will a uro share the pathology slides with you

If you have not already looked at it, here is a post of generic PCa information that covers a lot of situations, including questions.

Prostate Cancer: The Really Useful List made by HW people for HW people.
https://www.healingwell.com/community/default.aspx?f=35&m=1717641

As to showing you the slides, I know some here have gotten them, but I sat with a pathologist looking at some samples (not mine), and there was no hope of me seeing anything other than "good" and "really bad". You can get the slides sent to another pathologist for a second opinion. Mine were read at Bostwick, which is one of the most-respected labs for PCa.

The slides are yours, and you can ask for them, although your Uro may resist.

If you did manage to get the video, and there is any information about the type of equipment used, you could contact the manufacturer to ask what programs might work. Until recent years, it may have been a proprietary format owned by the manufacturer.

Surgeons will advise surgery if they think they can do it. It is their business (try to buy a Honda from the Dodge dealer). If they are honest, and think that another treatment is best, they will advise that. As an example, my Uro (also my surgeon) will not do surgery on any man 70 or over.

wow! thank you Mr. Moderator. I love this site. it is just positive encouragement is a gastly business.

As the Moderator has said, you are entitled to copy of the pathology report AND the radiology report from the ultrasound that was done at the time of the biopsy.

These are you records - you have an absoulute right to a copy. The biopsy slides should be in the custody of medical records or the pathology lab. If you would like another lab to read them, you can request that they be mailed to a second lab, or you may be able to check them out and take custody of the slides and deliver them yourself to the second lab, as I did when I had my slies re-read. The second lab then mailed them back to the original lab.  You are the customer - you have a lot more rights than you may think.

The urologist will probaby recommend surgery since urology is a surgical subspecialty - surprise, surprise.   But you are the decider. Please take time to get several more opinions from another urologist and radiation oncologist, if the biopsy is positive.  You have months, not weeks to make a decision, according to John Hopkins Urology.   CaP is a very slow growing cancer.

Here is a link to a webpage that has more info. that you may find useful. Good Luck in your journey.

http://members.triton.net/vandenbe/CAP/CaPArticles_AUAGuidlines.htm

great advice, thank you soooo much. I'm a patient man, maybe too patient, as my sonagram in Feb of 2010 showed a tiny nodule to tiny to be concerned about, and heavy duty calcification. But my prostate was 35 cc, and 4x3x5 so a little over the std 4x3x2 they like to see. so the oversize would also indicate my increasing psa. I was so concerned I did the ridiculous and went to 7 urologist!! all said absolutely get a biopsy, and my 2 gp's were animent. so here I go it looks like no cancer may means they missed it. a little cancer means lots of choices, and a lot of cancer leaves just a few choices (make will, sell off assets)

thanks Sephie, actually I have control of the situation. Prob my email style looks to read tense but I am not. This procedure is 20 minues and a core needle, my vericose was over an hour and heavy sedation, an hour to wake up. so as they say not a bad deal here. I'll be fine.

example of great reporting
Figure 3: An ideal pathology report

City Hospital
Department of Pathology
123 Main Street
One City, Anystate USA

PATHOLOGY EXAMINATION REPORT

Patient Name: John Doe

Medical Record #: 01020304

Date of Birth: 04/01/26 (Age: 81) Sex: Male

Procedure performed by: Dr. I. M. Best

Specimen #: S00-9999

Procedure date: 07/15/07

Report date: 07/16/07

Gross description by: Dr. Eagle Eye

DIAGNOSIS:

Prostate needle biopsies: 21

A) R5A: Fibromuscular tissue only; no prostatic epithelium seen.

B) R5MA: Atypical glandular focus suspicious for adenocarcinoma.

C) R5M: No malignancy identified.

D) R5MB: No malignancy identified.

E) R5B: No malignancy identified; focal chronic inflammation.

F) R4A: No malignancy identified.

G) R4MA: No malignancy identified; focal chronic inflammation.

H) R4M: No malignancy identified.

I) R4MB: No malignancy identified.

J) R4B: No malignancy identified; focal chronic inflammation.

K) L5A: Fibromuscular tissue and colonic mucosa; no prostatic epithelium seen.

L) L5MA: Adenocarcinoma, Gleason score 7 (3 + 4), involving 50% of core.

M) L5M: Adenocarcinoma, Gleason score 8 (4 + 4), involving 70% of core.

N) L5MB: Adenocarcinoma, Gleason score 8 (4 + 4), involving 80% of core.

O) L5B: Adenocarcinoma, Gleason score 8 (4 + 4), involving 80% of core.

P) L4A: No malignancy identified.

Q) L4MA: Adenocarcinoma, Gleason score 7 (4 + 3), involving 80% of core.

R) L4M: Adenocarcinoma, Gleason score 8 (4 + 4), involving 80% of core.

S) L4MB: Adenocarcinoma, Gleason score 8 (4 + 4), involving 80% of core.

T) L4B: Adenocarcinoma, Gleason score 8 (4 + 4), involving 70% of core.

U) L seminal vesicle: Seminal vesicle, no malignancy identified.

Note: Perineural invasion is seen. Focally, a tertiary Gleason 5 pattern is noted.

Clinical Data: None given.

Gross Description: Received in 21 formalin containers labeled with the patient’s name, “John Doe,” the medical record number, and additionally labeled “R5 apex,” “R5 mid-apex,” “R5 mid,” “R5 mid base,” “R5 base,” “R4 apex,” “R4 mid apex,” “R4 mid,” “R4 mid base,” “R4 base,” “L5 apex,” “L5 mid apex,” “L5 mid,” “L5 mid base,” “L5 base,” “L4 apex,” “L4 mid apex,” “L4 mid,” “L4 mid base,” “L4 base,” and “left seminal vesicle” are multiple prostate cores measuring up to 2.5 cm, entirely submitted in cassettes A–U respectively.

Report Electronically Signed Out — Eagle Eye, M.D. 07/16/07

You had asked in a post that you must have deleted about the ultrasound information. My uro did not offer any recording of the ultrasound process during the biopsy. I'm not sure that it was recorded, or even recordable. I have seen images from a CDU (Color Doppler Ultrasound), but that equipment is not the norm.

When 9 of 12 are postitve with high percentages, you don't worry much about it. So it was not an issue for me.

There is no standard report format that I am aware of. When I talked at length to a pathologist, he said that they use a format provided by the hospital's path lab. It was quite different in format from my Bostwick report, but the information was the same. The information they provide is based on a standard, but the experience of the pathologist is key for the interpretation.

Berdoo:

The report of the biopsy is generated by the pathology lab that produces and reads the slides, not by the urologist.

It is the job of the urologist to place each "core/sample" in a container that is marked from the location in your prostate where that particular core came from. The pathologist needs to know that info. for his/her report.

BTW, it's real easy to determine if a radiologist did a report on your biopsy ultrasound - You will receive a bill or statement from the Radiologist ! It's not included with the biopsy - that's done by the urologist. Everyone gets their cut. Diagnosing & treating CaP is a big business.

I am just in a rapid learning phase. and I guess some of my questions must present a naiveness but I assure ya'all No one will run over me. Now I'll admit a county uro may not exibit the technical skills and bedside manner of the urban uro they still are understanding and compasionate. The will have to deal with my investigative and quizical nature of a computer geek. Most folks do not question their docs here. There is kinda a trust. whatever he says to do they do. Unfortunately I don't work that way. NO ROADKILL Mr. Yooper

Berdoo and others - I'll give another brief example of being your own advocate, coupled with working with a medical group that is not only experienced and accomplished but also compassionate, with respect to sharing pathologies, reports, results and so on.

I was given color copies of my pre-plan (full volume study) as well as my post plan - during my follow-up with Dr. Moran a few weeks after my implant. He walked me through both and compared how things went with the actual implant versus the plan - as he stated, mine was "text-book, hit out of the park" - but had it been "off" I would have wanted to know that too. (Looking back I was also given a copy of my full volume study after it had been developed during another session with Dr. Moran where he walked me through what the plan and goals were)

Again, whatever treatment you or others that will follow choose - be sure you know as much as you can about who will be performing this on YOUR body - and if they have as much of a vested interest in all of this as WE do. . .

Berdoo, I like your style (truly, I do). You are doing "your job" in learning what you can before the fact. The biopsy pathology report is generated from the lab not from the urologist. It should show the name of the pathologist who actually interpreted the biopsy samples...I know both my husband's reports gave the pathologist's name, the date and the time of the reading. The biopsy report came from an outside lab, and the surgical pathology was done by the hospital's path lab and signed off by the head of the path department.

My husband is in the 95% who had surgery that ended our sex life, and he would disagree with you. And he would strongly disagree that prostate cancer is primarily an end-of-life disease. Don't judge what others have done until you have walked in their shoes. My husband wasn't considered high risk and was told that all 3 treatment options were available in his case: surgery, radiation, or AS. He chose surgery. Guess what, he was upgraded to a stage III with the cancer having broken into the capsule...the path report and surgeon agreed that it was removed just in time (before it actually broke through the capsule and invaded other tissue).

Sorry, but I don't like the broad generalization about prostate cancer being an old man's disease or something that doesn't need to be treated or the fact that you could pee in your pants or need medication to get a hard-on. Cancer doesn't play fair and those that choose to treat it shouldn't be made to look like fools for doing what they thought was the right thing for them.