In the biopsy report it was mentioned that there could be perineural invasion. Does this affect the HIFU procedure and nerve sparing?
Pathologists often report “perineural invasion” but this carries no prognostic significance and refers to small nerve fibers within the prostate. A tumor around these nerves is an indicator that there is a malignant cancer in the prostate. Surrounding the nerve bundles is an open space that acts as a free passage for cancer cells to grow. The presence of cancer cells in the “perineural space” is one of the factors used in making the diagnosis of prostate cancer (benign tissue will not get into that space). This does not indicate that the cancer has spread outside of the prostate (lymph nodes) but it does suggest that the cancer has been present for a longer period of time. This would not affect HIFU. These nerves have nothing to do with erectile function so it does not interfere with the nerve sparing technique. The main nerves for erections are outside of the prostate in the neurovascular bundles.
