Here’s the deal: All along, this whole “prostate cancer” thing seemed to me like a gigantic fraud. Well not fraud, but maybe “surreal.” That all changed yesterday.
I felt fine, always did. I wasn’t running to the bathroom two or three times a night. My doctor never felt anything. I have no family history of prostate cancer. It was just a blood test, an imprecise secondary indicator, that suggested a biopsy.
Okay, I believed the biopsy, but still it all seemed abstract.
So I had the surgery. Sure, take it out. I don’t really need it. But I want to know.
This is why I picked surgery over radiation. The radiation therapy is known to be effective, but it’s still all abstract, not real.
Yesterday I went in to have my staples and catheter removed. (Yay!) (Anyone who is facing this procedure and wants to know more about it, I’m happy to share in a private exchange.) Meanwhile my nurse practitioner delivered the pathology report, and I asked her for a printed copy.
I’ll post all of the relevant parts below, followed by a few word interpretations.
Here is the pathology report:
Patient Name: JONES, MORRIS M
Facility: West Los Angeles Medical Center
Provider: STEPHEN GUION WILLIAMS M.D.
Signed Out: 1/21/2010
FINAL PATHOLOGIC DIAGNOSIS
PROSTATE, ROBOT-ASSISTED LAPAROSCOPIOC[sic] PROSTATECTOMY:
1. PROSTATIC ADENOCARCINOMA, GLEASON SCORE 6 (3+3).
2. MAXIMUM TUMOR DIMENSION IS ESTIMATED AT 1 CM.
3. THE TUMOR INVOLVES THE GLAND IN A BILATERAL FASHION AND EXTENDS FROM THE APEX TO THE PROXIMAL PORTION OF THE GLAND.
4. VASCULAR INVASION IS NOT IDENTIFIED.
5. PERINEURAL INVASION IS NOT IDENTIFIED.
6. THE TUMOR IS CONFINED TO THE PROSTATE.
7. THE SEMINAL VESICALS ARE NOT INVOLVED BY TUMOR.
8. SURGICAL MARGINS OF RESECTION ARE FREE OF TUMOR.
9. HIGH GRADE PROSTATIC INTRAEPITHELIAL NEOPLASIA IS PRESENT.
10. THE NON-NEOPLASTIC PROSTATE SHOWS HYPERTROPHIC CHANGES.
11. TNM STAGE: II (PT2C NX MX).
Report Electronically Signed by
STEVEN R. MCLAREN D.O.
Date Signed out: 01/21/10
A microscopic examination is performed.
CLINICAL HISTORY (REQUIRED): Prostate Cancer
The specimen consists of a radial prostatectomy specimen weighing 42 grams. The prostate itself measures 3 x 4.5 x 4 cm. Attached to the specimen is the left seminal fesicle, which measures 3 x 1.5 x 1.2 cm with the contiguous vas deferens measuring 0.7 cm in length and 0.3 cm in diameter. The right seminal vesicle measures 4 x 1.5 x 1 cm with the contiguous right vas deferens measuring 0.6 cm in length and 0.3 in cm in diameter.[sic] The outer surface of the specimen is inked and the gland is serially sectioned. Sectioning of the gland reveals nodular tan-gray cut surfaces.
[Inventory of slices omitted]
[End of meaningful report]
Most of the report is just barely transparent enough to see that it’s good news. This whole report makes it all real for me! There was a 1 cm tumor contained within the gland, no invasion seen outside. And I guess I weigh roughly an ounce and a half less than I did with a prostate. This is why I opted for surgery instead of radiation, the detail and specifics without question or doubt. (Science is real!)
Item 9 is interesting, “High Grade Prostatic Intraepithelial Neoplasia” is also referred to in the industry by its shorthand HGPIN.
I believe this is shorthand for a common cell formation detected under microscope. Neoplasia is literally “new growth.” And intraepithelial means “within the layer of cells that forms the surface or lining of an organ.” It’s an abnormal mass of cells that are known to sometimes morph into cancer.
Finding HGPIN, aside from the tumor, is significant in that it adds to the diagnosis, and provides another data point in the statistical link between HGPIN and a cancerous tumor. Nice for me is that it’s fully contained within the gland, “intraepithelial.”
Following on with item 10, non-neoplastic would then refer to everything that isn’t “new growth,” all the non-tumor parts of the prostate. Hypertrophy is the increase in the volume of an organ or tissue due to the enlargement of its component cells. It’s just evidence that my prostate was getting bigger. That’s what they do.
Item 11 is meaningful too, and puts the cancer into a statistical class. TNM is short for “Tumor, Node, Metastasis.” Stage II says the tumor has not spread outside the prostate. The overall stage is then followed by T, N, and M numbers. T2C means the tumor is found in both lobes. (I suspect the qualifier PT2C means this is a prostate cancer specific designation.) NX and MX mean the lymph node and metastasis stages could not be determined. That makes sense, since the lab is handling a disconnected prostate gland in vitro.
I’m sure that an industry professional might correct some of my interpretation to be more specific, but I think I have the gist of the report.
And I like what I see.