Post Surgery Question

Hello Annieone 

That's a great question and one really you should be asking the surgeon.  As you are aware surgery is only usually performed when the cancer is contained within the gland.  Before the operation the surgeon will confirm he will try and be "nerve sparing" however once they start they can't guarantee this and they do try and remove the cancer wherever it is to leave clear margins.

I am under The Christie in Manchester and find them to be really helpful being a specialist cancer hospital and I am sure they won't mind you asking.

Best wishes for a speedy and full recovery. Brian.

Hi Brian 

The surgeon came round to speak to my husband after the op but I wasn’t there and I think my husband was still to sleepy to think ti ask? 
Do you know if it’s in the nerve bundle if that is classed as perineural invasion? 
We are not due to see the surgeon until middlen of August. 

thanks 

Hello Annieone 

I am not a medical chap but my understanding of Perineural Invasion in Prostate Cancer is where the cancer spreads around the nerve bundle, so the answer would be yes.

Best wishes - Brian.

Hi Annie 

I suppose one way to look at this is that the nerve bundle may have been removed because the surgeon saw something that he thought suspicious and it would therefore make sense to remove although nothing could be confirmed until a biopsy is done on what the surgeon has removed.

I would , if you can,  be pushing for a result on the post op biopsy, hopefully will be clear.

You are seeing the surgeon in 6 weeks anyway but understandably may not want to wait that long 

Don't forget he did say that he thought looked cancer contained so fingers crossed.

Best wishes 

Steve 

Hi Annieone 

I have found this.

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If the biopsy report mentions perineural invasion…

Perineural invasion means that cancer cells were seen surrounding or growing alongside a nerve fiber within the prostate.

When this is found on a biopsy, it means that there is a higher chance that the cancer has spread outside the prostate. Still, perineural invasion doesn’t mean that the cancer has spread, and other factors, such as the Gleason score and amount of cancer in the cores, are more important.

In some cases, finding perineural invasion may affect your treatment options, so if your report mentions perineural invasion, discuss it with your doctor.

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From my understanding the cancer has spread WITHIN the prostate to touch or surround the ends of the nerve bundles, or grown within the nerve, but hasn't necessarily breached the capsule.

I also found this which explains about the nerve bundles and their role in penile rehabilitation after surgery or radiotherapy.

https://www.pcf.org/c/interview-with-an-expert-rehabilitating-your-penis/#:~:text=On%20either%20side%20of%20the,blood%20vessels%20all%20clustered%20together).

The results from the histology after surgery will tell you whether the cancer had actually travelled along or between the nerves in the bundle.

Good Evening Alwayshope 

Thanks for posting - as usual a very comprehensive answer and I for one am learning all the time.

(however my childhood image of Micky Mouse has been shattered reading the article on "rehabilitating your penis" - I have had a vision!).

Thanks Again - Best wishes - Brian.

Sorry Brian  

Hi Steve

thanks for the reply 

my husband in his sleepy state “thinks” not sure if he dreamt it that he said something about needing to get a negative margin?? 
He also said everything went well but i suppose that could mean he didn’t die on the table lol 

Do you think it’s ok to ask the specialist nurses for the histology before the appt? It’s such  long wait! 

A 

There is this quote:

"You can have a good sex life after surgery."

Had I known that I may have had the surgery some years ago.......

On a more serious note, this seems to be very important to a lot of men and women.

My wife and I have had difficutlies on this particual subject for at least 5 years, and so we have thought about it a lot.

I had already decided, with my wife, that other forms of intimacy were just as important, and that this does not define me.

It definitely doesn't now.

It is a decision I (and we) had come to over time so now, when even the option might be removed, it seems far less important.

Perhaps we men are frightened to think about that kind of loss, as it confirms the aging process.

And on the same subject and a lighter note, there are two older (than me!) men on a park bench watching two rather scantily clad young women wander past.

One says "I wish I were 20 years older".

The other responds "Don't you mean younger?"

The first replies " No. If I were 20 years older it wouldn't bother me nearly as much."

Yes, I would Def.

I have read that if cancer cells anyway near nerves they have to remove them, obviously too risky to leave.

Anyway the main thing is hopefully he's got rid of the cancer cells and he does sound positive.

All the best 

Steve