second opinon on biopsy

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Califchief - 13 Sep 2006 03:32 GMT

mountainguy1958 wrote:

> A suggestion that has been made to me here more than once is
> that I not accept my urologist's biopsy until it has been
> confirmed by a "second opinion" from a nationally recognized
> lab. In a list of such labs that I have seen is DIANON Systems
> -- which IS the source of the biopsy report that my urologist
> provided to me.

Confirmation by a different lab is __not__ a "second opinion."
You have to go through the entire process, from Step One, with
a different doctor.

I would have a second biopsy, by a different doctor, and have
it examined in a different lab. Probably a new PSA test, too.

THAT is a "second opinion."

Because of the possibility that (a) the 1st doctor missed an
area of the prostate, and (b) the possibility that the lab
used contaminated slides, only a second biopsy -- by a second
doctor, using a second lab -- is the only method of obtaining
100% assurance that an error was not made.

Both (a) and (b) have happened. There is too much at stake
with PCa to not obtain second opinions - by a second doctor,
performing a second biopsy, examined in a second lab.

That is what insurance companies mean by "second opinion."

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I.P. Freely - 13 Sep 2006 15:15 GMT

> Confirmation by a different lab is __not__ a "second opinion."
> You have to go through the entire process, from Step One, with
> a different doctor.

My first uro willingly sent my slides to a second lab for confirmation,
even though the first lab was . . . taDaaaa . . . Bostwick. (The second
lab was a VA lab, and the teaching hospital that was going to treat me
wanted confirmation in their lab.)

I didn't need a true second opinion (second bx) because my first one was
bad enough and was assayed by a leading lab. Once they found significant
quantities of G4 in my prostate, we knew I needed aggressive tx anyway.

I.P.

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Steve Kramer - 14 Sep 2006 01:16 GMT

> mountainguy1958 wrote:
>
[quoted text clipped - 13 lines]
>
> THAT is a "second opinion."

True, Chief. If we were discussing the possibility that he had no cancer at
all, a second process might be wise. However, he has already accepted that
he has cancer. And, it would appear that he has a very small amount. So
small, in fact, that he is considering a "no treatment" option. Some have
suggested that he might consider having the slides evaluated by a second set
of eyes in order to assist in making a very narrow decision tree.

Of course, I think he is comfortable with the first set of eyes and is
already passed the point of second opinions re his Gleason.

Signature

PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA .1 .1 .1 .27 .37 .75
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32
Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05,
2/06, 6/06
PSA .07 .05 .06 .09 .08 .132 .145
Casodex added daily 07/06
Non Illegitimi Carborundum

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