RE: perineural invasion

[Guest guest]

First I think you have your terms for your

margins mixed up. A positive margin means the margin, or place where they

cut out your prostate, is positive for cancer. That would indicate that

they did not or were not able to remove all of the cancer cells when they

removed the prostate. What you want to see is ALL negative margins which

indicates that most likely all of the cancer is contained inside or around the

organ that they removed and that they did not cut through any cancerous areas

and possibly scattering cancerous cells into the prostate bed.

Assuming you did mix up your terms (the

rest of your message indicates so), I would say your prognosis sounds pretty

good. You didn’t say what your PSA level is now. That would

help indicate some more of your prognosis too. Keep an eye on your PSA

levels closely and if it does start to rise treat it aggressively since you

will only have one last chance to eradicate it.

From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of PAUL S

Sent: Thursday, August 11, 2011

9:29 PM

To: ProstateCancerSupport

Subject:

perineural invasion

I was diagnosed with prostate cancer in Sept of 2010.

My PSA was 7.1 and staged T2C. I talked to 2 surgeons and chose a doctor from

the University of

Chicago who has done

appx. 1500 robotic prostatectomies. My prostate was removed on Oct 1st. My

prognosis was very encouraging as the doctor said the cancer was confined to

the prostate and did not escape the capsule. I had very few side effects other

than a little incontinence and ED. Within 3 months, the leakage was gone and I

could have intercourse. It will be a year in October and I am feeling great

with no residual effects other than getting up appx 3 times a night to urinate.

The post surgery lab report was all positive with a gleason 6 with minor 3+4 in

one lobe. I had cancer in 6 of the 12 samples taken. No negative margins. No

cancer in surrounding lymph nodes. The only thing on the report that bothers me

was the comment; perineural invasion was present. I asked the doctor and he

said that it was not an issue. Any thoughts on this is welcome.

[Guest guest]

As I understand it PNI is not a reliable predictor for recurrence or any other negative prognosis. It identifies a location of some cancer cells within the prostate itself. That is, in the nerve area(s). It is a pathological finding without relevance for treatment. To the surgeon and to you I think it is true that it is not an issue. I was diagnosed with prostate cancer in Sept of 2010. My PSA was 7.1 and staged T2C. I talked to 2 surgeons and chose a doctor from the University of Chicago who has done appx. 1500 robotic prostatectomies. My prostate was removed on Oct 1st. My prognosis was very encouraging as the doctor said the cancer was confined to the prostate and did not escape the capsule. I had very few side effects other than a little incontinence and ED. Within 3 months, the leakage was gone and I could have intercourse. It will be a year in October and I am feeling great with no residual effects other than getting up appx 3 times a night to urinate. The post surgery lab report was all positive with a gleason 6 with minor 3+4 in one lobe. I had cancer in 6 of the 12 samples taken. No negative margins. No cancer in surrounding lymph nodes. The only thing on the report that bothers me was the comment; perineural invasion was present. I asked the doctor and he said that it was not an issue. Any thoughts on this is welcome.