1st psa after removal

Hi Gary73 ,

I am probably not the right person to answer this but I have noticed that if you get a quick response other people pitch in. 

So, what I did is use Microsoft's Copilot AI to explain the information you had received in layman's terms. 

I'm not going to reproduce the answers here because in terms of trusting the AI output I think everyone needs to make up their own idea. However, I have found that using them to simplify technical output is pretty effective.

There are a number of free AI's that you can use to do the same thing. All you have to do is to copy the text as you have above and ask you to explain them in layman's terms. 

You will get answers you can understand. 

Having done that myself I think it will point you at the questions you need to ask. Remember that this is a search and explain tool, not a medical expert. 

Your question about salvage radiotherapy is a good example. You will find that the translation will expand on what the mention of surgical margins means, and not what to do about it. The consultant needs to answer your questions about it. 

I hope I have helped and not hindered.

Hello Gary (Gary73) 

Not medically trained and still the owner of most of my prostate (various medical people keep helping themselves to bits!!).

The important bit to me is "margin status involved" which I understand they didn't get all the cancer.

I would be asking when are they doing your PSA tests and if they are rising what do they propose to do regarding the cancer remaining.

I hope this helps.

Best wishes - Brian.

Hi Gary73 , also not medically trained but have been on this journey a few years.  My thoughts as follows - the majority of the cancer has been removed but there is a chance that it had already got out.  This isn’t unusual and can be easily treated (generally with RT) to catch the escapees.  There are no guarantees with any cancer treatment that they can be 100% effective and the current thinking is to go hard at the little buggers to remove totally.  Your consultant should be able to give you a plan (or pass you to another consultant) who will attempt to eradicate any remaining cancer and the phrase ‘with curative intent’ should be used.  Please let us know how you get on and feel free to ask any questions.  David

Gary73 said:

margin status involved 

extent - <3mm

gleason grade at margin 3 

involved location- apical, left side intraprostatic 

Hi Gary73 - I’ve got a slight different take on this , so you could ask your consultant if this interpretation is correct:

It would appear to me that there was a small length of the margin (cut line when removing the prostate gland) of less than 3mm that has some Gleason grade 3 cells in it. The location is on the left hand side and the “intraprostatic” means it is has been discovered after the operation to cut out the gland (in the lab after examining the removed gland).  You need to ask about the Gleason grade 3 that has been discovered along the cut line, as this grade of Gleason is not prone to spread. Therefore, it is likely to be information only at this point.  Your post op PSA readings will be monitored to check that there is no spread.  The good news is that this is a microscopic examination of the gland itself in a lab, and they state Grade 3 Gleason. This is very accurate and unlike a scan diagnosis!   Liken it to a very slow growing wart (tiny at less than 3mm) that has tightly packed cells that are very unlikely to break away.  
once you ask your consultant, I would be interested to know if my interpretation is correct.    AW

Thanks a lot for your for your feedback I’m in hospital at 1pm today so I’ll certainly raise your points. 

Gary73 - good luck and let us know how it goes ..   AW

Well all done at the hospital, surgeon said that my psa was undetectable at 0.007 at least I think that was the figure. He was very guarded around the positive margin said he doesn’t foresee a issue and while my psa is undetectable I’m no different to anyone with negative margins and only to worry if it starts to continually rise. He said that it was a 1mm psm and Gleason 6 which is very low risk but with any psm still a risk. Spend a lot more time talking about erectile issues and how we can solve them. Very helpful in that respect. Very relieved today can relax for 3 months till we go again. 
just want to thank everyone for your advice. 

Thanks Gary73 - well, that’s great news!   So, 007 eh?  You need to buy a tux and bow tie !   Anyway, seriously, your consultant has said that he sees you as in a similar situation as a man with negative margins - specifically mentioning Gleason 6 - and I, too, would hope that there will be no further progression from 007!  Indeed, I think you PSA will go even lower as the remainder flushes out of your blood.  That said, 0.007 is “undetectable “ in most labs!  Really pleased for you.  AW