I'm curious -
Over the past couple of weeks I have talked with four guys I know who, like me, were biopsied elsewhere before electing M. D. Anderson
Cancer Center in Houston for treatment. It may just be a coincidence, but every one of us exerienced the same thing - our
Gleason score was higher at
MDA than our initial
Gleason score on biopsy [3 + 3 became 3 + 4; 3 + 4 became 4 + 3; that sort of thing.] Exact same slides, just different pathologist.
I know that I can send my slides to a third pathologist for another opinion [actually, in my case, a fourth opinion: I had a 3 + 3 on biopsy, a 3 + 3 when a second
urologist had the slides re-examined, but then a 4 + 3 at
MDA].
Given the very subjective nature of
Gleason grading, I'm wondering if
MDA just happens to have a pathology department that has a tendency to see 4's where others see 3's and so forth.
There might even be an institutional incentive to do so - MDA's survival statistics will look better over time if their reported
Gleason scores before treatment are higher.
MDA has a world-class reputation, and I am not arguing here that it doesn't deserve it. And in the final analysis, the
cancer is (hopefully "was") what it is, whatever the numbers put on it by a pathologist. But I can't help but wonder if anyone else has experienced the same thing at
MDA that my friends and I have - or have any other thoughts on the subject?
Thanks in advance.
Zen9
Post Edited (Zen9) : 11/16/2009 4:52:26 PM (GMT-7)