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. * Size: 1.5 cm Dr. Jonathan Epstein of Johns Hopkins University Hospital. Masks are required inside all of our care facilities. The urologist offered surgery and radiation as options on 3/10 when we met. Based on the results, our experts can provide you with an individualized treatment plan before you leave. Note respondents were able to choose more than one reason. Our collaborative processes also extend to our colleagues at Johns Hopkins Medicine, a world-wide leader in cancer research. focal peripheral zone lesions. Read books and realize as soon as they are published, they are outdated. It has been 2.5 years and the PSA has still not doubled as well. The majority had lower risk tumors and clinical staging of 1 40% sought second opinions with about half having more than one reason Men seeking second opinions tended to be younger and better educated citing the need for more information as their reason. 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. It was easy. You May Like: Best Treatment For Intermediate Prostate 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? Consultation with your nurse care manager. They basically said it didn't matter. Breast Cancer: When to Get a Second Opinion - WebMD 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. So off I went to see a community urologist who performed a needle biopsy in his office. Who Should Request a Second Opinion? Prostate cancer is a malignant (cancerous) tumor of the prostate, a gland found only in men. Your current doctor will frequently suggest a second opinion, if only to confirm the recommended course of action. of tumor in the rectal prostatic angles. Other: There is trace ascites in the mesosigmoid. For these reasons and others, it is advantageous to seek more than one opinion about how your cancer can be treated. Send a Consult for Second Opinion | Johns Hopkins Pathology Anything I am overlooking or need to add to my list of considerations? Netto says patients should be proactive in requesting that doctors take another look. * Location: Right, anterior, apex, peripheral zone Many researchers believe PTEN present is a strong brake on 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 assume the data on gleason scoring is much more robust/reliable than genomics as it has been around longer and used more extensively. - Benign prostatic tissue * Gleason Score: 3+3, Slide 1 (vs. Sloan's 3+4) 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. We are vaccinating all eligible patients. 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. Prostate cancer is a slow growing condition. Allow yourself the time to seek multiple opinions. However, older men 75 years were the least likely to report obtaining a second opinion due to dissatisfaction with their initial urologist. 2. They confirm everything except question whether one of the core samples is a 3+3 or 3+ 4. As evidenced on this site, some studies indicate that GS 6 shouldn't even be classified as PCa and that it isn't aggressive. The Radiation Oncologist knew of Dr Busch (by now in Alpharetta, GA) and spoke highly of him. 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. 180 days after treatment PSA was .50. Left mid-base transition zone (PIRADS 5). First 6 week PSA is undetectable. Am I wrong? Bring All Labs/Notes to Each Appointment. The https:// ensures that you are connecting to the But, after 4 drinks or if I'm tired/jet lagged I find that sleep is more appealing than sex. He said that he saw what JHs was referring to but did not determine EPE for a variety of reasons. - DCE = (+) But, ultimately decided on whole gland treatment using Proton Beam Radiation.So. -------------------------------------------------------- For cancers that are less common, second opinions can offer more treatment options. The margin of error is 1.4 percent, which is equivalent to 30,000 cancer diagnosis mistakes annually in the U.S. Of 6,171 biopsy slides sent since late 2008 for a second review at Johns Hopkins, pathologists disagreed with the diagnosis on 86 of them. It would be more convenient to use Mayo but I want the best practitioner regardless. NONE of the many radiation oncologists, surgeons or urologists I've spoken with in my journey have ever mentioned the term to me so I had to look it up. Please don't hesitate to make any observations or ask questions. Because every patient is different, there are several ways to approach prostate cancer treatment. If a targeted biopsy is planned, this lesion can be sampled at the same time. We prioritized treatment as AS, FLA/TULSA (if a lesion ever presented itself), and Proton Beam Radiation. Another type of prostate issue is chronic prostatitis, or chronic pelvic pain syndrome. P/ 310-827-7707 | F/ 310-574-4002 | [email protected]. Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. Some docs say clean up the prostatitis while others tell me to avoid overuse of Cipro as it loses its effectiveness over time. They seem to think it'll do the trick.I feel great and I am glad I chose this treatment path. Johns Hopkins Medical Laboratories 1620 McElderry St. Reed Hall Rm 315 Baltimore, MD 21205 Fax (410) 614-7712 Phone (410) 955-2405 8 am - 5 pm Normal LAB hours are: 5:30 am - 4:30 pm Mon-Fri Accessibility Treatment decisions for prostate cancer should not be rushed due to a mistaken belief that immediate treatment is required. Hello. I retested in January 2019 and scored 4.20. 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. Benign Processes: They hesitated calling it a TARGET LESION, but scored it PIRADS 4. Second opinions offer different things in different circumstances, Dr. Matasar says. 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! If the enlarged prostate is not completely removed, it will shrink. By seeking second opinions and hearing the benefits and drawbacks of a range of treatment options for your specific stage, you will be more equipped to make educated decisions. Get a Second Opinion | Johns Hopkins Pathology Pathology report indicated additional presence of cells at right apex, but unclear whether intraprostatic incision or extraprostatic extension. I also sent my biopsy slides to Johns Hopkins for a second opinion (Epstein's read was 3+4, but with lower pattern 4 involvement than the local pathologist.). This sounds to me like they're not familiar with the Oncotype DX test and makes me wonder how common is the test. 2017 Oct;22(10):1197-1211. doi: 10.1634/theoncologist.2016-0429. 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. PDF Cancer A Second Opinion A Look At Understanding Controlling And Curing Bookshelf But was able to walk right into the JH Urology clinic for immediate treatment (flushing of bladder cleared everything up). He is the past president of the International Society of Urological Pathology. Prostatic Adenocarcinoma This puts PCPs in a unique position to impact the treatment decisionif they only refer to urologists and not to radiation oncologists or medical oncologistssurgery is a likely treatment outcome. You think your doctor is underestimating how serious your cancer is. Patient-initiated second medical consultations-patient characteristics and motivating factors, impact on care and satisfaction: a systematic review. SMIL radiologist reported nothing found. ZERO - The End of Prostate Cancer Support Community. Nov 7, 2016. prostate cancer; quality of health care; second opinion; specialists; treatment. Mohamad Allaf, M.D., answers questions about prostate cancer diagnosis and treatment options and discusses robotic prostatectomy at Johns Hopkins. We experienced information overload and decision/analysis paralysis. 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. You may choose to consider a second opinion if you: 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. 7. Now its easier than ever to get the answers you need and peace of mind you deserve. The lesion also shows focal increased permeability. Therefore, the value of these second opinions remains unknown. Masks are required inside all of our care facilities. Got the fiducials placed, the Space-OAR gel placed, mold made, and had the pre-treatment MRI and CT Scan. Wondering if any of the "gurus" here want to take a stab at looking at this and see if they agree that it says what I think it says (I will be following up with doctor(s) to get their opinion, and I waive all HIPAA rights by allowing this to be seen). Thank you for your understanding and cooperation. Second Opinion Pathology | MD Anderson Cancer Center Johns Hopkins Hospital Prostate Cancer - ProstateProHelp.com 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. -------------------------------------------------------- Reasons for obtaining a second opinion from urologists. A 1.4 cm lesion in the left, apex, anterior transition zone demonstrates conflicting T2 and DWI characteristics for PI-RADS classification - an indeterminate lesion. Prostate cancer is the second-most diagnosed cancer in American men. Thanks for considering. I worked out every day. Prostate Cancer News, Reviews & Views: Second opinions Even if someone is being seen at a different academic center, the trials and other treatment options that we offer here may be different. So the pathologist suggested a second opinion. 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. Contact us or find a patient care location. 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. I am 62 years old. Following the advice of all on here, I need a team of doctors to manage my care. Also, infection was noted, so the current PSA is high in part due to prostatitis. The average age at the time of prostate cancer diagnosis is about 66. Benign prostatic tissue The symptoms of acute bacterial prostatitis are similar to those of CPPS. 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. Those readings were reported on a second opinion by Dr. Epstein. The Radiation Oncologist knew of Dr Busch (by now in Alpharetta, GA) and spoke highly of him. Biopsy Results: What Do They Mean? - Prostate Cancer Foundation 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. HMO members may also be discouraged from trying expensive treatments that have only a small chance of success, even if that chance is real. * PIRADS v2 Score: 5 The problem is that all 3 pathologies noted an intraductal component. The biopsy took 3 samples from the targeted region plus 16 sextant. And luckily I lived in Chattanooga and had mutual friends with Dr. Joe Busch (my Urologist never mentioned him, yet we could almost see his facility from the exam room in which he broke the news. The side effects of the cut, radiate, hormone regime are unacceptable to me. Shore ND, Karsh L, Gomella LG, Keane TE, Concepcion RS, Crawford ED. Is the destruction of my prostate inevitable and necessary for my survival (my understanding is that both surgery and radiation will do this)? The main purpose of the prostate is to produce semen, a milky fluid that sperm swims in. PI-RADS v2 score: 5. My thoughts focus on the fact that I have a disabled son who needs my care. Question anemia. Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, The Sidney Kimmel Comprehensive Cancer Center. I talked with Dr. Epstein who expressed Johns Hopkins' conservative views to not underestimate GS 6 and to consider surgery and/or radiation that have been used successfully for many years in saving lives. Symptoms include leaking and discomfort. I had no idea there were second opinions and I didn't have a clue about Genomic testing, or even genetic testing. 9: Prostate, left anterior MRI lesion Unfortunately, the 12/20/20 PSA reading was higher and that led to an MRI on 2/2/21 when two lesions were discovered. Here are seven tips for seeking second opinions for prostate cancer: 1. If I am rested, I find that I am more ready than if I am not. 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. John, I was diagnosed on 11 December, 2013. 4.5 year journey (18 months post proton beam), 4.5 Year Update (18 month post Proton Beam). This is not true. As some of you may know, I am a moderator for a support group for men on active surveillance for low-risk prostate cancer. 8600 Rockville Pike The peripheral zone has a patchy signal pattern. It got discussions started and questions answered. If these do not work, your symptoms could progress and become chronic. Second opinions are a common practice in any area of medicine that is complex and that has multiple treatment options available. Suspicion for malignancy left anterior base-to-apex transition zone; In the mean time my PSA was movingno longer static, but never back up to 6. 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. 9. Greatest dimension 2cm. There are also many reasons why you may want to seek another opinion during the course of your cancer care. Benign Processes: 2. 3 months has passed, and its time for a PSA and a plan to have an MRI. However, that information will still be included in details such as numbers of replies. 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. Second Opinions & Consultations - Johns Hopkins Pathology
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