If I can get this to print, this portion from another forum illustrates what I said on 15th December 2017 about differing assessments
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A Cautionary Tale about Pathology Reports
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Yesterday at 3:36 pm 7 replies Shared with the public
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Sometimes the medical professional with the minority opinion is correct.
In 2012, my psa reaches 6.9, so urologist finally ordered a biopsy. The pasthologist teported Gleason 3+4=7 which, at age 53, would indicate need for immediate treatment. The pathologists report was one page long and included detailed descriptions of his findings.
But like a good patient, I sought a second opinion from the suppossed best pathologist in town. His report simply said 3+3=6, one line., which would make active surveillance an option.
When the first pathologist saw the second pathologists report, he rebutted it with a full two page report of mostly medical jargon I couldn’t understand. My doctor believed the second report because of that pathologist’s reputation. I was more inclined to believe the first simply because the first pathologist provided so much detail.
So we sent the slides to Johns Hopkins (the suppossed know all and be all of PCA) for a tie breaker. Their pathologists report was also one line: 3+3=6. No further detail. Neither the second or third pathologist provided any detail or attempted to rebut the first pathologist, so I still tended to trust him and was inclined to start immediate treatment. But it was two medical professionals against one, so as a layman and against my better judgement, I opted to try active surveillance. We even went vegan.
Well, the first pathologist was correct, and during a year of active surveillance I went to PSA of 8.9, second biopsy done in 2013 by yet another lab came back as 4+3=7, with spread to both lobes. My urologist still wanted to continue a few more months of active surveillance because he had also tried some new genetic test which indicated I was low risk. I fired him that day.
I contacted a specialist in urologic oncology and told him my tale. I had an appointment in a week, a bone scan and MRI a week later, and a month later, radical prostatectomy (my choice). Post surgery path report showed Gleason 3+5=8 with tertiary grade four and extrprostatic extension.
Ten months later, PSA started rising again, so eight weeks salvage radiation got my PSA to undetectable level, but that only lasted for 15 months. Now I am on androgen deprevation therapy for life.
It’s water under the bridge now, but I sometimes have to wonder if Iwould be cancer free now if I had gone with my gut, trusted the first pathologist, and started treatment a year earlier.ec in terms of differences of opinion.