Have you considered sending your pathology to Berlin, for Dr. Helmut Bonkhoff...probably as Dr. Strum mentioned..the world's premier pathology doctor on PCa pathologies. He can not only review your slides, but you could test for these known gene issues of which have some known direct control via some certain known drug therapies or that information can be very useful in the near future with the breakthroughs that are in process and evolving.
Also, Dr. Myers showed a case of a patient with clear biopsies but fPsa at 17%, whom did W.W., 4-5 years later it became visible on color doppler ultrasound of 3 areas found...psa was the same original number too (which was very interesting to note). However the patient still had very good odds of dealing with PCa at that point. Monitoring A.S./W.W. is very important.
My brother is in year 7 now with A.S./W.W. but was diagnosed with indolent PCa, so far unknown clinically how perfectly, his psa stays stable but as Dr. Myers case mentioned..you need to know the biology things and not just a psa number. I support my brothers decision, it is his decision and not influenced by me or others.
(from www.yananow.net via Terry Herbert's comments on Dr. Bonkhoff and testings)
Additionally, other prognostic tests such can be extremely helpful to plan therapy. These tests are done using IHC (immunohistochemistry) and include: AMACR, AZGP1, AR, BCL-2, CGA, COX-2, EGF-R, FAS, HER2/Neu, HSP-27, MIB-1, MUC-1, PAP, PSA, p27, p53, Somatostatin, D2-40. Ploidy analysis can also be done by some of the above pathologists using the tissue blocks. There are extra fees for these services.
For me, the most detailed and comprehensive pathology review is done by Helmut Bonkhoff in Berlin, Germany. Also, I know when pathology material is sent to him that he reviews the material and not an unknown associate using his name.
(I see you are questioning things, and why not)..best to you in your decisions.
Post Edited (zufus) : 3/11/2011 5:11:08 AM (GMT-7)