Does a pathologist know if adenocarci... - Advanced Prostate...

Advanced Prostate Cancer

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Does a pathologist know if adenocarcinoma is neuroendocrine by looking at the initial biopsy or is this something that is discovered later?

Dachshundlove profile image
6 Replies

My initial post said that our path report said neuroendocrine and what it actually said was Adenocarcinoma. Sorry for the confusion you all are beyond wonderful in your efforts to educate those of us who are facing the steep learning curve!

Thank you all!💛

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Dachshundlove profile image
Dachshundlove
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6 Replies
Tall_Allen profile image
Tall_Allen

It can be found in the prostate, but most often it is found in metastases.

GP24 profile image
GP24

Did your doctors discuss this remark in the path report with you? For me this would be alarming because it requires a different treatment than the SOC. A neuroendocrine tumor is treated just as a small cell lung cancer. Or with LU-DOTATATE.

Dachshundlove profile image
Dachshundlove in reply to GP24

It was not noted on his path report. I was curious about neuroendocrine diagnosis. It seems like his psa did not fall as as much as expected with that loading dose of firmagon, but we don’t really have a good baseline either. Thank you for your response and helpful information!

GP24 profile image
GP24 in reply to Dachshundlove

You mentioned: "my husband’s initial path report said “neuroendocrine”", therefore I assumed this was noted in the path report. As Nalakrats wrote, this is very rare for newly diagnosed PCa.

Dachshundlove profile image
Dachshundlove

Thank you for the information. The people here astound me in a good way each and every day

DenDoc profile image
DenDoc

Definitely sounds like a situation that should involve second opinions, particularly for the pathology. Many use Johns Hopkins for pathology. If he is still being treated by a urologist he should see a medical oncologist, preferably a urologic oncologist at an academic center. Expertise is very important in treatment choices for rare presentations like this.

Another consideration is to get tumor genetics studied now rather than later when it will be harder to get a good biopsy unless he has mets that are easily reachable.

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