second opinions-

[cards]

Just met doctor who did my biopsy--10 days later this total stranger, after 30 minute conversation wants to remove my prostate. How many people here were in the same boat and felt compelled to get a second opinion? how easy is that to do? I'm guessing you have to contact a different pathology center to read results? thanks

[Roger2Dodger]

It is easy to get a second opinion. That is exactly what I did. You can obtain any copies of your biopsy, just go where it was performed and ask. They have to give you copies of any tests you might have done.

[cards in reply to Roger2Dodger]

I have those,its a detailed description of cells found from biopsy-it is spelled out in black and white--I'm referring to a different pathologist reviewing the sample and possibly INTERPRETING them differently-I'm guessing that he would actually need the samples

[Roger2Dodger in reply to cards]

Cards,

What was your Gleason score? Your PSA reading prior to the biopsy? Did they do a blind biopsy? (A biopsy taken without radiographic guidance ) and your age? The Reason for all the questions would help determine why the Doc wanted to remove your prostate before any detailed info was given to you. I can see why you are upset with the Doc.

A MRI guided biopsy is better to have, this guides the radiologist's instruments to the site of the abnormal growth. and a better understanding of the cancer to determine what treatment is best.

I would definitely get a second opinion. I went as far in my case to have genetic testing at prolaris prolaris.com/prolaris-for-p... With the Prolaris test, you have the ability to learn more about the aggressiveness of your specific prostate cancer tumor. This helps to make a more definitive decision on treatment, or Active Surveillance.

You have time to make decisions, my advice would be take that time and do your research, seconds opinions etc. Don't trust any one except your self. MO!

[cpcohen]

There are two separate questions:

a) Do you need treatment?

b) If so, what treatment would be "best" ?

It's quite possible that a doctor could look at your biopsy results, and decide in 30 seconds (rather than 30 minutes) that you needed treatment. And might feel that a "second opinion" wasn't worth getting, because the results were so clearly "this is a nasty cancer".

It's also possible that the doctor might feel that treatment _might_ be needed -- in which case, getting a second reading of the samples might be warranted.

. . . . What were your biopsy results?

You're right -- a "second opinion" on a biopsy means that you get the samples, and send them somewhere else. [Or that the hospital or doctor sends them -- I haven't been through the process myself.] Pathology isn't completely quantitative, and one man's interpretation of what he sees through the microscope may be different than another's.

The question "What's the best treatment for this cancer, for me?" -- that's more complicated. It'll take some study on your part, and possibly some discussion with one or more doctors.

Every doc tends to be biased in favor of _his_ specialty. Urologists like to remove prostates, radiation oncologists like to burn them out with radiation. Most docs minimize the importance, and likelihood, of side-

. Charles

[cards in reply to cpcohen]

thank you and yes,doctors without question minimize the importance and likelihood of side effects

[ng27868168 in reply to cards]

Cards, well here I go again, sticking my nose into a discussion where perhaps it shouldn't be because I tend to be a little more tough on PC advice. But I'll just say this......, the thinking on how to handle the meaning of PSA numbers and the info gathered by biopsy has changed since I was treated by surgery, radiation and Hormonal treatment for my PC 22 years ago in 1992 at age 52. The one basic fact that has NOT changed is, Prostate Cancer in its aggressive form will result in your death, if not treated, and it is very often a slow painful type of bone cancer. Again, let me make it clear, I am NOT a doctor and certainly not an expert, but having been an active member and facilitator of our local PC Support Group and an American Cancer Society mentor, I have seen men, especially younger men (50s/early 60s) who hesitated doing what was necessary to save their lives. And sadly were told by their Doc several years later that...., "I guess if we had known THEN what we know NOW, we should have been more aggressive in your treatment". There is a HUGE difference between what is called "watchful waiting" and "active surveillance". Once PC is out of the prostate capsule it's a whole new disease. And one basic mistake many of us "diagnosed" men make is to ask for and take the advice of other men who most times know only as much or less than you know instead of listening to the medical experts. Let me just say, there are much worse things in life than losing your erection or incontinence due to being treated successfully. Both of those are treatable IF they occur. Death by PC is not. At 77 years of age, and being able to enjoy these 22 years, I know that for a fact. Good luck.

[Darryl Partner in reply to cpcohen]

And Malecare.org

[Darryl Partner]

Biopsy second opinion info. malecare.org/second-opinion...

[GeoffNoLongerAS]

Multiple opinions are important. In my case I had three separate opinions. I also had my original diagnosis slides read by three additional sources. How you wish to proceed will be very much dependent on your umbers.

Earlier some had had posted a question on your numbers , PSA, change in PSA over time, and very important your biopsy numbers. Your Gleason score, how many samples, number of samples positive, %cancer in each sample. Those numbers should drive how quickly to seek treatment and what your options are.

Some extremes, a friend had a PSA of 1, then the next year it approached 900. He passed away a year later. In my case my PSA has been fairly stable and low, I was diagnosed with low grade PCa and have been on active surveillance for almost 9 years now. And as noted, there is a difference between AS and watchful waiting.

As an aside, my experience was not that positive with fancy biopsies. Early on the "cutting edge" biopsy was color doppler guided. I wet to one of the leaders in the field at the time. He said he felt the color doppler had identified the cancer and sampled in those locations. Did not find anything abnormal. A few years back I had the new at the time T3 MRI. Same result.

Due to a hip replacement I am no longer a candidate for and MRI guided biopsy.

I would suggest you post your numbers, I would think you would get more focused information.

The decision on the treatment path you will follow is as much a personal decision as it is a technical decision. You will receive a lot of advice however there is no best treatment. Only you can decide what is best for you.

[Arjayel]

It’s that fast because they know what they are dealing with. You have choices for treatment and they expect you to evaluate them - surgery or radiation. Post from ng27 is about as sensible as one can get. Yes there will be side effects no matter what you do and it’s a gamble as to how severe. I came through RP (Gleason 7, 61 yrs) with minimal effects. No significant incontinence and returning function but that’s my situation, we are all different. Research your options but get it done while it’s still encapsulated. We have all been there brother, in that shock phase, and you just gotta move forward, do your research to educate yourself, decide and save your life.

[Spitzz]

Get a 2nd and a 3rd opinion.. Have your biopsy read by a different pathologist for confirmation..

Going to be like a feminist "IT's YOUR BODY" get the most information and the best doctors

Good luck