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Another one bite the dust

User
Posted 04 Sep 2021 at 07:49

Very sorry about the positive margin issue. I dont know enough about the issue to offer an opinion im afraid but we are all rooting for you.


I also found the consultants optimism slightly disconcerting. How could he be so sure? But in the meantime I would try and put the upcoming psa test to the back of your mind. There really is no point in worrying as there is nothing you can do. Of course Thats easier said than done! Good luck

User
Posted 04 Sep 2021 at 08:07

@Jeremys,


Thanks for your kind message. I too cannot understand why my surgeon consultant is so optimistic. I will drop him an email and ask him to elaborate as his answers over the phone can be very dry. He is very good at responding to emails.


 

One day at a time...

User
Posted 04 Sep 2021 at 08:23

Plug your to numbers in here to work it out for yourself
https://www.mskcc.org/nomograms/prostate/post_op


 


What the surgeon has described is correct and not unreasonable. The big test will be that first post op PSA. Unfortunately you have to grin and bear it until then.

User
Posted 04 Sep 2021 at 09:05

Hi Francij1 and many thanks for the link. It's a good one. I was aware of it and did plug in my data which gave me a 10-year disease free survival rate of 61%, much lower than the 90%-95% quoted by my surgeon. My surgeon may have mixed up 2-year and 10-year probability, which is why I asked him to confirm the probability he gave me were for 10 years. I will get back to him and ask him which nomograms he is using...

One day at a time...

User
Posted 04 Sep 2021 at 10:22

I wonder if there are different types of positive surgical margins with some significant than others...?

One day at a time...

User
Posted 04 Sep 2021 at 11:33
The size of the margin and the Gleason grade at the the margin. TBH the recurrence rate of positive and negative margins is very similar and this supports your surgeons assertion that the trauma of the op and the hot knife fatally damages cells beyond the excision.

The good news for positive margins is should you have a recurrence it makes salvage RT more successful.

Try to forget about all this s*** until your next PSA!
User
Posted 04 Sep 2021 at 12:13

Jonathan, thanks for the insight! I know I suffer a lot from health anxiety and wish I could approach things differently but it's hard. I have emailed my consultant surgeon and asked him some detailed questions. I'm hoping he will come back with some more elaborated answers that substantiate his optimism. 


I really hate this cancer business...

One day at a time...

User
Posted 04 Sep 2021 at 21:26

Originally Posted by: Online Community Member


I must confess I am really feeling down and could do with some support...


This positive margin business is really dragging me down...



If the surgeon thinks you're probably alright, try to accept it. None of us have cast-iron guarantees, even those with negative margins.


I also had a small positive margin. My surgeon said it was "diathermied" which pretty much means it would have been fried by the heated snippers of the DaVinci robot.


If your PSA is low and stays low, you're OK - for now. It's a bit sad, but that's about as solid as the reassurance gets. But your attitude of 'one day at a time' is spot-on and is the right approach.

_____


Two cannibals named Ectomy and Prost, all alone on a Desert island.


Prost was the strongest, so Prost ate Ectomy.

User
Posted 04 Sep 2021 at 21:45

Hi Bob!


As Alex says there are no guarantees in this game. But so far the stats and data are on your side. It’s very much a roller coaster ride through and through. I pretty much expect mine to come back at some point but the longer I can push that back gives the science more time to evolve. Chin up and enjoy the bubbly as you defo have had a good outcome so it’s celebration time 🍻🥂

User
Posted 05 Sep 2021 at 08:25
@alex_cycles, you're right, I should accept my surgeon's explanation and go with the flow. After all, why waste energy on something that cannot be changed? I just need to accept the hand I have been dealt with and make the best of it. It's the PSA test that will tell me how successful the RP has been.

One day at a time...

User
Posted 05 Sep 2021 at 08:34
@TechGuy, hey good to hear from you!

That's one thing I have noticed with prostate cancer: it forces you to live more in the now and less in the future.

One day at a time...

 
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