Mets To Lymph Nodes in Pelvic - Need You Input

[Alyse]

My husbands cancer has spread to the lynph nodes in his groin/pelvic area. You can feel a huge mass on the left side. Is back on chemo, but when I asked the doctor if we could remove it he just said no.

Have seen a couple of postings that it looks like some of you have had surgery for this. I would be very gratefull hearing from you about what you have had done and what the results were. I am getting for the first time the feeling that since there has been new growth, he is being blow off since he is Stage IV.

Thank you for your input. Thank you for this site.

Alyse

[Debaroo]

Alyse, I'm sorry about your husbands cancer spreading... is it possible for them to use radiation on the area to help reduce the mass? I must admit that I am not sure of what is possible for these types of mets. I would seek out another opinion if the doctors appear to be slacking off. I know this is difficult, but I would really think that radiation would be able to be done. Take care and keep us posted, you are in my thoughts and prayers. Deb

[Andrea B.]

Alyse,

I am so sorry to hear about your husband's cancer spreading. My mom's cancer spread to lymph nodes in her chest area. I had read other people having surgery and didn't understand why my mom couldn't have it either. We got a second opinion and he explained it clearly to me. Mostly (a few other reasons too) it was because the surgery would postpone her being able to have chemo and radiation. She has completed radiation and it has been very successful. She is halfway through chemo and it is working too. I would seek a second opinion if you are not happy with his doctor's opinion. Also, don't rule out the success of radiation, check into this as well. All my best to you.

[john]

I'm not a doctor, but from a search on pubmed and other places, it seems like pelvic lymph node involvement is rare? Not sure if you want to ask the doctor about this. Like I said I dont know for sure, but I have never heard of it (not that I in anyway know everything about LC)

Have they measured his PSA? Best of luck and I am sorry to hear about the spreading of the cancer. Praying for everyone on the board.

: Diagn Cytopathol. 2002 Aug;27(2):75-9. Related Articles, Links

Prostatic adenocarcinoma metastases mimicking small cell carcinoma on fine-needle aspiration.

Parwani AV, Ali SZ.

The John K. Frost Cytopathology Laboratory, Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland 21287-6417, USA.

Prostate adenocarcinoma (PA) is known to metastasize widely to bone, lung, lymph nodes, and other sites. We have observed a rare, although distinctive, neuroendocrine (NE) cytomorphology of metastatic PA on fine-needle aspiration (FNA) that mimics small cell carcinoma (SCC). From a total of 117 cases, eight cases of metastatic PA diagnosed on FNA showed cytomorphologic features indistinguishable from SCC. All specimens were reviewed, along with immunoperoxidase (IPOX) studies using prostate specific (PSA, PSAP) and NE markers (synaptophysin, chromogranin, etc.). The patients ranged in age from 51-68 (mean age = 63). The PSA levels at the time of FNA ranged from <0.1 to 2,892 ng/ml (normal postprostatectomy <0.2 ng/ml). Sites of FNA included liver (two), soft tissue (five), and lymph node (one). FNA was performed from 11 mo to 6 yr after the initial diagnosis of the primary tumor. All primary PA were of high Gleason grade ranging from 7-9. None of the primary PA showed neuroendocrine morphology. Cytomorphologic characteristics observed on FNA included predominantly single cells with occasional sheets or loose cell aggregates. A predominant NE nuclear morphology was evident (i.e., hyperchromasia, fine dusty chromatin, inconspicuous nucleoli, nuclear molding, chromatinic crush artifact, karyorrhexis, mitoses, etc.), with none of the tumors displaying glandular formation. Taken together, these features gave these metastases a cytomorphology indistinguishable from SCC. IPOX studies revealed PSA-positivity (5/7), PSAP-positivity (4/7), and only focal NE markers positivity (3/6). Metastatic prostate carcinoma may rarely mimic a SCC (6.8% in this study). This often necessitates further patient workup to identify the primary source for the patient's metastasis, particularly if the patient has multiple lesions. An accurate diagnosis of these lesions as PA metastases is essential for effective, timely treatment and therapeutic design. Copyright 2002 Wiley-Liss, Inc.