I say bullshit to them. Family history of prostate cancer. Anyone else encounter something like this? 10. With that alone, I would likely be a candidate for continued Active Surveillance. He schedules appointments with a Radiologist and two local surgeons. Other labs for second . I'll post the whole thing, my doc and my own comments, and then cut/paste all my MRI results in case anyone REALLY liked data. 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." Our team approach brings together highly experienced prostate cancer experts from across disciplines to collaborate on each patients total care, from diagnosis through treatment and recovery. -------------------------------------------------------- Noted that some don't even include on report and should be looked as something to note but not obsess about. advising or treating it. JHs just said it was minimal less than 5%. I appreciate all the input because I am a little overwhelmed and confused as to the best course of treatment. You think another treatment might be available. By taking the extra time to seek a second opinion, you have a better chance at finding the most up-to-date approach and an experienced doctor. Similarly, among those who received definitive treatment, second opinions were not associated with receiving surgery. We specialize in minimally invasive procedures to treat BPH, including: For selected BPH patients, our specialists also perform transurethral resection of the prostate , a procedure that requires no incisions and has a high rate of success. John Hopkins Prostate Cancer Second Opinion Now, I would like to send Radiology for a similar review. There is hope. Did robotic radical prostatectomy 1/25/12. Dont Miss: New Treatments For Stage 4 Prostate Cancer. They told me to expect a spike in my PSA sometime in the future, and they told me that studies are showing that a slow, steady decline in PSA is often indicative of superior results (whatever that means. - Follow-Up Score (PRECISE) for this lesion = Stable MRI appearance: no new focal/diffuse lesions. The best protection for cancer patients who are Health Maintenance Organization members is to seek a second opinion even if she or he has to pay for it. The TRUS biopsy is behind me, the second opinion from Johns Hopkins is behind me, and its time for next steps. Second Opinions & Consultations - Brain Tumor | Johns Hopkins Pathology There is no extraprostatic extension. So the pathologist suggested a second opinion. Find more COVID-19 testing locations on Maryland.gov. They find that one of my 5-10% Gleason 6 core is actually a 50% Gleason 7(3+4) and the MRI was so cloudy with blood from original biopsy they said they couldnt determine much. It's a bit confusing since most experts now don't consider Gleason 6 to be a true cancer, so did i test positive in 2 cores or 4? doi: 10.1002/cncr.30412. 2017 Oct;22(10):1197-1211. doi: 10.1634/theoncologist.2016-0429. If the enlarged prostate is not completely removed, it will shrink. TZ zone more beneficial, but fairly large compared to whole gland and proximity to capsule edge would likely mean treatment would be suggested. Prostate Cancer Grading: Numerous publications show the clinical and economic benefits of obtaining a second opinion for Pathology specimens. Patient-Driven Second Opinions in Oncology: A Systematic Review. Brachytherapy Experience with Dr. Albert Chang at UCLA? The total number of cores with carcinoma is 3 If they have an enlarged colon, their physician can perform a TURP procedure. 6: Prostate, left medial base They seem to think it'll do the trick.I feel great and I am glad I chose this treatment path. I had my first of those 2 PSA tests last week and it dropped to 4.77. My profession for forty years was health actuary consultant, so I have a pretty fair understanding of health data, outcomes, and risks. When facing an intricate disease like prostate cancer, the above scenario is far too simple to have a promising outcome. Right mid anterior transition zone (PIRADS 2). It is OK to be scared. Those readings were reported on a second opinion by Dr. Epstein. Second opinion Biopsy came after FLA G-9. 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. Some specialize in reading only slides that come from a specific organ while others are generalists who read many different pathology slides from many different organ systems. 7 Tips for Seeking Second Opinions For Men with Prostate Cancer Johns Hopkins Prostate Cancer Doctors - HealthyProstateClub.com The results were ambiguous. The other samples produced 4 more positive cancer cores for a total of 7 of 12 positives. A newly published paper by Fischer et al. The people were great. 4, Dr. Jonathan Epstein explains the benefits of getting a pathology second opinion. Instructions for Second Opinion on Pathology (Gleason score) Thanks, BigD. And it is OK to have paralysis by over-analysis. Lesion 1: Left mid-base transition zone. I have searched the country for intervential radiologist that perform FLA on the prostate. - Prostatic adenocarcinoma, Gleason score 3+4=7 (grade group 2, pattern 4: 5%) involving 2 of 2 cores (medial core: 3.5 mm, 30%; lateral core: 2.5 mm, 20%), 0.5 mm to the blue inked tissue edge (the closer) In circumstances where there may not be a single established standard of care, we can ensure the treatment plan integrates the most current, up-to-date data, Dr. Matasar says. Surabhi Dangi-Garimella, PhD. For these reasons, it is a good idea for HMO members to get a second opinion and make sure they are informed about clinical trials or other promising new treatments. Hope to hear from a bunch of people. Secondary Gleason grade: 3 Four weeks after a radical prostatectomy for prostate cancer, he was back in the pool. Thanks to all of you for sharing! Radhakrishnan A, Grande D, Mitra N, Bekelman J, Stillson C, Pollack CE. Im currently 67 years old. In those cases, patients are tremendously grateful for having received the advice and encouragement to get a second opinion, Dr. Matasar adds. * Perineural Invasion detected Note respondents were able to, MeSH I'd like to talk with former patients who have gone through the procedure. E. Prostate, left mid, core biopsy: 1.Rebecca L. Siegel, Kimberly D. Miller, and Ahmedin Jemal, Cancer Statistics, 2019 CA Cancer J Clin. If the problem is unresponsive to other treatments, your doctor may suggest a surgical procedure. Overall my PSA is between 4 and 10. Now its easier than ever to get the answers you need and peace of mind you deserve. They did 9 patients in Phase I and there have been 12 so far in Phase II. notable articles of 2016 - Johns Hopkins Bloomberg School of I question the potential EPE and he said it didn't matter, but went ahead and ordered Oncotype. Two 1cc tumors, gleason score 3+4 each, one in each lobe. A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. Similarly, among those who received definitive treatment, second opinions were not associated with receiving surgery. In other words, can I have a team here in Wisconsin yet travel elsewhere to get my MRI? More medical freakouts. This shows very high signal intensity on the diffusion-weighted PSA was 3.0 in 2011 and rose to 6.0 in late 2013. * Adjacent organ invasion: None. When you get a diagnosis of breast cancer from your doctor, its not uncommon to get a second opinion. I wish the VA would be more informative about this disease they owe it to our veterans. However, many insurance and health care companies do pay for such opinions and acknowledge the importance of second opinions. Contact us or find a patient care location. Atrophy Getting a second opinion on a diagnosis can reverse a diagnosis or alter the treatment plan. I am 62 years old. I was to follow up with my new Urologist (another surgeon) for 3 months PSA checks and annual 3T-MPMRI.My PSA checks were static and the next year's MRI looked just like the first. They won't be offended, and they may even be able to recommend a specialist for you to see. Johns Hopkins second opinion identified a PI-RADS 4 Mayo Phoenix also reviewed MRI prior to targeted biopsy. Second opinions from urologists for prostate cancer: who gets them, why, and their link to treatment . Your email address will not be published. * Location: Right, anterior, apex, peripheral zone HMOs usually try to diagnose and treat patients within their system because the more money the HMO spends on second opinions and treatment outside the HMO, the less money there is available for operation costs and profits. curing cancer, prostate cancer questions johns hopkins hospital, josef issels wikipedia, cancer a second opinion a look at book by josef issels, coping with metastatic cancer cancer net, pdf americans health priorities curing cancer and, what is immunotherapy cancer research institute cri, cancer a second opinion a . The local pathologist read the biopsy and said 3+4=7 10% pattern 4 for both lesions. They also determined there was extrapostatic extension because there was some fat in the sample that involved the cancer. Its in your best interest to ask for another look at a cancer diagnosisIf youve recently been diagnosed with cancer, its wise to ask for a second opinion on your pathology specimen.Johns Hopkins researchers with the Urological Pathology Consult Division, led by Jonathan Epstein, M.D., first reported on biopsy errors a decade ago, when they found a margin of error in prostate cancer diagnoses large enough to give them pause. 2. The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System. I did a book review with his first book for several veterans groups including the Americal Division Veterans Organization which with I served at age 19. 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: Over 80,000 specimen cases are seen at Johns Hopkins each year. Prostate Cancer | Johns Hopkins Medicine I opted to waive the biopsy, wait 1 year and test again. Cancer. Slight BPH findings. Another type of prostate issue is chronic prostatitis, or chronic pelvic pain syndrome. Immediate means 6 weeks just to see his NP. It has been 2.5 years and the PSA has still not doubled as well. Do second opinions matter in prostate cancer care? - ecancer
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