Does histology regarding stage usually change after surgery.

We wives know you know 😜 

I don't know where the figure comes from, but I have heard that the original diagnosis is changed in 40% of prostatectomies, most of which are upgrades, but a small number are downgrades.

I think this just emphasises how imprecise prostate cancer diagnosis still is, although undoubtedly much better than is was in the past. There are some treatments, such as focal therapies and active surveillance, where the diagnosis really does need to be accurate. (Focal therapy centres do sometimes repeat the imaging.)

Hi Margot. I was told that I was Gleason 8 (4+4) mid Covid restrictions. It was 6 months before I was operated on. The surgeon told me that  delays during Covid were lengthy but generally hadn't affected outcomes. 

Best of luck to you both today.

Edited by member 18 Jun 2024 at 10:28  | Reason: Additional text

Margot, hope all goes well, I usually tell guys take it easy but keep mobile. Take care of yourself as well.

In hindsight I probably started with prostate issues when I was 50, I had terminal dribbling and didn't think to mention it to my GP. My GP missed a raised PSA of 6.9.when I was 59. I think those two events may have had more effect on my spread than my four months wait for the robot to be installed at our hospital. Back in those days the MRI was after the biopsy and I believe was looking at surrounding areas not the prostate.

I have had lots of treatments and have another scan on Monday to see what the next step is. I am still here and still moaning and dodging HT after 10 years. Hopefully your husband has many years in front of him. Sending hugs. 

Thanks Chris 

Thanks for the update Margot. I'm so pleased that the op appears to have been successful. I hope that the histology is good.

I'm not medically qualified, but I believe I've read, that removing some nerve bundles to leave negative margins does happen. 

I know in my case the surgeon removed the seminal vesicles, 9 lymph nodes, and the op was non nerve sparing. I apparently ended up with negative margins post op.

The attached link although quite old, 2009, explains things well.

https://www.health.harvard.edu/blog/positive-surgical-margins-following-radical-prostatectomy-20090617171

I hope you both manage to sleep well tonight.

Edited by member 19 Jun 2024 at 07:36  | Reason: Add link

Later, when the prostate is examined, they will determine how far it had actually spread within the prostate but the 'negative margins' at this stage is exactly what you want to hear!

I understand some people actually go down. I have one friend for whom that was the case. He had been told he had Gleason 7 (3+4) but in fact was Gleason 6 (3+3) following the slice and dice.

I was diagnosed on 4th December of 2023. PSA: 2.65 Gleason 7 (4+3), T2a originally but found to be T2c after PSMA PET MRA, N0, M0.

Post PR (27.3.24) my histology confirmed my original diagnosis with negative margins and no additional findings from the surgical procedure. All seemed to have gone well. Only difference was the tumour itself was actually smaller than had been originally reported. I had nerves removed on the left side where the cancer was found in the lower left periphery but spared on the right side where there were only traces of cancer in the transition zone. I was largely continent from the get go and certainly totally at one month. That had been a major concern for me.

I actually got my histology report a day before the third week anniversary date of the operation and not at the follow-up meeting which was scheduled for eight weeks following my surgery. That I felt to be a boon towards my recovery given the positive nature of the results.

Hope this helps.

Hi  Margot.

There seems to be quite a variation in recovering from the op. My goal was to get back to the pub ASAP, and I did it in four days. Others on here have not been so fortunate. 

You'll find that many have suffered pains in the area of surgery, it's quite a big op. Then you'll see there are differences in  incontinence and erectile dysfunction issues.

The main thing is he's eventually had the op and hopefully on his way to a cancer free life.