Clinical Summary Help

User

Posted 15 Feb 2023 at 16:03

I had RP Surgery just over 8 months ago, I recently received my clinical summary letter by post. I was wondering if some of you wonderful guys here can help decipher what it means in layman speak. So here goes:

Diagnosis: Acinar adenocarcinoma with Gleeson score 3+4 with Gleason pattern 4 of less than 5% maximum tumour6/28 number of cores involved at both prostate lobes

Histological Diags

Gl Score: G3+4 overall

grade group:2

stage: pT2 pNX

tumour volume : 6.2ml

Margin Status : Gland confined, clear margin

I know it is too late to look back, wanted to know what the above figures means, could I have waited a few years longer as it says the gleason pattern of 4 was less than 5%?

User

Posted 15 Feb 2023 at 19:10

Looks great and hope your recovery is going well. Keep an eye on PSA bloods and so long as stable should be all good.

Looks like the reports eludes to clear surgical margins which is very good news.

With any amount of type 4 (medium grade) cells I’d always be inclined to act. Even type 3 (low grade) can metastasise and this risk increases with higher grades. Sooner out the better is usually the view certainly if age is on your side.

I would T2c Nx Mx 3+4 which meant it was in all lobes of the prostate but confined in terms of surgical margins. No lymph node or seminal vessel involvement . Think I had around the same percentage of type 4 which was an upgrade on my biopsy results which were 3+3.

mets are always a best guess but regular PSA bloods should keep this under the radar as they can pop up anytime even decades or so later.

best of luck with the recovery

simon

User

Posted 15 Feb 2023 at 20:19

Gee Baba, layman's speak is "good news".

I don't know how they assessed you before the operation, but assuming you were already Gleason 7 from the biopsy they didn't find anything more threatening. And as far as they can possibly tell, they got it all out.

As Tech Guy says, no one can ever be 100% certain there isn't a very small amount of cancer left in you somewhere - but with your results anything that exists and starts growing will quickly be detected from PSA measurements. And something can be done about it.

Could you have waited longer? Well if you had, and the equivalent report said "positive margin" you would have regretted it. It isn't the sort of thing to gamble with.

How are you doing? At 8 months you probably get some sense of how you are recovering the functions that get knocked about a bit by surgery.

User

Posted 15 Feb 2023 at 20:29

Thanks a lot techguy. Maybe it is just looking back rather than forward. I was fairly certain, one of the consultants who called me in the early days, mentioned "slow growing" and not being sure if this was particular cancer was indolent and might not get worse if left alone.

User

Posted 15 Feb 2023 at 20:44

Originally Posted by: Online Community Member

Gee Baba, layman's speak is "good news".

Could you have waited longer? Well if you had, and the equivalent report said "positive margin" you would have regretted it. It isn't the sort of thing to gamble with.

How are you doing? At 8 months you probably get some sense of how you are recovering the functions that get knocked about a bit by surgery.

You are right, my Gleason score did not change. It remained Gl 3+4. I get your point about not doing anything and it gets worse. I just feel I walked into the surgery blindly. I was not told about the loss of election. I was told bi-lateral nerve sparring, the use of viagra or tadalafil would assist with erections. Never thought it possible that I would use these tablets and nothing would happen down there. I also have 2 pumps, varruerect (bought myself) and somaerect (NHS provided), probably used them 1ce this year. However, I have in the past week been more intentional with taking the 10mg tablets every other day.. Incontinence is also not an issue, no pads at all, however use 1 overnight, the past 7days marked improvement, as I have given up caffeine, no food or drink after 7pm and taking my PFE more seriously. So maybe I should not really complain.

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