Hello. EVERY DAY, they'd take a low dose X-RAY and low dose CT to align the fiducials and ensure my bladder was full and the bowel was empty. The Radiation Oncologist knew of Dr Busch (by now in Alpharetta, GA) and spoke highly of him. I suggest for all that hear, "you have cancer" that you seek more opinions! 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. Two weeks later I meet with my Johns Hopkins Dr. An accurate diagnosis is essential to ensure the most effective treatment. We surveyed men who were diagnosed with localized prostate cancer in the greater Philadelphia area from 2012 to 2014. 1. )As for side effectsI occasionally have some urgency/hesitancy having to pee. And again, most of you tell me time is on my side, so I am comforted in hearing that. PSA had increased to 5.4. 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. Receiving a second opinion was not associated with perceived quality of prostate cancer care. Xia L, Talwar R, Chelluri RR, Guzzo TJ, Lee DJ. 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. Find a doctor at The Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center or Johns Hopkins Community Physicians. What have your doctors told you? Second Opinions for Cancer Care - UChicago Medicine Call us with any questions: 410-955-2405, ext. Benign prostatic tissue They are not objective. If they do not cover this cost and you must pay out of pocket, keep in mind that a second opinion could save you from having to pay (financially and physically) for additional treatment down the line. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. Prostate cancer is an Dr. Epstein has 744 publications in peer-reviewed literature and has authored 50 book chapters with a H-factor of 118. The prostate gland is slightly enlarged secondary to transition zone hyperplasia (25cc total) 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. In order to receive appropriate treatment, patients must understand the treatment options that are available. I measure PSA frequently, and it is stable and slightly declining with the last score at 5.5. I would feel much more comfortable, if the numbers stay the same, being involved in a recognized Active Surveillance Program. I had the slides reviewed at Johns Hopkins and 1 of the HG PIN cores was changed to suspicious for adenocarcinoma while another HG PIN core was changed to benign. Some men have minimal or no symptoms at all. Below is the link with instructions and the authorization form for you to use with your doctor. Men often seek second opinions from urologists before they initiate treatment for their newly diagnosed prostate cancer. I trust the second opinion Dr. Bush gave. Read books and realize as soon as they are published, they are outdated. Masks are required inside all of our care facilities. Results: Overall PIRADS Score: 5/5 One core had 5%, one 20%, and one 40%. I am already positively surprised that I am still alive 4.5 years after my diagnosis. Treatment Advice: Sloans radiation oncologist says radiation treatment will likely be the same whichever pathologist report prevails, but may add hormone therapy for about 2 months. If I am rested, I find that I am more ready than if I am not. First MRI done in June 2016 by Scottsdale Medical Imaging - nothing found. Prostatic Adenocarcinoma Netto says patients should be proactive in requesting that doctors take another look. Just had my appointment today and they are pleased with the results, so far. Us Too Prostate is a great club and many of you have helped me a lot already. In fact, additional biopsies revealed no additional cancer. Prostate volume: 17.58 cc During your visit, our specialists will review your medical records, diagnostic tests and other information provided by you or your current physician. Radiation oncologist of same group of doctors says to do IMRT (using Rapid ARC program) as precautionary treatment, regardless of PSA scores. After all, it seems like good idea to deal with your cancer sooner rather than later. I have been drinking out of an information fire hose. Comments appreciated, My direct phone (mobile) number is 703-992-3662, or you can private message me via this platform. Last year, Epsteins lab reviewed the pathology reports of 30,000 cases in which patients requested second opinions.Netto says patients should be proactive in requesting that doctors take another look.A second opinion can reverse the diagnosis in up to 5 percent of cases for some types of cancers, he says, like those of the breast and pancreas.Diagnosis Errors by the Numbers. 3. Identified an approximate 2 cm lesion of mostly Gleason 7 (3+4) with only 20% being 4, contained in prostate. Greatest dimension 0.7cm . Atrophy Prostate Cancer | Johns Hopkins Brady Urological Institute Now the oncologist wants to perform a PSMA Pet Scan. asymmetric central zone tissue more pronounced on the left. - Perineural invasion is present BASE DATA: If youve received a new diagnosis or arent seeing results from your current treatment plan, a second opinion can help you move forward with confidence. Nor did I have any idea that the 1 core had 20% involvement and <5% pattern 4 involvement. 2. Instructions for Second Opinion on Pathology (Gleason score) In addition to providing a better understanding of your diagnosis, a second opinion can also shed new light on treatment options and give you confidence in how to proceed with your care. I've had what I would consider a fluctuating PSA since first tested in November 2018. If you choose to be treated at Johns Hopkins, you may be able to begin treatment immediately. 6. So, I made an appointment at Emory Proton Center (Atlanta, GA) and got their opinion. I have selected Focal Laser Ablation as my future (soon) treatment. However, that information will still be included in details such as numbers of replies. Symptoms include leaking and discomfort. The linear amount of tissue with carcinoma is 23 mm Surprisingly, while one in nine men will get diagnosed with prostate cancer in their lifetime1, there are very few doctors who specialize exclusively in treating prostate cancer. I had my first of those 2 PSA tests last week and it dropped to 4.77. Second opinions not likely to change prostate cancer treatment The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). By basing a treatment However, there were no other suspicious areas on MRI. This has only low-level nonspecific activity with SUV max of 2.05 and may be due to degenerative changes at the symphysis pubis." Here's what JH says (same lesion). Seeking a Second Opinion - American Cancer Society National Library of Medicine My girlfriend lives 2 blocks from the Emory Proton Clinic.We prayed on it and overthought the crap out of it. I was on disability from work the entire time (not that I was disabled, but as a pilot, I couldn't very well work and get treatment at the same time. 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. Good pathology readings require experience and a high level of expertise. Extracapsular extension: The prostatic capsule is preserved. 7: Prostate, left lateral apex I was disappointed that only TRUS was being used, but I did find out that this was for screening only and IF you pass screeningthey use MRI guided biopsy for post-ablation follow up. ZERO - The End of Prostate Cancer Support Community. I had no idea there were second opinions and I didn't have a clue about Genomic testing, or even genetic testing. Getting a second opinion on a diagnosis can reverse a diagnosis or alter the treatment plan. D. Prostate, left base, core biopsy: Prostate, right medial base: Surgery seems like overkill for me with too many risks for incontinence and permanent ED, am I overlooking something? Thank you, After more than three years on active surveillance, I've pretty much decided to have focal brachytherapy for my prostate cancer. * Gleason Score: 4+5, Slide 4 (vs. Sloan's 3+4) It will be interesting to see, I think. The survey asked the men if they had opted for a second opinion from a urologist following their diagnosis of prostate cancer, and the reasons for the second opinion. * Sloan only sent partial cores, slides 1 and 4. Being in Wisconsin, my insurance gives me the option of two hospitals to manage me. 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 . Even if someone is being seen at a different academic center, the trials and other treatment options that we offer here may be different. This has raised some questions on all the scans so far. Then about a month later I started 28 fractions of Proton Radiation.It was painless. Sometimes, you may find out about treatment options you didnt know were available. Four weeks after a radical prostatectomy for prostate cancer, he was back in the pool. Seminal vesicles are normal. SMIL radiologist reported nothing found. Second Opinion For Cancer Treatment And Care | CTCA | City of Hope 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. Had a little complication a day after release, excessive blood/clots in urine. Left mid-base transition zone (PIRADS 5). Slightly Even at the age of 48, he thought I would be a good candidate for AS. 5. and I have already proven to myself that my body is good at cell mutation, so I wanted to be careful.At the 3 year mark (6 months after last MRI), my PSA spiked to > 6. An acute bacterial infection can cause a burning sensation. I had no idea there were second opinions and I didn't have a clue about Genomic testing, or even genetic testing. Reason was large volume of cancer (even though most of mine was Gleason 6), presence of Gleason 7 in biopsy and the rapidly increasing PSA. 4.5 year journey (18 months post proton beam), 4.5 Year Update (18 month post Proton Beam). He said that he saw what JHs was referring to but did not determine EPE for a variety of reasons. Call us with any questions: 410-955-2405, ext. The problem is that all 3 pathologies noted an intraductal component. Dr. Albert Chang at UCLA appears to be the best in the biz for high dose rate (HDR) focal brachytherapy. I also learned a lot more about the high undisclosed risk of side effects of various treatment plans. He also said I would tolerate any option well based on my age and health. It starts many years ago. Johns Hopkins is home to many of the world's leaders in Pathology. Find more COVID-19 testing locations on Maryland.gov. Have been told a health condition is not treatable. This is not true. The .gov means its official. 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. Yet none of my doctors ever mentioned it! In My Opinion? Get A Second Opinion | ZERO Prostate Cancer HMO members may also be discouraged from trying expensive treatments that have only a small chance of success, even if that chance is real. 3 months has passed, and its time for a PSA and a plan to have an MRI. A week later had catheter removed and had no bladder leakage problems. Benign Processes: I have had a CT of the pelvic area - negative and a whole body bone scan - negative. The biopsy took 12 cores, two from each lesion area and 8 randomly. - One separate small tissue fragment with prostatic adenocarcinoma, 0.5 mm in linear length Also, infection was noted, so the current PSA is high in part due to prostatitis. Lesion #1 (index): PI-RADS v2.1 score 4, lesion measuring 10 mm centered at the right mid/apex posteromedial peripheral zone; findings equivocal for extraprostatic extension; no evidence of seminal vesicle invasion; The low ADC value in this lesion increases the likelihood of Gleason grade group 2 or higher. An accurate diagnosis is essential to ensure the most effective treatment. His most-frequently cited first or last authored publications is Pathological and Clinical Findings to Predict Tumor Extent of Nonpalpable Prostate Cancer, published in JAMA, which established the criteria for active surveillance.
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