Imagine that your prostate is an orange - the peel is the outer covering of the prostate and then the nerve bundles wrapping around the outer covering. The idea of nerve-sparing RP is to remove the orange while leaving the peel intact. There are two kinds of positive margin:
1. they discover after the op that the cancer had already got into the inner side of the peel
2. they discover that the orange isn't quite intact - a little bit was left behind
In case 1, a) the cancer cells have reached the peel but that bit of peel is now in a petrie dish in a lab or b) the cancer cells have reached the peel but may have been obliterated anyway by the heat / cutting / slashing. In case 2, that tiny bit of flesh that is missing from the orange might not have had any cancer cells in it anyway (because your whole prostate isn't cancerous) and / or may not have been left behind at all ... just because it isn't on the orange doesn't mean that it isn't in tiny ripped pieces on the surgeon's blade.
Neither scenario guarantees that there will be a recurrence although it is more likely in case 1 than in case 2 - data suggests that there is hardly any increased risk at all for case 2 over men who did not have a positive margin. Your surgeon has told you that you are in case 2 group.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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Ask for your pathology report - if the surgeon isn't sending you a written copy, s/he will be sending it to your GP who will be able to share it with you. It sounds like the surgeon is telling you that there was a positive margin but in most cases, that little bit of positive margin is actually burnt / slashed to death during the op and does not make future recurrence more likely. What was your post-op PSA reading?
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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Hi Lyn,post op PSA undetectable,yes I know he sends the report to the doctors so I should get a copy, heads spinning at the moment guess I might make sense of it once I see it
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Yes my surgeon told me pretty much the same thing. Pathology report came back showing a 3mm positive margin, even though my diagnosis pre and post op was T2a, hence 'contained'.
If you read my profile you will see the letter back from the consultant with the explanation.
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Hi Jim thanks for reply ,like Lyn says I need to see the pathology report which might explain things
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Imagine that your prostate is an orange - the peel is the outer covering of the prostate and then the nerve bundles wrapping around the outer covering. The idea of nerve-sparing RP is to remove the orange while leaving the peel intact. There are two kinds of positive margin:
1. they discover after the op that the cancer had already got into the inner side of the peel
2. they discover that the orange isn't quite intact - a little bit was left behind
In case 1, a) the cancer cells have reached the peel but that bit of peel is now in a petrie dish in a lab or b) the cancer cells have reached the peel but may have been obliterated anyway by the heat / cutting / slashing. In case 2, that tiny bit of flesh that is missing from the orange might not have had any cancer cells in it anyway (because your whole prostate isn't cancerous) and / or may not have been left behind at all ... just because it isn't on the orange doesn't mean that it isn't in tiny ripped pieces on the surgeon's blade.
Neither scenario guarantees that there will be a recurrence although it is more likely in case 1 than in case 2 - data suggests that there is hardly any increased risk at all for case 2 over men who did not have a positive margin. Your surgeon has told you that you are in case 2 group.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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User
Hi Lyn, Thanks for taking the time to send a detailed reply,It's abit of a rocky path with the unknown always on my mind.I see you have had a journey of your own with the 3 men in your life.i worry about my wife but she appears positive.I keep getting tested and hope for the best fingers crossed.All the best Mark