Biopsy second opinion

So I am getting a second opinion on my biopsy from Bostwick Labs. The question I have is does it matter which of there three labs it goes to? Or do all three meet the critera that Dr. Bostwick defines?

When I spoke to them they said that all second opinions are going to the Orlando lab right now.

Does Bostwick himself read all second opinions or do his employees do it?

Seems nothing in this PC world is black and white........

I have come to the conclusion that only a small number of biopsies need a second opinion..If your biopsy comes back a marginal positive, a small percentage of Gleason 6 cells in one sample for instance, then yes, a second opinion is a good idea. But when you see cancer in multiple cores, and a significant percentage of those cores are cancerous, I think virtually all big lab, big hospital pathologists can determine what they are looking at and write an accurate biopsy report. Once you get into Gleason grade 4 and grade 5 cells, even a student pathologist can spot those accurately enough to write a valid report....Just my humble opinion....

I used Bostiwick for a 2nd opinion. While the reports were similar, they did downgrade the 4+3 to a 3+4, but picked up another tumor location and the perinueral invasion, PNI.

The way I see it, before embarking on a treatment plan, a second opinion from a facility that specializes in prostate cancer is well worth it.

One other thing, The Dattoli center required a 2nd path report from an approved lab

If I'm putting a roof on my house I get a few estimates before picking a contractor and it's only money I could loose. So I figure I should get a second on the path on what could very well be a life changing decision. Bostwick is an approved lab for my health benefits so I hope they pay but if not I'll just send a check.
Peace of mind will be worth it.

Fauntleroy is if Bostwick downgrades me I'll be cured by a pathologist. lol

142 said...
Asking first is always best - ask the insurance company if they cover 2nd opinions. For the surgery / RT choice, they required multiple opinions.


As to Bostwick, they did my first opinion, and I felt no need for a second. Again, ask your insurance first, and get their acceptance sent in writing on every last exam and procedure you get done. It will save you a lot of money.

142 I'm not worried if they pay for the second opinion on the biopsy and based on past dealings they will require a second before surgery / RT. I've had the same health insurance for just about 23 years so I am quite familiar with the nuances of dealing with them. Their biggest thing about paying for procedures is it a "medical necessity" I wish my dental plan was as easy to deal with.

Good luck with the second opinion.

david

Major hospitals yes, but there are plenty of small rural hospitals out there that that have one to three pathologists, who see very few PCA slides. I was 3+3 locally, 3+4 preop at he UofWashington. and post op Pathology at the U o W, gleason 9 based on 4+3 tert 5, so my uninformed decision seridepitously, turned out to be the " right" one. my advice, if 3+3 get a reread, unless pathologist are well trained in reading all kine cancer cells. You know, so they can differentiate be tween the differentations of cells mo bettah.

I got my biopsy evaluation done at the Orlando lab and received a copy of it from my uro at my appointment with him confirming diagnosis.

It is very detailed, and perhaps I could describe it a bit so you may get an idea of what to expect if you do get your report from that lab.

Page 1: "Gross Description": detailed medical text describing the general physical situation and stats of my prostate; a photomicrograph (they call it) of a slice of tissue (like what you would see in a medical text); a "prostate biopsy map" (found this very informative): a schematic of the standard prostate, with black circles entered on it where malignancy was found in my case, along with a number indicating percentages found;

Page 2: "diagnosis, prostate needle biopsies": sector-by-sector account of tissue status in each apex and base, pretty technical, but highly informative; gives Gleason sums for each sector;

Page 3-4: "Patient Empowerment Report": I found this extremely helpful; sums up what was found in easy-to-follow terms, explaining what was done, and how to interpret the results; followed by an "Information and Resources" section, listing some PCa organizations (PC Infolink, UsToo, and more generally NCI and ACS, and a brief bibliography ("ACS Complete Guide to Prostate Cancer," "Prostate Cancer, What Everyman and His Family Needs To Know")

Page 5: "Treatment Options": general description of surgery, RT, HT, AS and Cryotherapy;

It closes with strong encouragement to see one's doctor, and go from there.

It looked very professionally done, and seemed to cover all the bases.