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Thread: Out damned spot! Out I say!

  1. #11
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    Quote Originally Posted by RobLee View Post
    . . .
    He recommended surgical excision, for the same reason you stated... that removing the mass would be the best way to determine it's exact nature, and that in most cases removal is also curative. And he stated that in 90% of cases he could do this laparoscopically, but due to the size of the mass, there was a one in three possibility that he may need to open me up.
    . . .
    Had I not already faced several other cancers, I probably would have been going crazy. You got counseling? How did you get counselling? I couldn't even get information!
    . . .
    Sorry to take so long, but be prepared for a roller coaster ride with your incidentaloma. Mine turned out very well (dispite some after effects) but I had been prepared for a far worse outcome. Good luck dealing with your curious condition.
    RobLee,

    Thanks for sharing your experience. I hope to be lucky and no conversion to open will be necessary -- just a small, asymptomatic lesion that has been mentally annoying. So far, in preparation for surgery, being off celecoxib hasn't been as bad as I thought (only some thumb pain from doing a bit of drywall mudding) since my knees haven't bothered me, but out of caution, I have stopped the intermittent jogging I was doing when walking one of our dogs.

    I am very lucky: my nurse navigator informed me that my hospital's cancer center offers six free psychotherapy sessions for all cancer patients. My reaction to the pathology report will drive whether or not I continue counseling and my Physical Therapist (PT) has said that she has a few others that I could try if I'm just not bonding well with the current one. Never been in therapy before. How much of it is the therapist driving you to self-realization which leads to motivation to change and how much of it is "this is the way things are and this is what you need to do"?

    I've found and read enough papers on imaging, diagnosis, variations and treatments, so I am just waiting to get the path report. I can distract myself at home with various chores and activities, but writing code at work has been difficult, especially when the early afternoon slump hits and I really just need a 30 minute nap! With time and active thought, the roller coaster ride has been smoothing out quite a bit, but what ride do I get on next? Won't know until the path report, so I'm trying to avoid obsessing over "What if" scenarios. I know that many paths forward are possible and that the one chosen will be due to the data that will arrive in the near future. This waiting is worse than after RARP since it could be seriously course altering. Time to do my PT exercises -- I find them calming and focusing.

    I don't enjoy being or having a curiosity. I hope this one goes smoothly.
    Thanks and best wishes,
    - Mark
    6/18 New PCP asks "When was your last PSA level checked?" --> 11.5 so off to URO
    9/18 PSA 12.4, TRUS biopsy 10/18 yields 2 of 12 positive: LA GS6 <5%, RA GS7(3+4) 5% and the 4 is cribriform approaching 50%
    Clinical staging T1c, Decipher biopsy 0.94, 58 years old at DX
    12/18 RARP, pathology GS7(4+3) with cribriform, tumors in 10-15% of gland
    -SVI, -LVI, +EPE, +PNI, +BNI, +SM multifocal >=3mm pattern 4
    pT3a,pNx (lymph nodes inaccessible due to large mesh placement from 15 year ago bilateral hernia repair
    4/19 second opinion of pathology GS8, primary tumor composed of >95% cribriform (4+4), <1% pattern 5 and very minor focus comedo-necrosis, intraductal and postive margin at bladder resection
    still at pT3a,pNx and started six months of ADT with ART to start in a month or two
    1/19 PSA <0.1, 4/19 PSA <0.1

  2. #12
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    Quote Originally Posted by farmanerd View Post
    Due to the lack of 100% specificity of MRIs, it could still be a benign something -- at least that's what I'm hoping. On July 9th, I will be getting laparoscopic surgery to remove my gall bladder and the small section of my liver that contains the lesion in order to get a pathologist's determination to answer the all important question: What is this thing? I've played through many "What if" scenarios in my mind and am now once againg trying to just relax until the surgery and the resultant pathology report.
    Uneventful surgery yesterday. Surgeon used four of the incision points from my RARP, so no new scars. Pain is much less than after RARP -- my wife, who had three c-sections having our children, said that it could be due to some nerves already having been severed. Some of the usual residual CO2 gas pain and slightly bloated belly from the inflation. Slowly increasing the time between pain meds and hope to be down to just Tylenol by the end of the day tomorrow. Took a short walk around the block yesterday and a slow half mile this morning. Will use the 'new to us' treadmill a few times during the day since the heat index will be over 100 degrees in St Louis today.

    Napping, walking, reading, eating/snacking, etc. will occupy most of the time while waiting for the pathology report which should be done by the end of the week. Fingers and toes crossed on this. Anyone have a lucky rabbit's foot that I could borrow?

  3. #13
    Wishing you all the best for the awaited news, farmanerd! Did the surgeon give any hints afterwards based on the appearance/feel of the critter?

    Djin

  4. #14
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    Have a not quite 8x10 glossy with a couple of images of the area before it was removed, but I was too foggy minded to remember how he described it to my wife. I'll ask her later today when her working from home eases up from dealing with issues that arose yesterday when she missed work to be with me. He probably wouldn't have said much more than this is what's being sent to pathology.

  5. #15
    Quote Originally Posted by farmanerd View Post
    Have a not quite 8x10 glossy
    Yeah, but is it autographed?????

  6. #16
    Top User garyi's Avatar
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    Rooting for you, farmanerd. None of us remember much about what the surgeon said during his first visit, other than the obligatory "the surgery went well and was a success".

    I didn't share my post surgery pictures with anyone!

    Hang in there. I suspect you'll do well.
    72...LUTS for the past 7 years
    TURP 2/16,
    G3+4 discovered
    3T MRI 5/16
    MRI fusion guided biopsy 6/16
    14 cores; four G 3+3, one G3+4,
    CIPRO antibiotic = C. Diff infection 7/16
    Cured with Vanco for 14 days
    Second 3T MRI 1/17
    Worsened bulging of posterior capsule
    Oncotype DX GPS 3/17, LFP risk 63%, Likelihood of Low
    Grade Disease 81%, Likelihood of Organ Confined 80%
    RALP 7/13/17 Dr. Gonzaglo @ Univ of Miami
    G3+4 Confirmed, Organ confined
    pT2 pNO pMn/a Grade Group 2
    PSA 0.32 to .54 over 3 months
    DCFPyl PET & ercMRI Scans - 11/17
    A one inch tumor still in prostate bed = failed surgery
    All met scans clear
    SRT, 2ADT, IMGT 70.2 Gys @1.8 per, completed 5/18
    Radiation Procitis, and Ulcerative Colitis flaired after 20 years
    PSA <.006 9/18, .054 11/18, .070 12/18, .067 2/19, .078 5/19, .074 7/19
    We'll see....what is not known dwarfs what is thought to be fact

  7. #17
    Congrats on everything going smoothly... or at least appearing so. Sounds like you've got this surgery thing DOWN.

    Gosh, I never got any photo's of my body parts from surgery. I thought it was supposed to be like your car mechanic, where they give you the defective part. Or the nail that was in your tire.

    Good luck on the path report, and to your wife for taking care of business.
    Late 2012: PSA 4, age 62 all DRE's 'normal'
    Early 2014: PSA 9.5, TRUS biopsy (false) negative
    2015: PSA's 12 & 20, LOTS of Cipro ... Mar'16: PSA 25, changed Urologist
    Jun'16: MRI fusion biopsy, tumor right base, 6/16 cores: 2ea 15-40-100% G8(4+4)
    Aug'16: DVRP,
    "broad cut" 11 LN-,-SM, 53g 25% involved, multifocal EPE, PNI, B/L SVI, pT3b

    Jan'17: started Lupron ADT, uPSA's ~.03
    May'17: AMS800 implanted, revised 6/17
    Aug'17: 39 tx (70 Gy) RapidArc IGIMRT
    Jan'18-July 2019: PSA's <0.008, T~12
    Apr'18: Dx radiation colitis, Oct'18: Tx sclerosing mesenteritis
    "Everyone you meet is fighting a battle you cannot see"

    Mrs: Dec 2016: Dx stage 4 NHL/DLBCL,
    Primary Bone Lymphoma
    spinal RT boost+6X R-CHOP21+6X IT MTX via LP. Now in remission
    Read our story at CancerCoupleBlog

  8. #18
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    The spot may have been a damned spot, but I'm NOT damned! Pathology: NO EVIDENCE OF MALIGNANCY! What a huge relief (and that is a serious understatement)!

    From the report:
    FINAL DIAGNOSIS
    Gallbladder plus liver mass, laparoscopic cholecystectomy with partial hepatectomy:
    - 1-cm capsular fibrosis and elastosis with vascular proliferation and no evidence of malignancy, see microscopic.
    - Gallbladder with cholesterolosis and no evidence of malignancy.

    MICROSCOPIC DESCRIPTION
    Sections of liver mass reveal a 1 cm focus of capsular fibrosis, elastosis and vascular proliferation, suggestive of segmental atrophy. There is no evidence of malignancy. Congo red stain is negative for amyloid. The remainder of liver parenchyma shows mild steatosis with no hepatocyte ballooning or Mallory's hyaline. Sections of the gallbladder reveal infiltration of foamy histiocytes into the tips with no evidence of dysplasia or malignancy.

    Slides are shown at the pathology intradepartmental case review conference.
    Surgical recovery is going well with long walks 2-3 times a day and a lot of movement around the house -- bedroom is on the third floor and it is where I escape for short naps. Not even Tylenol today and feeling great and I can finally sleep comfortably flat on my back -- no pillow wedge -- or on my left side. Started up some of the more basic pelvic floor PT exercises this morning and will slowly add more difficulty (core exercises). Next Eligard injection is Monday and I should be getting back into the ART queue with first treatment 7/22. Need to talk with URO to see if he has any recommendations on intermittent urinary urgency issues. Still need to work on ED issues -- tadalafil on the way. Weight has dropped a bit purposefully due to exercise and cleaning up my diet a bit: 153.8 lbs and 5'8'. Ahhhhhhh! Sorry I'm babbling, but I am just sooooo happy about this pathology result!

    There is some interesting reading on segmental atrophy, but I need to get the links off of my phone.

    Thank you for your thoughts, prayers and wishes. Best wishes to all! Time for another GOOD night's sleep.
    6/18 New PCP asks "When was your last PSA level checked?" --> 11.5 so off to URO
    9/18 PSA 12.4, TRUS biopsy 10/18 yields 2 of 12 positive: LA GS6 <5%, RA GS7(3+4) 5% and the 4 is cribriform approaching 50%
    Clinical staging T1c, Decipher biopsy 0.94, 58 years old at DX
    12/18 RARP, pathology GS7(4+3) with cribriform, tumors in 10-15% of gland
    -SVI, -LVI, +EPE, +PNI, +BNI, +SM multifocal >=3mm pattern 4
    pT3a,pNx (lymph nodes inaccessible due to large mesh placement from 15 year ago bilateral hernia repair
    4/19 second opinion of pathology GS8, primary tumor composed of >95% cribriform (4+4), <1% pattern 5 and very minor focus comedo-necrosis, intraductal and postive margin at bladder resection
    still at pT3a,pNx and started six months of ADT with ART to start in a month or two
    1/19 PSA <0.1, 4/19 PSA <0.1

  9. #19
    So happy for you and yours, farmanerd!! A pseudotumor! = false alarm. You even made their interdepartmental slideshow. Forum brethren and sistren, we have a celebrity!

    Djin

  10. #20
    Woohooo.!! Congrats sir

 

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