal bilateral intraprostatic
    Extraprostatic extension: 2mm foci present posteriorly in the right lower zone and right apex. Elsewhere tumour is confined.
    Surgical margins: Tumour focally extends into the surgical margins posteriorly in the right lower zone and right apex. Elsewhere surgical margins are clear.
    Distribution: left side 10%, right side 15%
    SVI-
    LVI-

  5. #45
    Hi rizzoaus. Thanks for the update. What was the post-RP PSA? If it was undetectable (e.g., with a < sign), that would be excellent. Just as it's excellent there was no seminal vesicle or lymph node involvement. Your dad will have to watch his PSA for the years to come, just as all us post-treatment guys do. If you do encounter a return of a rising PSA, generally speaking, the longer the time before it begins, and the slower the rate of rise, the better. Thus the first few PSA readings are very important.

    All the best for a healthy future for your dad and family!

    Djin
    Last edited by DjinTonic; 09-10-2019 at 09:51 AM.

  6. #46
    Quote Originally Posted by rizzoaus View Post
    Just a little update.

    Dad's post-surgery PSA test (six weeks) has come back and the doctor couldn't be happier. Back in another four months for another blood test, but he did say the next two would be the most important. Does this sound about right?
    The 4+3, +ECE and +SM suggests he will probably need SRT at some point, but keep your fingers crossed.
    YOB 1957

    DX 12/18, GS 8, 4+4 6/12 cores, LL Apex 100%, LM Apex 60%, LL Mid 50%, LMM 40%, LL Base 5%, LM <5%, Right side negative.

    3/6/19. Pathology - Grade Group 4 with Intraductal Carcinoma
    T3aNO, GS8, 21 mm unifocal tumor 10%. -7 Nodes, - SV, - Margins, - PNI,
    - bladder neck neg., +LVI, + EPE non focal apex/mid lateral 1mm max extension, Cribriform pattern present. Decipher .86 High Risk.

    PSA 3/27/19 03 (29 days)
    4/25/19 <.03. (58 days)
    5/25/19 <.02. (88 days)
    9/10/2019. <.02. (198 days)

    3 Part Modality Treatment

    2/25/19 Robotic Laparoendoscopic Single Site Surgery outpatient Cleveland Clinic,

    ADT - started 6/19, end date 6/21.

    ART - Completed 9/26/19. (78 Gy, yes, I glow in the dark)

  7. #47
    Experienced User
    Join Date
    Sep 2017
    Posts
    78
    Quote Originally Posted by Duck2 View Post
    The 4+3, +ECE and +SM suggests he will probably need SRT at some point, but keep your fingers crossed.
    Are you qualified to make such a prognostication? Why do you take time to coldly inflict this speculation on the OP? If this is a likely eventuality, it will be best for the OP's surgeon to have this discussion.

  8. #48
    Regular User
    Join Date
    May 2019
    Posts
    21
    Quote Originally Posted by DjinTonic View Post
    Hi rizzoaus. Thanks for the update. What was the post-RP PSA? If it was undetectable (e.g., with a < sign), that would be excellent. Just as it's excellent there was no seminal vesicle or lymph node involvement. Your dad will have to watch his PSA for the years to come, just as all us post-treatment guys do. If you do encounter a return of a rising PSA, generally speaking, the longer the time before it begins, and the slower the rate of rise, the better. Thus the first few PSA readings are very important.

    All the best for a healthy future for your dad and family!

    Djin
    Hey DJ,

    I don't have the actual number, but the specialist told dad it was undetectable!
    Son posting on behalf of father.
    AGE: 67
    Diagnosis: May, 2019
    RALP: 31st July, 2019

    Biopsy results;
    Right base: 20% Gleason Score 3+4 (10%), Group 2
    Right 2: 10% GS 3+4 (30%), Gr2
    Right 3: 50% GS 4 (60%) +3, Gr3
    Right 5 20% GS 4 (90%) +3, Gr3
    Index 1 70% GS 4 (90%) +3 , Gr3
    Left 2 <5% GS 3+3, Gr1
    Left 4 <5% GS 3+3, Gr1

    Stage: T3a N0 Mx
    Prostate: 86g
    Tumor grade: GS 7 (major 4 + minor 3, 70% Gleason pattern 4, grade group 3)
    Perineural invasion: Multifocal bilateral intraprostatic
    Extraprostatic extension: 2mm foci present posteriorly in the right lower zone and right apex. Elsewhere tumour is confined.
    Surgical margins: Tumour focally extends into the surgical margins posteriorly in the right lower zone and right apex. Elsewhere surgical margins are clear.
    Distribution: left side 10%, right side 15%
    SVI-
    LVI-

  9. #49
    Quote Originally Posted by rizzoaus View Post
    Hey DJ,

    I don't have the actual number, but the specialist told dad it was undetectable!
    That's exactly what you want to see on a post-rp PSA test.

    Prostate cells are what produces PSA. If the patient has no prostate, he should theoretically produce no PSA.
    Nov 2013 PSA 4.2 Biopsy Jan 2014- 1 core positive, 20% Gleason 6, doctor highly reco'ed robotic RP - 2nd opinion at UPMC April 2014, put on active surveillance. 2nd biopsy Feb 2015, results negative. PSA test Feb 2016, 3.5. 3rd Biopsy Feb 2016. 3 positive cores less than 5%, Gleason 6. Octotype DX done April 2016, GPS Score of 24--rated "Low risk". PSA test 8/2016, 3.2. PSA test 1/2018 2.2 (after 7 months of proscar) PSA test 7/2018 2.3, PSA test 7/2019 2.0


    DOB 1956, in Pittsburgh, USA

  10. #50
    Quote Originally Posted by rizzoaus View Post
    Hey DJ,

    I don't have the actual number, but the specialist told dad it was undetectable!
    That's very good news. I think you or your dad should get copies of his original lab reports -- keeping accurate records is a good idea.
    Last edited by DjinTonic; 09-11-2019 at 09:41 AM.

 

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