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Staging confusion T2 or T3?

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User
Posted 31 May 2023 at 18:02

I had my surgery three weeks ago and all went well. There was some confusion if I was T2 or T3 staging as there was bulging on the MRI, they had me as T3. however my surgeon said still within prostate and said T2. My PSA was 6 and gleeson 7 (3+4).


I had one side nerves sparred, pathology tested the prostate while the surgery was happening using the Nurosafe method, one side came back positive and hence was removed. As it’s confirmed that the cancer was present in the nerve bundle which is outside of the prostate, am I right in thinking that T3 was the right staging? I’d assume the chances to reoccurrence is higher being T3 than T2?  

User
Posted 31 May 2023 at 21:15
If the surgeon says that it was a T2, I think you have to trust him as he had the benefit of a) being inside you to have a good look round and b) having the qualifications & experience to be able to interpret the pathology. Having the nerve bundles removed on one side isn't usually because it had already spread to the nerve bundles, it is because it is almost impossible to cut a fine line between the edge of the prostate & the web of nerves. Imagine your prostate is a peeled orange - the orange sitting in your hand is covered with pith, the white webby stuff. In nerve-sparing surgery, they are trying to remove the orange while leaving the pith intact - a difficult task. Now imagine that cancer can be seen on the edge of the orange - it would be unwise for a surgeon to try to cut out the orange while leaving the pith in place due to the risk of leaving a bit of cancerous orange clinging there.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 31 May 2023 at 21:48

Thanks for the reply Lyn, I’ve not spoken to the surgeon yet, still a couple weeks away from the 6 week review. The surgeon had said T2 before the procedure yet the MRI and biopsy review said it was T3, hence why I was a little unsure.


Thanks for your explanation, that helps, I assumed as the nerves were outside of the prostate and the prostate frozen sections have already been in a pathology lab and confirmed positive during the op it would suggest spread outside the capsule, I thought that might mean a T3 staging. I’m pleased that it might still be T2 and not spread beyond the prostate.


The letter from the surgeon after the procedure doesn’t mention a stage but they did say that the prostate was removed with both nerves intact, prostate sent away came back positive on the LHS and that side nerves removed. Clever stuff!

 
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