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Post RP worries & concerns.

User
Posted 27 March 2017 05:13:42(UTC)

Hi posting this new thread after my first thread has went cold somewhat (feeling a bit sorry for myself I suppose) - This as I await Radical Prostatectomy on the 03rd of April.

I am 51 and was disgnosed in February after biopsy with low PSA of 5.9 but Gleason 9 (4+5) and told I have a aggresive, high risk, high grade strain. Understand cancer is confined to one side of prostrate with 78% population. My bone scans were clear and my MRI was inconclusive as cancer could not be seen, so biopsy was revisted to further confirm Gleason 9.

I do not qualify for Brachytherapy due to high grade G9 so have opted for the RP surgery.  My worry still being that the surgeon has said he will have to "dig deep" on the side with 78% population high grade and that I should expect problems with ED and incontinence. I understand nerve bundles will survive on one side but still worried about what I will be left with.

My other concern comes from the inconclusive MRI and the gleason 9 rating, as I understand that not many Gleason 9's achieve full remmision. I cant help thinking that the cancer is beyond the capsule and undetected and have been told that I will not get the full picture until they get in there and then get everything to the pathologist?

How long do the pathology results take after RP?

When will I have my 1st PSA test after RP?

What PSA level shows cancer is still there after RP?

Appreciate any advice or comments.

Thanks

User
Posted 27 March 2017 12:54:56(UTC)

Hi Tony

Please feel free to read my profile. I cannot answer your question about remission but clearly your medical team are hoping to achieve this for you or they would not offer to operate.

To answer your questions

Pathology results are usually 6-8 weeks after your op likewise the 1st PSA test.

Ideally your PSA should be under 0.1 or <0.1

Any further questions please ask and good luck next week

Bri

Thanked 1 time
User
Posted 17 April 2017 12:35:59(UTC)
Hi tony,

OH had a g9 tumour with similar stats to you. He had RRP in Dec 14 with rising PSA two years later. He's just finished salvage RT. We were offered adjuvant RT but decided not to take it as the surgeon said pathology showed clear margins.

Do discuss this option with your surgeon. If we had our time again, we'd have done it

Hope the surgery went welll
User
Posted 02 May 2017 15:13:48(UTC)
Hi Tony, I had Gleason 7 (3+4) pc on biopsy. Tumour showed up on MRI on one side of the gland,and there was a query whether it had breached the capsule. Post surgery the histology (about 7 or 8 weeks later) showed that the cancer had just broken through the capsule plus there was intraductal cancer too which made my prognosis less good. I was offered the opportunity to go on a radicals trial where randomly some patients were given adjuvant radiotherapy and some nothing. I decided not to participate.
Fast forward to September 2016 and my PSA(which had been <0.1 and so should yours ideally be after surgery) had risen to 0.7 and within another month and a bit was 0.6. MRI and then PET scan picked up one tumour on the Prostate bed and another in a seminal vesicle remnant. I have been on hormone therapy since December and just finished salvage radiotherapy last Wednesday.
I will be on HT for a further two years and then will come off it which will be the moment of truth and will answer the question mark over microscopic metastasis which my oncologist is all but convinced I have.
If I were to do this again I would go for adjuvant radiotherapy but hindsight is a wonderful thing. When PC recurs after negative margins it isn't a good sign if it occurs less than 3 years after RP. I would certainly have the conversation around adjuvant radiotherapy if I were you.
I was 55 on diagnosis, now 57.
I wish you all the best and hope you're RP went as well as it could.
 
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