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The value of second opinions

Tech70
Posts: 53
Joined: Nov 2017

When I was diagnosed last fall, all my test results, biopsy, Gleason, MRI and Oncotype testing pointed to Active Surveillance as the best mode of treatment.  The original biopsy had one positive core with a Gleason of 3+3.

The the pathology report on my second confirmatory biopsy came back with two cores, 3 & 7% showing a Gleason of 3+4.  These results could have potentially led to a decison not to persue AS but seek a more aggrresive form of treatment.  My urologist suggested that we have the slides re-evaluated at Johns-Hopkins.  I received the results yesterday at my urologist's and JH evaluated my slides as 3+3, so for the time being, I will be persuing AS.  Medicare declined coverage of the JH review, but it might be the best spent $250 of my life.

Old Salt
Posts: 720
Joined: Aug 2014

I suggest you send your urologist a bouquet or a six-pack of his favorite brew! Not all of them are fond of second opinions. But if you look at the pictures on the Johns Hopkins urology/pathology site, one can see that the interpretation isn't always straightforward. Moreover,  the  Johns Hopkins pathologist (Dr Epstein ) is the ultimate source of wisdom with respect to the Gleason scoring system.

http://pathology.jhu.edu/department/services/secondOpinion.cfm

Tech70
Posts: 53
Joined: Nov 2017

My urologist is a she, not a he, and a rather attractive one at that.  :)

hopeful and opt...
Posts: 2224
Joined: Apr 2009

You are far from the first man, myself included who has had a second opinion by a world class expert pathologiist that is different from the initial pathology results. This is all too common. There is a difference between the skills and facilities available to pathologists. Just like any other medical specialty, you want the very best, an "artist". Some of us at this board supported this decision. Hopefully others at this board who did not support having a second opinion will learn from this.

https://csn.cancer.org/node/315960

https://csn.cancer.org/no. Hopede/315620

Grinder
Posts: 438
Joined: Mar 2017

A hot lady urologist?! No way.

I do not support getting a 2nd opinion.

I got a 2nd , a 3rd, and a 4th opinion.

And they were all ugly dudes.

Maybe I need a 5th opinion after the fact. 

;)

VascodaGama's picture
VascodaGama
Posts: 2987
Joined: Nov 2010

Tech,

Great news. Hope you manage staying on AS forever.

Please allow me to add in your thread the comments from another mate on the Value of Second Opinions, in here;

http://csn.cancer.org/comment/1290680#comment-1290680

 

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