Biopsy report call-- what info to ask

Unless I am mistaken, there will be no report of extra-capsular penetration nor margins, these are items that is obtained after surgery from the after surgical pathology report. about all the biopsy can give you is the number of cores taken, the number containing cancer, the scaling of the Gleason score, with some description of the various types of defective cells observed, a rough estimate of the size of the gland, the ultrasound measurement is really just ballpark. Basically, you will be told that you have or don't have PCa, the GS, the number of cores involved and which lobe the cancer is in, and maybe a directional reference to where in the lobe (ie. upper, midddle, lower). The biopsy is really just a yes/no techinque, with not much in the way of really detailed information resulting from it during the initial exam of the biopsy slides. It is recommended that any biopsy be read by 1 or more outside specialists, and maybe even more specialized exam if the cancerous cells appear really aggressive type, or a really high Gleason scale.

Looks like a good list. A lot of us have learned the benefit of having a pencil and paper handy when talking to a doctor.

Almost all doctors will want to meet with you and discuss the results. (I don't know about your situation with long travel times) so
the call with the results is simply a courtesy to put an end to your wondering rather than to give you a full set of future options. By the way, my uro normally doesn't call unless asked. He says that people hear "cancer" on the phone and then don't hear another thing he says. He thinks that leaving people in that state is more cruel than having them wait a few days to come into the office where he can look them in the eye
and be sure that he is getting through. He actually called me at 7 in the evening because he didn't want to leave a message.

And don't depend on the doctor calling you. Most likely will be a nurse. In fact, many doctors will only talk to you in person.

I would suggest: 

(1) In addition to asking for the Gleason score, also ask whether any tertiary pattern was observed.  As you probbably know, the Gleason score consists of the two most prominent Gleason patterns that were observed.  (Hence the X+Y format).   But  there is sometimes a third (though less prominent) pattern observed, and that can also be relevant.  For example, a 3+3 with no tertiary pattern would be better than, say, a 3+3 with a tertiary Gleason 5. So it is worth asking.

(2) I would also request --- regardless of the Gleason score -- that your doctor arrange for a second opinion on the slides to be done by a pathologist with special expertise in prostate cancer pathology, such as Bostwick Labs or Dr. Epstein at Johns Hopkins.   If your doctor recommends someone else, make sure that lab/person really is an expert.  It is not uncommon for Gleason scores to be changed upon re-reading by such an expert, and because treatment decisions are often made, at least in part, based on Gleason scores, it is important to try to get it right.

Good luck.  I hope all off this turns out to be totally irrelevant to you.

Mel- Simply tell him how soon can I get a copy faxed, emailed, whatever,you want the full report in your blanking hands asap....I told you this prior....it is that blanking important...talk is cheap. Nice to go over it too, but make absolutely sure you get the copy and the docs name whom did the pathology is on it.

Best to you.

David (Purg) very bold and empowered of you to demand pathology copy, I did the same thing unannounced at uro's office, talk about catching them off guard, they probably wondered if you have a lawyer or suit pending  (LOL).  They were surprised and I could since I might have been the first one, to demand it on the spot. Naturally with their waiting room people sitting there, it would not look good to have a scene which I was prepared to give if I did not get a righteous answer from them. Probably uro-doc was thinking, oh---he is shopping elsewhere for treatments as he has the pathology report which for second opinions is a must have item.

 

Keep us posted on your journey Mel

Post Edited (zufus) : 12/5/2009 7:02:45 AM (GMT-7)