johns hopkins prostate cancer second opinion
Get a Second Opinion What can a second opinion tell me? 4. has now confirmed this assumption through a careful retrospective analysis of data from > 450 men whose records could be identified in the SEARCH database, all of whom received surgical treatment for Gleason 8 to 10 prostate cancer. And should I treat prostatitis before FLA? We provide second opinions on the full range of gynecologic cancers: Ovarian Uterine Cervical Vulvar Vaginal Fallopian tube Placental tumors Some peritoneal cancers Noted that some don't even include on report and should be looked as something to note but not obsess about. I had no idea there were second opinions and I didn't have a clue about Genomic testing, or even genetic testing. Background: Left mid-base transition zone (PIRADS 5). However, seeing him will be another 8 weeks, but he wants my biopsy slides (second opinion) before we meet. Olver I, Carey M, Bryant J, Boyes A, Evans T, Sanson-Fisher R. BMC Palliat Care. Request an Appointment 410-955-6100 In addition to cancer, our urologic team provides second opinions regarding urinary stone disease, urinary tract reconstruction, incontinence, male infertility and sexual health, and many other urologic conditions or procedures. U.S. News & World Report ranked the institute #7in the country. So, I made an appointment at Emory Proton Center (Atlanta, GA) and got their opinion. Benign Processes: Immediate means 6 weeks just to see his NP. Some men have minimal or no symptoms at all. FAX 310-574-4002 Another type of prostate issue is chronic prostatitis, or chronic pelvic pain syndrome. The margin of error is 1.4 percent, which is equivalent to 30,000 cancer diagnosis mistakes annually in the U.S. Of 6,171 biopsy slides sent since late 2008 for a second review at Johns Hopkins, pathologists disagreed with the diagnosis on 86 of them. 53 years old Fear, confusion and uncertainty set in. My dad 82 was diagnosed last week with prostate cancer with high PSA 100 and GLEASON: ( 4 + 4 ) = 8 / 1 0 , he had the PET Ga-68 PSMA image Friday and today we found out the result is stage 4 Metastatic lesions in the bone pelvic area. Cancer ABCs recommends: Johns Hopkins Hospital in Baltimore, Maryland, specifically Dr. Jonathan Epstein. Conflicting Prostate Biopsy OpinionsWhat to Do? I still have some urgency and frequency issues, but I am not complaining too bad. The James Buchanan Brady Urological Institute, Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov. This Dr is in charge of active surveillance program at JH so I knew that he wouldnt recommend surgery unless it was really needed. Tumor Quantifications: Find more COVID-19 testing locations on Maryland.gov. 4: Prostate, right medial base ZERO - The End of Prostate Cancer Support Community. Prostate Cancer Grading: They hesitated calling it a TARGET LESION, but scored it PIRADS 4. While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. Best wishes to all those whose concerns for the day are far more serious than mine. Am I wrong? And just this week, 1 YEAR post treatment, it is .46. The Radiation Oncologist knew of Dr Busch (by now in Alpharetta, GA) and spoke highly of him. However, there are also many more options for treatment and these options are more complicated than in the past. 6 A study at the Johns Hopkins Health System found it was 3.4 times more common in Black Americans than in White Americans. Ask your doctor for a copy of your complete medical record. Last checkup (July 2022) my PSA was .46 and it is currently at .32.I am still eating primarily a plant based diet (only lean meats/cheeses/eggs about 10% of my diet) and maintaining steady weight and I am still quite active physically.As for symptomswith 5mg Daily Cialis the occasional ED symptoms have pretty much gone away. The prostate gland is slightly enlarged secondary to transition zone hyperplasia (25cc total) Even for men with faster growing, more aggressive prostate cancer, taking the time to seek a second opinion should be a priority. The people were great. The other samples produced 4 more positive cancer cores for a total of 7 of 12 positives. I frequently make a 2 hour car ride and I have to stop about 25% of the time and when I don't, the urgency is a bit more evident and with the urgency come some hesitancy, but not terrible. This shows very high signal intensity on the diffusion-weighted Please don't hesitate to make any observations or ask questions. 2017 Oct;22(10):1197-1211. doi: 10.1634/theoncologist.2016-0429. Emotional outlook is fragile at times and straight clinical approach of doctors does not help. Diffusely decreased Greetings gentlemen! E. Prostate, left mid, core biopsy: After much discussion we both agreed that surgery was my best option and that he would do it at the end of July. Overall PIRADS Score: 5/5 Grade Group: 1 Should You Exercise When Youre Expecting? Surgery took about 3 hrs. We experienced information overload and decision/analysis paralysis. If the enlarged prostate is not completely removed, it will shrink. The study was published online Nov. 7 in the journal Cancer. MRI RE-READ #2 (VERY VERY well respected radiologist): Even at the age of 48, he thought I would be a good candidate for AS. Most reputable HMOs can, however, deliver state of the art treatment for most cancers. It took me awhile but minutes ago received my second opinion from Johns Hopkins. Dont Miss: Function Of The Prostate Gland And Seminal Vesicles. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). EDI am now 52 and not quite functioning like I did 4+ years ago. Ask us questions on this webpage. Because physicians may differ in their approach to treating breast cancer, its very important to check with a breast cancer expert to know youre receiving the best treatment for you. DRE is always normal. In severe cases, a catheter may be required to relieve the symptoms. But if I include the 3+3=6 cores then 4 cores tested positive and that moves me into the basic teal category and no longer a strong candidate for AS. And by FAA Aeromedical Ruling, I'd need a few post procedure reports before being cleared to fly again.) We specialize in minimally invasive treatments for prostate cancer such as: We place a high priority on sparing the nerves and tissue around the prostate whenever possible. The presence of any G4 has been my trigger to seek treatment. He said that it will improve in the future due to future improvements in the treatments. It has been 2.5 years and the PSA has still not doubled as well. I guess the PET scan will be the next step in what type of treatment options are in store.Has this occurred to anyone else? We will then prepare a written recommendation regarding your treatment plans or options. About 80 percent of prostate cancers are diagnosed at a localized stage, which means that the cancer hasnt spread outside of the prostate. Allow yourself the time to seek multiple opinions. - Johns Hopkins Medicine -- Get a Second Opinion Cancer patients are encouraged to obtain second opinions before starting treatment. Will these places of excellence consider me, or am I bound to my regular doctor for insurance purposes? of tumor in the rectal prostatic angles. JHs just said it was minimal less than 5%. - Benign prostatic tissue A second opinion is a review of the cancer diagnosis and the treatment recommendations of the physician who is treating the cancer by another, independent physician. Anyhow, as for treatment, yesterday I met with a Dr. William Wong at Mayo Phoenix. In fact, additional biopsies revealed no additional cancer. My diagnosis is T2c, Gleason 7 (3+4). Following application of the relevant exclusion criteria, 2365 respondents remained in the analytical cohort. Because physicians may differ in their approach to treating breast cancer, its very important to check with a breast cancer expert to know youre receiving the best treatment for you. BJU Int. Benign Processes: The .gov means its official. Reasons for obtaining a second opinion from urologists. HHS Vulnerability Disclosure, Help Second opinions are more likely to be comprehensive, or inclusive of every possible perspective, when performed in a cancer center with a multidisciplinary team, which usually includes surgeons, oncologists, radiation therapists, and sub-specialist oncologists. Peripheral Zone: The peripheral zone is of normal homogeneous prolonged T2 and there are no suspicious focal areas of But I've had trouble getting Dr. Chang's office to provide any patient referrals. Where to start for newly diagnosed advance prostate cancer Had a little complication a day after release, excessive blood/clots in urine. The people were great. MM, Much to my dismay my 4th targeted biopsy Oct 12 revealed 5% G4 (upgraded from Grade Group 1 to 2 (Gleason 3+4 intermediate/favorable). Instead, I did my homework. Surgeon wants next PSA in 3 months. He said that JHs said that it was 2 cores, but it was actually a fragmented core, that the fat did not present on the right place on the slide, that prior FLA (partial hemi-ablation) could affect the results, the MRI did not support, etc. It can be caused by many factors, including infection and inflammation. Wow, I sound like a snob now! Due to the spread of the Coronavirus worldwide and the first confirmed case of the Coronavirus disease in Turkey, the executive team of the Anadolu Medical Center has taken preventive measures to protect the patients and their relatives. Got the fiducials placed, the Space-OAR gel placed, mold made, and had the pre-treatment MRI and CT Scan. Even if someone is being seen at a different academic center, the trials and other treatment options that we offer here may be different. My girlfriend lives 2 blocks from the Emory Proton Clinic.We prayed on it and overthought the crap out of it. My thoughts focus on the fact that I have a disabled son who needs my care. He has had a nagging "groin injury" for may years (he played pick up basket ball until he got injured) and we are now wondering if this could be the source of that recurring ache. They did another 3T-MPMRI (Siemens machine) and it showed a faint area, near the margin, and very close to the down stream sphincter of prostate. Wondering if any of the "gurus" here want to take a stab at looking at this and see if they agree that it says what I think it says (I will be following up with doctor(s) to get their opinion, and I waive all HIPAA rights by allowing this to be seen). This has raised some questions on all the scans so far. Thank you for your understanding and cooperation. My urologist suggested a couple more PSA tests followed by an MRI. Of course that was before I found this webpage and I really didn't know what 1 core of 18 samples showing 3+4=7 Gleason meant. 1.Rebecca L. Siegel, Kimberly D. Miller, and Ahmedin Jemal, Cancer Statistics, 2019 CA Cancer J Clin. !I'll try editing a previous post and see if it reads like a journal instead of creating a new thread every update.I just got my PSA results and the numbers are still trending in the right direction. Oncologist. Epub 2018 Mar 28. THANKS! Prostate dimensions: 4.1 x 2.8 x 3.4 cm I'd like to talk with former patients who have gone through the procedure. restricted diffusion. A blocked urethra can also damage the kidneys. I am also not comfortable making a decision based upon 1 genomics test, when my other prior test(s) disagrees and the gleason score disagrees. Your Primary Care Physician referred you to your diagnosing urologist whom you now trust. Following application of the relevant exclusion criteria, 2365 respondents remained in the analytical cohort. I also changed my diet to plant based food, started juicing, and started taking supplements (think Turmeric, Green Tea, etc.). A enlarged prostate can also cause blockages in the urethra. ---------------------------------------------------------- A new study by researchers at the Johns Hopkins University has found that second opinions did not change treatment choice among men diagnosed with low-risk prostate cancer. Types of questions that pathologists often address in our second opinions: Last checkup (July 2022) my PSA was .46 and it is currently at .32.I am still eating primarily a plant based diet (only lean meats/cheeses/eggs about 10% of my diet) and maintaining steady weight and I am still quite active physically.As for symptomswith 5mg Daily Cialis the occasional ED symptoms have pretty much gone away. I then had the PHI test which showed PSA 8.70 and overall PHI 125.9. If youve received a new cancer diagnosis or arent seeing results from your current treatment plan, an expert second opinion can help you move forward with confidence. Men who sought second opinions because they were dissatisfied with their initial urologist were 51 percent less likely to receive definitive treatment, and men who wanted more information about treatment were 30 percent less likely to report excellent quality of cancer care compared with men who did not receive a second opinion. Also indicated everything else was "organ confined." 2. Four had 60-70%, five have between 5-10%. A enlarged prostate can also cause blockages in the urethra. Required fields are marked *, PHONE 310-827-7707 They want him to start radiation 25 sessions and chemo pills of Casodex 50 mg 28 pills. I just received a second opinion report from Johns Hopkins. They replied they are sending the slides but they said they're looking into the DX test and will get back to me once they have that information. Radhakrishnan A, Grande D, Mitra N, Bekelman J, Stillson C, Pollack CE. At this point, I am convinced I made the right treatment choiceOHFOR THOSE THAT DON'T KNOW, THE VA HAS MADE REPRODUCTIVE CANCERS A PRESUMPTIVE CONDITION FOR THOSE THAT SERVED IN MOST OF THE WAR ON TERROR LOCATIONS.Good luck fellas and my prayers are with all of you having to contend with this disease. * Seminal vesicle invasion: None. That said, I have some questions that I derived, keeping in mind that 99% of what I have learned since February has come directly from this group: J Am Board Fam Med. Prostate cancer is a malignant (cancerous) tumor of the prostate, a gland found only in men. Us Too Prostate is a great club and many of you have helped me a lot already. present in bladder. So, I asked the Radiologist if she will schedule one for me. With AHN Cancer Institute, you already get a world-class cancer program with leading expertise, care, and outcomes. There are also many reasons why you may want to seek another opinion during the course of your cancer care. Benign Processes: The percentage of Gleason grade 4 and/or 5 is 5 % and transmitted securely. 1st opinion"Note is made of sclerotic changes in the right pubic bone adjacent to the symphysis pubis having only low-level activity and this is thought to be more likely due to degenerative changes rather than bony metastasis." International Patients: How to Request a Remote Second Opinion I also sent my biopsy slides to Johns Hopkins for a second opinion (Epstein's read was 3+4, but with lower pattern 4 involvement than the local pathologist.). Centro Diagnostico Italiano , Milan, Italy, Manfred Dietel, M.D.Institute of Pathology Charit, Humboldt University of Medicine, Berlin, Germany, Jonathan I. Epstein, M.D.The Johns Hopkins Medical Institutions, Baltimore, MD, Robert J. Kurman, M.D.The Johns Hopkins Medical Institutions, Baltimore, MD, Elizabeth Montgomery, M.D.The Johns Hopkins Medical Institutions, Baltimore, MD, Manuel Sobrinho-Simes, M.D.University of Porto, Porto, Portugal, Ronald S. Weinstein, M.D.University of Arizona, Tuscon, AZ, Franco VisinoniMilestone Medical Technologies, Bergamo, Italy, Also Check: How Old Can You Be To Get Prostate Cancer. Perineural invasion is identified Treatment must be chosen based on stage and your Masks are required inside all of our care facilities. And just this week, 1 YEAR post treatment, it is .46. The urologist/surgeon indicated that other forms of treatment like TULSA are not options since my cancer is multifocal. For this study, published in the journal Cancer, 2386 men in the greater Philadelphia area, who were diagnosed with prostate cancer between 2012 and 2014, responded to survey questions. The more often a doctor diagnoses and treats prostate cancer the more proficient they become. Here are some recent updates: Uterine cancer.Women who use chemical hair straighteners frequently could have a higher risk of developing uterine cancer than women who have never used the products, according to new findings from a national study that has followed nearly 34,000 U.S. women for more than a decade. I guess TWO national centers of excellence are better than one? Possible additional organ confined malignant lesion in right apex I really just want the results of their innovative PTEN test. Another type of prostate issue is chronic prostatitis, or chronic pelvic pain syndrome. You receive a secure, private online consultation without leaving home. Reinterpretation of imaging scans and lab tests. Our collaborative processes also extend to our colleagues at Johns Hopkins Medicine, a world-wide leader in cancer research. 5. According to the doctor it is around 3 mm. And again, most of you tell me time is on my side, so I am comforted in hearing that. Prostatic Adenocarcinoma Some pathologists have more experience than others. Now its easier than ever to get the answers you need and peace of mind you deserve. Johns Hopkins second opinion identified a PI-RADS 4 Mayo Phoenix also reviewed MRI prior to targeted biopsy. Prostate Cancer News, Reviews & Views: Second opinions My experience at Johns Hopkins was awesome. Expert review of your case by a Cleveland Clinic specialist. Study after study confirms that doctors favor the treatment they are trained to do urologists typically recommend surgery and radiation oncologists recommend radiation. The main purpose of the prostate is to produce semen, a milky fluid that sperm swims in. * Prostate size: 3.9 x 2.8 x 3. cm MRI obtained outsideon 04/16/2021. A new study by researchers at the Johns Hopkins University has found that . The Stanford Medicine Online Second Opinion program offers you easy access to our world-class doctors. !I've pasted a previous update below for background.I just got my PSA results and the numbers are still trending in the right direction. 6. Epub 2010 Oct 20. She put me in the hospital. My new Dr however didnt order PSA so I asked him for one. At that point I agreed to the TRUS biopsy which I had on October 10, 2020. The primary goal is to be cured with the least toxic, most effective approach. I have selected Focal Laser Ablation as my future (soon) treatment. Because every patient is different, there are several ways to approach prostate cancer treatment. Urologists are trained as surgeons, radiation oncologists administer radiation, and medical oncologists provide cognitive oversight and general management of the cancer. 4. I had a telemed session with Dr. Chang, and it sounds like a pretty simple procedure, with urinary side effects that resolve pretty quickly. We will give that a shot and see how it turns out. feel the clock ticking. I have had a second opinion from Johns Hopkins that confirmed the initial pathology of gleason 3+4. How to Get a Second Opinion Our team at Johns Hopkins has a dedicated service to interpretation of brain tumors and render second opinions on a daily basis. Of course that was before I found this webpage and I really didn't know what 1 core of 18 samples showing 3+4=7 Gleason meant. I've been on AS since April 2016. Second Opinion Pathology | MD Anderson Cancer Center Whether you want expert confirmation, lack understanding or confidence in your treatment plan, have a rare or unusual type of cancer, your cancer isnt responding to current treatment its reassuring to know that you have options through a second opinion. Move ahead to Dec 2020. OTHER: None. 2 cores from left base of 3+4=7 with only 5% involvement. Include Your Primary Care Physician as Member of Your Treatment Team. And it is OK to have paralysis by over-analysis. Thank you! Bones: There is marketed marrow heterogeneity in the pelvic bones are not in the femoral heads. I have been drinking out of an information fire hose. First of all we would like to emphasize that the health of our employees, our patients and their relatives is our first priority. 5. 1st opinion"Nonspecific sclerotic change of the right pubic bone with low-level radiotracer activity, favor degenerative change rather than osseous metastasis." Read books and realize as soon as they are published, they are outdated. 2. TZ zone more beneficial, but fairly large compared to whole gland and proximity to capsule edge would likely mean treatment would be suggested. Doctors can review their peers treatment suggestions and explain why they agree or disagree. In My Opinion? Get A Second Opinion | ZERO Prostate Cancer Its gone.I have been advised to have a Axumin Pet scan as follow up as the first pathology report indicated perineural invasion present as well as probable introductal carcinoma. Seeking a Second Opinion - American Cancer Society Therefore, the value of these second opinions remains unknown. Many health insurance companies will pay for a second opinion, especially if it is for a medically necessary treatment. Interesting differences: * Seminal vesicle invasion: None. Unfortunately, what you do not realize may harm you! I appreciate all the input because I am a little overwhelmed and confused as to the best course of treatment. As a result, patients struggle to differentiate bias from fact. But I did speak to an oncologist who wanted to order Oncotype, which I did. The linear amount of tissue with carcinoma is 23 mm About 60% of prostate cancers occur in people older than 65. Second opinions offer different things in different circumstances, Dr. Matasar says. A doctor may prescribe surgery or perform an endoscopic procedure. D. Prostate, left base, core biopsy: Dr. Albert Chang at UCLA appears to be the best in the biz for high dose rate (HDR) focal brachytherapy. When you get a diagnosis of breast cancer from your doctor, its not uncommon to get a second opinion. And by FAA Aeromedical Ruling, I'd need a few post procedure reports before being cleared to fly again.) Note respondents were able to, MeSH It was easy. undefined will no longer be visible to you including posts, replies, and photos. Prostate cancer is a slow growing condition. Benign fibromuscular stroma; no prostatic glands are identified Can it be salvaged or are the risks of cancer too high? -------------------------------------------------------- If you have received a diagnosis or recommendation for treatment and want another opinion, our service can help you make a more informed decision. Men often seek second opinions from urologists before they initiate treatment for their newly diagnosed prostate cancer. The site is secure. SMIL radiologist reported nothing found. NOTE: THINK THIS LOWERS MY PSA DENSITY SOME IF MY GLAND ISN'T a 17CC PEANUT! You know - urinary incontence, erectile dsyfunction, and exhaustion (hormones) are not my cup of tea. This championship swimmer sought a second opinion at Johns Hopkins. Would it be rational to stay on AS until biopsy results show a higher volume of PCa for sampled cores (i.e. Second opinions from urologists for prostate cancer: Who gets - PubMed I can do radiation as a monotherapy.
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