Can Cancer Return After Rp Even If You Had No Positive Margins

I am curious to know if anyone knows of a case where the prostate was removed and the pathology report came back with gleason 6, no positive margins, all cancer confined to prostate, and then after a few years, the PSA started to rise again? 

Yes it is possible, though in early stage disease not oftern.  If the PSA did not go to zero after surgery then some would recommend ADT and irradiation to make sure no local disease remained.  If it went to zero and then started rising then there is some need to try to determine local recurrence versus distal spread since the former is salvageable.  If you see no disease, then based on patient age, health etc.  Some would treat the prostate bed and surrounding tissues anyway.

 

On 10/28/2007 chas036 wrote:

I am curious to know if anyone knows of a case where the prostate was removed and the pathology report came back with gleason 6, no positive margins, all cancer confined to prostate, and then after a few years, the PSA started to rise again? 

The answer to that is it can return.  With this disease "cure" is a word that is used very seldom.  We all to never have to deal with it again but it you can have negative margins and gleason 6 or in my case 7 and have it return for or five years later.  That is why it PSA testing will end up usually being a life long test at least annually after a few years of testing every six months.   Some PCa have returned 14 years leater.  I hope that helps.

 

Anybody that thinks they are 100% cured after treatment is deluded. it can come back at any time. For me, I had a very small spot gleason 8 on the right side, had surger to remove the entire prostate and a lymph node sampling, everything came back from pathology as no spreading at all, no cancer in the sampled lymph, and 100% successful with a rapid drop in PSA to zero. It came back 9 months later. I am fighting it with hormone drugs that are starting to fail now.

Someone in my support troup had a recurrence after 10 years. That was rare but it happened.