Im also wondering why no one has scheduled me for MRI to see what biopsy missed. All views would be appreciated. B. Prostate, right mid, core biopsy: 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. The only prescriptions I take are for GERD (Protonix), cholesterol (Atvorstatin), and allopurinol for an episode of gout that I got while doing physical rehab for a bad tibia break (I shattered my tibia plateau 2/2020 and have pretty much recovered). Call us with any questions: 410-955-2405, ext. It hasn't let me down. It took me awhile but minutes ago received my second opinion from Johns Hopkins. 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(Of Waiting): The How-to Guide for Men with Prostate Cancer PROSTATE ONCOLOGY SPECIALISTS, Your email address will not be published. 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. Metastatic disease considered less likely for this pattern. Both Drs and nurses knew what they were doing and had lots of experience. 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. With The Clinic by Cleveland Clinic, patients have access to Cleveland Clinics 3500 specialists. After all, it seems like good idea to deal with your cancer sooner rather than later. If you're seeking a second opinion on treatment (see below), the specialist you choose often will be able to order a pathology second opinion for you, through his or her hospital's pathology department. First of all we would like to emphasize that the health of our employees, our patients and their relatives is our first priority. After a little experimenting I have been able to achieve a partial erection. I had a very bad experience with an incompetent nurse that did a catheter change. I'm 58 yrs old and had a TRUS random biopsy October 2020 after my PSA continually stayed between 4.4 and 8, and PHI score was 126. Second opinions from urologists for prostate cancer: who gets them, why, and their link to treatment . Left mid-base transition zone (PIRADS 5). Enter the last name, specialty or keyword for your search below. Required fields are marked *, PHONE 310-827-7707 I trust the second opinion Dr. Bush gave. DRE is always normal. I had FLA done after first biopsy which staged me at 3+4 = 7. You may also complete an online appointment request form and we'll respond to schedule an appointment. A doctor may prescribe surgery or perform an endoscopic procedure. Even at the age of 48, he thought I would be a good candidate for AS. The lesion also shows focal increased permeability. 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. Many researchers believe PTEN present is a strong brake on Benign fibromuscular stroma; no prostatic glands are identified Low volume post-void residual urine is present in the bladder. Reasons for obtaining a second opinion from urologists. 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. D. Prostate, left base, core biopsy: 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. 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. The Radiation Oncologist knew of Dr Busch (by now in Alpharetta, GA) and spoke highly of him. By basing a treatment Hi All, There is no extraprostatic extension. So, Radiation Oncologist prescribed Cialis 5mg, daily. Read books and realize as soon as they are published, they are outdated. Without your support, I could easily have subjected myself to random biopsies that are risky, don't do a good job of finding lesions, and can mess up the clarity of the prostate for an MRI. If pain is present, a digital rectal examination will reveal hard areas. Dr. Albert Chang at UCLA appears to be the best in the biz for high dose rate (HDR) focal brachytherapy. Extracapsular extension: The prostatic capsule is preserved. I was never under the misconception that I'd never have to do something, but I was going to wait until I needed to do something. So, I made an appointment at Emory Proton Center (Atlanta, GA) and got their opinion. Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. Four had 60-70%, five have between 5-10%. Two things you learn here is get a second opinion from Johns Hopkins on biopsy and get treated at Center of Excellence. Seminal vesicles are normal. MRI RE-READ #2 (VERY VERY well respected radiologist): 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. Have you heard of PRECISE follow up score for an MRI? Radhakrishnan A, Grande D, Mitra N, Bekelman J, Stillson C, Pollack CE. * Location: Right, anterior, apex, peripheral zone My understanding is that brachy is great for efficacy with less risk to the bowel and the same risk for incontinence and ED as other forms of radiation. 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.
Second opinions not likely to change prostate cancer treatment probably organ confined disease. I recently sent my Pathology Slides to Dr. Epstein for a Second Review. I measure PSA frequently, and it is stable and slightly declining with the last score at 5.5. Over 80,000 specimen cases are seen at Johns Hopkins each year. 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? You're more likely to develop prostate cancers that are more likely to spread. Remember if you ship them include the following information: You May Like: Blood In Urine After Prostate Biopsy. So my question for you is have you ever heard of PRECISE and if so what should I make of it? Now its easier than ever to get the answers you need and peace of mind you deserve. F. Prostate, left apex, core biopsy: Some docs say clean up the prostatitis while others tell me to avoid overuse of Cipro as it loses its effectiveness over time. Spent the night in hospital with very little pain after the first couple of hrs. I assume the data on gleason scoring is much more robust/reliable than genomics as it has been around longer and used more extensively. 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).
Pathology Second Opinion-J.Epstein,M.D. Pathologist-Johns Hopkins 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. I really liked the new group I went to as they identified the lesion right away, unlike the radiologist who performed the first procedure, and they also have a urologist on staff as well monitoring everything. Other labs for second . The results of Oncotype came back and it was a bad report.
PDF Cancer A Second Opinion A Look At Understanding Controlling And Curing * Gleason Score: 3+4 (4 of 6 specimens), 14 specimens taken This is a PI-RADS 5 lesion in At the Breast Cancer Program at the Johns Hopkins Kimmel Cancer Center in Baltimore, MD, a second opinion requires only that you or your doctor send us your pathology slides, key medical records and signed paperwork requesting the opinion. More medical freakouts. To learn more about how to get a Neuropathology second opinion, please visit our Neuropathology Division second opinions website. official website and that any information you provide is encrypted I was never under the misconception that I'd never have to do something, but I was going to wait until I needed to do something. 24.5 BMI Prior to the results, the oncologist said that the literature shows that a 3+4=7 with less than 5% pattern 4 behaves just like a 3+3=6 and basically is an indolent tumor. Patients may experience a fever or chills as a result of the infection. P/ 310-827-7707 | F/ 310-574-4002 | MAIL@PROSTATEONCOLOGY.COM.
Get a Second Opinion: Johns Hopkins Kimmel Cancer Center Second opinions offer different things in different circumstances, Dr. Matasar says. Keeping a timeline and organized medical records is important because it can contribute to your treatment plan. Heres What You Need to Know, Prostate Cancer Spotlights in 2020: A Year in Review, Find out about PSMA PET Imaging on Prostate Pros Podcast. Patient-initiated second medical consultations-patient characteristics and motivating factors, impact on care and satisfaction: a systematic review. Does this also include HIFU, Cryoablation? And just this week, 1 YEAR post treatment, it is .46. Other: There is trace ascites in the mesosigmoid. Seems like a simple request. 8: Prostate, left lateral base This is the most common urinary tract problem in men under 50, and the third most common in men over 65. Results: 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 . Will these places of excellence consider me, or am I bound to my regular doctor for insurance purposes? Receiving a second opinion was not associated with perceived quality of prostate cancer care. )I contacted Dr Busch (still in Chattanooga at the time) and he called me directly to talk me off the ledge. Accessibility Pathology reports are subjective. Transurethral microwave thermotherapy : In selected patients, microwave energy helps to restructure prostate tissue and alleviate symptoms such as incontinence and voiding dysfunction, 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. 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. 2020 Dec 1;3(12):e2028320. 10: Prostate, right anterior MRI lesion No extraprostatic extension. You're also at greater risk of prostate cancer forming before age 50. I personally have benefitted from second opinions on my so-called cancer journey. 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. Cancer 2017;123:1027-34. Johns Hopkins second opinion identified a PI-RADS 4 Mayo Phoenix also reviewed MRI prior to targeted biopsy. One of the problems with second opinions is that insurers may not cover the expense. Blessings. If anyone has used him, please let me know what your experience was like. A doctor may prescribe surgery or perform an endoscopic procedure. 2 cores from left base of 3+4=7 with only 5% involvement. When I read the forums and questions on this site everyone mentions their Gleason Score from their biopsy. Should You Exercise When Youre Expecting? I guess TWO national centers of excellence are better than one? 2011 Feb;29(1):3-9. doi: 10.1007/s00345-010-0602-y. My urologist has decided we'll go ahead with the MRI due to the continued elevated PSA scores, in addition to the overall PHI score. Utilize your primary care physicians as an un-biased resource to help you get second opinions from a range of specialists. 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.
Second Opinions & Consultations - Brain Tumor | Johns Hopkins Pathology 2/13 PSA 5.2/fPSA 12.5% taken AFTER DRE (negative DRE) (lab #1) Confirm biopsy and imaging results with centers of excellence before making any final decisions. 3. * Prostate size: 3.9 x 2.8 x 3. cm FYI-We are also considering the trial at Princess Margaret Hospital in Toronto. They seem to think it'll do the trick.I feel great and I am glad I chose this treatment path. PI-RADS v2 score: 5. Careers. In the mean time my PSA was movingno longer static, but never back up to 6. I don't know if the FLA could affect the results, or if it was just done because it was not in the study parameters of the test. 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. 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. information. They want him to start radiation 25 sessions and chemo pills of Casodex 50 mg 28 pills. Also, their protocol would be another biopsy, but he was comfortable with the image and velocity of PSA that he didn't have to have one to start treatmentand I was pretty hesitant (given the image and PSA) to take ADT, and didn't see a biopsy changing my mind regarding treatment and/or ADT.Oh. My direct phone (mobile) number is 703-992-3662, or you can private message me via this platform. My first PSA was 8.03. - Benign prostatic tissue Two from one lesion were positive as was one of the two from the other. I also changed my diet to plant based food, started juicing, and started taking supplements (think Turmeric, Green Tea, etc.). Their MRI was more sensitive and found there were actually 2 lesions close together that looked like one on the prior MRIs. Ex-Uro wanted to do biopsies and keep doing them until we find "it", even though he didn't know the size of the prostate nor had he ruled out prostatitis. * Extracapsular extension: Possible involvement of the anterior Breast cancer.A new study suggests surgery may not always be necessary for all breast cancer patients. A newly published paper by Fischer et al. Sometimes, you may find out about treatment options you didnt know were available. Thank you! (TZ) One suspicious area - lesion size: 2cm x 1.4 cm But, after 4 drinks or if I'm tired/jet lagged I find that sleep is more appealing than sex. Interesting differences: Getting a second opinion from us is easy, convenient, and all done remotely. In other words, can I have a team here in Wisconsin yet travel elsewhere to get my MRI? Read books and realize as soon as they are published, they are outdated. An acute bacterial infection can cause a burning sensation. Generally, the symptoms can stabilize over time. About 80 percent of prostate cancers are diagnosed at a localized stage, which means that the cancer hasn't spread outside of the prostate. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. Symptoms include leaking and discomfort. I just turned 71 in February. * Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project Need guidance choosing from multiple treatment options. T2W MRI score= 2, DW MRI score= 3, DCE MRI score=positive Request an Appointment 410-955-6100 My current situation is age 67, no health issues, never had erectile dysfunction or incontinence, 6 tall, 175 lbs, generally fit and active. The purpose of starting this discussion is to gather peoples thoughts and opinions and actual experiences with Prostate Focal Laser Ablation. AHN patients have unprecedented access to the Johns Hopkins Center for Fetal Therapy. Read Also: Long Term Side Effects Of Brachytherapy For Prostate Cancer. So, I made an appointment at Emory Proton Center (Atlanta, GA) and got their opinion. Future study is needed to determine when second opinions contribute to increasing the value of cancer care. A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. Obviously the Covid 19 issue is playing a part in all of our decisions. Ramsey SD, Zeliadt SB, Fedorenko CR, Blough DK, Moinpour CM, Hall IJ, Smith JL, Ekwueme DU, Fairweather ME, Thompson IM, Keane TE, Penson DF. A second opinion can help you make an informed, confident decision about your medical care. I made the appointments. 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. My strong preference would be to do FLA again and monitor. Clipboard, Search History, and several other advanced features are temporarily unavailable. 4. In the United States, studies estimate 72 new cases of PN for every 100,000 people between the ages of 18 and 64 years old. 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. Prostate, left lateral base: Best practices dictate that you obtain a second confirmatory pathology evaluation. 1st opinion"PYL PSMA PET/CT scan demonstrating foci of moderate to intense uptake in the prostate gland consistent with known prostatic cancer. Masks are required inside all of our care facilities. 2. 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." It starts many years ago. Only took Motrin and Tylenol for pain after release. Biopsy in 12/27/11 showed 3/14 cores, Gleason 6 with PSA of 4.5. Treatment decisions for prostate cancer should not be rushed due to a mistaken belief that immediate treatment is required. But, ultimately decided on whole gland treatment using Proton Beam Radiation.So. It is not uncommon that two different pathologists looking at the same slide come to a different interpretation and opinion about what is in their microscope! An accurate diagnosis is essential to ensure the most effective treatment. - High grade prostatic intraepithelial neoplasia (HGPIN) About 80 percent of prostate cancers are diagnosed at a localized stage, which means that the cancer hasnt spread outside of the prostate. Disclaimer. A enlarged prostate can also cause blockages in the urethra. government site. 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. Overall, obtaining second opinions was not associated with definitive treatment or perceived quality of cancer care. Getting a second opinion can sometimes lead to a complete change in diagnosis in non-cancerous growths, inflammatory disorders, infections, cancer and other conditions. I did ask some questions about the study, if anyone is interested. 2016 American Cancer Society. Family history of prostate cancer. According to The National Institute on Aging, prostate problems are common after age 50. A enlarged prostate can also cause blockages in the urethra. At that point I agreed to the TRUS biopsy which I had on October 10, 2020. * Should still go for a Johns Hopkins second opinion on the pathology or is that overkill since the first one was done at MSKCC? Check Biopsy and Imaging Results for Accuracy. My involvement is below maximum of 15% of core. Primary Gleason grade: 3 However, he also said it's treatable even at a 2cm size and the transition zone is a favorable spot. Are you sure you want to block this member? He also said I would tolerate any option well based on my age and health. Lesions are all small or very small. Several friends rushed towards surgery and now wish they had the information he provides before they decided to go with such care. 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. 10. 2017 May-Jun;30(3):298-307. doi: 10.3122/jabfm.2017.03.160359. When I was diagnosed I really thought that I will live only 2 years. In general, a second opinion is a good option for people who have recently received a cancer diagnosis but have not started treatment, as well as for people who have already completed chemotherapy or radiation treatment. Had third MRI in July 2019 this time at Mayo which I believe does a better job than SMIL. The biopsy took 12 cores, two from each lesion area and 8 randomly. This approach helps to decrease side effects that can affect a patients quality of life, such as erectile dysfunction, incontinence or other urinary-tract symptoms. I worked out every day. * Seminal vesicle invasion: None. Does 3+4 at some point typically evolve into 4+3 and also serve as a trigger point for moving from AS to treatment? Following application of the relevant exclusion criteria, 2365 respondents remained in the analytical cohort. Prostate, left medial base: Other Features: 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.
Following application of the relevant exclusion criteria, 2365 respondents remained in the analytical cohort.
Get a Second Opinion | Johns Hopkins Pathology As soon as pathology slides were ready, Emory sent them to Dr. Epstein at Johns Hopkins. We can help with your case. His reasoning over the last couple of years is that the suspected lesion was not changing in size at all. - 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) The all-inclusive cost for a virtual second opinion for patients in the U.S. is $1,850. MRI RE-READ #1 (well known radiologist, but free advice over phone, but no written report): Lymph nodes: There is no suspicious lymphadenopathy in the pelvis. Learn more through his bio: Progress in the field.In recent years, advancements in research have changed the way cancer is treated. If you have received a diagnosis or recommendation for treatment and want another opinion, our service can help you make a more informed decision. It didnt look at changes of grading of the cancer.The chances for some type of modification based on a second opinion are even greater than the study indicated.Asking for a second opinion could lead to a significant change in surgical or medical intervention, Netto says.Even if the diagnosis error isnt catastrophic, such as advising a patient that he has cancer when he really doesnt, an error in grading can be consequential. Can it be salvaged or are the risks of cancer too high? Let me know what everyone thinks if you see anything interesting or of note here or just have some advice. Fear, confusion and uncertainty set in. Had a little complication a day after release, excessive blood/clots in urine. undefined will no longer be visible to you including posts, replies, and photos. 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. A week later had catheter removed and had no bladder leakage problems.
Not all men with Gleason 8-10 disease are going to do badly after That being said, they can be a beneficial member of the treatment team. I certainly would - after all, there's a certain brotherhood bond here. Cancer vaccines.For a long time, the promise of cancer vaccines that would protect healthy people at high risk of cancer has only dangled in front of researchers. Greetings gentlemen! Rectal cancer.A small trial that saw 18 rectal cancer patients taking the same drug, dostarlimab, appears to have produced an astonishing result: The cancer vanished in every single participant. J Am Board Fam Med. 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. Thanks, BigD. Through the AHN Cancer Institute, you benefit from personalized treatment in your community, close to home, from your dedicated care team. 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.
Prostate Cancer | Johns Hopkins Brady Urological Institute He is the past president of the International Society of Urological Pathology. If these do not work, your symptoms could progress and become chronic. I applaud Dr Scholz for his dedication and explanation of such a complex cancer, that has not had his common sense help available for men with prostate cancer. I now have my list whittled down to 3. Just got my pathology results. Note respondents were able to, MeSH I've tried to find out about Dr. Wong but there's very little info on him. Do any of you have an opinion or actual experience with any of the three listed below?