BOSTWICKLABORATORIE~

100 Charles Lindbergh BlvdUniondale New York, NY 11553

Phone 888-512-5288 Fax 516-512-530 I

PHYSICIAN INFORMATIONAli Mohammad Sarram M.DAdvanced Urology, PC11960 Lioness WaySuite 210Parker, CO 80134

Phone: (303) 695-6 J 06Fax: (303) 695-1211

CLINICAL HISTORYI Provided ICD-9 codes: 790.93. PSA: 3.8 ng/m!. Date: 7/24/09. Previous Biopsy: None.

GROSS DESCRIPTIONPROSTATE, NEEDLE BIOPSIES:

The specimen was received in 12 vials containing pink-tan 0.1 ern diameter prostate biopsies in formalin; submitted in toto.Site LengthRight Apex 0.9cm (Fragmented)Right Mid 1.6cm (Bisected)Right Base 1.3cmRight Lat Apex 0.8cmRight Lat Mid 1.6cm (Bisected)-Right Lat Base 1.2cmLeft Apex 1.0cmLeft Mid 1.5cmLeft Base 1.1ernLeft Lat Apex 0.7cmLeft Lat Mid 1.0cmLeft Lat Base 1.6cm (Bisected)

Name:SSN:Date of Birth:Requisition #

www.bosrwicklaboratories.com

PATIENT INFORMATION

Peter Waldheim

:=EE:; Sex: MaleAge: 69I Chart#:"

(AI)(BI)(CI)(Dl)(EI)(Fl)(GI)(HI)(II )(11)(KI)(Ll)

PHOTOMICROGRAPH

SPECIMEN INFORMATION

Date Collected: 09/11/2009Date Received: 09114/2009

Date Reported: 09/1 5/2009

PROSTATE BIOPSY MAP

BENIGNCJ

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 4COMPRISES 70% OF THE CANCER.

(CI) Right Base: Benign prostatic tissue.

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Peter Waldheim(Dl) Right Lat Apex:

(E 1) Right Lat Mid:(Fl) Right Lat Base:

(Gl ) Left Apex:

(HI) Left Mid: v ._

(II) Left Base:

(11) Left Lat Apex:

(K I) Left Lat Mid:

(L1) Left Lat Base:

ADENOCARCINOMA (GLEASON SCORE 3;1:3 =7 6) INVOLVING 3% OF THESPECIMEN (1 OF 1CORES CONTAIN CANCER). ,HIGH-GRADE PROST ATIC INTRAEPITHELIAL NEOPLASIA.Benign prostatic tissue.Benign prostatic tissue.ADENOCARCINOMA (GLEASON SCORE 3 + 3 = 6) INVOLVING 5% OF THESPECIMEN (1 OF 1CORES CONTAIN CANCER).ADENOCARCINOMA (GLEASON SCORE 3 + 3 = 6) INVOLVING 30% OF THESPECIMEN (1 OF 1CORES CONTAIN CANCER).Benign prostatic tissue.ATYPICAL SMALL ACINAR PROLIFERATION SUSPICIOUS FOR BUT NOTDIAGNOSTIC OF MALIGNANCY.ATYPICAL SMALL ACINAR PROLIFERATION SUSPICIOUS FOR BUT NOTDIAGNOSTIC OF MALIGNANCY.

BILLING INFORMATION

DescriptionLVL IV-SURG PATH GROSS&MCRSCP XM

Stephen Lawhorn, M.D.

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Peter Waldheim

BOSTW'CKLABORATORIES@

PATIENT EMPOWERMENT REPORT

Patient Name: Peter Waldheim

Diagnosis:

Accession#:

Cancer of Prostate

----RectumBladder

Report Signed: 911512009 1:01:24PM

Prostate Gland/Urethra 4'------,;<--- Vas Deferens

penis-~- rC --------- Testicle

ABOUT YOUR BIOPSYBiopsy cores were taken from several different areas of your prostate to get arepresentative sampling of the entire gland. After the procedure, the tissuesamples were sent to our laboratory. There, a pathologist examined the biopsycores under a microscope and determined that there were cancerous cellspresent.

YOUR PROST ATE MAPThe diagram to the left illustrates wbich areas of your prostate tissue containmalignant cancer cells. The percentage shown in each area illustrates theamount 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. Thesenumbers illustrate your Gleason grade and score. The Gleason grade is a ratingfrom I (least aggressive) to 5 (most aggressive) that indicates the aggressivepotential of the cancer. This grade is determined by the pathologist, based ontbe shape and arrangement of the cancer cells within the biopsy tissue.

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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 cancerin 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 RESOURCESMost 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 youso 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 withthe 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 prostatecancer 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.

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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 inthe fields of diagnosis and treatment.

• The "New" Prostate Cancer InfoLink Social Network (www.prostatecancerinfolink.ning.com) is a sister site whereyou can meet patients, wives, healthcare professionals and others in an online gathering of people with a commoninterest - how to deal with prostate cancer.

• The National Cancer Institute (,vww.cancer.gov) provides hundreds of pages of information about cancer, fromdiagnosis and treatment to policy and research.

• The American Cancer Society (www.cancer.org) offers free literature on cancer topics; sponsors support groups andcancer recovery programs, funds scientific research and provides community education.

~'(ji.

Peter Waldheim

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 withinformation 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 isbest. Before selecting a course of treatment, make sure you have a sense of your cancer's current state and its potential forfuture 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.

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