He was diagnosed this summer with two Gleason 6 positive cores on one side, 7.6 PSA and had RP as soon as it was possible. At first it seemed like pretty standard early disease, but pathology report revealed otherwise. I added a picture, sorry, it's not in English, but most things are obvious. Localisation on both sides, acinar adenocarcinoma structures in bladder neck area, tumor grows perineurally, is encapsulated, without penetrating the gland. No lymphovascular invasion. What I have trouble understanding is stage listing. On top it says N0 but it is together with pN+ which are contradictory, aren't they? Then on the bottom there's Nx to add more confusion. His next test is PSA 3 months after surgery and I was just looking for people to talk to. Pathology results came back way worse than I expected and I'm worried about happens in the future. Maybe folks around here have similar experiences? Thank you very much!
Dad just had RP, confusion about path... - Advanced Prostate...
Dad just had RP, confusion about pathology report and I'm concerned about what's next.
I can tell you that my initial pathology report contained errors. The summary on the first page didnt match the detailed description in later pages. I sent a note to my surgeon and he had the pathology dept redo the analysis completely from scratch. It was to my benefit (no EPE....which was the discrepancy between the summary and detailed description) but unfortunately I still had seminal vesicle invasion.
The bottom line is check every syllable and if something is amiss in your mind ask your dr to clear it up.
I recommend a second opinion for the pathology report. The top Pathologist in the US is Dr Epstein at Johns Hopkins.
Ask for an independent review of the slides and a new report. I expect it will reassure you.
Just watch the PSA as it should be almost undetectable for 5 years at least.
Greetings Andrew, Would you be kind enough to furnish us with more information concerning your Father. Age, Location, Treatment Center, Doctor's name(s)? All info is voluntary but helps us help him and helps us too. Thank you.
Good Luck, Good Health and Good Humor.
j-o-h-n Tuesday 11/26/2019 2:31 PM EST
Did they remove some lymph nodes and find some cancer there? that would be the only reason for a pN+ (the N0 just means that no enlarged lymph nodes were found before the RP). It is almost unheard of for pN+ to be associated with a Gleason score of 3+3 (I suspect the pathologist read it wrong).