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2 pathologist are disagreeing about my biopsy.

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Posted 4/25/2008 11:39 AM (GMT -7)
I had a 50 point biopsy from a Urolgist in Wheeling, WV.  His pathologist said he found cancer on 6 needles.  I had my slides sent for a second opinion to Ohio State Univ. where a guy that studied under John Epstien from Johns Hopkins said he could not diagnose cancer.  He saw atypical cells, but they were not conclusive one way or the other of cancer.  They said it was atrophy which looks similar to cancer.  So my roller coaster begins.  My slides are now on the way to John Epstien at Johns Hopkins for his opinion.  Hope for the best.

Has this happened to other people?

Posted 4/25/2008 11:55 AM (GMT -7)
Chris,
Do you know what your gleason score was with your biopsy?
Posted 4/25/2008 11:56 AM (GMT -7)
Yes.  He said it was a 3+3=6.  2% to 5% involvement.  The doctor at OSU said he would not treat me yet, because they can't confirm there is cancer.

Posted 4/25/2008 12:26 PM (GMT -7)
Chris, with a PSA under 3, what caused you to have the biopsy in the first place?  Did the DRE show something?

Posted 4/25/2008 12:28 PM (GMT -7)
I am 42 years old.  My PSA in one year went from 2.57 to 2.75.  It is very high for my age.  I found an old copy of a phsycial from 11/03 and my PSA was 2.4 then.  I was 38.  It was my choice to do the 50 point from the start.  I thought it was wise.    The people at OSU said my gland size is 35cc and a PSA density of 2.75 was reasonable for that size.  Most people are 20cc.  I don't know what to think.  I guess I wait for Johthan Epstien opinion.  Hope everyone is well...
Posted 4/25/2008 12:42 PM (GMT -7)
Chris,
I commend you for getting a second, third and however many opinions you need to make a good decision for yourself. Kinda wish we had too. My husbands was 3+3 also but his PSA was 4.3. We have talked about it since and I know hindsight is 20/20 but I do wish we had taken alittle more time.
We were so scared, we jumped. Take all the time you need. I think its a very positive approach!
Cindy
Posted 4/25/2008 2:23 PM (GMT -7)
Hi Chris,

I agree with Cindy - take your time in investigating all decisions. This could be exceptionally good news. We actually waited for 5 months before surgery and even though this was long, the reason was that I needed to be absolutely convinced (my husband took the doctor's word, but relied also on me for an opinion). If there had been any doubt of diagnosis, we would have travelled the world to investigate further. Actually we talked about flying to John Hopkins ourselves (and that is a fair distance from here). If you are getting a third opinion from there, I'm sure this is an excellent move. Good luck. Lana
Posted 4/25/2008 7:38 PM (GMT -7)

Chris,

A similar thing happened to me.  My local urologist did the biopsy and sent the samples off to a lab.  Of the 10 samples one came back cancer.  I opted for a second opinion and went to Vanderbilt University.  Their pathologist read the slides and said that the one that the other lab had called cancer he was calling atypical.  My urologist at Vandy knows Dr. Epstein and he always sends any controversial slides to him.  This happens 4 or 5 times a year at Vandy.  My urologist said that everytime Dr. Epstein had called it as cancer the post op path report confirmed it.  In my case he called it as cancer and he was right.  Having the slides read by Dr. Epstein is the best thing for you.

Tamu

Posted 4/25/2008 7:45 PM (GMT -7)
Chris--Jonathan Epstein at JHU is one of the world's experts on prostate cancer pathology.  My biopsy slides were sent there for a 2nd opinion and came back with the same readings from him as the local pathologist.
Posted 4/25/2008 10:04 PM (GMT -7)

For what it is worth, get the second and third opinions, but do it quickly. 

In my case, the post op pathology report stated the cancer "extends out to but not through the prostatic capsule".  I believe if I would have waited very long, it may have penetrated the capsule.

I had only one of twleve biopsy cores show cancer and that one was only 10%.  My PSA was only 3.4.

Good luck and best wishes.

Posted 4/26/2008 9:13 PM (GMT -7)
Hey ~ Chris, As time permits please put together a "Signature" (directions attached to link)... so we can see where you are in your Journey... it's important! A Signature ~ tells the story of our Journey... click here   STAY CLOSE! v        bluebird ~   Moderator for Prostate Cancer Forum
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