This doctor or team of doctors will review the following: The doctor then communicate their opinion regarding treatment to both the patient and the primary physician. 2/23 PSA 4.7/fPSA 12% taken for 4K score (lab #2) Best practices dictate that you obtain a second confirmatory pathology evaluation. 2016 American Cancer Society. Thanks! Obtaining a second opinion in Pathology can in a small percent of cases lead to a complete change in diagnosis in a wide range of conditions including non-cancerous growths, inflammatory disorders, infections, and cancer. Greatest dimension 2cm. However, seeing him will be another 8 weeks, but he wants my biopsy slides (second opinion) before we meet. 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. Many men name the diagnosing urologist as their treating doctor and do not seek other opinions. I am 62 years old. FAX 310-574-4002 Epub 2017 Jun 12. This kills both birds with a single stone. As soon as pathology slides were ready, Emory sent them to Dr. Epstein at Johns Hopkins. Even at the age of 48, he thought I would be a good candidate for AS. Pingback: PROSTATE PROS Episode 6: Breakthroughs in Radiation PROSTATE ONCOLOGY SPECIALISTS, Pingback: Like Man, Im Tired (Of Waiting): The How-to Guide for Men with Prostate Cancer PROSTATE ONCOLOGY SPECIALISTS, Your email address will not be published. Some men have minimal or no symptoms at all. He spent an hour on the phone reassuring me that I didn't need to rush into anything, and they he'd love to scan me 6-8 weeks after my TRUS Biopsyhave to let the trauma and all the blood leave the prostate for a good image. Utilize your primary care physicians as an un-biased resource to help you get second opinions from a range of specialists. Oncologist. They hesitated calling it a TARGET LESION, but scored it PIRADS 4. ZERO - The End of Prostate Cancer Support Community. It hasn't let me down. They seem to think it'll do the trick.I feel great and I am glad I chose this treatment path.
Prostate cancer is a slow growing condition. Doctors can review their peers treatment suggestions and explain why they agree or disagree. Got my physical and normal DRE with new Dr. No issues identified. We have a surgery date set up for the end of July at Johns Hopkins (our second opinion team).His stats:63yo, non smoker, 167lbs, Vegetarian/Vegan diet no other known health issuesWalks dogs for a living and cares for our small farmPSA 3.3 (Jumped from 1.6 in a year)Biopsy Scores 3+5, 4+3. Find more COVID-19 testing locations on Maryland.gov. It hasn't let me down. Either the patient or the primary physician can initiate the process of getting a second opinion. My strong preference would be to do FLA again and monitor. Y'all are in my prayers! Advances in our understanding of breast cancer have opened up new treatment options or clinical trial opportunities, including targeted drug therapies and tissue-conserving procedures proven to greatly reduce pain and nausea. You May Like: Prostate Radiation Treatment Side Effects. With no travel needed and no red tape, its easy to get a second opinion, all from the comfort of your home. Two from one lesion were positive as was one of the two from the other. I am already positively surprised that I am still alive 4.5 years after my diagnosis. Pathology report indicated additional presence of cells at right apex, but unclear whether intraprostatic incision or extraprostatic extension. Ozzieville (Michael), Hello All and thanks for being here~This is my first post.My husband was diagnosed with PC (adenocarcinoma with Extensive Intraductal Carcinoma Present) a few weeks ago. The presence of any G4 has been my trigger to seek treatment. I was offered to have my first biopsy sent to Johns Hopkins for second opinion and said why not? which came back with Gleason 9 three weeks after having the what we thought was G-7 ablated. doi: 10.1002/cncr.30412. PREVIOUS MRI RESULTS (LOTS of them) Another type of prostate issue is chronic prostatitis, or chronic pelvic pain syndrome. There is no evidence Patients are often under the mistaken notion that they have to pick between their oncologist and MSK, but thats often not the case, Dr. Matasar explains. Caused me to bleed heavily. (TZ) One suspicious area - lesion size: 2cm x 1.4 cm Also these lesions did not abut or touch the wall of the prostate. When people recommend going to a Center of Excellence, believe them. Federal government websites often end in .gov or .mil. Be well. Seminal vesicles are normal. I still have some urgency and frequency issues, but I am not complaining too bad. For cancers that are less common, second opinions can offer more treatment options.
Prostate Cancer News, Reviews & Views: Second opinions The primary goal is to be cured with the least toxic, most effective approach. 2. You can find out by reviewing your plan or by reaching out to your insurance company. Five years ago I had a TURP. I have searched the country for intervential radiologist that perform FLA on the prostate. A doctor at MSK can collaborate with another doctor to offer support and help ensure the best outcomes. Usually, patients obtain a second opinion after being referred to a second physician or to a special team of experts in a cancer center, called a multidisciplinary team. Family history of prostate cancer. My goals are to control PCa, to minimize side effects, and to keep options open in the future. Background: 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. Not all cancers are the same and not all treatment plans are absolutely clear. Their opinions are widely held to be definitive. radiation, active surveillance, surgery, hormone therapy, and more. I sent a message to my urologist requesting my slides be sent to Dr. Epstein at Johns Hopkins for a second opinion and I also requested an Oncotype DX test to get an idea of risk for my low teal or basic teal cancer. He turned to the Top Gun of Prostate Pathology: Jonathan Epstein, MD, the guru of Gleason scoring at Johns Hopkins University in Baltimore. of tumor in the rectal prostatic angles. It starts many years ago. There is no bony or bulky nodal disease in the pelvis According to The National Institute on Aging, prostate problems are common after age 50. Radhakrishnan A, Grande D, Mitra N, Bekelman J, Stillson C, Pollack CE. 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. * Adjacent organ invasion: None. Here are seven tips for seeking second opinions for prostate cancer: 1. However, there are other cases when a second opinion results in a very different diagnosis or set of treatment recommendations. I've been on AS since April 2016. A. Prostate, right base, core biopsy: This Dr is in charge of active surveillance program at JH so I knew that he wouldnt recommend surgery unless it was really needed. Anyone with insight into this and advice? very activerun/cycle 6 days a week We experienced information overload and decision/analysis paralysis. Dont Miss: New Treatments For Stage 4 Prostate Cancer. They are not objective. This teamwork ensures the best possible patient outcomes. I also changed my diet to plant based food, started juicing, and started taking supplements (think Turmeric, Green Tea, etc.). 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. The study was published online Nov. 7 in the journal Cancer. Do any of you have an opinion or actual experience with any of the three listed below? 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. When I was diagnosed I really thought that I will live only 2 years. While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. sharing sensitive information, make sure youre on a federal 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. Symptoms include leaking and discomfort. Different institutions have different levels of experience when it comes to analyzing prostate biopsy samples and interpreting imaging results. Medical record collection from doctors and hospitals. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. Seeking second opinions is becoming standard practice, and it is mandatory at Johns Hopkins. Careers. If you are considering undergoing a specialized treatment, such as cancer surgery, within your HMO, it is important to inquire about the number of such procedures performed each year by the HMO and the results. prostate cancer; quality of health care; second opinion; specialists; treatment. A blocked urethra can also damage the kidneys. Ask your PCP to refer you to several different types of treating doctors before making a treatment decision. 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? Had third MRI in July 2019 this time at Mayo which I believe does a better job than SMIL. So the pathologist suggested a second opinion. Please enable it to take advantage of the complete set of features! My new Dr however didnt order PSA so I asked him for one.
Biopsy Results: What Do They Mean? - Prostate Cancer Foundation Our gynecologic pathology team can also help determine if the tumor is localized or has metastasized from another region of the body. Also, infection was noted, so the current PSA is high in part due to prostatitis. Since I have gotten so much out of this forum, I thought Id provide my story to help others. I appreciate all the input because I am a little overwhelmed and confused as to the best course of treatment. Masks are required inside all of our care facilities. An official website of the United States government. F. Prostate, left apex, core biopsy: Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. Prostate dimensions: 4.1 x 2.8 x 3.4 cm Getting a second opinion can sometimes lead to a complete change in diagnosis in non-cancerous growths, inflammatory disorders, infections, cancer and other conditions. Second Opinion Results, Johns Hopkins biopsy reading of 2 slides sent by Sloan: A PSA test at time of biopsy revealed my PSA had risen to 6.5. Following the advice of all on here, I need a team of doctors to manage my care. In adjusted analyses, however, only age and education were significantly associated with obtaining second opinions from urologists. Find more COVID-19 testing locations on Maryland.gov. Avoiding obsolescence in advanced prostate cancer management: a guide for urologists. poorly defined margins and intermediate to low T2. More medical freakouts.
Where Should I Go for a Second Opinion? - breast cancer It is OK to not understand all the terminology. * Size: 1.1 cm Overall, nearly 80% of men received definitive treatment 76.5% of men who obtained a second opinion from a urologist received definitive treatment compared to 81.6% who did not . Using the Bullet Volume gives you gland of 25.55. DRE is always normal. Read Also: Long Term Side Effects Of Brachytherapy For Prostate Cancer. 1st opinion"PYL PSMA PET/CT scan demonstrating foci of moderate to intense uptake in the prostate gland consistent with known prostatic cancer. Accessibility 9: Prostate, left anterior MRI lesion If you are considering undergoing a specialized treatment, such as cancer surgery, within your HMO, it is important to inquire about the number of such procedures performed each year by the HMO and the results. 2. So, I asked the Radiologist if she will schedule one for me. Right mid anterior transition zone (PIRADS 2). and transmitted securely. I luckily found this webpage and I started reading everything I could get my hands on. Keep in mind that not all PCPs are knowledgeable about prostate cancer or know the skill levels of all the specialists in the field. There is no extraprostatic extension. Results:
Get a Urology Second Opinion | Johns Hopkins Brady - Hopkins Medicine He adds that second opinions also can provide insight into topics like clinical genetics and family risk or issues related to complementary or integrative medicine approaches to manage symptoms. -------------------------------------------------------- Metastasis. All wanted to do what they do, schedule treatment which at this time is only Gleason 6 which I now know is not life threating. The PSA Doubling Time parallels my Urologist Doubling Time (I keep changing Uro until I find one who makes sense)! Prostate cancer is an My Oncotype rating was GPS 54, with a 26% chance of metastisis within 10 years. 5. I assume the data on gleason scoring is much more robust/reliable than genomics as it has been around longer and used more extensively. And just this week, 1 YEAR post treatment, it is .46. His reasoning over the last couple of years is that the suspected lesion was not changing in size at all. We had the 3T MRI (no coil) and MRI guided biopsy at Sperling in NY, and then had a 2nd Opinion done by Johns Hopkins. Got the fiducials placed, the Space-OAR gel placed, mold made, and had the pre-treatment MRI and CT Scan. 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, Read Also: Nhs Prostate Cancer Risk Calculator. Identified an approximate 2 cm lesion of mostly Gleason 7 (3+4) with only 20% being 4, contained in prostate. Sometimes, you may find out about treatment options you didnt know were available. peripheral zone signal intensity on T2-weighted images.
Prostate Cancer | Johns Hopkins Medicine So, I believe I made the right choice. Methods: My PSA went up from 3.5 post FLA (It was 7.2 pre-procedure) to 6.7 in 2021, so I went to another radiologist to do an MRI guided biopsy of the suspected area that was near the prior ablation zone. A fusion biopsy was performed in late May and I just received those results last Thursday. The results seemed fairly benign and my urologist and I decided to continue to monitor with 2 more PSA tests and then consider an MRI in April 2021. 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. information. He schedules appointments with a Radiologist and two local surgeons. Just got my pathology results. 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. Medical record collection from doctors and hospitals. 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. Does this also include HIFU, Cryoablation? 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. Dr. Epstein has 744 publications in peer-reviewed literature and has authored 50 book chapters with a H-factor of 118. Lesions are all small or very small. Targeted MR/Fusion biopsy of one 4x8 mm lesion on Right side showed 3+3 in 2 of 5 cores (20% of total volume), and random Right side: 1 core 3+4 (10%, 20% on second opinion from Johns Hopkins) and 1 core 3+3 (10% volume) ; Left Side 1 core 3+3 (10%, no PCa on second opinion from Johns Hopkins). Time moves fast when dealing with cancer, but Doctors dont. T2W MRI score= 5, DW MRI score= 5, DCE MRI score=positive intricate disease and not all doctors have the same amount of experience It works. I really just want the results of their innovative PTEN test. Call us with any questions: 410-955-2405, ext. Johns Hopkins Medicine A commercially available genomic test may help oncologists better determine which patients with recurrent prostate cancer may benefit from hormone therapy, according to new research from the Johns Hopkins Kimmel Cancer Centerand 15 other medical centers. There is no extraprostatic extension. As evidenced on this site, some studies indicate that GS 6 shouldn't even be classified as PCa and that it isn't aggressive.
Johns Hopkins Hospital Prostate Cancer - ProstateProHelp.com I assume it is not free. PSA had increased to 5.4. The side effects of the cut, radiate, hormone regime are unacceptable to me. Move ahead to Dec 2020.
Second opinions from urologists for prostate cancer: Who gets - PubMed If they have an enlarged colon, their physician can perform a TURP procedure. PROSTATE PROS Episode 6: Breakthroughs in Radiation PROSTATE ONCOLOGY SPECIALISTS, Like Man, Im Tired (Of Waiting): The How-to Guide for Men with Prostate Cancer PROSTATE ONCOLOGY SPECIALISTS, Considering Prostate Cancer Clinical Trials? Reasons for obtaining a second opinion from urologists. What are your opinions of what that is, and where to get it? He also stated that he would ONLY recommend FLA if done within a trial. I worked out every day. My urologist suggested a couple more PSA tests followed by an MRI. The Radiation Oncologist said he would be comfortable waiting a little more, but he wasn't confident that I'd grow a target lesion, nor would I be able to wait years before having to do "something." Patients may experience a fever or chills as a result of the infection. Grade Group: 2 P60 MD006900/MD/NIMHD NIH HHS/United States, T32 HL007180/HL/NHLBI NIH HHS/United States, K07 CA151910/CA/NCI NIH HHS/United States, P30 CA016520/CA/NCI NIH HHS/United States, K07 CA163616/CA/NCI NIH HHS/United States. If I don't meter fluids before bed, I can expect to get up 3-4 times in the night.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 vesicles: The seminal vesicles are normal and symmetrical bilaterally. Want confirmation about a diagnosis or treatment. You feel healthy, you arent in pain, you Especially opinions other than those of the first Urologist you see. Grade Group: 1 Negative cancer in lymph nodes, seminal vesicles, and all margins. prostate volume). If you have received a diagnosis or recommendation for treatment and want another opinion, our service can help you make a more informed decision. In other words, can I have a team here in Wisconsin yet travel elsewhere to get my MRI? I have had a second opinion from Johns Hopkins that confirmed the initial pathology of gleason 3+4.