Lymph NodesWhen cancer occurs in the prostate, the gland's cells multiply abnormally and may eventually grow through the prostate capsule and invade nearby tissue. It may also spread to the lymph nodes of the pelvis, or it may spread throughout the body via the lymphatic system or the bloodstream. Carefully removing and examining the lymph nodes-pelvic lymph node dissection-has traditionally been the final check to see if cancer has spread. It may be through "open" surgery or via laparoscopy, using a fiberoptic probe inserted through a small incision in the abdomen. When PSA level, tumor grade, and stage are evaluated, doctors may choose to bypass pelvic lymph node dissection. However, such clinical decisions may be revised to take into account new findings after surgery (prostatectomy). Pathologic staging judges tissues removed at prostatectomy. The pathologist looks for cancer in outer areas of the gland and at the surgical margins-the outermost cut edges of the surgical specimen. Second Opinions and Third OpinionsDiagnosis and pathology reports can be in error. Have your biopsy slides read by a second, and perhaps, a third pathologist, preferably at different clinic or hospital. Then, have both or all of your reports reviewed by a second urologist. Then, you will have a significantly increased degree of confidence that you are hearing a prostate cancer diagnosis appropriate for you. |