Prostate Cancer Survivors






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Surgical pathology

We got my husbands surgical pathology and I'd appreciate any feedback.
Prostate Gleason 3+4=7
Margin involved by invasive carcinoma Apical, left.
Perineural invasion present

Pt2c bilateral disease
Lymph nodes clear
Focal high-grade prostatic intra epithelial neoplasia (PIN)

It's all very confusing to us. The surgeon said he may have to undergo radiation depending on his psa tests.

Again, I'd welcome any comments.

Re: Surgical pathology


Here is a link to the American Society that explains all of these terms:

Gleason 3 + 4 is the lowest Gleason Score that would get treatment these days so that suggests fairly non-aggressive cancer.

Positive margins means the prostate had cancer on the surface which probably means that the cancer got out.

"Perineural invasion present" means that even though the cancer is low grade it still has followed the nerves out of the prostate so it probably got out.

Focal high-grade prostatic intra epithelial neoplasia (PIN) This is just pre-cancerous cells found which is to be expected since cancer cells were found.

Yes, follow up radiation may be required if the PSA starts going up past 0.2.

I had a worse outcome and got follow up radiation/hormone treatment at the 0.2 PSA level. Since it is salvage radiation it is a lower dose and seemed to cause me no ill effects but the hot flashes from the hormone treatment caused sleep problems so I was glad when they went away. Still no re-occurrence 6 years later.

Re: Surgical pathology

I appreciate all of your comments and am asking once again. My husband is doing quite well except for the incontinence which has been a challenge. His first PSA after surgery was .11, 3 months later ,12 and his latest was .13. Our Urologist says it looks good. I saw our medical doctor today and he asked about him and I told him these results. He was quite upset and wants us to see the urologist again as he doesn't like the fact that it is rising. He thinks he should have the radiation. It's all so confusing. I don't want him to have unnecessary treatment but surely don't want to be sorry that we didn't do enough. Again, thank you for your help!

Re: Surgical pathology

Strictly a layman's view, but if it were me, I'd want a pelvic scan and if that showed any residual PCa, I'd definitely go for radiation, despite the risks and side effects. Your oncologist's view would be crucial at that point.

OC in England