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2 pathologist are disagreeing about my biopsy.

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2 pathologist are disagreeing about my biopsy.  
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Posted 4/25/2008 1:39 PM (GMT -6)
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 1:55 PM (GMT -6)
Chris,
Do you know what your gleason score was with your biopsy?
Age 51 Kent
January 08 PSA 5.2 round of antibiotics went to 4.3
February 08 anpther round of antibiotics went to 4.2
March 17,08 had biopsy, 2 days later told cancer was on
one entire side of prostate.
Gleason 3+3
Doctor thinks its best to get the whole prostate with Perineal  Prostatectomy.
Surgery scheduled for this Thursday April 10th.
Cindy (the wife!!)
Surgery preformed and doing great. Only took 1 1/2 hours. Will know in two weeks about pathology report. Surgeon feels he he got all cancer and confined to prostate. Both nerves were spared.
Home 4-11 - incision looks completley healed on the outside by 4-25
Cath out 4-22 dripping some
Cancer confined to one side of prostate.
Cialis 5 mg at night to start
Outlook very positive!!

Posted 4/25/2008 1:56 PM (GMT -6)
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 2:26 PM (GMT -6)
Chris, with a PSA under 3, what caused you to have the biopsy in the first place?  Did the DRE show something?
Danman Bob
Age 57
Nerve-sparing, open prostate surgery November 13, 2007
Gleason score 9, PSA 14
Biopsy result - 9 of 12 sticks showed cancer
Despite high Gleason score, cancer was confined to the prostate
Possible post-surgery radiation therapy...decision likely in late April 2008, depending upon PSA at that time
Unrelated surgery January 2008 delayed incontinence recovery, which is now showing good signs of improvement (fraction of a pad a day as of March 2008)
Began using Viagra 3 times a week December 2007 to stimulate blood flow
Began using Osbon Erec-Aid Esteem manual pump for therapy mid-February 2008
Will probably begin using bimix injections in addition to Viagra and pump in May 2008

Posted 4/25/2008 2:28 PM (GMT -6)
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 2:42 PM (GMT -6)
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
Age 51 Kent
January 08 PSA 5.2 round of antibiotics went to 4.3
February 08 anpther round of antibiotics went to 4.2
March 17,08 had biopsy, 2 days later told cancer was on
one entire side of prostate.
Gleason 3+3
Doctor thinks its best to get the whole prostate with Perineal  Prostatectomy.
Surgery scheduled for this Thursday April 10th.
Cindy (the wife!!)
Surgery preformed and doing great. Only took 1 1/2 hours. Will know in two weeks about pathology report. Surgeon feels he he got all cancer and confined to prostate. Both nerves were spared.
Home 4-11 - incision looks completley healed on the outside by 4-25
Cath out 4-22 dripping some
Cancer confined to one side of prostate.
Cialis 5 mg at night to start
Outlook very positive!!

Posted 4/25/2008 4:23 PM (GMT -6)
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

Creed_three (Lana & CJ)
 
Husband CJ aged 50 yrs (49 years at diagnosis and surgery)
PSA (2002) 2.1.  PSA (2006) 3.5.  1 x (5%) core of 12 positive at biopsy. 11 cores negative. Open Radical Prostatectomy with nerve sparing, on 17th April 2007 (Sydney, Australia).
Gleeson 3 + 4 = 7.  Cancer confined. 1st PSA 0.01 (June 07) 2nd PSA 0.02 (Oct 07) undetectable. 3rd PSA 0.02 (April 08) undetectable.

Post Edited (creed_three) : 4/26/2008 12:11:10 AM (GMT-6)

Posted 4/25/2008 9:38 PM (GMT -6)

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

Diagnosed 7/6/06, 1 of 10 core samples, 40%,Stage T1c, Gleason 3+3
Da Vinci on 11/01/06, Catheter out on 11/13/06
56 Years Old
Post Op Path, Gleason 3+3, Approx. 5% of prostate involved
Prostate Confined, margins clear
Undetectable PSA on 12/18/06, 6/25/07, 1/8/08
No more pads as of 1/13/07
Began injections in April '07
 

Posted 4/25/2008 9:45 PM (GMT -6)
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.

Age 59  PSA quadrupled in 1 yr (0.6 to 2.5) 
DRE neg  1 of 12 biopsies pos (5%) 
Open surgery June 2006 
Cancer confined to prostate (1 pea-sized area) 
T2a  Gleason 5 (3+2)  PSA < 0.1  

Posted 4/26/2008 12:04 AM (GMT -6)

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.

Age: 50 (March 2008)

DX 1/08 @ 49 yo

7/05: PSA 2.6 DRE Normal

9/07: PSA 3.4 DRE Normal

1/08: Biopsy 1 of 12 cores with 10% involvement, T1c, Gleason 3+3=6

4/08/08:  Da Vinci Rad. prostectomy @ Banner Thunderbird, 5 hrs.

                Advised both nerve bundles spared

                Post Op Pathology Report: Tumor confined w/in prostate, pT2c, NX, DX 

    Gleason is 3+3=6, bilateral with 15% total involvement near apex

                Margins and Seminal Vesicles negative!!!

4/18/08:  Staples and Catheter removed. Drip, drip, drip, drip...

Posted 4/26/2008 11:13 PM (GMT -6)
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!
 

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