Ours is a good example of where the second expert opinion went from a diagnosis of ASAP (which basically means that cancer is suspected but cannot be diagnosed) to 3+3.
I believe that decisions should be made on the best data available and the $400 we spent on the expert biopsy review was worth every cent.
Reading those slides is not a black and white deal - it is a bit if a dark art. There are only a handful of people in the world who look at prostate slides day in and day out. They are used to seeing benign cells that look like cancer and vice versa. The sheer number of diseases an average pathologist sees and the variety in the pathology of prostate cancer makes a slide review a very sensible option. We researched our first pathologist - the only paper he had ever written was on liver viruses.
That is why the experts in the field, Walsh, Strum are two easy examples to check on, recommend a biopsy review by an expert.
Husband's age: 52. Sydney Australia.
Family history: Mat. grandfather died of PC at 72. Mat. uncle died of PC at 60. He has hereditary PC.
PSA: Aug07 - 2.5|Feb08 - 1.7|Oct09 - 3.67 (free PSA 27%)|Feb10 - 4.03 (free PSA 31%) |Jun10 - 2.69. DRE normal.
Biopsy 28Apr10: negative for a diagnosis of PC however 3 focal ASAPs “atypical, suspicious but not diagnostic” for PC. Review of biopsy by experienced pathologist, 1/12 core: 10% 3+3 (left transitional), 1/12 core: ASAP (left apex)
Nerve sparing RP, 20Aug10 with Dr Stricker. Post-op path: 3+4 (ISUP 2005). Neg (margins, seminal vesicles, extraprostatic extension). Multifocal, with main involvement in the fibro-muscular zone. T2C.
Post RP PSA,
Lab 1: Sep10 – 0.02|Nov10 – 0.03|Dec10 – 0.03
Lab 2: Nov 10 - 0.01|Dec10 – 0.01
Post Edited (An38) : 2/6/2011 6:20:35 AM (GMT-7)