Looks like you have contemplated plenty on this and know that it is a best guess gamble just like about
anything in PCa. As for the Gleason scores Dr. Chinn mentioned in latest issue of Paact Newsletters, 'Molecular Pathology'-article that Gleason scores are not your truest measure??? (what???) Two men can have the same Gleason score(s) and one can be much more aggressive than the other....if you learn alot about
pathology you will come to understand why we are not given the righteous pathology information that could be gleaned and only a few experts even know how to do it. We are still in the less than definitive mode in PCa (i.e.- comparatively semi stone-age).
Risk factors in PCa pathology: ploidy DNA analysis types, 24- variant types of PCa (average pathologists would be clueless), specialized staining methods like chromagrainin for over expression of AR(androgen receptor) gene...has prognostics known just by having staining done and studied by the few experts(some people ask for this testing), then other genetic testings that might be offered: P53, BCL-2, HER-1 & 2, Cox-2, CGA, MUC-1, VEGF-R and some others. Then scanning methods which are still evolving, so we end up with making decisions (docs or patients) with less than perfection in the data collected and actually known.
Pathology links that will enlighten us: www.yananow.org/Mentors/BonkhoffStrum.pdf www.nature.com/modpathol/journal/v21/n2s/full/modpathol200811a.html
Paact Newsletters online www.paactusa.org
(newsletters tab, newest issue Dr. Chinn)
Just pointing some things out, I can admit I am just a dumb layperson....I sure as heck question everything in PCa and have found plenty of reasons and not just pathology. Good luck no decision is all that simple and all have risks and variables builtin.
Post Edited (zufus) : 5/18/2011 5:59:13 AM (GMT-6)