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RECOGNISED EXPERT PATHOLOGISTS

Dr Stephen Strum and Donna Pogliano, a prostate cancer activist, co-authored a wonderful source of very detailed information on prostate cancer. It is not an 'easy read' to glance through while lounging by the pool, but it allows laypeople to get a good understanding of complex medical issues. The full title of the book is A Primer on Prostate Cancer. The Empowered Patients Guide. The ISBN number is 0-9658777-6-0 and it has been available at Amazon and Barnes & Noble as well as at the Life Extension Foundation site, whose support saw the book published.

Dr Strum also provides an excellent service on the Physician To Patient mailing list. When responding to queries on that List he often says:

The Gleason score is a critical item; it is used as a variable in virtually every prognostic and treatment algorithm. An accurate GS mandates an expert pathology opinion from a PC pathology expert.

The ones that I am most familiar with include:

Helmut Bonkhoff [Berlin, Germany); Tel: +49-30-8331802 or +49-30-8330441; bonkhoff@prostapath.de

David Bostwick (Virginia) [800] 214-6628 Ronald

J. Cohen (Western Australia) [61 8 9386 9888]; ronnie@uropath.com.au

Jon Epstein (Hopkins) [410] 955-5043 or 410-955-2162 (Dr. Epstein does not do ploidy analysis)

David Grignon (Michigan) 313-745-2520 Scott Lucia 303-724-3470

Dr.Jonathan Oppenheimer, Prostate Pathologist. Oppenheimer Urologic Reference Laboratory (Tennessee] [888] 868-7522

A second opinion on the microscopic pathology is usually covered by insurance but if not, runs about $500 pending on what is done. A copy of the original pathology report with the actual slides or recuts from the tissue blocks are sent to the outside reviewer. My preference is to request that tissue blocks be sent to the expert reviewer to optimize the recuting process. Your primary care doctor or you can initiate such a 2nd opinion but you need to request this and ask for a specific physician or lab to be used.

Additionally, other prognostic tests such can be extremely helpful to plan therapy. These tests are done using IHC (immunohistochemistry) and include: AMACR, AZGP1, AR, BCL-2, CGA, COX-2, EGF-R, FAS, HER2/Neu, HSP-27, MIB-1, MUC-1, PAP, PSA, p27, p53, Somatostatin, D2-40. Ploidy analysis can also be done by some of the above pathologists using the tissue blocks. There are extra fees for these services.

For me, the most detailed and comprehensive pathology review is done by Helmut Bonkhoff in Berlin, Germany. Also, I know when pathology material is sent to him that he reviews the material and not an unknown associate using his name.

Sound advice indeed, provided you can find a local urologist or oncologist who can interpret the reports - for more on Dr Benthoff go along to Bob Parson's Pathology 101.

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