SPECIMEN INFORMATION

BOSTWICK Date Collected: 09/11/2009

LABORATORIE~ Date Received: 09114/2009
100 Charles Lindbergh BlvdUniondale New York, NY 11553 Date Reported: 09/1 5/2009
Phone 888-512-5288 Fax 516-512-530 I www.bosrwicklaboratories.com

PATIENT INFORMATION PHYSICIAN INFORMATION

Ali Mohammad Sarram M.D

=EE:;
Name: Peter Waldheim Advanced Urology, PC
SSN: 11960 Lioness Way
Date of Birth:
Requisition # : I
Sex: Male
Age:
Chart#:"
69 Suite 210
Parker, CO 80134
Phone: (303) 695-6 J 06
Fax: (303) 695-1211
CLINICAL HISTORY
I Provided ICD-9 codes: 790.93. PSA: 3.8 ng/m!. Date: 7/24/09. Previous Biopsy: None.
GROSS DESCRIPTION
PROSTATE, NEEDLE BIOPSIES:
The specimen was received in 12 vials containing pink-tan 0.1 ern diameter prostate biopsies in formalin; submitted in toto.
Site Length
(AI) Right Apex 0.9cm (Fragmented)
(BI) Right Mid 1.6cm (Bisected)
(CI) Right Base 1.3cm
(Dl) Right Lat Apex 0.8cm
(EI) Right Lat Mid 1.6cm (Bisected)
(Fl) -Right Lat Base 1.2cm
(GI) Left Apex 1.0cm
(HI) Left Mid 1.5cm
(II ) Left Base 1.1ern
(11) Left Lat Apex 0.7cm
(KI) Left Lat Mid 1.0cm
(Ll) Left Lat Base 1.6cm (Bisected)
PHOTOMICROGRAPH PROSTATE BIOPSY MAP

BENIGN
CJ
3+3~
t ••.••

La1eral Lateral

SUSPICIOUS ~ MAUGNANT_

DIAGNOSIS

PROSTATE, NEEDLE BIOPSIES:

(AI) Right Apex: ADENOCARCINOMA (GLEASON SCORE 3 + 3 = 6) INVOLVING 15% OF THE
SPECIMEN (1 OF 2 CORES CONTAIN CANCER).
(BI) Right Mid: ADENOCARCINOMA (GLEASON SCORE 4 + 3 = 7) INVOLVING 25% OF THE
SPECIMEN (2 OF 2 CORES CONTAIN CANCER). GLEASON PATTERN 4
COMPRISES 70% OF THE CANCER.
(CI) Right Base: Benign prostatic tissue.

Page I of4
Peter Waldheim
(Dl) Right Lat Apex: ADENOCARCINOMA (GLEASON SCORE 3;1: 3 =7 6) INVOLVING 3% OF THE
SPECIMEN (1 OF 1 CORES CONTAIN CANCER). ,
(E 1) Right Lat Mid: HIGH-GRADE PROST ATIC INTRAEPITHELIAL NEOPLASIA.
(Fl) Right Lat Base: Benign prostatic tissue.
(Gl ) Left Apex: Benign prostatic tissue.
(HI) Left Mid: v ._ ADENOCARCINOMA (GLEASON SCORE 3 + 3 = 6) INVOLVING 5% OF THE
SPECIMEN (1 OF 1 CORES CONTAIN CANCER).
(II) Left Base: ADENOCARCINOMA (GLEASON SCORE 3 + 3 = 6) INVOLVING 30% OF THE
SPECIMEN (1 OF 1 CORES CONTAIN CANCER).
(11) Left Lat Apex: Benign prostatic tissue.
(K I) Left Lat Mid: ATYPICAL SMALL ACINAR PROLIFERATION SUSPICIOUS FOR BUT NOT
DIAGNOSTIC OF MALIGNANCY.
(L 1) Left Lat Base: ATYPICAL SMALL ACINAR PROLIFERATION SUSPICIOUS FOR BUT NOT
DIAGNOSTIC OF MALIGNANCY.

BILLING INFORMATION
Description
LVL IV-SURG PATH GROSS&MCRSCP XM

Stephen Lawhorn, M.D.

Page 2 of4
 Peter Waldheim

BOSTW'CK
LABORATORIES@
PATIENT EMPOWERMENT REPORT

Patient Name: Peter Waldheim

Diagnosis: Cancer of Prostate

----Rectum Accession#:
Bladder
Report Signed: 911512009 1:01:24PM

/ Prostate Gland

4'------,;<--- ABOUT YOUR BIOPSY

Urethra

penis-~- rC --------- Vas Deferens

Testicle
Biopsy cores were taken from several different areas of your prostate to get a
representative sampling of the entire gland. After the procedure, the tissue
samples were sent to our laboratory. There, a pathologist examined the biopsy
cores under a microscope and determined that there were cancerous cells
present.

YOUR PROST ATE MAP

The diagram to the left illustrates wbich areas of your prostate tissue contain
malignant cancer cells. The percentage shown in each area illustrates the
amount of the biopsy core where cancer cells were found.

You may also see additional numbers (i.e., 3+3=6) in some of the areas. These
numbers illustrate your Gleason grade and score. The Gleason grade is a rating

~
&...
.. BaflGN
from I (least aggressive) to 5 (most aggressive) that indicates the aggressive
potential of the cancer. This grade is determined by the pathologist, based on
laCera. tbe shape and arrangement of the cancer cells within the biopsy tissue.

HGPIN~ suSPtclOUS ~ MAUGtu..HT-..

Your Gleason score is the key number to note. This is the combination ofthe Gleason grade of the two largest areas of cancer
in the biopsy tissue. This number from 2 to 10 tells you and your doctor how aggressive your cancer may be. Generally,
cancers with scores lower than 7 are less aggressive, with those above 7 being more aggressive.

INFORMA nON AND RESOURCES

Most men diagnosed with prostate cancer in America today can be effectively treated with minimal risk for serious side effects.
Bostwick Laboratories encourages all newly diagnosed patients to seek out information that will be helpful and relevant to you
so you can understand your options for management of your diagnosis. We urge patients to join a support network, if possible,
before making any treatment decisions.

National Patient Support Organizations:

• Man to Man (phone 800-227-2345) is a network of support groups for men with prostate cancer that is affiliated with
the American Cancer Society. Some groups also offer Side by Side, special groups or sessions for women partners.
• US TOO International, Inc. (phone 800-808-7866) is a nationwide network of support groups for men witb prostate
cancer as well as their wives and families. They provide information, counseling and educational meetings.

Not-for-Profit Web Sites:

There is also a tremendous amount of good information available on the internet, especially at the sites noted below.

Page 3 of 4
 Peter Waldheim
Use these sites to learn more about your diagnosis and treatment options and to connect with other patients.
• The" ew" Prostate Cancer InfoLink (www.prostatecancerinfolink.net) is an online resource for people around the
~ world. This site offers user-friendly and personalized prostate cancer information on the web from leading experts in
the fields of diagnosis and treatment.
• The "New" Prostate Cancer InfoLink Social Network (www.prostatecancerinfolink.ning.com) is a sister site where
you can meet patients, wives, healthcare professionals and others in an online gathering of people with a common
interest - how to deal with prostate cancer.
• The National Cancer Institute (,vww.cancer.gov) provides hundreds of pages of information about cancer, from
diagnosis and treatment to policy and research.
• The American Cancer Society (www.cancer.org) offers free literature on cancer topics; sponsors support groups and
cancer recovery programs, funds scientific research and provides community education.
~'(ji.

For Further Reading:

There are a number of excellent books available to provide you with detailed information on every aspect of prostate cancer.

• The American Cancer Society's Complete Guide to Prostate Cancer is an encyclopedic introduction to the disease,
edited by Dr. Bostwick and other colleagues.
• Prostate Cancer, What Every Man - and His Family - Needs to Know is another excellent resource with
information on prostate cancer, its diagnosis and treatment options.

TREATMENT OPTIONS

Every patient diagnosed with prostate cancer must make a decision, along with his physician, as to what kind of treatment is
best. Before selecting a course of treatment, make sure you have a sense of your cancer's current state and its potential for
future growth. The most common treatment options for prostate cancer include:

• Surgery (radical prostatectomy, laparoscopic radical prostatectomy)

• Radiation therapy - external beam radiotherapy or radioactive seed implantation (brachytherapy)
• Cryotherapy (freezing the prostate)
• Hormone therapy
• Active surveillance (also called "watchful waiting")

WHAT ELSE SHOULD YOU DO?

• Talk to your doctor. Ask questions about treatment plans that may be appropriate for you.
• Write down your questions so you remember to ask your doctor about them.
Tell your doctor and pharmacist about every medication and nutritional supplement you are taking.
• Educate yourself and your family about your disorder and what it may mean.
Exercise regularly.
Do your best to maintain a healthy, balanced lifestyle.

Page 4 of4