The wait is over, surgery completed 1... - Advanced Prostate...

Advanced Prostate Cancer

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The wait is over, surgery completed 12/18

kpminn profile image

After the agonizing months of wait and indecision I had the da Vinci Radical Prostatectomy on Dec 18th. My recovery has gone well and have been liberated from my cath since yesterday. Now I'm trying to adapt to the new world order. I got some of those Depends. The ones with the virile studly guy on the package. He's half my age and looks like he just left the gym. But it does somehow make me feel better. The next ones will be the older guy with a bit of a paunch. That will make me feel even better. I'm hopeful that I will continue to make progress in that regard. I'm concerned about my Pathology Report as there are some adverse findings.

Da Vinci Radical Prostatectomy 12/18/2018


TUMORAcinar adenocarcinoma

Histologic Type

Gleason Pattern

% of Pattern 4 70%

% of Pattern 5 5%

Primary Gleason Pattern 4

Secondary Gleason Pattern 4

Tertiary Gleason Pattern 5

Total Gleason score 8

Intraductal Carcinoma (IDC) Present

Extraprostatic Extension (EPE)Present, nonfocal

Seminal Vesicle Invasion Present, right

Perineural Invasion Present

Margins Uninvolved by invasive carcinoma

Lymph nodes Uninvolved by invasive carcinoma

Pathologic stage classification

Primary tumor pT3B

Regional lymph Nodes pN0

Additional Pathological Findings High-grade prostatic intraepithelial neoplasia (PIN)

We will continue to monitor PSA closely and take appropriate action if/when necessary

Best regards


12 Replies

Welcome kpminn, I don’t know about your pathology., Others will answer that. Just wanted to welcome the new world of disorder.. you’ll adjust. I believe that for you, things and your conditions will improve as you recover.. Those initial terrors and fears shall subside.. Live healthy ...

Read the report. You fit perfectly for being staged a PT3b. Your first PSA usually at 60 days after the surgery, will reveal much, as to further treatment. You may find that the surgery got much of the cancer, and prayerfully your PSA will be less than 0.1

The fact that your margins were clean is very positive, as well as the Lymph Nodes being free is also a very good sign.

The intraductal is the part of the pathology that is in itself a rare agressive form. Maybe it was all contained in the removed material, as the Ductal Pca types tend to be late movers out of the Prostate. But there is nothing that can be done as of now, but stay positive and let the process evolve when the first PSA results come in.


kpminn profile image
kpminn in reply to Nalakrats

Thanks Nalakrats! I’m adrift in a sea of acronyms. There is so much information it’s difficult to process. I have a consult with my Urologist next week and hoping for some clarity


Had my robotic prostatectomy on November 14 at Rutgers Cancer Institute, as part of being a participant of the SIMCAP clinical trial. Similar results to yours, but with 2 lymph nodes out of 27 positive and Gleason score undeterminable due to having been on ADT for 4 months prior to surgery. Continuing on ADT (Zytiga, Prednisone, Eligard, Xgeva).

Had PSA tested one week later when catheter removed. Probably too soon to be relevant, but it did go up slightly from 0.12 to 0.15. Was told that this was not at all unusual.

Incontinence is minimal, with occasional leaking. Using just 2 pads/guards each day.

Wishing you luck and continued progress.

kpminn -

Congrats & welcome to the other side!


We really really like older guys with a bit of a paunch. Welcome to The Far Side.

j-o-h-n profile image
j-o-h-n in reply to monte1111

speak for yourself...

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 12/30/2018 1:55 AM EST

monte1111 profile image
monte1111 in reply to j-o-h-n

I did proofread the spelling and punctuation. Nice to get up on a sunny Sunday morning and laugh at myself.

j-o-h-n profile image
j-o-h-n in reply to monte1111

Confucius say… honor your personality flaws, for without them, you would have no personality at all. Happy New Year.

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 12/30/2018 6:40 PM EST

Could you tell us where you're located (in MInn) and where you're being treated (Docs name too)?

I buy my Depends by the truckload. After the 10th truckload you get a year's supply of personalized paper cups, all you have to do is change your name to "dixie".

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 12/30/2018 2:06 AM EST

kpminn profile image
kpminn in reply to j-o-h-n

John, I’m in Hugo and my surgery was done by Dr’s Knoedler and Gaertner. They have done over 4000 da Vinci’s and are the best!

Thanks for your response. You're near the Mini-apple, I'm in the Big-apple.

Congratulations on your successful surgery. Your response could be helpful to others on this forum.

4,000 da Vinci's? Looks like those two doctors really got "the code" down pat.

Happy New Year.

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 12/30/2018 7:18 PM EST

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