In May of 2016, Mitchell Garber was diagnosed with prostate cancer after a two-year period of a doubling PSA. Though the initial biopsy revealed intermediate grade cancer – adenocarcinoma – the tumor was found in fewer than five percent of one core. After this diagnosis, Mitchell spent a few weeks learning about his treatment options, and eventually decided on DaVinci robotic surgery.
Prior to his surgery, Mitchell decided to get a second pathology opinion and sent his biopsy slides to a renowned pathologist at John Hopkins for examination. The pathologist who reviewed the slides couldn’t establish a definitive diagnosis, requesting a follow-up with further testing. Based on the report from this second pathologist, Mitchell’s surgery was cancelled.
On the recommendation from the John Hopkins pathologist, Mitchell went back to his urologist for a repeat biopsy. The repeat biopsy revealed low-grade cancer – the tumor was again found in fewer than five percent of one core. There was not enough cancerous tissue to do any genomic testing to predict the aggressiveness of his cancer. Once again, Mitchell decided to get a second pathology opinion of the biopsy slides and again sent these slides to John Hopkins for examination. This time the pathologist at John Hopkins confirmed the diagnosis of low-grade prostate cancer.
The initial pathologist consulted another renowned pathologist from Memorial Sloan Kettering, who confirmed the low-grade prostate cancer diagnosis on both biopsies. It was important that Mitchell obtain several opinions on his atypical results, but he found that getting three different pathology opinions on his first biopsy was a large source of stress.
The second biopsy revealed low-grade prostate cancer, and though getting additional pathology opinions was stressful, he is thankful that he got a second – and third – opinion on the results. Mitchell and his urologist decided on a treatment plan of active surveillance. He now sees his urologist to repeat his PSA every six months to determine the frequency of repeat biopsies and possible further treatment in the future.
“Listen to your doctor, but consult a second opinion after you’re diagnosed, particularly on the pathology of your biopsy. Though it was stressful, getting additional pathology opinions changed my decision regarding my treatment plan.”
Following his decision on active surveillance, Mitchell took advantage of ZERO’s patient support resources, attending a webinar on localized prostate cancer to better familiarize himself with his choices regarding his disease. With two biopsies and a new treatment plan, he understood the value of gathering as much information as he could in order to make the best decision for himself.