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Biospsy versus pathology

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Prostate Cancer
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Posted 10/22/2015 4:13 PM (GMT 0)
I'm probaby confused.

I read a lot about 2nd opinions on biopsies.

After RALP my Gleason path was Gleason 8. Of course, I wish it was lower.

Is a pathology after surgery easier for a lab to read correctly? In other words, in a 2nd opinion worth having? Have not had a post op PSA, just wondering. Thanks.

Paul
Posted 10/22/2015 4:46 PM (GMT 0)
Paul-

I got a second opinion on my post-op pathology from Epstein. My stats are pretty similar to yours (see below), with the same upgrade from G7 to G8. The reason why I wanted to get a 2nd opinion was to get a verification on the pathology from someone who does nothing but look at PCa all day so I could feel comfortable that we were basing our approach on solid data. As it turns out, Epstein agreed with the upgrade to G8 in the post-op analysis that Kaiser did of my prostate, but he also noted that there was Tertiary grade 5 cells present. Based on this information, we were perhaps a bit more hyper vigilant with regard to post-op uPSA testing, and jumped into Salvage RT when my uPSA reached .07.

Having a 2nd opinion from someone with the credentials of Dr. Epstein made me feel confident in my medical team at Kaiser, and helped to solidify how we approached my PCa post-RALP.

Hope that helps you somewhat.

Cheers,
Rich
Posted 10/22/2015 6:18 PM (GMT 0)
Generally, the pathology grading is pretty accurate because they're looking at the whole gland instead of just small cores. But I think Rich G makes a good point. Sometimes a second pathologist will find things by taking finer slices, but it is pretty rare. At any rate, the grade won't get lower. I think his and your GS8 and pT3a would warrant hypervigilance anyway though.

- Allen
Posted 10/22/2015 10:02 PM (GMT 0)
Thanks Rich and Allen.

Surgeon didn't seem to make a big deal about the Gleason 8 because "the margins were negative." I was better when I knew less about the seriousness of G8. Now I am a little freaked. The one good thing is I will be 69 in Nov. Never planned on making it this far anyway!
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