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Re: How common is a post-operative Gleason upgrade from 6 to 8 (almost 9)

Jack,
I certainly agree with the prior posting. And my strong suspicion is that the urologist who took the biopsy samples missed finding the most dangerous areas of the cancer. As I recall the biopsy sampling is done while the urologist has a view of the prostate via an ultrasound image. That gives him information as to where to sample. And clearly a well experienced urologist would know how to understand what he sees in the image, and take samples accordingly.

After surgery the pathologists get to examine the prostate in its entirety, so they will give the fullest, most accurate picture of what's there.

Of course the pathology lab could be mistaken, but I find that less likely given the huge difference in grading. I'd sure go back to the original urologist (who did the sampling) and discuss with him what has transpired.

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