Another link to Dr. Bonkhoff & Pathogenesis in pathology (some photos within)

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Date Joined Dec 2008
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   Posted 3/12/2011 7:11 AM (GMT -6)   
Thanking fellow forum member An38 for the weblink-I had been looking for this kind of information for us to read and see (THANKS), I posted prior about this artcile written in 2009 by Dr. Bonkhoff and Richard Berges. I saw a presentation on this as a full abstract and it had more content than even the link An38 has, but this is still very good.
I have been trying to stress the importance of pathology on this forum for over 2 years, if you look into this closer you will gather the why it is that important:
Now I contend that the leading oncologists, like the guys I know something about this is why the particular names are here (yeah could easily miss other qualified onco's):
Myers, Strum, Scholz, Lam, Sartor, Leibowitz, Volgelzang, et al  are apparently very good at treating patients with PCa, via experiences and open mindedness...and they are usually doing so without the defined pathology that Bonkhoff's information that would make their job even easier. Kind of making these onco's almost like a fractional version of Kreskin (LOL) for predicting protocols at a given stage for certain patients.
Dr. Strum has decades of patient experiences and literally has read about everything on the subject matter and he has experience even as a pathologist in his career, he  has endorsed Dr. Bonkhoff a decade or so ago to us PCa patients. He also has maintained a list of 'expert' pathologists for us in the PCa community.  I am saying Dr. Strum has laid down the pavement perhaps the best for PCa patient like us to listen, learn and follow better pathways....excellent legacy in PCa historically....sadly he is within retiring from practice.
He also pointed out that the Combidex scanning method...was the biggest breakthrough he saw in his lifetime with PCa  (that's how important that is).  Even Dr. Barenszt in Holland knows about the newer USPIO (Sand Lakes-Florida) scanning method and it maybe be comparable, but the images are not as clear is what I am hearing. But glad that atleast that method is here, it could improve.  Knowledge is power in this, I hope Combidex is revived and it may return as an option and maybe someday get approved here.
(I thank An38 for finding this particular link) cool

Post Edited (zufus) : 3/12/2011 5:35:01 AM (GMT-7)

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Date Joined Jan 2010
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   Posted 3/12/2011 9:27 AM (GMT -6)   
the home link to Dr. Bonkfhoff site is:

- lots of interesting stuff....

- the zufus link just goes to the pdf download file on my macintosh - and not the site itself

Post Edited (tatt2man) : 3/12/2011 12:13:56 PM (GMT-7)

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   Posted 3/12/2011 11:10 AM (GMT -6)   
tatt2man- thanks for more complete link on anything on Bonkhoff and pathology, it confirms what should be held up in medical useage and practice as the real science and biology of PCa. Seems ignored by many which raises my questions.

Your link now is clickable event (I thank you again)

John T
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   Posted 3/12/2011 11:42 AM (GMT -6)   
This is a great list of predictive markers. Why anyoneone would get treatment for advanced or agressive PC with out at least testing some of these markers is beyond me. They have been available for some time and it seems that only a handful of doctors are regularly using them.
65 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, no side affects and psa .1 at 1.5 years.

James C.
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Date Joined Aug 2007
Total Posts : 4463
   Posted 3/12/2011 11:54 AM (GMT -6)   
JohnT, where in the US is this detailed marker testing done?
James C. Age 63
Gonna Make Myself A Better Man
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS6
9/07: Nerve Sparing open RP, Path: pT2c, 110 gms., clear except:
Probable microscopic involvement-left apical margin -GS6
3 Years: PSA's .04 each test until 04/10-.06, 09/10-.09, 12/10-.09, 02/11-.08
ED-total-Bimix 30cc

Veteran Member

Date Joined Jan 2011
Total Posts : 735
   Posted 3/12/2011 12:03 PM (GMT -6)   
I am not sure that Bostwick Labs do ALL those tests, but they have a very comprehensive list of services. See:


Phoenix, Arizona
Surviving prostate cancer since 1992. RP; Orchiectomy;
GS (4 + 2); bilateral seminal vesicle invasion; tumor attached to rectal wall. Last PSA September, 2010: <0.1 ng/ml
Laughter is the best medicine!

Veteran Member

Date Joined Nov 2009
Total Posts : 7270
   Posted 3/12/2011 12:47 PM (GMT -6)   
John and others:
It gets very confusing reading all this -- so many different markers.
Can most of these be ascertained via blood tests or do you need the original pathology samples?
I wonder if they do these readings at places like MSK, Mayo, MD Anderson , Umich, Dana Farber?

Veteran Member

Date Joined Jan 2011
Total Posts : 735
   Posted 3/12/2011 1:19 PM (GMT -6)   
Hi Mel.
Many of the tests are done by blood samples. Others are tissue tests. Yes, I am sure some of those places will do some of the tests. Understand that not all those tests are needed for everybody. Some are used to clarify and provide information about the potential aggressivity of the cancer.


Phoenix, Arizona
Surviving prostate cancer since 1992. RP; Orchiectomy;
GS (4 + 2); bilateral seminal vesicle invasion; tumor attached to rectal wall. Last PSA September, 2010: <0.1 ng/ml
Laughter is the best medicine!

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 3/12/2011 4:53 PM (GMT -6)   
Excellent RalphV- do post things like this that you know about that are significant information that many just have no idea about. I will make your link clickable event now:     (Dr. Bostwick tests
Ralph- can you help me at your website I wanted to post an update on hormone therapy on my case (2006 was the last info), I cannot get logged in..let me know???

Mel- great questions, remember the 24 variant types of PCa that have been identified...well that happened at Univ. of atleast they are aware of the importance of pathology valued information. The best in the USA is Bostwick in my book and he does many tests, including ploidy  (Epstein doesn't do ploidy). I met Bostwick at my local docs seminars he holds...the man is on fire for us and gives a darn..the real deal not faking his passion, especially when in front of us for 1-2 hours and took all our questions. 
Mel- those other hospitals don't do any of those testings, not without read pathology tested for such and then know how to interpret that 'Greek' or have it told to them via the pathologist.  Now do you see why Dr. Strum says:  Bostwick, Oppenheimer, Epstein, and Bonkhoff is considered the best...and master of pathology...Bonkhoff's testings go way beyond Bostwick and he is a great one. I just contacted my patho-doc  Grignon (whom was on Strums list of experts, longer list) I am going to take possession and considering review by Bonkhoff.

Post Edited (zufus) : 3/12/2011 3:05:57 PM (GMT-7)

Elite Member

Date Joined Oct 2008
Total Posts : 25394
   Posted 3/13/2011 2:33 AM (GMT -6)   
Excellent link, worth saving.
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 2/11 1.24
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10,

Veteran Member

Date Joined Mar 2010
Total Posts : 1152
   Posted 3/13/2011 6:41 AM (GMT -6)   
Dr Bonkhoff has responded promptly to my e-mail on what tests I thought Paul should do. He suggested that if things continue the way they are for Paul, then none. Seems like a nice guy.

He gets requests for review from right across the world including the US. I think most of the tests require the biopsy slides or the RP slides of the prostate. The release form is in the link below. It's in English because many of the requests for review are international.

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|Feb10 – 0.03
Lab 2: Nov 10 - 0.01|Dec10 – 0.01|Feb10 – 0.01
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