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Biopsy question????

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Posted 10/10/2006 9:11 PM (GMT 0)
Hello friends,

Well, after a long weekend of waiting, we found out that my husband's biopsy results are being sent out to another facility to be looked at a second time....and it could be up to two weeks before we get the results. My husband asked what this meant and was only told that 1 in 4 get sent out like this, and that the doctor wasn't sure why. He asked to speak with the doctor and was told that he didn't know anything about it. I'm a bit concerned about this! How is it that the doctor would have no idea what was going on?

My husband is quite frustrated with the situation, as am I. I'm wondering if anyone else has dealt with this issue?

I'm off to do research. Seems as though I've found more through research than through the medical professionals! LOL.

Blessings to you all!

Sara

Posted 10/10/2006 10:31 PM (GMT 0)

Sara:

Over the years I had four biopsies and two were sent for second opinions to Jonathon Epstein, M.D., a Johns Hopkins pathologist who specializes in examination of prostate tissue.  On many occasions pathologists who do not specialize in prostate tissue send the slides to people like Epstein for a more authoritative opinion.  I bet that's what's happening in your situation...which is good.  So, be patient.

Posted 10/10/2006 11:04 PM (GMT 0)

Sara,

I intended to lurk unregistered until I saw your posting.  I'm in biopsy limbo also and didn't figure to jump in until I knew something.  It's not unusual that a urologist or gp might not be expert in the area of pathology but they should be familiar with the terms/process.  My first biopsy came back with the term "atypical" on the first examination by the pathologist and then another deeper "slice" into the tissue was stained in the lab and they still couldn't decide for sure.  That took two weeks. The sample was then sent to another lab.  Still inconclusive.  That took another week.  I'm sitting here now with the anesthesia effect wearing off from my second biopsy (today).  Finding cancer cells, if there, is worse than finding a needle in a haystack.  It's like sticking a needle in a haystack and hoping you hit an area that will provide definitive diagnosis.  I would guess your dr. could find out if the first pathologist found atypical cells, "PIN" cells, or cells that could be cancerous but not in sufficient quantity or pattern to make a diagnosis.  Hence the second opinion from another pathologist.  Or - hence - hence - a second biopsy down the road.  Anyway, a pathologist or dr. that wants a second opinion is miles ahead of one that isn't positive but makes the call that will change your life. My wife and I started searching the internet and getting books to research this stuff.  Getting good information and seeing what the other folks on this board have been through or done makes being patient a little easier.  Good luck to both of you.

Boo 

Posted 10/11/2006 12:38 AM (GMT 0)

This is a stepping-stone that we did not have to traverse… so I can’t lend any helping hand to this posting….

 

Sara ~ I'm sure your heart rate lowered a little after reading the above postings... knowing that you aren't alone really makes a difference...

 

Sharing is Caring and we are all here for both of you!!!

 

Welcome Boo!!!

Your information will be invaluable to others… Thanks for signing on sooner than later…

You will truly be amazed at the extra support you will receive ~ personally now that you’re here with us.

In new friendship ~ Lee & Buddy

Posted 10/11/2006 12:57 AM (GMT 0)
hello folks, I am very new to this forum stuff but am have also been tossed into the PC ring of friends. It would bother me that my Dr. did know why my cores were sent away for further examination, I assume. Ask, no demand, answers. Read, read, read you have time according to all that I have been reading to fully understand what is going on. I was diagnosed in Aug. scared the wits out of me but since have learned much and one thing for sure is not even the medical profession knows what to do for sure. Sara you and your husband educate yourself on what you will be going through and don't leave a Dr.'s office without answers. Get a notebook and write queations down, as you think of them, to ask the Dr. Do not be affraid to get more than one oppinion, if your Dr. can't or won't give you answers get a new one there are thousands of them. Best of luck to you
Posted 10/11/2006 3:03 AM (GMT 0)
Only the ordering Physician should answer your question Sara. It probably isn't that he didn't know but, more that it isn't his place to answer the question perhaps. A second opinion is a sign of a responsible Pathologist/Physician IMHO. Some samples have such small amounts of irregular cells that one set of eyes just isn't enough.
Posted 10/11/2006 11:48 AM (GMT 0)

Because biopsy readings are so subjective, it's common to request a 2nd opinion.

Often it's done in the case of a grey area to gauge if it's negative or positive. If they're informed, some men request a 2nd opinion on a positive biopsy to help clarify their gleason score, as this will have a bearing on  what treatment they might choose.

I had the same problem with a 10 snip biopsy in 2004: after another opinion, they eventually decided that one  was positive (G6) and one  had high grade PIN.

All 12 samples in my 2006 biopsy were clear.

My PSA has remained fairly stable in the meantime. 

Interpretation of PSA results, biopsy readings and treatment options are not as black and white as some like to imagine.

Posted 10/11/2006 1:34 PM (GMT 0)

Sara,

This is my first reply to this forum and since you have a question which I have had experince in I thought that this was a good time for me to jump in.  I was diagnosed with PC the first part of July.  I decided to seek out a second opinion for treatment options from a university medical center.  At my first appointment with the medical center staff they explained to me that it is their protocol to always have two readings of the slides.  In my case the first reading was done by a firm that my urologist had sent my biopsy core samples.  The results were of the 10 samples one had 40% adenocarinoma.  The medical center that I went to optained the same slides and their pathologist read it as "atypical" which was explained to me as being inconclusive.  The medical center urologist told me that of the hundreds of cases they get a year they will have 4 or 5 that will have this discrepancy between pathological analysis.  I was one of these 4 or 5.  In these cases they always send the slides to Dr. Epstein at John Hopkins for his analysis since he is the expert in the field.  In my case Dr. Epstein confirmed it has being adenocarcinoma so I am scheduled for a Da Vinci on November 1st.  The medical center urologist also told me that out of the 4 or 5 a year they have as being inconclusive that 2 or 3 will come back as atypical and not cancer.  As my urologist said, you do not want to remove a healthy prostate.  Also, my urologist said that in every case that Dr. Epstein has determined the prostate does have cancer that the post surgery pathological results confirmed it.  My only recommendation to you is that if you are uncomfortable with your doctor then seek out a urologist that handles hundreds of cases a year and not a local urologist that my see only 15 to 20 a year. 

Tamu

Posted 3/17/2014 2:49 AM (GMT 0)
Sara,
I had the same experience and it turned out that I had A-typical cells which are cells that are not cancerous but are multiplying or growing incorrectly. Not to scare you but some people call them precancerous cells. Ive also read that you can get a-typical cells from irritation and or age, hope that helps.
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