Staples removed & post-operative biopsy clarified

Yesterday I had my first Doctor visit after surgery. The main purpose was to remove the staples, but I also asked him to clarify the post-operative biopsy results.

On 1/27/06, I reported:
Post operative biopsy:

1) No Cancer in Lymph nodes.
2) No Cancer beyond margin (where surgeon cut).
3) There is one area of concern, which means a small chance of finding Cancer in the future.

Points 2 & 3 were clarified yesterday.

The Prostate has a well defined edge, referred to as the capsule. When removed in surgery the cut is outside the capsule, removing a small amount of tissue that surrounds the capsule. This removed tissue outside the capsule is the margin. The margin is very thin of course.

The ongoing concern in my case is based on the fact that one area of cancer cells did extend through the capsule, but did not reach through the margin.

Visualize an orange that looks fine before peeled, but when you peel it (remove the margin) you discover a blemish that is evident on the inside of the peel but not outside the peel. Sounds like a pretty close call to me!

We also learned another point in the post-operative biopsy. The earlier biopsy returned a Gleason’s Grade of 6 (out of 10), but the post-operative biopsy returned a Gleason’s Grade of 7.

Given this new understanding, my optimistic response is as follows:

1) I’m glad I had this surgery (got rid of that nasty orange).
2) Apparently my cancer was worse than the first biopsy revealed.
3) Apparently my cancer is fully removed, but only time can confirm this.
4) Apparently cancer has not spread to my lymph system (very good news).

Now … this last point is totally my logical speculation. I’m glad I chose my doctor’s conventional slice me open and cut it out technique rather than the newer robot assisted Laparoscopic technique (sometimes called DaVinci). I suspect (and this is my speculation) that the robot assisted method has a thinner margin, which might have left cancer cells not removed in my case.

I’m feeling strong, sleeping well and almost ready to return to work (perhaps next week) with just one large hurdle as far as I know. Monday afternoon I’ll loose the catheter and have to relearn how to function without it.

dws.

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