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I recently had DaVinci surgery and the biopsy report was positive in every way but one. Everything was contained in the prostate and all eleven lymph nodes were clear. There is a line in the biopsy report which states "suspicious for angiolymphatic invasion". My surgeon only mentioned how positive the report was and I discovered the line later when I read it for myself. Since the lymph nodes were all clear I don't understand why there is suspicion of angiolymphatic invasion. Can anyone explain what it means?
Angiolymphatic invasion means that cancer was found in the blood vessels and lymph vessels. In your case the surgeon was suspicious that this might be so, but not sure. I suggest you ask why.
As you didn't have any positive lymph nodes, we can hope that the cancer may not have spread beyond the prostate. There is no way to know for certain. The lymph vessels in the groin are connected to the body's entire lymphatic system.
There is never a guarantee that cancer has not left the prostate even when the margins appear clear and the nodes are negative. When the surgeon is not sure he/she "got it all", they like to recommend a systemic treatment which reaches every part of the body. You may find ADT is recommended, if your PSA begins to rise.
Ed.
I want to thank you for your prompt reply to my question about angiolymphatic invasion. It was concise and instructive, although it was not the reply I was hoping for. I wanted to hear that "suspicious" was a term labs used to cover themselves if prostate cancer returns.
Well I can offer a few words that may be encouraging. I dealt with my prostate cancer issue back in 2007. With surgery and then adjuvant radiation. About 2 years thereafter, during a checkup, I had a good exchange with my radiation oncologist, an experienced but younger person. I cannot recall what prompted this commentary, but my oncologist indicated that getting out of the prostate was the initial barrier to metastasis, but that current theory also leaned towards believing that cancer cells in the lymph or blood systems also had additional barriers to overcome before establishing themselves in other locations. We didn't look into any detail about the nature of those barriers, but the idea rang true to me. In short, getting out of the prostate does not suffice to create viability in other locations.
