Histology (Pathology) Results in Great Result 98% Certain its all gone

After 6 anxious months, sleepless nights, tests, biopsies , major abdominal surgery for prostate removal the news we have been waiting for arrived.

Went and saw Alan Doherty at the Birmingham Prostate Clinic, The Priory. He described the grading of the surgery he does as 1 - 5 with 5 being the best. He put my operation in the context of A Levels - basically the A*. If he could have a * grading , my operation would have been graded 5*. Everything went perfect apart from the blood loss - he has advised me to take iron tablets as I am still anemic . ( Anemia is a condition in which the body does not have enough healthy red blood cells. ). He would also still like me to take some rest in the afternoon - recovery wise I am well ahead of the curve.

The big results though is the histology that has come back from the labs. It totally justifies having had the operation. The cancer was not just on the right side of the prostate but also on the left and it was concentrated also at the Apex. Margins are all clear so he gives this a 98% Cureative factor.

ADENOCARCINOMA, GLEASON 3

+ 3 = 6 PRESENT BILATERALLY;

THE BULK OF THE TUMOUR BEING IN THE RIGHT APEX.

Tumour volume: Approximately 0.7 eu em (about

1.4%).

Apical margin: Negative.

Bladder margin: Negative.

Circumferential margin: Negative.

Perineural invasion: Present.

Vascular/lymphatic invasion: Negative.

Extraprostatic extension: Negative.

Involvement of seminal vesicle(s): Negative.

Premalignant change: Multifocal high-grade prostatic intraepithelial neoplasia.

Other pathology: Nodular hyperplasia, chronic active inflammation.

Pathologic stage (TNM 2010): pT2cNx

Tumour map attached.

Radical Prostatoseminovesiculectomy:

Specimen and organ confined ADENOCARCINOMA,

GLEASON 3 + 3 = 6, pT2cNx. Local excision appears complete.IsabeIle

The above tumour map was given to me by Mr Doherty, it was done by the labs. Basically they carved up the prostate into six slices including the seminal vesicles. The cancer is shown in red. Nice record to have.

PROSTATE:

Radical Prostatectomy specimen weighing 50.9 gms and measuring 37 (Length) x 42 (Width) x 40 (Height) mm, with seminal vesicles up to 21 mm in length. The specimen was cut into six parallel slices and all embedded into seven large blocks.

Mr Doherty wants me to go back in January when I will have a high sensitivity PSA blood test - this is not the same test that is done at the doctors or under the NHS hospitals. The BPC do this test and I will then see him a few days later to go through the results.  I will be tested like this in the future, but its all looking really good.

The only slight concern that I have re this histology report is " Perineural invasion: Present." - looking on the net and on the prostate cancer forums this indicates that the cancer got into the nerve system in the prostate and there may be a chance in the future of a re-occurance of cancer elsewhere in my body as a result. This is a slim chance that would be picked up by regular PSA screening. Its something called PNI. Apparently most doctors ignore it. I dont have to worry about it for now.

Another interesting aspect of this pathology report - I had BPH and had ignored it. All that going to the loo quite often and stinging ... yep I had ignored it - problem with always workign and no time to go to doctors as I was always working away from home ( Other pathology: Nodular hyperplasia, chronic active inflammation. )

One thing this cancer has taught me - I am now going to take a closer look at my health and looking after it.

Now the cancer is  sorted out, the side effects of the oepration have to be sorted. My incontince is being brought under control and he is happy with what I am doing. Things can only get better and the exercise I am doing will help.  My fitness has counted a lot for this, especially the fact that I was doing pelvic exercises before the operation.

The bladder diary that I have kept for the past 5 days shows the improvement.

From an erectile dysfunction point of view he wants me to go on 5mg Cialis per day. This will get the blood flowing and will aid penile recovery. My GP will prescribe these and he will drop him a note.

So, am really chuffed as punch today  - can now see many years ahead.

Told him that I will be climbing Snowdon in December. Must get the fitness going.

Am now signed off from work until near the end of November to recouperate. Will see how I get on by then to judge my return to the hectic work life I had before ther cancer.