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Clinical Gleason downgraded before Surgery

Posts: 797
Joined: Jan 2010

When I meet with Dr. Catalona in Chicago last Tuesday (March 2) for a Consultation (yes surgery was the next day) I was informed that the Pathologist from Northwestern had downgraded my clinical Gleason Grade to a 3+4 from a 4+3 which he told me he rarely sees when they review the biopsy slides… This downgrade is important to me…On Monday I get the actual and final pathology report and we will see who was right….Hope for the best and deal with what is presented…

randy_in_indy's picture
Posts: 495
Joined: Oct 2009

After I had very conflicting results of reading a biopsy...as is true to my form I relentlessly persued the lab that originally graded the biopsy to talk with the actual person that does that grading.... I talked for over an hour with this scientist until I was satisfied with her explination of how two scientists could read the same slides and see very different gradings which happened in my case (well at least in my view) What I ultimately learned was that it is very subjective and there is even some chance that the original biopsy reslut is not exactly the same slides that the next person who looks at them and grades them...or was it they may have viewed the slides at a different plane....under the microscope so hence were not really comparing apples to apples. At any rate...I think I put the most faith in the post op path report that is the real deal...ALL and the TOTAL amount of "your" junk being analyzed hopefully by a competent scientist. Reading and grading tissue samples is not an objective science...its way more subjective and art than you would think at least that is what I gathered from my hour+ talk with one who actually does the grading on those reports.


Posts: 797
Joined: Jan 2010

Yes the post op will say it all...Yes it is funny how subjective a lot of this is...I know the guy who arranged the original reading and it was done very very "conservatively" I was just please that Northwestern who from my understanding is more conservative when assigning Gleason Grades and they came up with a lower reading and they were surprised... I guess I am "grasping at straw" in the final days as I await my results and cath removed and honestly I could have had my results from Northwestern today but choose to have my urologist tell me in person on Monday when he removes my cath...funny what we prefer
Best to all

hopeful and opt...
Posts: 2339
Joined: Apr 2009

thanks for sharing that conversation with the scientist.......every step of this jouney has to be carefully done.......and we need to have an expert......even in evaluating the parrifin blocks of a biopsy..........ira

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