Why would you even imply that there is some conspiracy theory about
other motivations being done on a removed prostate. That's absurd at the least. I just don't buy into these dark theories. You did say correctly, that the cancer is what it is, both before it is removed, and after it is removed.
The real reason for the change is as simple as already stated, much more to look at post surgery, then the volume in the cores removed during a biopsy. Nothing more, nothing less.
Just not into conspiracy theories. There's no motivation or hidden agenda for the surgery center or hospital to class the post surgery specimen higher or lower than what it is. In some cases, where there is a close call, it is subjective. True type 4 cancer cells are distintly different looking than type 3 cancer cells. And if the patient goes the extra step, and it gets a second pathology opinion, more likely it will be the same.
What is a shame, is when some one is basing a period of AS on a single biopsy pathology report, let's say, it showed a Gleason 6. That patient is always going to be gambling that the last core taken just missed the bulk of an even larger tumor area, and area that might be Gleason 7 or higher. I wouldnt want to chance AS on anything less than a large number of cores, as commonly done in the saturation type biopsies, it would be less likely.
I will use my own case as an example. First biopsy, negative, but quite a bit of HGPIN present. PSA still racing upwards. A year later, second biopsy, negative but even more HGPIN found, as well as some suspicious shadows on the scan portion. Me - I wanted to wait a full nother year to do another biopsy if needed. Uro was deeply concerned about
all the HGPIN and shadows found, talked me into to 3rd biopsy 6 weeks later, roughly. Didnt want to do it, but went along with it. 3rd biopsy - only 7 cores, all in the shadows, left side of prostate, all came back positive with fairly heavly % of cancer.
If I had gambled and had my way after the 2nd biopsy, I can only imagine what would have been found a full year later, with my PSA almost tripling the last year.
David in SC
57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.33rd Biopsy
: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3Open RP:
11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09Path Rpt
: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence: 1 Month ED: Non issue at any point post surgery, no problem post SRT
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one: July
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped 9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4, Caths #11 and #12 same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 31 days, 5/24 put in Cath #17