Clinical or Pathological Diagnosis: which to use?

Just wondering something. When I look up stats, it says clinical diagnosis stage, I was diagnosed T2b but was staged T3b after surgery. When I look at info which should I use ?

Gave your thread a title as an aid to those who may have the same questions. -- PeterDisAbelard

Post Edited By Moderator (PeterDisAbelard.) : 9/9/2014 8:11:13 PM (GMT-6)

the stage III one for sure

The clinical path report is only a best guest based on your biopsy and DRE. Biopsies are a shot in the dark somewhat, sampling only a very section of the prostate. The post surgical pathology report is derived from the actual dissection of your prostate into slices and then viewed under a microscope. Additional positive surgical margins are discern by inking the outside of the prostate and then viewing the prostate to see if any cancer is included in the inked area. Also seminal vesicles and lymph nodes can be examined for cancer.

Additional comment, which supports the earlier comments but adds color/understanding…   You said, “ When I look up stats, it says clinical diagnosis stage ,…”   Many, or maybe most (but not all), of the informational artifacts available are for newly diagnosed men, and most provide information about possible treatment options.   So, logically, these stress the importance of knowing and understanding the set of measurements that one would know “from the clinic,” at the time of diagnosis.   The most important thing to know is what your NCCN “risk category” is.   Your risk category is based on a combination of your PSA, biopsy Gleason score, and the clinically assessed stage.   The clinical stage may also be altered based on advanced imaging results.  If the sites you visit are talking about treatment, then of course they are speaking to the clinical staging.   For the subset of men who then proceed to surgery and have their prostate removed, it is sent to a hospital staff pathologist who examines the gland more comprehensively (but still only a sample) than the biopsy samples were able to reveal, and he/she provides the surgeon with a post-surgical Gleason score and staging from a different reference (p) scale.   Any and all post-surgery pathological results should be labeled with a preceding “(p)” to properly designate and differentiate it from the clinical (where the “(c)” is optional, and assumed when absent) assessment.   Imaging findings are not incorporated into pathologic staging.   Not all men proceed to surgery…others follow Active Surveillance, or have radiation, or other “non-radical” (which simply means “removal”) treatment, so they never have a pathological staging result.   For those who do go through surgery, the pathological examination provides the most complete and most comprehensive result, so the previous clinical staging becomes a reference-only data point and, essentially, moot.   Hope this helps clarify. Post Edited (JackH) : 9/11/2014 8:43:55 AM (GMT-6)

Thank you again for clarifications. This disease is so confusing, when I ask my doctor about the cancer, he tells me in a very nice manner that, unfortunately the cancer didn't read the books that he did, so it doesn't play by the same rules. I thank you all for extending the same manner as my doctor in your responses.