Seeking guidance with different Prostate Cancer biopsy results

[Larry954]

My urologist had a local pathology laboratory perform the analysis of my biopsy and it resulted in a 4+3=7. I chose radiation therapy and went to a center of excellence and they performed another assessment of the biopsy which resulted in a 4+5=9. Finally we had Joh Hopkins assess the slides and they were 4+3=7.

Has anyone else faced a similar situation and if you did what did you do to resolve the different assessments? Should I rely on John Hopkins which is arguably recognized as the top in this field?

Many thanks for your feedback!

[Tall_Allen]

No resolution is necessary. Johns Hopkins is the Gold Standard.

[Larry954 in reply to Tall_Allen]

I understand their reputation and recognition is tops. The pathologist at UM Sylvester worked under Epstein for 4 years I believe, while JH has a relatively newer pathologist. That, plus the personal desire to adopt a treatment plan that has the highest likelihood of success leads me to the conundrum.

[Tall_Allen in reply to Larry954]

JH has a team with depth.

[climb4blue]

I had a conflicting pathology too. A second opinion by Epstein at JH downgraded my GG 2 to GG 1. I had PNI and an unexpected doubling time during my due diligence decision making that swayed my decision to choose to treat as GG 2 and with it a more aggressive treatment with SBRT plus ADT (Orgovyx) since I suspected the dominant lesion may have been missed altogether in spite of having an mRI guided transperineal biopsy.

All the best to you in your decision making journey..

[Larry954 in reply to climb4blue]

Thanks for your post

[lpol83712]

I have had 2 biopsies and both had different pathologies at different places. The second one was the one requiring treatment but was only one grade difference so not as critical. I had Gleason 8 at Mayo Rochester and reviewed at Hopkins as 4 plus3. I chose radiation and was treated at UCLA as MRI directed SBRT seemed best. They wanted me to compromise and took ADT 1 year. I’m not sure if artera gives a pathology determination and might help but you could at least give a call. With AI determination it should be ultimately more consistent.

[Larry954 in reply to lpol83712]

Thank you for your input.