johns hopkins prostate cancer second opinion

Little is known about men with localized prostate cancer who seek second opinions, the reasons why, and the association with treatment and quality of care. probably organ confined disease. Does 3+4 at some point typically evolve into 4+3 and also serve as a trigger point for moving from AS to treatment? About 60% of prostate cancers occur in people older than 65. Some men may have an enlarged prostate but not notice it. Some men may have an enlarged prostate but not notice it. A. Prostate, right base, core biopsy: Urology. When you review your pathology report and are going to be making important decisions, like treatment decisions, which will be based on the information from the pathology report. They are not objective. We have a consult on Friday with the 1st opinion doc to review all tests. Good Morning Brothers- He has had a nagging "groin injury" for may years (he played pick up basket ball until he got injured) and we are now wondering if this could be the source of that recurring ache. 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. Second opinions are a common practice in any area of medicine that is complex and that has multiple treatment options available. I trust the second opinion Dr. Bush gave. If anyone has used him, please let me know what your experience was like. doi: 10.1002/cncr.30412. So, I asked the Radiologist if she will schedule one for 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 . My girlfriend lives 2 blocks from the Emory Proton Clinic.We prayed on it and overthought the crap out of it. 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. It is best to begin by talking with the doctor who made your initial prostate cancer diagnosis. So the pathologist suggested a second opinion. I also had my PTEN test by META-MARK ( I don't have much to say about how I was treated by MM, but I won't be using their services again). The prostate gland is slightly enlarged secondary to transition zone hyperplasia (25cc total) Studies show the clinical and financial benefits of obtaining a pathology second opinion. Watch: Are supplements good for prostate health? I am meeting with a multidisciplinary team of docs on March 18 at St. Joe's in Atlanta. 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. Of these, 40% obtained second opinions, most commonly because they wanted more information about their cancer (50.8%) and wanted to be seen by the best doctor (46.3%). 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. My first PSA was 8.03. Another DRE that results in identifying that my prostate is enlarged, but cant find and nodules. Overall my PSA is between 4 and 10. MM, Much to my dismay my 4th targeted biopsy Oct 12 revealed 5% G4 (upgraded from Grade Group 1 to 2 (Gleason 3+4 intermediate/favorable). MRI June 2017 again at SMIL. * Sloan only sent partial cores, slides 1 and 4. and transmitted securely. Men often seek second opinions from urologists before they initiate treatment for their newly diagnosed prostate cancer. 10. Find more COVID-19 testing locations on Maryland.gov. MONDAY, Nov. 7, 2016 Second opinions have little impact on prostate cancer patients treatment decisions, new research suggests. Have been diagnosed with a serious or rare health condition. I also changed my diet to plant based food, started juicing, and started taking supplements (think Turmeric, Green Tea, etc.). It got discussions started and questions answered. BASE DATA: However, there are other cases when a second opinion results in a very different diagnosis or set of treatment recommendations. 2. Tumor Quantifications: The average age at the time of prostate cancer diagnosis is about 66. Greetings gentlemen! Bethesda, MD 20894, Web Policies Patient-initiated second medical consultations-patient characteristics and motivating factors, impact on care and satisfaction: a systematic review. * Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project How long do you have left? This kills both birds with a single stone. And collaborating with Johns Hopkins Medicine means we can provide you with second opinions, streamlined and guided access to clinical trials, and a proven track record of excellence in care. I had been carefully watching as my PSA increased to 3.2 from 3.9 in summer 2010. This fee includes: Recommended Reading: Radiation Therapy For Prostate Cancer. In severe cases, a catheter may be required to relieve the symptoms. 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. There is no extraprostatic extension. However, it also is possible to seek a pathology second opinion on your own, and it does not require an in-person office visit. Benign fibromuscular stroma; no prostatic glands are identified Our gynecologic pathology team can also help determine if the tumor is localized or has metastasized from another region of the body. You can find out by reviewing your plan or by reaching out to your insurance company. Several friends rushed towards surgery and now wish they had the information he provides before they decided to go with such care. Also Check: Prostate Cancer Stage 7 Treatment. I had a follow up 3T MRI guided biopsy on March 18 at Emory. Masks are required inside all of our care facilities. Benign Processes: For a second opinion on the results of your prostate biopsy, there is no place better to get one than from the well known prostate pathologist, Dr. Jonathan Epstein at Johns Hopkins. If pain is present, a digital rectal examination will reveal hard areas. I wish the VA would be more informative about this disease they owe it to our veterans. focal peripheral zone lesions. About this time, I started reading this forum and my ignorance starts going away. You receive a secure, private online consultation without leaving home. A newly published paper by Fischer et al. If they have an enlarged colon, their physician can perform a TURP procedure. This condition causes pain in the lower back and groin area, and may cause urinary retention. 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." My new Dr however didnt order PSA so I asked him for one. Required fields are marked *, PHONE 310-827-7707 2018 May;115:133-138. doi: 10.1016/j.urology.2018.01.048. Therefore, the value of these second opinions remains unknown. With that alone, I would likely be a candidate for continued Active Surveillance. Anyone with insight into this and advice? With world-renowned expertise, multidisciplinary specialistsand the latest data, we partner with you tomake informed decisions about managing your prostate cancer. The total number of cores with carcinoma is 3 LESION 1 Maybe lycopene and pomegranate have helped. - Benign prostatic tissue PROSTATE LESIONS: Prostate, right lateral base: C. Prostate, right apex, core biopsy: 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? How could this compare using only partial slide re-reading? * Should still go for a Johns Hopkins second opinion on the pathology or is that overkill since the first one was done at MSKCC? * Other 12 slides not sent The biopsy took 3 samples from the targeted region plus 16 sextant. Men often seek second opinions from urologists before they initiate treatment for their newly diagnosed prostate cancer. -------------------------------------------------------- desired outcome. When you get a diagnosis of breast cancer from your doctor, its not uncommon to get a second opinion. Associated fees may be incurred up to $1,800 in a minority of more complicated cases requiring special studies. 2 of the 12 samples showed High Grade PIN and one area showed "suspicious for low-grade adenocarcinoma". Atrophy My long-term prognosis appears to be good with minimal side effects. * Membranous urethral length: 1.2 cm 3. 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. Depending on your location, you may be able to have a telemedicine consultation. If you have received a diagnosis or recommendation for treatment and want another opinion, our service can help you make a more informed decision. 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. 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. Emotional outlook is fragile at times and straight clinical approach of doctors does not help. They agreed with the PI-RADS 4. I've also read that some study's have shown that intraductal may be resistant to hormonal therapy, radiation and/or chemo. Sought Johns Hopkins second opinion of pathology slides. How important is Oncotype DX test for Gleason 7? Total Gleason score: 7 Getting a second opinion from us is easy, convenient, and all done remotely. TZ zone more beneficial, but fairly large compared to whole gland and proximity to capsule edge would likely mean treatment would be suggested. 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. 4: Prostate, right medial base 2020 Jul 21;19(1):112. doi: 10.1186/s12904-020-00619-9. An acute bacterial infection can cause a burning sensation. In adjusted analyses, however, only age and education were significantly associated with obtaining second opinions from urologists. Please don't hesitate to make any observations or ask questions. Y'all are in my prayers! Patient-Driven Second Opinions in Oncology: A Systematic Review. How to Get a Second Opinion Our team at Johns Hopkins has a dedicated service to interpretation of brain tumors and render second opinions on a daily basis. This has only low-level nonspecific activity with SUV max of 2.05 and may be due to degenerative changes at the symphysis pubis." Six weeks later I have the biopsy in his office and a week later I get the results. Perineural invasion is identified In severe cases, a catheter may be required to relieve the symptoms. 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. Identified an approximate 2 cm lesion of mostly Gleason 7 (3+4) with only 20% being 4, contained in prostate. I asked the urologist who did our Second Opinion at Johns Hopkins and although he thinks RP is the way to go (due to higher PSA of 10.18), he highly recommended Dr. Eggenger (Chicago). * Adjacent organ invasion: None. Not all cancers are the same and not all treatment plans are absolutely clear. Cancer. Race and ethnicity. 30%/40% or higher)? 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). An official website of the United States government. T2W MRI score= 2, DW MRI score= 3, DCE MRI score=positive Some of the more common treatments that you and your doctor may discuss include: Prostate cancer experts at the Brady Urological Institute have created tools that help patients and doctors across the world assess risk and make treatment decisions. Interesting differences: Jonathan Epstein, MD received his doctorate from Boston University. LESION 2 -------------------------------------------------------- I have selected Focal Laser Ablation as my future (soon) treatment. My questions are: Prostate cancer is a slow growing condition. Read Also: What Are The Signs Of Prostate Infection. I'm going to reach out to UCLA to see what they can do. I had the MRI in April 2021 and it showed a PI-RADS 4 lesion. Best practices dictate that you obtain a second confirmatory pathology evaluation. The total number of cores identified is 3 For these reasons and others, it is advantageous to seek more than one opinion about how your cancer can be treated. 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. Results: There are three main types of doctors that manage prostate cancer: urologists, radiation oncologists, and medical oncologists. My family doctor was alarmed because such a steep increase in prostate-specific antigen could be a sign of prostate cancer. We prioritized treatment as AS, FLA/TULSA (if a lesion ever presented itself), and Proton Beam Radiation. I have developed an "abscess" on my prostate. Confused about Pathology report and course of action, Phone Number for John's Hopkins Radioogy Second Opinion. 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. Benign Processes: Good pathology readings require experience and a high level of expertise. Immediate means 6 weeks just to see his NP. Surgical Delay and Pathological Outcomes for Clinically Localized High-Risk Prostate Cancer. The researchers also found that patients who obtained second opinions because they wanted more information, were seeking the best doctor, or had been encouraged to do so by family or friends were more likely to undergo surgery. It starts many years ago. If you are diagnosed with a urologic cancer, including but not limited to the prostate, bladder, kidney, and testicular or urinary tract, its important to consider a second opinion. The people were great. Getting a second opinion on a diagnosis can reverse a diagnosis or alter the treatment plan. However, many insurance and health care companies do pay for such opinions and acknowledge the importance of second opinions. - 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 Any score above 55 has a greater than 50/50 chance of finding clinically significant cancer. Does that mean my Gleason Score based on my biopsy would be less than a Gleason 6? Thank you for your participation! -------------------------------------------------------- They seem to think it'll do the trick.I feel great and I am glad I chose this treatment path. I am doing my own research, but I am curious as to thoughts of the best possible MRI to obtain to give me the best chance at finding something the needle biopsy didnt find. They did 9 patients in Phase I and there have been 12 so far in Phase II. This fee includes: Studies show the clinical and financial benefits of obtaining a pathology second opinion. To learn your stage of prostate cancer, take the staging quiz on keytopc.com. They may defer to the recommendation of the specialist, or refer you to a doctor with limited prostate cancer experience.

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