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  • Getting another opinion from a patholigist?

    I get the feeling ive got a more serious case. I just get the feeling i got Chariocarcinoma. The rare serious case. I read how patholigists do not provide facts but opinions. My tumor makers have risen suddenly.

    How can i go to get a second opinion (preferably from Dr.Einhorn)? I mean the patholigist would need to see my tumor that was removed? I mean how would this be possible?

    Any help would be great. Thanks

  • #2
    Matthew,
    Pathologists tend to do the opposite...they state the facts on a biopsy and do not render a diagnosis or opinion. From your post I can't tell if you actually had surgery or why you think it's chorio. If you had the surgery, your slides are generlly kept at the hospital's path dept. for a number of years. You can have them sent to an "expert" institution for a second opinion by their pathology dept. If you want you can also meet with an expert such as Dr Einhorn, but the docs are not the ones looking at the slides. For instance at Sloan you can go to their website and download a form for a pathology second opinion.
    Retired moderator. Husband, left I/O 16Dec2005, stage I seminoma with elevated b-HCG, no LVI, RTx15 (25Gy). All clear ever since.

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    • #3
      Karen, sorry i meant to say Einhorns pathology dept. I know Einhorn is there to treat it. Im just guessing he is the best, so the pathology dept. can be more accurate. I dont know, im just taking a wild guess.

      Do Patholigists generally be able to get it wrong?

      Its just i read this and started thinking maybe the patholigist who was looking at my tumor was wrong maybe with the tumor type. Here it is

      In the case of testicular cancer, you must be aware that pathologists are no different from general practitioners, urologists, or oncologists, and the pathology report is usually an opinion, not a hard fact. Testicular cancer is relatively rare, and chances are pretty good that a normal pathologist does not get to see testicular tumors more than a couple of times a year, if that. If your cancer is unusual or your treatment is highly dependent on the pathology report, then it probably is a good idea to get a second opinion from the pathology department at a referral center that sees testicular cancer frequently. Some pathologists that fall into this category can be found on our experts list.

      What do you think?

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      • #4
        Im thinking its chorio coz just under a month of having the tumor i started getting abdominal pain and chest twicthes. Only chorio is so quick and rapid. Its known that early treatment is good but here with early treatment, tumor removed, 3xbep and rplnd. Tumor markens are rising and all im getting offered now is high extensive chemo. I mean why is this happening when i caught this early. Im thinking this must be chorio as its so dangerous even IF its caught early.

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        • #5
          Matthew,
          I guess it depends on where you had your surgery. Even though I was 99% confident that the pathology report was correct for my husband, we did send the slides to Sloan Kettering for a second opinion, and they confirmed the pathology. It can never hurt to get a second opinion, from my point of view.
          What was your pathology report and and when did you do the surgery, chemo and rplnd? What level are your markers and when was your last CAT?
          Retired moderator. Husband, left I/O 16Dec2005, stage I seminoma with elevated b-HCG, no LVI, RTx15 (25Gy). All clear ever since.

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          • #6
            Matthew, are you saying that you've already been through the orchiectomy, 3xBEP, and RPLND surgery? More than a second opinion on just the pathology, it sounds as though you should get a second opinion on the course of treatment from here from a center that treats testicular cancer frequently.
            Scott, [email protected]
            right inguinal orchiectomy 6/5/2003 > nonseminoma, stage I > surveillance > L-RPLND 6/24/2005 for recurrence, suspected teratoma but found seminoma, stage II > chylous ascites until 9/2005 > surveillance and "all clear" since


            Your donation funds Livestrong services for people facing cancer now. Please sponsor my ride!

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            • #7
              Matthew,

              the pathologist at IU is Dr. Thomas Ulbright (http://cancer.iu.edu/research/member...io.php?id=3051). Have your slides send to him, and if your insurance does not pay, be prepared to incurr costs of about $250.

              As far as your rising markers go: it would be useful to learn more about your case history before speculating on the causes.
              Last edited by matthias; 03-18-06, 07:01 PM.

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              • #8
                Utimately all initial treatment decisions are based on a pathology "opinion".

                Also, while a pure (100%) choriocarcinoma is always fatal, I would expect even the most backward pathology department to identify those quite easily. While chorios are very infrequent and unwelcomed news in men, they are quite often seen (and much more benign) in women.

                Of course, none of this contradicts Scott's very valuable advice: get a second pathology opinion, get a second (and third) treatment opinion as needed. It's your life, take control...LiveStrong.





                Originally posted by Scott
                Matthew, are you saying that you've already been through the orchiectomy, 3xBEP, and RPLND surgery? More than a second opinion on just the pathology, it sounds as though you should get a second opinion on the course of treatment from here from a center that treats testicular cancer frequently.

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                • #9
                  Im definitly looking into getting a second opinion.

                  I dont know if this is possible, but can i just call Dr. Einhorn and ask for his opinion just like that. Or is he too busy for that?

                  Would i need to make an appointment and actually go there instead?

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                  • #10
                    More info about the chorio

                    Hi Matthew.

                    My name is Patti and my husband is 100% choriocarcinoma.

                    When he had his orchiectomy, that's when the local pathologist diagnosed is at choriocarcinoma. We never got a 2nd opinion because it made sense. Kevin's cancer had metatasized to his lungs (very, very small tumors) and that's when he went through 3 rounds of bep. Choriocarcinoma usually goes from the testicule, to the lung, then to the brain and then other places; choriocarinoma does not go the lymph nodes. Lance Armstrong was mostly choriocarincoma. And choriocarcinoma is not always fatal either.

                    You say that you need to go through high extensive chemo, what do you mean by that? Are you going to get high-dose chemo/stem cell transplant? Kevin had that done too at Indiana University and Dr. Einhorn was his doctor.

                    If you need anything, let me know.

                    Patti
                    Wife of Kevin Murphy
                    Diagnosed 7/16/04 100% Choriocarcinoma
                    Oriechtomy 7/20/04
                    4xBEP 8/04-11/04 BHCG:1200 (lung only)
                    Rediagnosed 12/27/04 BHCG: 50
                    1xVIP 1/05 (lung)
                    HDC/Stem cell Indiana 2/05-4/05 BHCG: 51-4.5 (lung)
                    HDC failure 5/05
                    3xGemzar/Taxol 6/05-9/05 (lung only)
                    VP-16 w/Avastin 9/05-1/06 (lung only)
                    Cyberknife 5" lung tumor 2/06
                    cyberknife 6 brain tumors 3/06
                    1xOxaliplatnin 3/06 (liver, lungs, kidneys, left hip)
                    Passed away 4/13/2006

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