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Second & THIRD Opinions on Biopsy Slides (& an Update on My Lupron Dilemma)
I would imagine that most of you have had your biopsy slides sent out for a second opinion; so variances in the results are probably nothing new to you. Still, I decided to go ahead & post my results for two reasons: 1) I want to impress on those who have not done it why it is important. 2) I simply thought that some readers might be interested in looking at the varying results of three different labs.
Notes: 1) Lahey Clinic performed the biopsies. 2) Two years worth of slides were sent to Johns Hopkins, while Bostwick Labs only received those from 2011 (I had only asked for the 2011 slides to be sent to both). 3) Bostwick did not identify the number of cores. 4) Cancer was found only in the Left Mid Lob (LML) & Left Base (LB) at all three labs. 5) All three labs agreed that I am a Gleason 6. 6) While Bostwick found PNI (Perineural Invasion) in the (LB), Lahey Clinic & Johns Hopkins saw no evidence of it.
2011:
Lahey Clinic: (LML): 2 cores/ Both 45% cancerous; (LB): 2 cores/ Both 45% cancerous
J. Hopkins: (LML): 2 cores/ Both 5% cancerous; (LB): 2 cores/ 40 & 10% cancerous
Bostwick Labs: (LML): 20% cancerous; (LB): 20% cancerous with PNI
While the increased number of cores & percentages at Lahey Clinic in 2011 MAY show progression, it is equally possible that they are the result of changes in needle placement from year to year. There is even the possibility that the increases may be the result of different findings by different Pathologists at this same lab. (The second & third opinion results best illustrate this possibility). In reality though, it is probably more accurate to view the core & percentage increases in 2011 as being the result of all three possibilities, but the uncertainty was reason enough for me to stay on AS after getting what, on the surface, seemed like disturbing evidence of progression.
So, the good news is Johns Hopkins has “broken the tie” in favor of no evidence of PNI. My next step & stop is the CDU & biopsy at Dr. Bahn’s Institute in Ventura, CA. Hopefully, he will be able to shed further light on the location & the aggressiveness of the cancer. After that, I will most likely be getting an MRI for the same reason.
BTW, in regards to my plans for a CDU & MRI scan, I found out that my testosterone level is 533 (which, for all intents & purposes, is normal for my age). I discovered that I made an error in remembering the date of my Lupron injection. As of December the 8th, it had been nine months. So, I am glad to report that I seemed to recover quite well. Thanks once again to Bruce, Frank & Terry for individually responding to my call for help on that matter.
Re: Second & THIRD Opinions on Biopsy Slides (& an Update on My Lupron Dilemma)
Alan, I noticed you are going to get a consult with Dr. Bahn in Ventura. Do you live in Ventura Co. I live in Ventura County. I am scheduled to get salvage radiation treatments next Monday at UCLA. If any of my experiences with treatments in our area would be of interest to you let me know. My Email is BZFIRE@aol.
