I had a very bad experience with an incompetent nurse that did a catheter change. Disclaimer. Instructions for Second Opinion on Pathology (Gleason score) 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. In terms of cancer, changes can be from cancer to benign (or vice versa) or from one type of cancer to another, which could have a significant impact on treatment and prognosis. The average age at the time of prostate cancer diagnosis is about 66. BONES: No suspicious osseous Y'all are in my prayers! Especially opinions other than those of the first Urologist you see. Second Opinions - Bladder Cancer | Johns Hopkins Pathology Second Opinions An accurate diagnosis is essential to ensure that the correct and most effective treatment is given. They basically said it didn't matter. When I read the forums and questions on this site everyone mentions their Gleason Score from their biopsy. Dont Miss: Function Of The Prostate Gland And Seminal Vesicles. LESION 1 This may cause a conflict of interest between the patient and the HMO, especially if very expensive treatment is only available outside the HMO system. By choosing the first doctor you speak with to be your treating physician, you may be putting your health in the hands of someone who lacks the expertise to accurately and safely treat your prostate cancer. 5. I am 65 and in excellent general health. PMC 10: Prostate, right anterior MRI lesion Do I need a third opinion? information. The local pathologist read the biopsy and said 3+4=7 10% pattern 4 for both lesions. Prostate, left medial base: 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 . Anything I am overlooking or need to add to my list of considerations? Our OB-GYNs, maternal-fetal medicine specialists, and pediatricians collaborate regularly with the Johns Hopkins team getting second opinions and access to hundreds of clinical trials. very activerun/cycle 6 days a week 8600 Rockville Pike Greatest dimension 0.7cm . A doctor at MSK can collaborate with another doctor to offer support and help ensure the best outcomes. They hesitated calling it a TARGET LESION, but scored it PIRADS 4. So off I went to see a community urologist who performed a needle biopsy in his office. So now things are getting exciting. The other samples produced 4 more positive cancer cores for a total of 7 of 12 positives. In the rare chance a baby needs highly specialized care, the team at Johns Hopkins is available to treat rare and complex conditions through breakthrough fetal procedures. I want to insure that the Imaging was read correctly and nothing was overlooked or missed. I still have some urgency and frequency issues, but I am not complaining too bad. Some men may have an enlarged prostate but not notice it. We will then prepare a written recommendation regarding your treatment plans or options. 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. Is there such a thing as having a team that isnt equipped with the best equipment nor the most experienced radiologists? It is OK to be scared. Further, the two tumors in question have not really changed much in size for more than 2 years. Find more COVID-19 testing locations on Maryland.gov. -------------------------------------------------------- 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. Patient preferences and urologist recommendations among local-stage prostate cancer patients who present for initial consultation and second opinions. We provide second opinions on the full range of gynecologic cancers: Ovarian Uterine Cervical Vulvar Vaginal Fallopian tube Placental tumors Some peritoneal cancers You May Like: Prostate Cancer External Beam Radiation Side Effects. Is it done through my doctor or do I do it myself with sending CDs of the MRI? Benign fibromuscular stroma; no prostatic glands are identified In adjusted models, obtaining a second opinion was not associated with receipt of definitive treatment . I was confident I was making the right decision. Discover what's to love about Charm City for yourself. A diagnosis is usually reached within 3-5 days of your slides' arrival at Johns Hopkins. AHN patients have unprecedented access to the Johns Hopkins Center for Fetal Therapy. * Both Sloan and Johns Hopkins admit that large discrepancies are unusual, yet both stand by their opinions. Second opinions apply to biopsies and imaging as well. Obviously the Covid 19 issue is playing a part in all of our decisions. Using an Ellipsoid Volume the dimensions would give you a volume of 20.44. 3. These results, if validated in other studies, justify additional investigation on how second opinions can contribute to increasing the value of cancer care, the authors concluded. I'm leaning towards SBRT. If the enlarged prostate is not completely removed, it will shrink. Second opinions from urologists for prostate cancer: who gets them, why, and their link to treatment . Your Primary Care Physician referred you to your diagnosing urologist whom you now trust. Move ahead to Dec 2020. Xia L, Talwar R, Chelluri RR, Guzzo TJ, Lee DJ. Find more COVID-19 testing locations on Maryland.gov. - Johns Hopkins Medicine -- Get a Second Opinion 1st opinion"PYL PSMA PET/CT scan demonstrating foci of moderate to intense uptake in the prostate gland consistent with known prostatic cancer. Prostate, right anterior MRI lesion: So, I go one better, I call up Johns Hopkins and find a Dr who does DaVinci Prostate Surgery. And, even working in a fairly technical field myself, I was amazed at the technology and precision of that Proton Machine. You're at greater risk if you're Black or of African ancestry. "We were surprised by the relatively large percentage of men who obtain second opinions for their prostate cancer," said lead author Dr. Archana Radhakrishnan of Johns Hopkins University in . I met with the radiologist 3/17 and he leans toward an IMRT radiation regimen of 5 or 20 sessions TBD combined with ADT (6-month shot but maybe 4 months was enough). 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. Getting A Second Opinion On Your Pathology Report - Cancer ABCs These findings are suspicious for degenerative changes however a subtle/early metastatic lesion cannot be excluded and continued periodic follow-up is recommended." A doctor may prescribe surgery or perform an endoscopic procedure. We are vaccinating all eligible patients. Bladder: Normal. But, after 4 drinks or if I'm tired/jet lagged I find that sleep is more appealing than sex. I trust the second opinion Dr. Bush gave. ---------------------------------------------------------- MRI June 2017 again at SMIL. Asking about other experience with conflicting Prostate Biopsy Opinions. Any score above 55 has a greater than 50/50 chance of finding clinically significant cancer. 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. Also, infection was noted, so the current PSA is high in part due to prostatitis. 53 years old They seem to think it'll do the trick.I feel great and I am glad I chose this treatment path. Study after study confirms that doctors favor the treatment they are trained to do urologists typically recommend surgery and radiation oncologists recommend radiation. Further, among men with low risk disease, we did not observe a significant association between second opinions and receipt of definitive treatment or surgery. I have been drinking out of an information fire hose. * Perineural Invasion also detected In severe cases, a catheter may be required to relieve the symptoms. HMO members may also be discouraged from trying expensive treatments that have only a small chance of success, even if that chance is real. Recovery from Prostate Cancer | Bills Story. My girlfriend lives 2 blocks from the Emory Proton Clinic.We prayed on it and overthought the crap out of it. The researchers did not include more minor errors in rating how fast-growing and how advanced a cancer was. I'm trying to figure out why the PSA keeps rising. Bones: There is marketed marrow heterogeneity in the pelvic bones are not in the femoral heads. With no travel needed and no red tape, its easy to get a second opinion, all from the comfort of your home. Second Opinions & Consultations - Brain Tumor | Johns Hopkins Pathology 2016 American Cancer Society. Maybe lycopene and pomegranate have helped. - 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) doi: 10.1002/cncr.30412. The Johns Hopkins Brady Urological Institute is known around the world for its expertise in diagnosing and treating urologic conditions. And it is OK to have paralysis by over-analysis. Many thanks for that. Race and ethnicity. 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. Forty percent of the men obtained a second opinion from urologists, most often because they wanted more information about their cancer or wanted to be seen by the best doctor . Many men name the diagnosing urologist as their treating doctor and do not seek other opinions. Should You Exercise When Youre Expecting? This is often the case when the primary physician advises an expensive treatment. And when I attempt to ask questions about intradcutal, I get responses about how little is known about it because it's so rare or that it is controversial or that they're not familiar with the study I'm referencing. I worked out every day. * Gleason Score: 3+3 (2 of 6 specimens) In the rare chance a baby needs highly specialized care, the team at Johns Hopkins is available to treat rare and complex conditions through breakthrough fetal procedures. Ask us questions on this webpage. JHs just said it was minimal less than 5%. I tried to send the samples out for genetic testing to Prolaris and Decipher, but there was an ordering error and they never went thru. But, after 4 drinks or if I'm tired/jet lagged I find that sleep is more appealing than sex. Men often seek second opinions from urologists before they initiate treatment for their newly diagnosed prostate cancer. Dont Miss: New Treatments For Stage 4 Prostate Cancer. IMPRESSION: The percentage of tissue with carcinoma is 70% In order to give treatment for each patient with utmost security we would like to announce that currently there will be no visitors allowed.Please note that only one attendant per in-patients is permitted. Getting a second opinion on a diagnosis can reverse a diagnosis or alter the treatment plan. PROSTATE LESIONS: Prostate cancer is a slow growing condition. T2W MRI score= 5, DW MRI score= 5, DCE MRI score=positive Johns Hopkins is home to many of the world's leaders in Pathology. Our singular focus on treating cancer, and only cancer, means we have the expertise to confirm a diagnosis or treatment plan and offer options that may not have been considered. Research was mixed on PINS, but in those days, many doctors saw them as likely to develop into cancer. PREVIOUS MRI RESULTS (LOTS of them) Both of which are normal volumes, the Bullet Volume is considered more precise in prostates smaller than 55ml. 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. Secondary Gleason grade: 4 Now its easier than ever to get the answers you need and peace of mind you deserve. And again, most of you tell me time is on my side, so I am comforted in hearing that. Required fields are marked *, PHONE 310-827-7707 Second Opinion Results, Johns Hopkins biopsy reading of 2 slides sent by Sloan: Also, Oncotype subsequently invalidated my results because they found in the history that I had a prior FLA. We can help with your case. Seek Perspective from a Range of Specialists. Had my PSA remained static I'd have remained on AS and had I grown a Target Lesion I'd have sought focal treatment.This science is emerging and only getting better. Prostate Cancer Pathology in 2021 | Jonathan Epstein, MD | PCRI 2021 Conference, Why Prostate Cancer Survivor John Shearron Thinks Its Important To Do Your Research | PCRI, John Hopkins Prostate Cancer Second Opinion, a higher risk of developing uterine cancer, surgery may not always be necessary for all breast cancer patients, The cancer vanished in every single participant, Long Term Side Effects Of Brachytherapy For Prostate Cancer, treat rare and complex conditions through breakthrough fetal procedures, Prostate Cancer External Beam Radiation Side Effects, Can Enlarged Prostate Cause Blood Clots In Urine, Life Expectancy Stage 4 Prostate Cancer No Treatment, Prostate Cancer Spread To Skull Prognosis, Diagnostic Procedures For Prostate Cancer. The all-inclusive cost for a virtual second opinion for patients in the U.S. is $1,850. Six weeks later I have the biopsy in his office and a week later I get the results. Treatment must be chosen based on stage and your I have searched the country for intervential radiologist that perform FLA on the prostate. At the Johns Hopkins Medical Institutions, he is Professor of Pathology, Urology, and Oncology the recipient of the Reinhard Chair of Urological Pathology and Director of Surgical Pathology. Seminal vesicles and other margins are negative for tumor. Grade Group: 1 - Prostatic adenocarcinoma, Gleason score 3+4=7 (grade group 2, pattern 4: 5%) involving 1 of 2 cores (lateral core: 4 mm, 35%), 0.1 mm to the blue inked tissue edge 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. I had my first of those 2 PSA tests last week and it dropped to 4.77. You think your doctor is underestimating how serious your cancer is. Not all men with Gleason 8-10 disease are going to do badly after Based on this forum, Im very lucky for this outcome. Good Day Everyone. Keeping a timeline and organized medical records is important because it can contribute to your treatment plan. Results: - Benign prostatic tissue Natural history of progression after PSA elevation following radical We surveyed men who were diagnosed with localized prostate cancer in the greater Philadelphia area from 2012 to 2014. However, there were no other suspicious areas on MRI. Get a Second Opinion 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. ---------------------------------------------------- Benign fibromuscular stroma; no prostatic glands are identified Tumor Quantifications: D. Prostate, left base, core biopsy: Receiving a second opinion was not associated with perceived quality of prostate cancer care. Didn't know if she had the catheter in far enough and not getting any urine through itwondered if she had inflated the balloon enough and wondering if it was the reason that I have developed an abscess. MONDAY, Nov. 7, 2016 Second opinions have little impact on prostate cancer patients treatment decisions, new research suggests. It got discussions started and questions answered. Got my physical and normal DRE with new Dr. No issues identified. Send a Consult for Second Opinion | Johns Hopkins Pathology 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. I'm going to reach out to UCLA to see what they can do. Transition Zone: In the left base, mid and apical transition zone there is a large mass measuring 2 cm in size which has LESION 2 Five years ago I had a TURP. Johns Hopkins Precision Medicine Center of Excellence for Prostate Cancer, Schaufeld Program for Prostate Cancer in Black Men, Read about the latest prostate cancer discoveries by our world-renowned researchers, Learn more about prostate cancer in our health library, Watch: What to expect during your post-surgery hospital stay. Men often seek second opinions from urologists before they initiate treatment for their newly diagnosed prostate cancer. - Perineural invasion is present Given that some 3+4 is now evident, I can no longer say that all my PCa is all 3+3 and that I can stay on AS for an extended period. Prostate, right medial apex: Prostate, right lateral apex: 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. * Membranous urethral length: 1.2 cm In order to receive appropriate treatment, patients must understand the treatment options that are available. Had a little complication a day after release, excessive blood/clots in urine. I find that when I'm trapped in the cockpit not able to use the bathroom for a long time is when I experience that most. I would feel much more comfortable, if the numbers stay the same, being involved in a recognized Active Surveillance Program. Johns Hopkins second opinion - nothing found. It would be more convenient to use Mayo but I want the best practitioner regardless. Thank you for your participation! H. Prostate, lesion #2, core biopsy: Also indicated everything else was "organ confined." Cancer. 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? Extraprostatic extension: negative I really just want the results of their innovative PTEN test. I appreciate all the input because I am a little overwhelmed and confused as to the best course of treatment. OTHER: None. If anyone has used him, please let me know what your experience was like. By basing a treatment They may defer to the recommendation of the specialist, or refer you to a doctor with limited prostate cancer experience. I assume it is not free. I wanted to keep my options open. Metastatic disease considered less likely for this pattern. the transition zone. If I am rested, I find that I am more ready than if I am not. 3. This condition causes pain in the lower back and groin area, and may cause urinary retention. At this point Im still ignorant about what I ought to be doing (MRI guided biopsy is what I should have gotten). Many health insurance companies will pay for a second opinion, especially if it is for a medically necessary treatment. 180 days after treatment PSA was .50. While I now concluded we need to find "it", I researched the best approach to see what is really going on and to do this safely. PDF Cancer A Second Opinion A Look At Understanding Controlling And Curing Following application of the relevant exclusion criteria, 2365 respondents remained in the analytical cohort. I retired as a Dentist at the VA and saw many veterans with a wide range of outcomes as most of them became 100% service connected when diagnosed with prostate Ca due to exposure to Agent Orange if they served in Vietnam. So, I believe I made the right choice. I had no idea there were second opinions and I didn't have a clue about Genomic testing, or even genetic testing. Allow yourself the time to seek multiple opinions. I say bullshit to them. Being in Wisconsin, my insurance gives me the option of two hospitals to manage me. I did genetic testing and there were no mutations of concern, and everyone agreed that there probably wasn't "enough meat on the bone" to get a good genomic test from the biopsy.After seeing Dr Joe Busch, he said he didn't see any target lesions (PIRADS2), nor did he think I was in any danger. Two weeks later I meet with my Johns Hopkins Dr. Surgery took about 3 hrs. 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. Secondary Gleason grade: 3 C. Prostate, right apex, core biopsy: Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, The Sidney Kimmel Comprehensive Cancer Center. * Gleason Score: 4+5, Slide 4 (vs. Sloan's 3+4) To learn more about how to get a Neuropathology second opinion, please visit our Neuropathology Division second opinions website. Laparoscopic prostatectomy: The prostate is removed with a miniature telescopic instrument, which allows for a quicker recovery, Robotic surgery: This breakthrough technology, which often is used for prostatectomy surgery, requires only a few small incisions. Contact us or find a patient care location. 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. I just received a second opinion report from Johns Hopkins. Now, I would like to send Radiology for a similar review. 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. My first PSA was 8.03. 2015 Feb;115(2):188-97. doi: 10.1111/bju.12665. 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. A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. Greetings gentlemen! Request an Appointment 410-955-6100 I have completed all that is necessary to enter Johns Hopkins Second opinion and PTEN test program. Be well. Read books and realize as soon as they are published, they are outdated. * Seminal vesicle invasion: None. 2nd opinion"Sclerotic change at the right pubic bone with max SUV of 1.4." 1. There are so many different departments at Hopkins that I don't know the optimal department to contact. I am relatively new to this forum and trying to educate myself as to my best course of treatment. The PSA Doubling Time parallels my Urologist Doubling Time (I keep changing Uro until I find one who makes sense)! Got the fiducials placed, the Space-OAR gel placed, mold made, and had the pre-treatment MRI and CT Scan. Identified an approximate 2 cm lesion of mostly Gleason 7 (3+4) with only 20% being 4, contained in prostate. 3T MRI with coil is done initially, along with a TRUS biopsy. Benign prostatic tissue His reasoning over the last couple of years is that the suspected lesion was not changing in size at all. Interesting differences: Urologists are trained as surgeons, radiation oncologists administer radiation, and medical oncologists provide cognitive oversight and general management of the cancer. When to move from Active Surveillance to Treatment for Prostate Cancer? Anyway, I'm reaching out to this group to see if anyone would be willing to chat with me about their brachytherapy experience at UCLA (even to talk me out of it). Is the destruction of my prostate inevitable and necessary for my survival (my understanding is that both surgery and radiation will do this)? And just this week, 1 YEAR post treatment, it is .46. A blocked urethra can also damage the kidneys. Some men may have an enlarged prostate but not notice it. * Adjacent organ invasion: None. Thanks, BigD. Have been diagnosed with a serious or rare health condition. 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. In My Opinion? Get A Second Opinion | ZERO Prostate Cancer Just got my pathology results. * Seminal vesicle invasion: None. 4. After all, it seems like good idea to deal with your cancer sooner rather than later. Video consultation and written report from your expert. Am I missing anything? 3. If I am rested, I find that I am more ready than if I am not. Overall PIRADS Score: 2/5 Assessment categories for this lesion: I have a history where Foley catheters were unable to be placed going back to 2005 for unknown reasons.
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