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Re: After 6 months I'm reading the body of the pathology report......
I never yell at anyone, let alone someone who is asking intelligent questions, the answers to which may help others. It's great that you are getting around to reading your reports - something we suggest everyone should do (possibly a little earlier than you are!!) - and trying to gain an inderstanding of what they mean, so you can make a better decision.
Your question is If they ain’t sure in the lab if a sample is or ain’t cancer....how can they/ I be sure a microscopic piece of tissue left near the exit door/margin is cancer and not a piece of BHP/nodule left behind? (Incidentally, I removed the CAPITALS - as you may or may not know, that is the equivalent of yelling in cyberspace, and we try not to yell here on Yana.)
The simple answer to the question is that no one can ever be certain that the minute piece of material that is being examined is adenacarcinoma or one of the many variations in cellular structure that occurs for many reasons creating what are known as atypical cells - we'd probably call them abnormal cells. Not all abnormal cells are dangerous - think, for example of a freckle (which is a bunch of atypical skin cells and melanoma, which is a bunch of potentially very dangers atypical skin cells)
So what the pathologist seems to be saying is that there are some pieces of the gland that seem to consist of BHP atypical cells. That is what in legal terms may be regarded as an obiter dicta, although it may also be put in to explain the nodule, or even part of the increased in PSA, generated by the larger number of cells associated with BHP.
I don't think, from what you have said previously, that anyone says they have identified atypical cells outside of the portion of your body they removed in surgery. I think that what your report says is that there is a positive margin, which implies a greater probability that the disease may have extended beyond the capsule.
The recommendation for early secondary treatment - EBRT in your case - is based on the theory that early radiation to a disease that is still ocntained within the capsule - and as we've discussed that is what the Stage T3 opinion is saying - will have a greater chance of remission.
The opposite view to that is that although there may be a probability of extra capsular extension, there is also a probability that the disease was in fact contained within the removed material, in which case the application of additional therapy would not be appropriate.
Does that help? If not, ask away, with no fear - and no yelling:-)
