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Thread: Second Biochemical Recurrence of Prostate Cancer--SEEKING ADVICE & CONVERSATION

  1. #21
    Senior User
    Join Date
    Nov 2018
    Posts
    263
    They took 16 nodes from me.
    DOB 1955
    63 at dx
    3/2018 PSA 4.05 DRE normal refer to URO small town
    10/2018 PSA 6.28 DRE normal
    Bx 11/2018 12 cores 3 pos 1 - 5% left mid 2 - 50% left base
    GS 3+4=7 T1c
    Appt Mayo Clinic Phoenix Az 1/4/2019
    Dr. Paul Andrews recommend
    MRI 2/27/2019 Mayo AZ
    RALP 2/28/2019 Mayo AZ Dr. Paul Andrews
    Path: GS 3+4=7, Tertiary Gleason Pattern none, Grade Group 2
    Tumor presents moderate to extensive volume mainly posterior
    portion of prostate. Largest tumor nodule measures 8 mm
    Prostate: 21g 3.5 x 3 x 3 cm
    EPE: Neg
    Bladder Neck Invasion: Neg
    Seminal Vesicle Invasion: Pos (left seminal vesicle)
    Margins: Pos left lateral base & central base 2mm focus each
    Lymph Nodes involved: 0
    Lymph Nodes Ex: 16
    Nerves spared right side only
    Path Staging (AJCC 8th Edition)
    Primary Tumor pT3b
    Regional lymph nodes: pNO
    Distant Metastasis: Mx
    Continence 99% 9 wks
    ED Present
    PSA 4/17/2019 <.10
    PSA 5/2/2019 <.007
    PSA 6/10/2019 <.10
    PSA 8/1/2019 <.007
    PSA 9/16/2019 <.10

  2. #22
    Top User garyi's Avatar
    Join Date
    Apr 2017
    Posts
    1,466
    I contributed only four nodes....
    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, .081 9/19, .116 11/19
    We'll see....what is not known dwarfs what is thought to be fact

  3. #23
    Quote Originally Posted by garyi View Post
    I contributed only four nodes....
    With an 80% estimate of pT2 and G7 (3+4), I can see why your surgeon took perhaps only the sentinel lymph nodes (those closest to the prostate on the chains of nodes draining it) or perhaps some larger nodes.Those are the nodes more likely to be posotive.

    Djin
    Last edited by DjinTonic; 11-05-2019 at 07:40 PM.

  4. #24
    Top User garyi's Avatar
    Join Date
    Apr 2017
    Posts
    1,466
    Correct, Djin, and none of my nodes were swollen, or otherwise indicated any activity, per my scans.
    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, .081 9/19, .116 11/19
    We'll see....what is not known dwarfs what is thought to be fact

  5. #25
    To have a median of 15, we would have to see a bunch of men with >20 removed. At least with the men on this forum it isn’t even close to a median of 15.
    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 Intraductal Carcinoma
    T3aNO, 1 mm EPE, GS8, 21 mm uni-focal tumor involved 10% of prostate.

    7 Nodes, SV, SM, PNI, and BNI were negative.

    LVI and Cribriform pattern present.

    Decipher .86 High Risk.

    Post Surgery PSA
    3/25/19 .03. (<1 month)
    4/25/19 <.03. (2 months)
    5/25/19 <.02. (3 months)
    9/10/2019. <.02. (6 months)
    11/27/2019. <.02. T<3. (9 months)

    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)

  6. #26
    Quote Originally Posted by Duck2 View Post
    To have a median of 15, we would have to see a bunch of men with >20 removed. At least with the men on this forum it isn’t even close to a median of 15.
    Correct, although I've seen some Brothers who had >20 removed. We're lucky the authors were able to find a significant number of men with these large numbers of nodes removed to get the statistics they did. We all benefit from the statistics they developed.

    Djin

 

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