Final path report back ! Has anyone ever heard this?

 Well, 2 weeks and  we called our M.D. for the final info on Rod's pathology report. He said that they couldn't find any cancer and had sent it back for another review. He called later and told us that the second report showed only some precancerous lesions, the original gleason 6 core specimen was removed at biopsy and that was all they had found. My comedian husband said of the biopsy MD "He must have been a good fisherman". Of course we thank God for this but are so confused also. Surgery was the only decision, and recovery will take time and patience. I just wanted to know if anyone has heard of this happening? Annie

Yes, I have heard of it.  It is called "vanishing cancer."  They see it on the slides from the biopsy, but the can't find it in the speciman.  It happens rarely with cancers.  I have heard of it in prostate and colon cancer.  I spoke to a doctor about this and his opinion is they removed the cancer with the biopsy.  Now be happy that you still had the surgery, because if they found it once it probably would occur again later in another part of your prostate.  This is great news.  You got your cancer as early as anyone ever could.

Since regular prostate cells don't escape the prostate I would think you could never have prostate cancer.  In other words I'm no MD, but I would think that recurrence would not be possible.  I think you are 100% cured.  No questions...

Google "vanishing cancer"  a few studies exist.  The one I read said after 28.5 years there were no recurrences of cancer in any of the 38 patients.....

Post Edited (ChrisR) : 6/12/2008 7:06:14 PM (GMT-6)

Hey Annie,

That's just incredible!  Seems like very good news to me.  What a blessing!

I'm curious, what are the next steps for Rod?  Are they going through the "normal" routine of checking PSA every three months the first year, then on 6 month intervals?

Tony--I was one of those who had only one positive core, <5%.  My biopsy slides were sent for a second opinion (my urologist always does this) to Johns Hopkins University, to be read by Jonathan Epstein, one of the world's leading experts on prostate cancer pathology.  He concurred with the first reading.

This is the same with me, one core at less than 5%. I, too, sometimes wonder

Guys,  I had a consult with Dr. Partin this week at Johns Hopkins.  I have 4 cores out of 56 with what Epstien calls "small focus".  Partin to me this means I have "one cell" of cancer in each spot.  If I had 12 cores taken I probably would have only had one core positive.  Maybe not.  However, base on percentages 1 of 12 is 8%.  4 of 56 is 7%.  So I technically have "insignifigant cancer."  Partin said he thinks it is so early I could wait 5 years to treat.  No way am I doing that.  I want it gone now.  Nobody knows what this cancer is going to do.  If the cancer is as small as he says, secretly I am hoping it is gone with the biopsy.  I doubt it...  Also, even post-op they can't sample the entire gland.  They don't slice 1,000,000 times and look at each slice.  I will be glad it is gone even if they don't find cancer post-op...

Hi Quincy,
I am very sorry to mislead. Your post-op was positive and you did the right thing taking action. I mean to say, ALL positive findings from a biopsy should be rechecked by a second party. And I don't mean re-biopsy, I mean the slides re-checked by another pathology group. Your final pathology was confirmation that you did the right thing.

Selmer, PIN is no longer significant. It used to be used to confirm the need to take nerve bundles, but has since been classified as little importance.

aus, I've seen that report before and that debate is still to be determined for some small G6 and most <=G5 cancers in older men. But again they refer to confirmed cancers. Problem with that report is that it relies on hindsight. If a person has a 3+3 in a single core at clinical, many times it's upgraded to a 3+4 or higher post-op. IMHO then waiting is dangerous.

Chris, I appreciate your spirit. I agree with your approach and feel I have misled you guys. But pre-cancerous is different than cancerous. Before anyone takes a knife to you, have that second is what I'm saying.

I guess I should ease up on this by saying, no one has made a mistake here except the pathologist who states that cancer exists when it did not, and a patient having to go through what we go through when it is likely they did not have to. If a second opinion could be useful, this was the case. But once it is confirmed by a second pathology group, "take is out asap" is still a good decision whether by surgery or other means.
Tony

Hi Sox,

I am very happy to hear you news,  you most likley will never suffer from Prostate Cancer. Yours and our prayers certainly may have been heard.

I am concerned that this may effect others who have insignificant sounding biopsies.  I for one was very close to watchful waiting. Here is my example.

Diagnosis

3+3 = Gleason 6, 1 of 10 needles at only 1%, 1 lobe involved., T1C

Post Surgical

3+4 = Gleason 7, 10% involvement in both lobes, encapsulated, bad margin, T2C

Your case is the exception to the rule it seems.  I am so happy for you but it is unlikely that we will see this again on this site.  I hope you have a special celebration planned.

All the best,

Frank

I do understand the procedure may still have been a benefit for someone like Rod. That's a good thing, too. I think I'm reacting a bit. I am very happy for Rod that he does not have to worry about this anymore. I don't want to be misunderstood. This time, the mistake happened on a high risk patient. Imagine if it happened on someone with no risk factors...

Tony

Hi Chris,
No they can't. And you are very right. This disease is an awful experience, and I certainly Hope we all do well. Given Rods family history he's going to have a lot less to worry about now. Certainly my intentions are in the right place by suggesting we ALL should get second opinions on our biopsy slides. And don't worry about the bad things and count on the good things. I know you will do well. My mantra is Stay Positive!

Tony

I am 42 years old...

Psa 2.4  11/03

Psa 2.57 8/06

Psa 2.75 7/07

PSa 2.75 2/3

4 out of 52 or 56 cores depending on who you ask.

All cores "small focus" or 2% to 5% from original pathologist.

Gleason 6 from Epstien and local pathologist.

I had my slides read at Ohio State University and they said they were in conclusive.  They had to send them to Johns Hopkins.

I was told from Dr. Partin that Gleason 6 was a default score and they don't go any lower then that.

Dr. Partin said "small focus" meant there was one cell in each slide.

I don't know how they can see or find one cell and how they can then grade it.

Anyway, none of this means anything because nobody can predict this cancer with any degree of accuracy.....I am just pissing in the wind with all of this.  I will get it removed and hold my breath every day for as long as I have left until recurrence happens....

Post Edited (ChrisR) : 6/13/2008 2:00:39 PM (GMT-6)

I am 42 years old...

Psa 2.4  11/03

Psa 2.57 8/06

Psa 2.75 7/07

PSa 2.75 2/08 same as 7 months before

4 out of 52 or 56 cores depending on who you ask.

All cores "small focus" or 2% to 5% from original pathologist.

Gleason 6 from Epstien and local pathologist.

I had my slides read at Ohio State University and they said they were in conclusive.  They had to send them to Johns Hopkins.

I was told from Dr. Partin that Gleason 6 was a default score and they don't go any lower then that.

Dr. Partin said "small focus" meant there was one cell in each slide.

I don't know how they can see or find one cell and how they can then grade it.

Anyway, none of this means anything because nobody can predict this cancer with any degree of accuracy.....I am just pissing in the wind with all of this.  I will get it removed and hold my breath every day for as long as I have left until recurrence happens....

Post Edited (ChrisR) : 6/14/2008 7:16:12 PM (GMT-6)

Selmer,

I did have a biopsy because my PSA was high for my age.  My gland size is 36.2cc I was told. 

Thanks for everyones support.  I know there are a lot of people here who would trade places with me and I feel for everyone.  I just seem to be having a hard time lately with this.  I am 42 and like many other we hopefully have a lot of years left to deal with this.  Not to mention none of us want to put our family through this either.

I just feel from reading everyones journey on the site that no matter how "well off" you are the tables can always turn on you.

I guess I am still scared and feel I will be the rest of my life no matter what any Dr. tells me.

Thanks again all.