Seminal vesicle positive in prostate cancer

Posted , 4 users are following.

So, my fear of being told my contained prostate cancer had been found in the lymph nodes proved unfounded today at my 6 week post RP follow-up. Great. Then I was told my T2a tumour was actually 3b as it affected both seminal vesicles, some vasular invasion, perineural invasion, and one bit of extra-prosatatic disease!

Great. Particularly bad news as I am about continent and feeling better. Age 56.

So, the god news was all margins were negative, and all cancer removed. Except it may not be and today, not expecting this news at all, I find out that if the seminals are involved, there's a much higher chance of recurrence. He said let's wait and see what the PSA does before we even think about RT.

Now, if all has been removed, and it's all negative margins around the whole specimen (indeed both nerves saved), what can the seminals do now they are not there? Does it mean they could well have 'leaked' cancer cells already?

A real blow.

1 like, 5 replies

5 Replies

  • Posted

    I, too, have heard that if there is seminal vesucle invasion that there is a greater chance of reoccurance.  I am not sure why.  I suggest you ask why this is, but I agree with your doctor that you should keep an eye on PSA tests and do not assume that further treatment is in your future.  

    Keep positive and live healthy!

  • Posted

    After the pre-op biopsy did you have any scans?

    Where do you live? Australia? UK?

    in my recent reading in the topic, an indicator of possible recurrence is the  PNI, perinrural invasion quite separate to other matters.

    what was your Gleason?

    • Posted

      I had MRI before the biopsy. It showed one small area on one side. Bit wrong!  Pointless in fact! I live in the UK.  PNI...yes, I'm worried about that too. Nothing's been said to me about it, but I have requested a second visit to follow up my histology, this time with the actual consultant. not the registrar. I hope to get some answers to things I should have been told. Simply saying 'they got it all out' is not enough. They willnearly always say that, yet recurrence happens BECAUSE they have NOT got it all out!  Sure, my margins are clear, but even then, it's not fully safe. And that means horrid treatment etc...

    • Posted

      When they say they " got it all out" the best I infer is that they got all they could see out OR th got the whole prostate and even an extended lymph resection.

      the problem is that if microscopically a spread took place then of course they cannot see that.

      what was your Gleason?

      what PIRADS score did the MRI report mention?

      if a future PSA test shows a rise I think the question you need to ask is WHEN should you begin further treatment? Or do they expect patients to begin ASAP?

    • Posted

      Sorry Barney, I missed your reply!

      Gleason is 3+4, and my first psa came 3 weeks ago as <0.02 which is undetactable...for now!  They got the whole gland and seminal vesicles, all with clear margins, and 31 lymph nodes, all clear. 

      As far as starting any more treatment, I believe I can do any time if I want to, but that as my psa is 'undetactable' (not everyone gets that on removal of the prostate), we should keep a close eye on the psa.

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