johns hopkins prostate cancer second opinionjohns hopkins prostate cancer second opinion

Prostate cancer is the second-most diagnosed cancer in American men. What is NOT OK is quitting or avoiding the bad news, or handing the entire decision over to someone else.Good luck fellas! Bones: There is marketed marrow heterogeneity in the pelvic bones are not in the femoral heads. 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.). focal peripheral zone lesions. 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. Low post-void residual volume is Johns Hopkins Prostate Cancer Second Opinion After much discussion we both agreed that surgery was my best option and that he would do it at the end of July. These findings are suspicious for degenerative changes however a subtle/early metastatic lesion cannot be excluded and continued periodic follow-up is recommended." Consultation with your nurse care manager. I have searched the country for intervential radiologist that perform FLA on the prostate. I had two no-risk, non-invasive tests: a Free PSA with an adverse score of 9% and a PCA3 test with a disappointing 41. 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. 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. Instead, I did my homework. Benign Processes: of tumor in the rectal prostatic angles. Keywords: You receive a secure, private online consultation without leaving home. - Johns Hopkins Medicine -- Get a Second Opinion Over kill and redundancy I know, but it's my money, my prerogative. Does 3+4 at some point typically evolve into 4+3 and also serve as a trigger point for moving from AS to treatment? Out of 12 cores, 9 are positive. 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. However, he also said it's treatable even at a 2cm size and the transition zone is a favorable spot. Benign fibromuscular stroma; no prostatic glands are identified Who should I contact at Johns Hopkins to get a second opinion on a biopsy? Seems like a simple request. No one at Hopkins has ever died of prostate cancer if he had Gleason 3 + 3 cancer." How long do you have left? Benign prostatic tissue This kills both birds with a single stone. Benign Processes: Then about a month later I started 28 fractions of Proton Radiation.It was painless. We will then prepare a written recommendation regarding your treatment plans or options. 1. The more accurate the information we have, the better our treatment decisions. AHN patients have unprecedented access to the Johns Hopkins Center for Fetal Therapy. We can help with your case. Especially opinions other than those of the first Urologist you see. Disclaimer. * Seminal vesicle invasion: None. How much is the fee for an opinion of my recent MRI? My strong preference would be to do FLA again and monitor. You have a rare or unusual cancer. Unfortunately, what you do not realize may harm you! Confounding this, I have read that the different genomic tests can disagree with each other, and that Oncotype is usually a more aggressive finding. 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. When Primary Care Providers (PCPs) Help Patients Choose Prostate Cancer Treatment. Prostate, left anterior MRI lesion: 2011 Feb;29(1):3-9. doi: 10.1007/s00345-010-0602-y. So, I made an appointment at Emory Proton Center (Atlanta, GA) and got their opinion. MRI RE-READ #3 (National Cancer Center of Excellence): Best practices dictate that you obtain a second confirmatory pathology evaluation. More medical freakouts. What have your doctors told you? When to move from Active Surveillance to Treatment for Prostate Cancer? You're more likely to develop prostate cancers that are more likely to spread. 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." A second review of Pathology more frequently also brings changes to the cancer grade or stage, which can affect prognosis as well as therapy. We are vaccinating all eligible patients. )I contacted Dr Busch (still in Chattanooga at the time) and he called me directly to talk me off the ledge. John Hopkins Prostate Cancer Second Opinion 2018 May;115:133-138. doi: 10.1016/j.urology.2018.01.048. Prostate, left medial base: I want to insure that the Imaging was read correctly and nothing was overlooked or missed. 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. the transition zone. 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. Lesion 1: Left mid-base transition zone. 30%/40% or higher)? Extracapsular extension: The prostatic capsule is preserved. 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. You It is OK to be overwhelmed with info. For cancers that are less common, second opinions can offer more treatment options. Overall, obtaining second opinions was not associated with changes in treatment choice or with improvements in how patients viewed their quality of cancer care. Another type of prostate issue is chronic prostatitis, or chronic pelvic pain syndrome. So, I believe I made the right choice. This teamwork ensures the best possible patient outcomes. MRI RE-READ #1 (well known radiologist, but free advice over phone, but no written report): You may be concerned that the cancer will grow rapidly out of control before you are able to get a second opinion. Does every biopsy provide a Gleason Score? The TRUS biopsy is behind me, the second opinion from Johns Hopkins is behind me, and its time for next steps. Find more COVID-19 testing locations on Maryland.gov. 3. * Gleason Score: 3+3 (2 of 6 specimens) For these reasons, it is a good idea for HMO members to get a second opinion and make sure they are informed about clinical trials or other promising new treatments. 3. This is why the prostate is important to the body. I've also read that some study's have shown that intraductal may be resistant to hormonal therapy, radiation and/or chemo. Greetings gentlemen! Prostate Cancer | Johns Hopkins Brady Urological Institute A enlarged prostate can also cause blockages in the urethra. Federal government websites often end in .gov or .mil. The Stanford Medicine Online Second Opinion program offers you easy access to our world-class doctors. You May Like: Prostate Cancer External Beam Radiation Side Effects. 2016 American Cancer Society. Sought Johns Hopkins second opinion of pathology slides. 2017 May-Jun;30(3):298-307. doi: 10.3122/jabfm.2017.03.160359. The percentage of tissue with carcinoma is 45% Mayo's report came back with the same PI-RADS 4 with the wording that it was more conspicuous but unchanged. National Library of Medicine Mohamad Allaf, M.D., answers questions about prostate cancer diagnosis and treatment options and discusses robotic prostatectomy at Johns Hopkins. One core had 5%, one 20%, and one 40%. It will be interesting to see, I think. 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. Obtaining a second opinion on your pathology report is no different than getting a second doctors opinion, it is a must for all of us. To schedule an in-person visit for a second opinion or to determine if a telemedicine consultation is possible, call: 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. Discover what's to love about Charm City for yourself. Overall PIRADS Score: 5/5 Following application of the relevant exclusion criteria, 2365 respondents remained in the analytical cohort. 2: Prostate, right lateral base The all-inclusive cost for a virtual second opinion for patients in the U.S. is $1,850. Emotional outlook is fragile at times and straight clinical approach of doctors does not help. * Extracapsular extension: Possible involvement of the anterior 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%). He said that it will improve in the future due to future improvements in the treatments. Then about a month later I started 28 fractions of Proton Radiation.It was painless. Two weeks later I meet with my Johns Hopkins Dr. The https:// ensures that you are connecting to the 2nd opinionBone Scan:"Mild increased activity is seen in the right symphysis corresponding to the abnormalities on the prior PET/CT examination. A. Prostate, right base, core biopsy: 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. Some docs say clean up the prostatitis while others tell me to avoid overuse of Cipro as it loses its effectiveness over time. Bookshelf At a rectal exam 6/20 the urologist told me my prostate felt normal, not enlarged, nor did he feel any tumors. 3/5 And 2 cores from left apex of 3+3=6 with 10% involvement. Even for men with faster growing, more aggressive prostate cancer, taking the time to seek a second opinion should be a priority. "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 . Patients may experience a fever or chills as a result of the infection. Race and ethnicity. Expert review of your case by a Cleveland Clinic specialist. Its in your best interest to ask for another look at a cancer diagnosisIf youve recently been diagnosed with cancer, its wise to ask for a second opinion on your pathology specimen.Johns Hopkins researchers with the Urological Pathology Consult Division, led by Jonathan Epstein, M.D., first reported on biopsy errors a decade ago, when they found a margin of error in prostate cancer diagnoses large enough to give them pause. 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. I did a book review with his first book for several veterans groups including the Americal Division Veterans Organization which with I served at age 19. They seem to think it'll do the trick.I feel great and I am glad I chose this treatment path. The other samples produced 4 more positive cancer cores for a total of 7 of 12 positives. Second Opinion Pathology | MD Anderson Cancer Center )I contacted Dr Busch (still in Chattanooga at the time) and he called me directly to talk me off the ledge. However, there are other cases when a second opinion results in a very different diagnosis or set of treatment recommendations. I just received a second opinion report from Johns Hopkins. 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. Allow yourself the time to seek multiple opinions. Obviously the Covid 19 issue is playing a part in all of our decisions. I have had a CT of the pelvic area - negative and a whole body bone scan - negative. Get a Second Opinion What can a second opinion tell me? I'm currently in the process of getting an appointment set up with a Dr. Wang at UCLA. Younger men were more likely to cite wanting more information about their cancer and to see the best doctor as the reason to seek a second opinion . 2020 Dec 1;3(12):e2028320. Knowing your stage and information specific to that stage makes you more medically sophisticated and enables you to navigate through the potential biases of surgeons and radiation therapists. While I have three lesions, they are small and, without 3T mp MRI, might not have been discovered. 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. 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. Include Your Primary Care Physician as Member of Your Treatment Team. Three lesions: 1) GS 6 involving 30% of one core; 2) GS 6 involving less than 5% in one core; and 3) GS 6 involving less than 5% in another core. BJU Int. Especially opinions other than those of the first Urologist you see. Johns Hopkins Health - Second Opinions, Second Chances, Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, High Blood Pressure May Take Its Toll on Your Kidneys. 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." The prostate gland is slightly enlarged secondary to transition zone hyperplasia (25cc total) Getting a second opinion from us is easy, convenient, and all done remotely. He adds that second opinions also can provide insight into topics like clinical genetics and family risk or issues related to complementary or integrative medicine approaches to manage symptoms. Good Morning Brothers- Dont Miss: Can Prostate Problems Cause Burning Urination, Why Prostate Cancer Survivor John Shearron Thinks Its Important To Do Your Research | PCRI, Prostate Cancer Pathology in 2021 | Jonathan Epstein, MD | PCRI 2021 Conference, Johns Hopkins Prostate Cancer Second Opinion, treat rare and complex conditions through breakthrough fetal procedures, Function Of The Prostate Gland And Seminal Vesicles, Best Treatment For Intermediate Prostate Cancer, How Old Can You Be To Get Prostate Cancer, New Treatments For Stage 4 Prostate Cancer, Prostate Radiation Treatment Side Effects, Can Prostate Problems Cause Burning Urination, Prostate Cancer Spread To Skull Prognosis, Life Expectancy Stage 4 Prostate Cancer No Treatment, Diagnostic Procedures For Prostate Cancer. Send a Consult for Second Opinion | Johns Hopkins Pathology My PSA went up from 3.5 post FLA (It was 7.2 pre-procedure) to 6.7 in 2021, so I went to another radiologist to do an MRI guided biopsy of the suspected area that was near the prior ablation zone. 3: Prostate, right medial apex I am meeting with a multidisciplinary team of docs on March 18 at St. Joe's in Atlanta. Diffuse probable benign peripheral zone changes limit evaluation for Asking about other experience with conflicting Prostate Biopsy Opinions. I would really love to hear from you. 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. At this point Im still ignorant about what I ought to be doing (MRI guided biopsy is what I should have gotten). Wow, I sound like a snob now! In severe cases, a catheter may be required to relieve the symptoms. He schedules appointments with a Radiologist and two local surgeons. An official website of the United States government. Research was mixed on PINS, but in those days, many doctors saw them as likely to develop into cancer. Men who sought second opinions because they were dissatisfied with their initial urologist were less likely to receive definitive treatment (odds ratio, 0.49; 95% confidence interval, 0.32-0.73), and men who wanted more information about treatment were less likely to report excellent quality of cancer care (odds ratio, 0.70; 95% confidence interval, 0.49-0.99) compared with men who did not receive a second opinion. The total number of cores identified is 3 Note respondents were able to choose more than one reason. Not all cancers are the same and not all treatment plans are absolutely clear. The study included nearly 2,400 men in the Philadelphia area recently diagnosed with localized prostate cancer. This condition causes pain in the lower back and groin area, and may cause urinary retention. Conclusions: In some situations, insurers will even insist on a second opinion. Oncologist. But was able to walk right into the JH Urology clinic for immediate treatment (flushing of bladder cleared everything up). 4.5 year journey (18 months post proton beam), 4.5 Year Update (18 month post Proton Beam). 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. I had no idea there were second opinions and I didn't have a clue about Genomic testing, or even genetic testing. 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. I worked out every day. From what I've learned from Dr. Scholz videos at PCRI, and from posts on this site it would lead me to believe the DX test is fairly common knowledge. Second Opinion Results, Johns Hopkins biopsy reading of 2 slides sent by Sloan: In order to receive appropriate treatment, patients must understand the treatment options that are available. HMO members may also be discouraged from trying expensive treatments that have only a small chance of success, even if that chance is real. First MRI done in June 2016 by Scottsdale Medical Imaging - nothing found. If youve received a new cancer diagnosis or arent seeing results from your current treatment plan, an expert second opinion can help you move forward with confidence. Unlike pathology labs in most hospitals, Jonathan Epstein's lab at Johns Hopkins has pathologists who specialize in reading prostate tissue samples. PSA that brought me to this was 7.1. How could this compare using only partial slide re-reading? I assume it is not free. Call us with any questions: 410-955-2405, ext. 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.
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