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2nd Opinion Pathology

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sharpcut
sharpcut

Thank You generous members who have posted their stories ! Very Helpful ! 

I received my 2nd opinionon the Pathologist's Report from John Hopkins . Dr Epstein Although I have yet to speak to him It appears my biopsies have been upgraded to some degree from the initial Pathologist's report

Prostatic Adenocarcinoma , Gleason Score . 4+3 = 7 (grade group 3) Discontinuously involving 90% of one core (90% Gleason pattern 4) . Perineural Invasion identified in this case

Prostatic Adenocarcinoma , Gleason Score . 3+4 = 7 (grade group 2) Involving 2 cores (70% . 90%) 

Less than or equal to 5% Gleason Pattern

Prostatic Adenocarcinoma , Gleason Score . 3+4 = 7 (grade group 2) Discontinuously involving 70% of one core (10% Gleason pattern 4) . 

Small Foci Prostatic Adenocarcinoma , Gleason Score . 3+3 = 6 (grade group 1) Discontinuously involving 60% of one core 

Prostatic Adenocarcinoma , Gleason Score . 3+3 = 6 (grade group 1) Involving 20% of 1 core Separate Core with High Grade PIN with Adjacent Small Atypical Glands where it is difficult to determine whether these are adjacent small atypical glands represent outpouchings from adjacent high grade PIN Prostrate Tissue with small Focus of Atypical glands Suspicious for low grade Adenocarcinoma 

Prostatic Adenocarcinoma , Gleason Score . 3+4 = 7 (grade group 2) Involving 10 % 1 core 

Approaching 50% Gleason Pattern 4 

Grade Group Patterns 1 (favorable) to 5 (least favorable)

My PSA is 4.6 up from 4.0 . 4.2 . 2/18

My prostrate Vol 18.9 psad .24 . 8 of 12 cores Positive 

I guess I will make Appointments to see Dr James Easthem . MSK . and/or Dr Ash Tewari . Mt Sinai 

Not knowledgable enough yet but so far leaning towards Image result for Robotic Prostatectomy

Any comments very much appreciated . Thank You . Keith

0 likes, 6 replies

6 Replies

  • RichardKen
    RichardKen sharpcut

    Posted

    Do consider the possible downsides of prostate surgery before making a decision.

    Cheers Richard

    • sharpcut
      sharpcut RichardKen

      Posted

       Yes . Thank You RichardKen  will post after consults
  • Davey22
    Davey22 sharpcut

    Posted

    I had very similar diagnosis. After 3 opinions from specialists, the best treatment was removal. I believe this is your best course of action. Let us know what Dr. Easthem determines as the best solution.
    • sharpcut
      sharpcut Davey22

      Posted

      Thank you . Dave .  Will post after consults
  • n-mac
    n-mac sharpcut

    Posted

    Hi sharpcut,

    I just replied to you on the other thread that you'd started.  Sounds to me as a lay person that based on this new data, you are likely not a good candidate for any sort of focal therapy.  Things appear to be just way too far spread (8 of 12).  Anyway, if it turns out that you see Dr. Coleman, then please tell him that Neil (RALRP on 03/31/17 at Josie Robertson Surgery Center) says "Hi, is doing fine, living large, and sends his best regards".  

    IMO, likely the finest urology surgeon that God ever created!

    Best,

    n-mac.

    • sharpcut
      sharpcut n-mac

      Posted

      Thank you Neil .  I will consider Dr Coleman  Sounds very good !!  No side effects from surgery ?   keith
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