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Tomz55
New Member


Date Joined Apr 2011
Total Posts : 6
   Posted 5/9/2011 8:10 AM (GMT -6)   
Two questions:

1. When I receive the biopsy slides, is it possible to examine them (for Gleason score) without a microscope? If not, what microscope is needed to be able to see the cells structure and evaluate Gleason score?

2. How much Gleason 3 and 4 are difference (in the eye)?
I want to know the possibility that the pathologist was wrong...

Thanks in advance!

Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1267
   Posted 5/9/2011 8:27 AM (GMT -6)   
Tomz55

Whether or not a pathologist is right, or wrong, is often a question of opinion as pathology is both an art and a science.

What many people do with their slides is to get a second pathologist to have a look and give an opinion.

As for you, or I, looking at slides, even with a perfect microscope, and having any idea of what the story was, no way! I think we'd have a better chance of landing a 747 on a short runway with a major cross wind after too much to drink and no one to coach us, than know anything about what cells are telling us. The good guys doing this are good men and women because they've studied for many years and done tens of thousands of practice runs trying to get it right.

The problem you and I would have isn't telling the difference between a 3 cell or a 4 cell ---- it would be trying to figure out what was a cell and not a cell in the first place.

At least that's my thinking .....

I suggest you have a second pathologist look at the slides.

Sheldon AKA Sleepless

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4157
   Posted 5/9/2011 8:27 AM (GMT -6)   
Hi Tomz:
 
Determination of Gleason score in your pathology slides takes real expertise.  If you are concerned about the accuracy from the original reading, I suggest you have them sent to one of the acknowledged experts in the field.  Two of the best are Dr. Eptein at Johns Hopkins and Dr. Bostwick at Bostwick labs.  You can go to their web sites for info on submitting slides for second opinions.
 
Tudpock (Jim)
Age 62 (64 now), G 3 + 4 = 7, T1C, PSA 4.2, 2/16 cancerous, 27cc. Brachytherapy 12/9/08. 73 Iodine-125 seeds. Procedure went great, catheter out before I went home, only minor discomfort. Everything continues to function normally as of 12/8/10. PSA: 6 mo 1.4, 1 yr. 1.0, 2 yr. .8. My docs are "delighted"! My journey:
http://www.healingwell.com/community/default.aspx?f=35&m=1305643&g=1305643#m1305643

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 5/9/2011 9:10 AM (GMT -6)   
I suppose there is also the question of anyone actually getting thier hands on the actul slides. Seems there would be issues with that, including how to store them and keep them safe from deteriation from humidity, temp changes, light exposure, etc. The odds a layman could read them to stage the Gleason is slim and none. There's often differences in grading among expert pathologists.
James C., Age 64, Kingsport, E. TN
Gonna Make Myself A Better Man tinyurl.com/28e8qcg
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

Herophilus
Veteran Member


Date Joined Sep 2009
Total Posts : 663
   Posted 5/9/2011 9:27 AM (GMT -6)   

Tom,

I like your style !

Hero


Age 51 PSA 6.8
Bxy 10 of 12 Cores positive for Gleason 6. up to 75%
Robotic surg 11-02-09
Post op path. 20% neoplasm;4+3=7 Gleason
All nodes (14) and other related tissue negative for cancer
No EPE
Post op PSA x 3, all <0.01
walkbobwithjack.blogspot.com

GTOdave
Regular Member


Date Joined Oct 2010
Total Posts : 175
   Posted 5/9/2011 9:35 AM (GMT -6)   
Later today I will perform heart surgery on myself. I am saving BIG BUCKS!
52 yr old, PSA 3.5, Gleason 6 with 3 of 4 top nodes (0%;1%;10%;1%) cancerous. Bottom 2 floors are clean.
PSA 7/08: 2.2; 7/09: 2.9; 7/10: 4.1; 11/10: 3.5

First post-op PSA <.00! 7 weeks after

DaVinci surgery at Yale 3/4/11. Dr. John Coleberg THE BEST!!!

45 gram gland weight
Gl 3+3
PT2C
margins clear
no metastasis
5% of gland adenocarcinoma

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 5/9/2011 11:16 AM (GMT -6)   
i never heard of a patient examining their own biopsy slide.
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 margin
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, 4/11 3.81
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

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 5/9/2011 12:24 PM (GMT -6)   
Well I have heard of a patient looking at his slides(he looked just like me).
 
(since no reply----removed the info--fun game)

Post Edited (zufus) : 5/10/2011 1:56:06 PM (GMT-6)


Herophilus
Veteran Member


Date Joined Sep 2009
Total Posts : 663
   Posted 5/9/2011 12:55 PM (GMT -6)   

Zufus,  

I am really impressed (astounded)...in a good way;  I might just add that I’m most difficult to impress.

Hero


Age 51 PSA 6.8
Bxy 10 of 12 Cores positive for Gleason 6. up to 75%
Robotic surg 11-02-09
Post op path. 20% neoplasm;4+3=7 Gleason
All nodes (14) and other related tissue negative for cancer
No EPE
Post op PSA x 3, all <0.01
walkbobwithjack.blogspot.com

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 5/9/2011 5:43 PM (GMT -6)   
Thanks HERO -that was a heroic way to say so...... I hope this man gets possession and looks at his slides, then maybe sends them out for review to whom he chooses for 2nd opinion(s). Who knows maybe he has a kid whom might catch the spark of curiosity and passion to help his dad or relative and turn into another doctor or pathologist???
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