Connect
Comment receiving replies
@jeffmarc
Thanks for your input and video link
Those are great question
I do know the 10% pattern relates to the 4 on my 3+4 Gleason and the 35-45% refers to involved area which I assume indicates 35-45% of the biospy sample is a 4.
What seems weird is that result states "No tumor in the extraprostatic adipose tissue" but another section states EPE is 23%. Also that the "organ confined" at 74% seems to indicate how probable the cancer is contained which I assume means there"s a 26% chance it's NOT. Throw in the part that states NO Perineural Invasion makes this even more difficult to understand.
I don't really get the sense my Urologist gets too involved with these results and I'm basically here waiting to see if this Prolaris test comes back with anything.
It seems like the world of "intermediate risk" is not very clear and would love to find somebody that could offer an unbiased opinion on this.
Replies to "@jeffmarc Thanks for your input and video link Those are great question I do know the..."
@ireland1964 The higher number indicates percentage of core with cancer (35%, 45%). The 10% pattern indicates the percentage of the total (i.e. 3.5% or 4.5% of core) that was 4. So that puts you as intermediate favorable 3+4 with a low percentage of 4. Since all cancer is on one side you are probably a good candidate for focal therapy such as Nanoknife, Tulsa Pro, Cyro, etc. if you do not want to do active surveillance. Any of the focal therapy will leave you with better quality of life than either RP or RT. Not sure these were mentioned; they do have higher recurrence rates.
It does look like the percentages came from a monogram that estimated chances based on PSA, number of cores, Gleason, age, etc. rather than any finding. Note that they all add up to 100%. So it is saying that with no other information (no PSMA PET, etc. to confirm) that there is only a 3% chance of being more than a EPE. The actual EPE tissue in the biopsy showed no cancer.
Connect
@ireland1964
You might wanna get a second opinion from a pathologist that it has looked at hundreds of thousands of biopsies. I know a bunch of people that have gone to this guy and he is really good. You can call him before you sign up for a second opinion and discuss it, and you can then speak to him for quite a bit of time after to go over what he’s found. He does, however, charge $500 for a biopsy review. He will arrange to have whatever he needs sent to him for the review.
Dr. Jonathan Epstein biopsy
https://advanceduropathology.com