Had a consultation with a Uro at City of Hope yesterday, as part of a consultaion, CoH had their pathologist read my slides again. Their report pretty much confirmed the initial report issued by USC with the exception of lower the volume of two cores, added the length of lesions, and added one ASAP.
Right Lateral Base = G6 = 10%
Right Base = G6 = 20%
Left Apex = G6 = 20%
City of Hope
Right Lateral Base = G6 = 5% = 1mm in length
Right Base = G6 = 10% = 2mm in lenght
Left Apex = G6 = 20% = 4mm in lenght
Left Mid = Atypical Small Acinar Proliferation.
I am curious as to how they determined the lenght of the lesions?
Again, I was offered both AS and Surgery. It looks like every hospital has an AS program now. Their requirements are pretty much the same as at UCLA.
They look at stained slides and note the appearance of the cells (Gleason grades) in the lesions. If that particular slide's cells are within normal range, it is not part of the cancerous length. Some pathologists are better at identifying those grades than others. That's why it's a good idea to have the cores read by a pathologist who specializes in reading prostate cancer only. It takes a lot of experience.
It doesn't look like the two readings would make a difference in your treatment options.
Thanks Allen. At this point I think I will not need to send my slides out to either John Hopkins or Bostwicks for another opinion? Supposedly, both USC and City of Hope are quite conservative in their gradings?
It's not a matter of conservative. Sometimes the grading stays the same, sometimes upgraded, sometimes downgraded. But with two reports telling you practically the same thing, and more importantly, pointing to the same treatment options, I could see why you wouldn't need to see yet another one to increase your confidence.