What to make of 2nd. opinion Gleason Score reduction?

[Guest guest]

When I was originally diagnosed with PCA in August 2007 my Gleason Score was " 6 "

(3+3).

Based upon this result, my Clinical Staging of T1c and my PSA of 2.5 I proceeded

with " Active Surveillance " with a PSA taken every 3 months and an occassional

DRE which proved negative.

Two months ago my Urologist suggested I have another biopsy and the result of

this test (Bostwick Labs) was a Gleason Score of " 7 " (3+4). My Urologist

conceded that I might have had the Gleason " 7 " 2 years ago but that it was

" missed " at that time.

Nevertheless I had the slides sent to the office of Dr. athan Epstein at

s Hopkins University for a second opinion and I received the results a few

days ago showing a Gleason " 6 " (3+3).

Can someone explain what factors could explain this " reduction " in my Gleason

Score and moreover, would it be prudent to go back to " Active Surveilllance " as

I believe that there is a scandalous amount of overdiagnosis and overtreatment

in the Prostate Cancer field?

Any feedback will be greatly appreciated.

Thanks,

Sy

[Guest guest]

(snip)

> Can someone explain what factors could explain this " reduction " in my

> Gleason Score

Gleason scores are determined by pathologists who examine the specimens

microscopically.

It is not unusual for variations between different opinions to appear.

And that's what they are: opinions.

Oppenheimer and Gleason are both highly recommended pathologists.

> and moreover, would it be prudent to go back to " Active Surveilllance "

I hope that there is no one here so foolish as to try to give Sy

treatment advice. That is his choice alone, with advice from (a)

competent medics and ( from his own study.

Regarding study, I recommend this piece by Mark Scholz, a well-respected

PCa specialist: " The Way to Find the Best Available Treatment for Your

PC. Advice For Men Newly Diagnosed with Prostate Cancer. "

http://www.prostate-cancer.org/education/riskases/Scholz_FindingBestTreatment.ht\

ml

> as I believe that there is a scandalous amount of overdiagnosis and

overtreatment in the Prostate Cancer field?

Maybe there is and maybe there isn't, but is Sy willing to bet his life

that treating HIM would be wasted motion?

So here's my usual advice: Study, Learn, Take Charge.

Regards,

Steve J

" Empowerment: taking responsibility for and authority over one's own

outcomes based on education and knowledge of the consequences and

contingencies involved in one's own decisions. This focus provides the

uplifting energy that can sustain in the face of crisis. "

--Donna Pogliano, co-author of _A Primer on Prostate Cancer_, subtitled

" The Empowered Patient's Guide. "

[Guest guest]

(snip)

> Can someone explain what factors could explain this " reduction " in my

> Gleason Score

Gleason scores are determined by pathologists who examine the specimens

microscopically.

It is not unusual for variations between different opinions to appear.

And that's what they are: opinions.

Oppenheimer and Gleason are both highly recommended pathologists.

> and moreover, would it be prudent to go back to " Active Surveilllance "

I hope that there is no one here so foolish as to try to give Sy

treatment advice. That is his choice alone, with advice from (a)

competent medics and ( from his own study.

Regarding study, I recommend this piece by Mark Scholz, a well-respected

PCa specialist: " The Way to Find the Best Available Treatment for Your

PC. Advice For Men Newly Diagnosed with Prostate Cancer. "

http://www.prostate-cancer.org/education/riskases/Scholz_FindingBestTreatment.ht\

ml

> as I believe that there is a scandalous amount of overdiagnosis and

overtreatment in the Prostate Cancer field?

Maybe there is and maybe there isn't, but is Sy willing to bet his life

that treating HIM would be wasted motion?

So here's my usual advice: Study, Learn, Take Charge.

Regards,

Steve J

" Empowerment: taking responsibility for and authority over one's own

outcomes based on education and knowledge of the consequences and

contingencies involved in one's own decisions. This focus provides the

uplifting energy that can sustain in the face of crisis. "

--Donna Pogliano, co-author of _A Primer on Prostate Cancer_, subtitled

" The Empowered Patient's Guide. "

[Guest guest]

(snip)

> Can someone explain what factors could explain this " reduction " in my

> Gleason Score

Gleason scores are determined by pathologists who examine the specimens

microscopically.

It is not unusual for variations between different opinions to appear.

And that's what they are: opinions.

Oppenheimer and Gleason are both highly recommended pathologists.

> and moreover, would it be prudent to go back to " Active Surveilllance "

I hope that there is no one here so foolish as to try to give Sy

treatment advice. That is his choice alone, with advice from (a)

competent medics and ( from his own study.

Regarding study, I recommend this piece by Mark Scholz, a well-respected

PCa specialist: " The Way to Find the Best Available Treatment for Your

PC. Advice For Men Newly Diagnosed with Prostate Cancer. "

http://www.prostate-cancer.org/education/riskases/Scholz_FindingBestTreatment.ht\

ml

> as I believe that there is a scandalous amount of overdiagnosis and

overtreatment in the Prostate Cancer field?

Maybe there is and maybe there isn't, but is Sy willing to bet his life

that treating HIM would be wasted motion?

So here's my usual advice: Study, Learn, Take Charge.

Regards,

Steve J

" Empowerment: taking responsibility for and authority over one's own

outcomes based on education and knowledge of the consequences and

contingencies involved in one's own decisions. This focus provides the

uplifting energy that can sustain in the face of crisis. "

--Donna Pogliano, co-author of _A Primer on Prostate Cancer_, subtitled

" The Empowered Patient's Guide. "