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Re: Referral suggestions? - Johns Hopkins or in this vicinity
Chris,
You say you have decided on surgery and do not wish to discuss any other options, so I will respect that, despite my personal views on what might be a better option.
I was interested to see your comments on the P504S test - one of which I was unaware until now (you truly do learn something new every day!). One of the studies I found was P504S immunohistochemical detectionand I found it interesting to read that (my emphases}:
In 81 of 377 (21%) foci of benign prostatic tissue there was staining that was almost always focal, faint, and noncircumferential. .......Circumferential luminal to subluminal and diffuse cytoplasmic staining is the most specific staining pattern for prostatic carcinoma and is almost never associated with benign prostatic tissue.
If you had faint staining and it was focal and noncircumferential (whatever that may mean) then the chances seem high that prostate cancer may not be an issue. For this reason I would strongly suggest that you have your biopsy results read by an EXPERT PATHOLOGIST
If you are close to Johns Hopkins it would seem logical to use Jon Epstein and his lab and to consult the expert surgeons there if the pathology second opipnion still shows that surgery is your best option.
Re: Referral suggestions? - Johns Hopkins or in this vicinity
Regarding the Immunohistochemistry results (p504s), as I said, all were faintly positive or greater. Of the 8, three were positive, 3 were focally positive, two were "faint positivity.
Thanks for the update on the A/S suggestion. There are other, fairly sound reasons for recommending surgery vs A/S - prostate size (50cc), frequency of urination, age/health, etc.