Confirmation-biopsy results -- seeking perspectives

1. Biopsies are a bit random so that's not unusual.
2. Yes, that's prostatitis and likely part of the PSA results.

I think you're go to go on the AS.

Andrew

I wouldn't guess that's an issue since it's such a small and low-grade amount of cancer. Most important, if your doctor thinks you're good to go, then rock on. I hope you can do AS forever and if not, for a very long time!

Congratulation...that's fantastic!

I have nothing different to add to the other responses you have already received...just the additional "congratulations!"

Congratulations and to many years on AS.

Fairwind said...
Since your life IS on the line here, you could have those biopsy samples sent to an expert lab like Dr. Epstein at Johns-Hopkins Pathology for a second opinion....

Second opinion/expert reading of slides is always prudent...but you have been diagnosed/confirmed with just about the smallest possible sliver of PC which still must be called officially "cancer." Perhaps more significantly, this is your 5th biopsy. In other words, your life is not really "on the line" or at risk from PC by any reasonable stretch of the imagination...

Post Edited (NKinney) : 4/24/2018 5:23:30 AM (GMT-6)

I agree with the others. You fit perfectly into an AS protocol, based on what is known now.

Once I was into an established program of visits and testing, my children told me "Dad, the only thing you need to know about prostate cancer is when your next appointment is".

Sage advice. I haven't followed it but that is no reason why you shouldn't.

Folks, I can't tell you enough just how much I appreciate all the responses.

It plays so much better in my "head" that I am now "officially" on active surveillance. That limbo period from diagnosis until the confirmation biopsy did have me in a bit of a holding pattern because until the results came through, I felt, in the immediate, there was still a lot up for grabs.

For clarity -- when I was first diagnosed in August 2017, I had my slides sent over to Epstein at Johns Hopkins. His evaluation was exactly the same as the reading I received from MSKCC. With these latest biopsy results -- essentially 1 core of 14 with 2% of G6 -- I'm debating whether I should send the slides over again given the amount of G6 cancer and that this is my sixth (!) biopsy.

To reiterate -- I just want everyone to know how valuable this forum has been to me. From the rational perspectives provided by the insightful experts/authorities to the courageous, frank experiences detailed by the heroic "fighters," this forum has been crucial to keeping my head screwed on straight as I navigate the journey. Thanks!

logoslidat said...
MSKCC is no slouch at reading slides...JohnH and Epstein are not the only game in town...

I'm going to agree. And I stand corrected...this was your 6th, not 5th biopsy...H4H, you have virtually eliminated risk of the blind biopsy; risk of "missing" something significant reduces multiplicatively with each successive biopsy.

Speaking for a minute more about MSKCC's pathology...their department does have multiple teams of disease-specific pathologists. But moreover, as a popular second opinion hospital for all cancers, MSKCC has built up a library of 25 million digitized pathology slides. [Side Note: If you go to MSKCC for diagnosis OR second opinion, they always biopsy you there and never rely on another organization's pathology work for their own diagnosis—this is a medical best-practice (also widely practiced elsewhere, although not universal).] As a result, MSKCC is going to be at the very center of machine learning/artificial intelligence in the pathological space (AI was a topic of another recent HW thread, about a week ago).

There's going to be some interesting "computational pathology" stuff coming out of MSKCC soon as they are staffing-up now. If you are interested in what's happening at MSKCC: LINK

I think this stuff is cool (geek alert!). In the 2nd half of the 1980's and into 1990's I was programming Seiko robots (or managing engineer/programmers) for automated electronics assembly, and machine vision capabilities were changing every year. Everything we built had to have fiducial marks (a term which will resonate with you radiation guys) or other distinguishing, consistent edge feature to align to.

Post Edited (NKinney) : 4/24/2018 11:08:08 AM (GMT-6)