Someone on Mayo Clinic Prostate chat group asked about cancer found to the margin on the prostate. I wrote:
A year ago I had a robotic radical prostatectomy. Immediately after, while I was still groggy on narcotics, the surgeon told me he found some “sticky” tissue at the margins and scraped some extra material out beyond the prostate because of that. With current medical records transparency, I saw the pathology report before speaking with the surgeon. It noted Gleason 4+3, level 3/5, with positive margins. There were also numerous sections examined described as “fibroadipose, vascular and muscular tissue” from the medial margin and base, which were free of cancer. And about a dozen lymph nodes were removed, free of cancer.
During my first post op visit, he was able to clarify all this. “Sticky” is his vernacular for tissue that looks and acts like cancer. He saw it was at the edges of the prostate, so he scrapped/cut more tissue away from the pelvic sidewall in those areas. I asked if I’d need hormone therapy or radiation, and he said, “Let’s wait and see what the PSAs show.” Meaning, over time, is there biochemical evidence cancer remained and is growing. So far, a year later, all my PSAs are “undetectable”.
I think this is one area where robotic is clearly superior to open RP. The operative field is visualized in greater detail, magnified if you will, and a conscientious surgeon can see better and do more than with the naked eye, or even loupes over their glasses.
Ask your surgeon if they were aware of the margin spots at the time of the RP, and if so, what they did about it.