Did anyone have their surgery pathology slides reviewed by another clinic?

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AEG
Regular Member


Date Joined Nov 2005
Total Posts : 154
   Posted 8/8/2007 11:52 AM (GMT -7)   
I was wondering if anyone here had their surgery pathology slides reviewed by another clinic?  Do you think it's necessary to get a 2nd opinion?
 
A.
 

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8122
   Posted 8/8/2007 12:16 PM (GMT -7)   
Hi A,

Big Yes.

Nevada Urology did my biopsy. They said I had cancer (3+4, 80% 4 of 8 cores). I had those slides sent to City of Hope. They said I had cancer agreed with original path report. Had surgery at CoH 2/16. Post op pathology was poor 4+3 25% of prostate involved with seminals, Stage III (pT3b). Slides sent to NCI and they confirmed post op path report. Had slides sent to Johns hopkins, they confirmed second pathology also.

I was hoping for a screww up but no luck.

Tony

AEG
Regular Member


Date Joined Nov 2005
Total Posts : 154
   Posted 8/8/2007 12:45 PM (GMT -7)   
Hi Tony,

Thats very interesting.
 
Did you have your "surgery" pathology slides re-checked by another clinic as well?
 
All the best to you,
 
A.
 
 
 

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8122
   Posted 8/8/2007 12:54 PM (GMT -7)   
Yes,
The post op slides from CoH are the ones I was referring to for the review by NCI and Johns Hopkins, not the pre-ops. I am not sure if the prostate was sent to those facilities but for sure the post op slides were. I am under the care of NCI with one of the nations leading prostate oncologists. Dr. V worked with Scardino, Epstein many times in the past on prostate studies and books. He requested that Epstein at JH also review the slides. I am considering a visit to Myers, but I may just want to have the slides and completed treatments sent to him. I am always checking that I am on the right path.

Tony

AEG
Regular Member


Date Joined Nov 2005
Total Posts : 154
   Posted 8/8/2007 1:33 PM (GMT -7)   
Hi Tony,

Sorry, I didn't read your prev post correctly.

A.

myman
Veteran Member


Date Joined Feb 2007
Total Posts : 1219
   Posted 8/8/2007 1:53 PM (GMT -7)   
Yes, and both results were the same.  Clean margins. Same Gleason score.
Yet, the pc had metastasized to distant lymph nodes but there weren't enough cells to show (it takes many) up for months.  Crazy, huh?
How many times have we mentioned here the sameness and the differences? Amazing isn't it?
 
Susan
Husband Diagnosed 11/17/05 Age: 63 No Symptoms
PSA: 7.96, Positive DRE
Biopsy Right: 6 of 6 Cores Positive Biopsy Left: 1 of 6 Cores Positive
Gleason: 4+3 = 7 Stage: T2B N0 MX
3 mo. PSA Post Surgery: 11.8, 12.9, 13.9 Bone scan, CT scan, Endorectal MRI, Chest XR - neg.
9/06/06: 6 mo. PSA: 18.8 Distant lymph node involvement Start HT Lupron 3 mo. shots
12/06/06: PSA 0.8
03/07/07: PSA 0.3
06/06/07: PSA 0.1


David123
New Member


Date Joined Aug 2007
Total Posts : 9
   Posted 8/8/2007 4:47 PM (GMT -7)   
Yes, I did, the first lab said Gleason 4+4 and I had it read by Hopkins and they said 3+4. Big difference.

AEG
Regular Member


Date Joined Nov 2005
Total Posts : 154
   Posted 8/8/2007 4:55 PM (GMT -7)   
Hi David,

Great to see you on the board, welcome!

Wow, that is a big difference. I should probably have my husband's checked by another facility.

Regards,

A.

AEG
Regular Member


Date Joined Nov 2005
Total Posts : 154
   Posted 8/8/2007 4:58 PM (GMT -7)   
Hi Susan,,

Are you saying that both results indicated that the margins were clear but the PC had metastasized to the lymph nodes? I didn't even know that was possible.

A.

StrictlyInc
Regular Member


Date Joined Dec 2006
Total Posts : 353
   Posted 8/8/2007 5:04 PM (GMT -7)   
I never thought of having surgery slides sent for a second opinion. I guess that is something that should be considered even if the first opinion says that margins were clear.

The thought of sending them for a second opinion and having it come back that the margins were not clear is scary.

The thought of finding out that even though the margins were clear there was metastasizing to the lymph nodes is even more scary.

(I didn't even know there were surgery slides, per se..., just biopsy slides - which I did get multiple opinions on)
____________________

Prostate cancer diagnosed: May 15, 2006 (age 40)
Gleason score: pre-surgery 3+3=6; post-surgery 3+4=7
daVinci radical prostatectomy: July 25, 2006
size of tumor: approx 1.1 inches; negative margins from surgery

- number of pads/day at 3 months after surgery: 3 to 5
- number of pads/day at 4 months after surgery: 1 to 2
- number of pads/day at 6-12 months after surgery: 0 to 1

- 1st post-surgery PSA: 0 (Nov 2006); 2nd post-surgery PSA: 0 (Feb 2007)
- 3rd post-surgery PSA: 0 (May 2007); 4th post-surgery PSA: 0 (June 2007)

The search for timber: took Viagra/Cialis approx. every other day, ErecAid once a day, injections. Peyronie's diagnosed 7/5/07. Now on Cialis, L-arginine and pentoxyfylline, ordered to be celibate for 6 weeks.

- PGE1 batting average: .364 (4 for 11)
- Bimix batting average: .200 (2 for 6)
- Trimix batting average: .500 (1 for 2)

"Lost in the valley without my horses, no one can tell me what my remorse is..."


myman
Veteran Member


Date Joined Feb 2007
Total Posts : 1219
   Posted 8/8/2007 5:46 PM (GMT -7)   

AEG - If you read Don's stats you can see his PSA was higher 6 weeks after surgery (LRP) than before.  Two sets of doctors were overseeing his care - we worked in Maine and live in Fl.  Almost every test was done twice with all docs talking with each other (surgeons, radiologists, oncologists) and all coming to the same conclusion.  Cancer had escaped the prostate before surgery.  It did not show in the prostate bed so the next place to look was the lymph nodes - the usual path.  The thinking was by everyone to wait until it showed up...no one was in favor of giving him HT until they knew where the cancer was.  We agreed.  Well, it showed after 6 months in distant lymph nodes.  At that time Don was started on HT.  In fact, all Don's info was sent to Loma Linda a few months ago and they concurred that Lupron shots are the treatment for where he is right now.

Susan


Husband Diagnosed 11/17/05 Age: 63 No Symptoms
PSA: 7.96, Positive DRE
Biopsy Right: 6 of 6 Cores Positive Biopsy Left: 1 of 6 Cores Positive
Gleason: 4+3 = 7 Stage: T2B N0 MX
3 mo. PSA Post Surgery: 11.8, 12.9, 13.9 Bone scan, CT scan, Endorectal MRI, Chest XR - neg.
9/06/06: 6 mo. PSA: 18.8 Distant lymph node involvement Start HT Lupron 3 mo. shots
12/06/06: PSA 0.8
03/07/07: PSA 0.3
06/06/07: PSA 0.1


KenW
Regular Member


Date Joined Mar 2007
Total Posts : 74
   Posted 8/26/2007 1:06 PM (GMT -7)   
My first Gleason score was 4+3. Sent slides to Stanford for 2nd opinion. Came back as 3+4 which is much less aggressive.

Diagnosed with a Gleason 4X3. Second opinion at Stanford came back as 3X4, 1 out of 7 samples, Left Side. DRE showed Normal. Before Biopsy Psa gradually crept to 10. Dropped to 6.4 with Alt. suppliments.
Proton Beam Therapy at Loma Linda 11-06. 1st PSA 4 Months 3.4, PSA at 8 Mo. 1.7. - 1 Yr. PSA 1.8 ( Different Lab ) 4 th PSA Slightly up at 2.19- Free PSA at .33 probably due to BPH.

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