I'm interested in conversations about and I want to talk about
Know exactly what you want?
Show search

Notification

Error

Questions ?

Email this conversation Print this conversation
User
Posted 29 Apr 2024 at 10:19

Hi,

My post operation pathology:

G7 (3+4) , T2c,

negative margin, the local excesion was complete

one nerve bundles saved

PeriNeural invasion positive

PSA undetectable 30 months post operation. 

 

Question ?

How could have negative margin and yet PeriNeural invasion positive?

What are statistics and chances of reoccurrence UNDER SUCH CIRCUMSTANCES?

 

THANKS IN ADVANCES FOR REPLY

p.s

I asked asked this question from couple of members. They kindly replied but also suggested to put my question in public so others in similar situation could benefit and learn from each others replies.

Thanks again to both of them

Edited by member 01 May 2024 at 16:55  | Reason: Not specified

User
Posted 29 Apr 2024 at 10:19

Hi,

My post operation pathology:

G7 (3+4) , T2c,

negative margin, the local excesion was complete

one nerve bundles saved

PeriNeural invasion positive

PSA undetectable 30 months post operation. 

 

Question ?

How could have negative margin and yet PeriNeural invasion positive?

What are statistics and chances of reoccurrence UNDER SUCH CIRCUMSTANCES?

 

THANKS IN ADVANCES FOR REPLY

p.s

I asked asked this question from couple of members. They kindly replied but also suggested to put my question in public so others in similar situation could benefit and learn from each others replies.

Thanks again to both of them

Edited by member 01 May 2024 at 16:55  | Reason: Not specified

User
Posted 29 Apr 2024 at 11:17

Perineural invasion means that it was observed that the cancer was tracking along inside nerve sheaths *inside* the prostate. This represents a possible route by which the cancer could track along nerves to outside the prostate without being noticed and cause recurrence in the future. To be honest, I wouldn't worry about this. PNI is associated with more aggressive disease, and more aggressive disease is associated with a higher recurrence rate. It's difficult to separate that out in to the effect of just the PNI, so I doubt there's reliable data on that alone.

A nerve sheath would be too small to be observed as a positive margin.

Perineural invasion is nothing to do with the neurovascular bundles spared (or not) for erections.

User
Posted 16 Nov 2024 at 08:40

Gleason 8 to Gleason 6? !!

 Whoever did the first biopsy should have gone to Specsavers. 😁

 

Edited by member 16 Nov 2024 at 09:10  | Reason: Typo

User
Posted 29 Apr 2024 at 11:32

I was Gleason 9 (4+5) with PNI and EPE. Apparently they all slightly increase the risk of recurrence, I shall do my best to prove them wrong.

I should get my PSA results tomorrow, hopefully 15 months post op they'll still be undetectable.  If so I'll crack a phial of Invicorp to celebrate.😁

 

User
Posted 01 May 2024 at 17:16

Hi Fred, 

You can't ejaculate after prostatectomy.

However you can still orgasm, but I dont think that'll affect your PSA.

User
Posted 06 Nov 2024 at 12:11

I think I have seen posts on this forum referring to surgery, which describe the top of the prostate as more or less merging with the bladder neck. So a surgeon can't really get the last bit at the top, without risking more damage to continence. If the tumour had been identified in that region you would probably not have been offered surgery in the first place so I don't think you have anything to worry about.

Hopefully one of our more knowledgeable members can confirm or deny, my interpretation of prostate anatomy described above.

 

Dave

User
Posted 16 Nov 2024 at 16:39

Its not uncommon for a Gleason 8 (4+4) to be downgraded to a Gleason 7 (4+3), but definitely uncommon the 8 to drop to a 6.

Show Most Thanked Posts
User
Posted 29 Apr 2024 at 11:17

Perineural invasion means that it was observed that the cancer was tracking along inside nerve sheaths *inside* the prostate. This represents a possible route by which the cancer could track along nerves to outside the prostate without being noticed and cause recurrence in the future. To be honest, I wouldn't worry about this. PNI is associated with more aggressive disease, and more aggressive disease is associated with a higher recurrence rate. It's difficult to separate that out in to the effect of just the PNI, so I doubt there's reliable data on that alone.

A nerve sheath would be too small to be observed as a positive margin.

Perineural invasion is nothing to do with the neurovascular bundles spared (or not) for erections.

User
Posted 29 Apr 2024 at 11:32

I was Gleason 9 (4+5) with PNI and EPE. Apparently they all slightly increase the risk of recurrence, I shall do my best to prove them wrong.

I should get my PSA results tomorrow, hopefully 15 months post op they'll still be undetectable.  If so I'll crack a phial of Invicorp to celebrate.😁

 

User
Posted 01 May 2024 at 17:01

How orgasm effects PSA reading post diagnosis treatments such as prostatectomy where PSA is usually low (say below 0.2)? By this I amen what is the magnituade of rises that ejaculation has on PSA?

Edited by member 01 May 2024 at 17:25  | Reason: Not specified

User
Posted 01 May 2024 at 17:16

Hi Fred, 

You can't ejaculate after prostatectomy.

However you can still orgasm, but I dont think that'll affect your PSA.

User
Posted 01 May 2024 at 18:55

That is right Adrian unless you haven't regained complete continence then you would probably ejaculate urine as I do. It is a strange feeling when I orgasm, because it isn't dry orgasm my 'pleasure' due to ejaculation is still present but not the same as before. I wonder any other member has had a similar experience?

 'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.'                    Richard Feynman (1918-1988) Nobel Prize laureate

 

 

User
Posted 01 May 2024 at 20:35

Hi Pratap.

I've now stopped urinating whilst I orgasm, but what I miss is that pumping feeling when I used to ejaculate sperm. Mind you at least it's less messy.

User
Posted 06 Nov 2024 at 10:30

Hi again.

My post radical prostatectomy pathology reported to be negative margin and the local excesion was complete.

However, I had a Sonography for my abdominal (kidney) that reported as there were "part of remaining prostate I

cm2 of 1 gram?

I wonder do they usually remove the whole prostate or is it possible that they leave few cm beyond? And if the answer is yes, then would that tiny bit left beyond be non cancerours or what?

Advance thanks for reply.

Edited by member 06 Nov 2024 at 10:32  | Reason: Not specified

User
Posted 06 Nov 2024 at 12:11

I think I have seen posts on this forum referring to surgery, which describe the top of the prostate as more or less merging with the bladder neck. So a surgeon can't really get the last bit at the top, without risking more damage to continence. If the tumour had been identified in that region you would probably not have been offered surgery in the first place so I don't think you have anything to worry about.

Hopefully one of our more knowledgeable members can confirm or deny, my interpretation of prostate anatomy described above.

 

Dave

User
Posted 16 Nov 2024 at 02:09

How a biopsy report of G8 down graded to G6 after prostetectomy?

I always thought MRI might get down after surgery (as happened in my case - T3a to T2b) but downgrading of G is it not unusual ".

I read a survivor story in YANA that said:

"Friday could not have gone any better. The path report indicated lymph nodes were clear, seminal vesicles were clear, and there were negative margins on the prostate. Additionally, the path report gave a final Gleason score of 6 as opposed to the 8 from the biopsy report"

https://www.yananow.org/display_story.php?id=387

Edited by member 16 Nov 2024 at 02:16  | Reason: Not specified

User
Posted 16 Nov 2024 at 08:40

Gleason 8 to Gleason 6? !!

 Whoever did the first biopsy should have gone to Specsavers. 😁

 

Edited by member 16 Nov 2024 at 09:10  | Reason: Typo

User
Posted 16 Nov 2024 at 16:39

Its not uncommon for a Gleason 8 (4+4) to be downgraded to a Gleason 7 (4+3), but definitely uncommon the 8 to drop to a 6.

 
Forum Jump  
Email this conversation Print this conversation

Join the online community now.

Click through to become a member and gain access to support, information and real time replies.




MenuTop ▲
©2025 Prostate Cancer UK