CancerCompass message board discussion started by MyMi00004 on 3/5/2008 http://www.cancercompass.com/message-board/message/all,21678,0.htm Thu, 04 Dec 2008 00:00:00 GMT Thu, 04 Dec 2008 00:00:00 GMT http://backend.userland.com/rss RSS.NET: http://www.rssdotnet.com/ I don't know if waiting until mid May for surgery is a smart thing to do; or would it be in my best interest to have the surgery performed somewhere else sooner?      I am 46, PSA in Nov 07 increased to 2.75 from a 2.49 in Aug 05. I had biopsy in January 08. The first pathology report indicated my Gleason score = 8, Stage Ta1. There were 8 cores taken with 1 core positive on one side of the prostate.  I had the same biopsy slides sent to Johns Hopkins for a second reading in February (I just got the results yesterday). They report Gleason of 3+3=6 and 3+4=7 which appears better then the original score of 8, however the second report indicates cancer cells found on both sides.When I was told I had prostate cancer in February, my Urologist stressed that I act on this rather quickly because of the Gleason score of 8 indicating it was an agressive cancer, however caught at a very early stage. He suggested I have surgery by the end of March. Yesterday I went to the Vattikuti Urology Institute at Henry Ford Hospital in Detroit for a second opinion.  Their Veil of Aphrodite Nerve Sparing procedure is highly recommended and I have had many people tell me that Henry Ford is the place to go. The earliest they could schedule surgery was mid May. Although Henry Ford is probably the most experienced and best at preserving the nerves; I left there feeling unsure about the change in urgency.  Does the second Gleason score of 6 & 7 really change my situation that much that delaying surgery isn't that big of an issue? I almost felt they may have been presented this way because mid May is the best they could offer?  Also, is it common to have this difference between two pathology reports of the same biopsy, or should I consider getting a 3rd opinion?               MyMi00004 Wed, 05 Mar 2008 00:00:00 GMT Yes it is common to have difference between two pathology reports, which is why it's important to have slides sent to a well regarded establishment like Johns Hopkins as you have done.With Gleason scores, the primary pattern is the first number (in your case 3) the secondary pattern is the second number (4) The revised Gleason score does change your situation: while there was some 4 there as a secondary figure,  the primary pattern of 3 is not regarded as high risk cancer. The specialist would have considered your overall diagnosis and figures, including the % of cancer found in each core.Choice of a top doctor is the most important consideration for the best prognosis possible.I would do everything possible and if necessary travel or wait within reason to have the best surgeon available as he will provide  best chance of fewer side issues, and have a huge difference to both short and long term outcome.  Johnw100 Wed, 05 Mar 2008 00:00:00 GMT alos make sure that surgery is the best option... so many men like my dad had the surgery and then it spread becuase they CAN NOT gaurantee that they GOT IT ALL. now it in his bones!!  some say and actually most top doctors say not to do the surgery!  USC has one of the best prostate cancer doctors there! Smpal Thu, 06 Mar 2008 00:00:00 GMT My husband is also 46 and had a Gleason 3+3. We had to wait 5 months for the best surgeon (Dr. Lee at University of Pennsylvania) to perform DaVinci and Dr. Lee was very reassuring about the slow growth of this cancer. He felt very confident that my husband would be OK waiting and that in fact the cancer was unlikely to grow much at all even within a one year period. Now of course we still felt nervous but the fact that younger men like you and my husband are increasingly being diagnosed is testament to the fact that it's likely that many men walk around with PC until their first PSA test at 50 or 55. Anyway, I am probably not articulating this very well but he had really good surgical outcome. Both nerves spared. The best news--post surgery his pathology report was exactly as it was before surgery, no additional growth or spread and so we were very relieved that there were no mistakes in the original reading and also that waiting 5 months was not an issue. Bottom line, a really good surgeon will give you the best advice and if surgery is required sooner than May, he or she will tell you so. If they have given you a few months to wait, I suggest you take the time to do what we did. Put PC out of your mind for a bit (I know it's hard but try). If you're married or have a significant other, splurge on a romantic trip and enjoy a break from it all. It really helps. Best of luck. It will work out. mediamom Thu, 06 Mar 2008 00:00:00 GMT I just read your post and noticed that you sought and obtained a second opinion on the slides from John Hopkins.  I  posted a message on biopsy second opinions (above) asking how you go about getting one.  Did you have to make contact with John Hopkins or did your Urologist do it for you?  I wish you the very best with your treatment. danbFla Tue, 11 Mar 2008 00:00:00 GMT Since you have time, read the following book by Bob Marckini:"You Can Beat Prostate Cancer, and You Don't Need Surgery To Do It"It's found at most bookstores or go to www.protonbob.com. I'm sure glad I did. Oceanman Thu, 20 Mar 2008 00:00:00 GMT I don't want to scare you but I feel compelled to share my husband's story about waiting.  My husband was diagnosed in June 07 with PC.  We were referred to Ohio State as my husband wanted surgery with the DaVinci method.  Both our family doctor and his urologist recommended this procedure and doctor.  My husband was 57 when he was diagnosed with a Gleason score of 8 (4+4),  cancer on right side only.  Surgery was scheduled for November - the same reason we had to wait as for you - that's the quickest he could get on the surgery schedule.  His Dr. at Ohio State said it would be no problem, we had a year to decide what to do.  Must admit, it scared us to wait.  He had is surgery on November 7, 2007.  His first PSA reading the end of January was 18, yes 18, not 1.8!  A blood test repeated 2 weeks later and it was 24.  The last reading was 40!  Needless to say we are back at Ohio State with an oncologist now for further treatment.  He is currently on Casodex and starting hormone therapy in April.  He had had a bone scan, CT scan and other tests done in September of 07 and his tumor was a T2, contained in the prostate.  His pathology report came back a T3a, it had escaped in that period of time.  Makes us wonder now if we should have been so passive about the treatment.  Good luck! Lynne52 Fri, 28 Mar 2008 00:00:00 GMT