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Pathology report - bahhhhh :/

Prostate Cancer | Last Active: Aug 25 10:31am | Replies (38)

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Hi Jeff - thanks for giving me some advice for going forward 😟. Do you have any idea of how and where to send the whole gland for examination ? I guess it would be very difficult

Yes - it could be possible that cribriform made it to 5 level, and this also shows that biopsy is not so precise as we would like to think. It is often said that only when gland is out and on the table to be examined as a whole by pathologist the real and whole picture is known.

Pathology report was sent this morning without doctor's comments ( directly from pathology) so we will try to get hold of doctor tomorrow and possibly get some more info and explanation about findings.

My husband is not on any ADT , his initial findings pointed to intermediate unfavorable with no extensions and very small tumor burden. Out of 14 samples only single one had 4+3, and 2 others were 3+3 , all the rest clear. PSMA clear on everything but that one spot on the right side of prostate and he had detailed TRUS in July which also confirmed that all was contained in a gland.

We will ask about possible ADT and ARSI, thanks for telling me about that possibility.

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Replies to "Hi Jeff - thanks for giving me some advice for going forward 😟. Do you have..."

I wish I knew a specific place you could send that. I did do a search on the web with this search “ after a prostatectomy can the tissue and the video of the surgery be sent to a second doctor for analysis”. There was quite a bit of information starting off with this.

Yes, it's generally possible and often recommended to have the tissue from a prostatectomy (and potentially the video of the surgery, though less common) sent to a second doctor for review and analysis. This is especially relevant in cases like prostate cancer, where accurate staging and grading are crucial for determining the best course of treatment.

If you do the search in quotes above, you can find a lot more information. They start off recommended you talk to your doctor About having this done.

I can imagine how frustrating it is to be told they don’t know about the margins. They tell you the tumors are not extending beyond the margins, I sure would like to know why they can’t say the margins are clear. Is there something they are not addressing in the report?

Dr. Epstein does a lot of secondary analysis of biopsies. He may also do analysis of Prostatectomy tissue. You should contact his office, if your doctor can’t give you satisfactory answers. If nothing else, their office can probably refer you.
https://advanceduropathology.com/

Hi @surftohealth88 : I am sorry to hear that the final pathaolgy report upgraded the grade of the cancer but was inconclusive about the stage, though your husband's recent negative PSMA PET scan is somewhat rassrruing (even though we know this tool is not 100% perfect in every scenario).

With repect to second opinion on patholgy, the gold standard is the Epstein Lab of John Hopkins which has done thousands and has established protocols for the transfer of tissue specimens and patholgy slides. You may want to look into that.

I also recommend Parick Walsh's book entitled "Gude to Surving Prostate Cancer" to everyone since it is the most comprehensive, and most undertandable with each chatpter starting with a summary, It has been updated recently. As you well know Dr Walsh of John Hopkins is the father of radical prostatectomy, is a big believer of second opinion on pthology, and Epestein is the pathologists whom he recommends.