I was monitoring twitter the other day and spotted the following article Perineural Invasion On Prostate Biopsy: Does It Mean that I Have Advanced Prostate Cancer?
In simple terms this describes how the cancer invades the spaces around a nerve and can use these nerves that are inside the prostate as channels to escape the capsule and invade other part of the body.
"Since having PNI on final pathology clearly and negatively affects prognosis its presences should influence the treatment decisions."
As I didn't know I had PNI at biopsy it wasn't detected , it couldn't impact my decision to have surgery. But not detected was just that they didn't hit the sampling area. It makes sense though to assume that I was a higher risk and need to ensure that I keep up the monitoring each year. Based on this article I would fall into a category that could have a recurrence within the next 3 years. ( John Hopkins study ).
Finally this quote sums it up " Perineural invasion (PNI) on biopsy is a very significant and needs to be treated as such, despite Gleason grading and PSA scores. It can indicate high risk prostate cancer, even in men with who otherwise we would consider to be low risk. "
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