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Worried after post op appointment

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User
Posted 01 Nov 2024 at 21:37

Hi All


I was diagnosed with PC in June 2024 and had RALP 7 weeks ago today. I had PSA 16.4 and gleeson score of 7 (3+4) and MRI suggested T2.


Recovery is going okay, happy with the bladder control, only using one pad during the day and one at night just in case. 


I had my post op follow up this week and the good news was my PSA was undetectable but the not so good news was that the tumour was larger than they expected. Follow up PSA in three months before any further treatment is decided upon. 
I was comfortable with that until tonight when my NHS app updated with a note to my GP. It says “ Histology: RALP - pT3a pNx pMx, positive base, clear circumferential and apex“. I’ve been onto google but even more confused!! 
Am I overthinking or is this quite worrying!!!

User
Posted 01 Nov 2024 at 21:37

Hi All


I was diagnosed with PC in June 2024 and had RALP 7 weeks ago today. I had PSA 16.4 and gleeson score of 7 (3+4) and MRI suggested T2.


Recovery is going okay, happy with the bladder control, only using one pad during the day and one at night just in case. 


I had my post op follow up this week and the good news was my PSA was undetectable but the not so good news was that the tumour was larger than they expected. Follow up PSA in three months before any further treatment is decided upon. 
I was comfortable with that until tonight when my NHS app updated with a note to my GP. It says “ Histology: RALP - pT3a pNx pMx, positive base, clear circumferential and apex“. I’ve been onto google but even more confused!! 
Am I overthinking or is this quite worrying!!!

User
Posted 01 Nov 2024 at 22:55
Key measure after a RALP is "undetectable PSA" the rest is probably meaningless on the grand scheme of things.

The positive margin and a T3A increase your risk of recurrence but while your PSA says undetectable you can forget about that.

If you want to visualise the risk use the post prostatectomy risk nomogram at Sloane Kettering hospitals website.
https://www.mskcc.org/nomograms/prostate/post-op
User
Posted 01 Nov 2024 at 23:33

I had robotic surgery almost 21 months ago, I was T3a, capsular breach, I had no positive margins but my Gleason was 9 (4+5). Today I was told my PSA is still undetectable.


As francij1 states, your risks of recurrence, like mine, are increased but your undetectable PSA is what counts. Best of luck with a continuing recovery.


PS: Those nomograms can be depressing reading. I almost got PTSD after calculating mine. 🙂 


 

Edited by member 02 Nov 2024 at 00:34  | Reason: Typo

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User
Posted 01 Nov 2024 at 22:55
Key measure after a RALP is "undetectable PSA" the rest is probably meaningless on the grand scheme of things.

The positive margin and a T3A increase your risk of recurrence but while your PSA says undetectable you can forget about that.

If you want to visualise the risk use the post prostatectomy risk nomogram at Sloane Kettering hospitals website.
https://www.mskcc.org/nomograms/prostate/post-op
User
Posted 01 Nov 2024 at 23:33

I had robotic surgery almost 21 months ago, I was T3a, capsular breach, I had no positive margins but my Gleason was 9 (4+5). Today I was told my PSA is still undetectable.


As francij1 states, your risks of recurrence, like mine, are increased but your undetectable PSA is what counts. Best of luck with a continuing recovery.


PS: Those nomograms can be depressing reading. I almost got PTSD after calculating mine. 🙂 


 

Edited by member 02 Nov 2024 at 00:34  | Reason: Typo

User
Posted 02 Nov 2024 at 07:06

Thanks for the replies. Feel a bit better in my head now. It can get a bit overwhelming with all the medical jargon!!

 
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