Does histology regarding stage usually change after surgery.

User

Posted 19 Jun 2024 at 00:19

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 08:36 | Reason: Add link

User

Posted 19 Jun 2024 at 09:21

Margot, good to hear things went well. As you probably know nerve bundles affect the ability to get natural erections, but better to lose the nerve bundles than leverage some cancer behind. I supposedly didn't have any nerves spared,but we have had lots of fun.

The surgeon cannot see individual cancer cells but when the prostate is sliced up and looked at under a microscope the may see if there was anything left behind. A recent trial may change that in the coming years.

Take care of each other, thanks Chris.

Added.Have a look at Lyn's post,it explains margins.

https://community.prostatecanceruk.org/posts/t29400-Staging-confusion-T2-or-T3

Edited by member 19 Jun 2024 at 09:27 | Reason: Not specified

User

Posted 19 Jun 2024 at 09:39

It is my understanding that when the surgeon refers to 'negative margins' it means that they believe that they have removed all of the cancer mass during the operation - whether that includes seminal vessels, nerve bundles, lymph nodes or just the prostate.

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!

User

Posted 19 Jun 2024 at 09:41

I saw this on the site earlier this year:

Is it realistic to think not rushing into anything and taking a year and reevaluating where things are, or the Doctor's just going to focus on my one outlier of 4+4(only 8% tissue) and tell me I need to start treatment. The study I found reported in The Journal of Urology titled Most Gleason 8 Biopsies are downgraded at Prostatectomy - Does 4+4 =7.

Also study Urol Oncol. 2020 Titled Should all prostate needle biopsy Gleason score 4+4=8 prostate cancers be high risk? Found after prostatectomy that if patients had 3 predictive factors that associated with downgrading in almost

60% of patients that had 4+4. One, that < or = 2

biopsy cores of 4+4. Two, < or = 50% maximal

tumor involvement of the cores demonstrating 4+4, and third the presence of a Gleason pattern 3 in separate biopsy cores. The probability of downgrading increased when combinations of these factors were present. I fit that in my pathology report so l am hesitant to run off screaming I have Gleason 8. It was only in one core minimally and I

User

Posted 21 Jun 2024 at 09:21

Hi Margot,

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.

User

Posted 22 Jun 2024 at 09:14

Thanks so much for the reply!
My husband is now recovering from the surgery he’s felt quite sore and off but I’m hoping this will soon go away!
He to had the nerves taken on the left side of the prostate where he had one tumour thought to be 16mm before surgery

So now it’s the anxious wait foe histology, he is Gleeson 9 so I hope it remains the same but also have a worry it won’t! However the surgeon did say the prostate looked intact from his eye but we have to wait to see!
Can I ask how you felt after surgery and how long before you wasn’t so uncomfortable?

M

User

Posted 22 Jun 2024 at 09:30

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.

User

Posted 22 Jun 2024 at 09:55

In my own case - post surgery - I was primarily fine. The only discomforting element were the surgical clips. I wrote a note on these boards and one correspondent suggested that I had perhaps been too active. That was far - in reality - from the case. It was merely the clips which became progressively troublesome as the skin surrounding them loosened. (I don't know if this is the same situation with your husband.) I put dressings back to cover them (stopping them from being pulled by clothing/bed sheets) and was really not troubled after that point. The awareness made ALL the difference. Still, mine was simply surface discomfort. I didn't - and still don't - have any major concern with anything approaching internal pain.

Don't know if this relates to your husband's case - but certainly I send every good wish for the best possible recovery going in his regard.

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