johns hopkins prostate cancer second opinion

This teamwork ensures the best possible patient outcomes. Your current doctor will frequently suggest a second opinion, if only to confirm the recommended course of action. sharing sensitive information, make sure youre on a federal 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. If I am rested, I find that I am more ready than if I am not. 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. 2. It is still important to do your own research. prostate volume). I trust the second opinion Dr. Bush gave. I followed up with the original pathologist to compare and he was more forthcoming. So, I also sent this MRI result to Johns Hopkins for a second opinion. Biopsy in 12/27/11 showed 3/14 cores, Gleason 6 with PSA of 4.5. Not all men with Gleason 8-10 disease are going to do badly after Surabhi Dangi-Garimella, PhD. 9. In the mean time my PSA was movingno longer static, but never back up to 6. 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. 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? In severe cases, a catheter may be required to relieve the symptoms. Consultation with your nurse care manager. Either the patient or the primary physician can initiate the process of getting a second opinion. Over 80,000 specimen cases are seen at Johns Hopkins each year. This condition causes pain in the lower back and groin area, and may cause urinary retention. I just turned 71 in February. Second Opinions & Consultations - Brain Tumor | Johns Hopkins Pathology You May Like: Best Treatment For Intermediate Prostate Cancer. Our collaborative processes also extend to our colleagues at Johns Hopkins Medicine, a world-wide leader in cancer research. Patient-initiated second medical consultations-patient characteristics and motivating factors, impact on care and satisfaction: a systematic review. 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. 2. - 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) Other labs for second . 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. Tumor Quantifications: You can call and speak with his assistant at: (410) 614-6330. Studies show the clinical and financial benefits of obtaining a pathology second opinion. A blocked urethra can also damage the kidneys. Most reputable HMOs can, however, deliver state of the art treatment for most cancers. His reasoning over the last couple of years is that the suspected lesion was not changing in size at all. 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. 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. 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. The people were great. Johns Hopkins Health - Second Opinions, Second Chances - Hopkins Medicine Brachytherapy Experience with Dr. Albert Chang at UCLA? And by FAA Aeromedical Ruling, I'd need a few post procedure reports before being cleared to fly again.) In those cases, patients are tremendously grateful for having received the advice and encouragement to get a second opinion, Dr. Matasar adds. Did robotic radical prostatectomy 1/25/12. It has been 2.5 years and the PSA has still not doubled as well. Unauthorized use of these marks is strictly prohibited. Medical record collection from doctors and hospitals. My direct phone (mobile) number is 703-992-3662, or you can private message me via this platform. 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. C. Prostate, right apex, core biopsy: 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. Younger men also sought the 'best' doctor. Find more COVID-19 testing locations on Maryland.gov. This site needs JavaScript to work properly. Olver I, Carey M, Bryant J, Boyes A, Evans T, Sanson-Fisher R. BMC Palliat Care. Who should I contact at Johns Hopkins to get a second opinion on a biopsy? This is why the prostate is important to the body. 2.Tammy Jiang, Christian H. Stillson, Craig Evan Pollack, Linda Crossette, Miupdachelle Ross, Archana Radhakrishnan, and David Grande, How Men with Prostate Cancer Choose Specialists: A Qualitative Study, Journal of the American Board of Family Medicine: JABFM, 30(2), (2017): 220229. Pathology reports are the opinion and interpretation of the individual pathologist viewing the tissue samples. Whats right for you will depend on the stage of the cancer, your level of risk and your general overall health. Low post-void residual volume is I am an airline pilot with exposure to radiation, jet fuels/fumes, etc. Do any of you have an opinion or actual experience with any of the three listed below? Over kill and redundancy I know, but it's my money, my prerogative. )I contacted Dr Busch (still in Chattanooga at the time) and he called me directly to talk me off the ledge. I guess TWO national centers of excellence are better than one? In the United States, prostate cancer is among the most common cancers found in men. 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. But, ultimately decided on whole gland treatment using Proton Beam Radiation.So. Where to start for newly diagnosed advance prostate cancer A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. 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. Now Im still ignorant and dont really know a Gleason from a Duck, so when the Dr says your treatment is radiation or surgery Im devastated. They won't be offended, and they may even be able to recommend a specialist for you to see. 10: Prostate, right anterior MRI lesion However, many insurance and health care companies do pay for such opinions and acknowledge the importance of second opinions. Dr stated that after seeing my muscles on the inside during operation he would have predicted this. 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. Metastasis. How important is Oncotype DX test for Gleason 7? Because I had an implant in my ear, they would only give me a 1.5T MRI. 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. * Prostate size: 3.9 x 2.8 x 3. cm Asking for your comments: Compared with other men, African-American men and men with a family history of the disease are at higher risk of developing prostate cancer. Prostate cancer is a malignant (cancerous) tumor of the prostate, a gland found only in men. Everything seems to be on track to remove the cancer and be cured! In some situations, insurers will even insist on a second opinion. However, there are also many more options for treatment and these options are more complicated than in the past. Another type of prostate issue is chronic prostatitis, or chronic pelvic pain syndrome. J Am Board Fam Med. Cancer ABCs recommends: Johns Hopkins Hospital in Baltimore, Maryland, specifically Dr. Jonathan Epstein. 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. It hasn't let me down. Left mid-base transition zone (PIRADS 5). They are not objective. First 6 week PSA is undetectable. Because physicians may differ in their approach to treating breast cancer, its very important to check with a breast cancer expert to know youre receiving the best treatment for you. After sending off all of our records, CD of MRI and path reports, my husband is booked for screening in December. Good pathology readings require experience and a high level of expertise. Johns Hopkins Prostate Cancer Doctors - HealthyProstateClub.com radiation, active surveillance, surgery, hormone therapy, and more. 9: Prostate, left anterior MRI lesion Masks are required inside all of our care facilities. Other: There is trace ascites in the mesosigmoid. Your current doctor will frequently suggest a second opinion, if only to confirm the recommended course of action. 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. They confirm everything except question whether one of the core samples is a 3+3 or 3+ 4. This suggests that for some men, second opinions offer a way to pursue the treatment they already planned on, rather than to explore other treatment options, according to study authors Dr. Archana Radhakrishnan, of Johns Hopkins University in Baltimore, and her colleagues. Prostate volume: 17.58 cc Be well. If the enlarged prostate is not completely removed, it will shrink. In My Opinion? Get A Second Opinion | ZERO Prostate Cancer Since I have gotten so much out of this forum, I thought Id provide my story to help others. Getting a second opinion from us is easy, convenient, and all done remotely. 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. 3T MRI with coil is done initially, along with a TRUS biopsy. Total Gleason score: 6 So, Radiation Oncologist prescribed Cialis 5mg, daily. This is a PI-RADS 5 lesion in Study after study confirms that doctors favor the treatment they are trained to do urologists typically recommend surgery and radiation oncologists recommend radiation. Im immediately referred to Urologist. 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. Get a Second Opinion: Johns Hopkins Kimmel Cancer Center You may also complete an online appointment request form and we'll respond to schedule an appointment. Nor did I have any idea that the 1 core had 20% involvement and <5% pattern 4 involvement. I then had the PHI test which showed PSA 8.70 and overall PHI 125.9. My urologist suggested a couple more PSA tests followed by an MRI. Masks are required inside all of our care facilities. Slightly An acute bacterial infection can cause a burning sensation. Getting a second opinion on a diagnosis can reverse a diagnosis or alter the treatment plan. (Recommended by my oncologist, Dr. Mark Scholz.) No extraprostatic extension. My Oncotype rating was GPS 54, with a 26% chance of metastisis within 10 years. If they have an enlarged colon, their physician can perform a TURP procedure. 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. Yet none of my doctors ever mentioned it! 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. 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. Seeking second opinions is becoming standard practice, and it is mandatory at Johns Hopkins. Many men name the diagnosing urologist as their treating doctor and do not seek other opinions. I didn't study for the test and it's possible some morning activities might have affected my test score :) I had the MRI in April 2021 and it showed a PI-RADS 4 lesion. Are considering a treatment that involves significant risks, such as surgery. Our gynecologic pathology team can also help determine if the tumor is localized or has metastasized from another region of the body. Associated fees may be incurred up to $1,800 in a minority of more complicated cases requiring special studies. Surgical Delay and Pathological Outcomes for Clinically Localized High-Risk Prostate Cancer. After a second opinion from both Johns Hopkins and Stanford, the two 4+3's were downgraded. Epub 2018 Mar 28. Hello, I apologize upfront for the length of this post, but I was recently diagnosed with prostate cancer (T2C) and figure more information is better than not enough. The all-inclusive cost for a virtual second opinion for patients in the U.S. is $1,850. I am unfortunately "officially" joining the club after getting my biopsy results today. He said that JHs said that it was 2 cores, but it was actually a fragmented core, that the fat did not present on the right place on the slide, that prior FLA (partial hemi-ablation) could affect the results, the MRI did not support, etc. A man with a father or brother who had prostate cancer is twice as likely to develop the disease. A small early-stage clinical trial found that a carefully selected group of patients who responded remarkably well to chemotherapy could skip surgery altogether. images and markedly reduced ADC. I was to follow up with my new Urologist (another surgeon) for 3 months PSA checks and annual 3T-MPMRI.My PSA checks were static and the next year's MRI looked just like the first. Watch: Are supplements good for prostate health? Note respondents were able to, MeSH 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. doi: 10.1001/jamanetworkopen.2020.28320. We can help with your case. Here are the details: A week later had catheter removed and had no bladder leakage problems. It is OK to not understand all the terminology. I'm Gleason 3+4=7, and I believed only 2 cores tested positive. Second Opinions An accurate diagnosis is essential to ensure that the correct and most effective treatment is given. 2 of the 12 samples showed High Grade PIN and one area showed "suspicious for low-grade adenocarcinoma". Just had my appointment today and they are pleased with the results, so far. Which Patients Report That Their Urologists Advised Them to Forgo Initial Treatment for Prostate Cancer? But I've had trouble getting Dr. Chang's office to provide any patient referrals. Second Opinions in Prostate Cancer - American Council on Science and Health That being said, they can be a beneficial member of the treatment team. 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. Using the Bullet Volume gives you gland of 25.55. Masks are required inside all of our care facilities. official website and that any information you provide is encrypted 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. 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 purpose of starting this discussion is to gather peoples thoughts and opinions and actual experiences with Prostate Focal Laser Ablation. My goals are to control PCa, to minimize side effects, and to keep options open in the future. and I have already proven to myself that my body is good at cell mutation, so I wanted to be careful.At the 3 year mark (6 months after last MRI), my PSA spiked to > 6. So I initially thought this makes me a good candidate for AS. It's really that simple! Five years ago I had a TURP. The results were ambiguous. However, many insurance and health care companies do pay for such opinions and acknowledge the importance of second opinions. Due to the spread of the Coronavirus worldwide and the first confirmed case of the Coronavirus disease in Turkey, the executive team of the Anadolu Medical Center has taken preventive measures to protect the patients and their relatives. Am I missing anything? They did another 3T-MPMRI (Siemens machine) and it showed a faint area, near the margin, and very close to the down stream sphincter of prostate. According to the study, one in every 600 diagnoses showed mistakes.This study only addressed major changes in diagnoses, such as a diagnosis of cancer being reversed to no cancer, says Johns Hopkins pathologist George Netto, M.D. I had a telemed session with Dr. Chang, and it sounds like a pretty simple procedure, with urinary side effects that resolve pretty quickly. I retested in January 2019 and scored 4.20. 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. Question anemia. Their opinions are widely held to be definitive. 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. Get a 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. Anyhow, as for treatment, yesterday I met with a Dr. William Wong at Mayo Phoenix. The Journal of the American Board of Family Medicine published a study in 2017 that found that many patients do not get a second opinion outside of their PCPs original referral2. - 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 Bethesda, MD 20894, Web Policies Have you heard of PRECISE follow up score for an MRI? * Location: Left, anterior, base to apex, transition zone Has anyone sent Radiology (mpMRI) reports and images to Hopkins for Second Opinion Review? 1st opinion"PYL PSMA PET/CT scan demonstrating foci of moderate to intense uptake in the prostate gland consistent with known prostatic cancer. 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. Two from one lesion were positive as was one of the two from the other. The Radiation Oncologist knew of Dr Busch (by now in Alpharetta, GA) and spoke highly of him. We will then prepare a written recommendation regarding your treatment plans or options. Greetings gentlemen! 2017 Oct;22(10):1197-1211. doi: 10.1634/theoncologist.2016-0429. * Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project PDF Cancer A Second Opinion A Look At Understanding Controlling And Curing I have completed an exhaustive research effort on Prostate Cancer and PCa treatments. 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. There are lots of lessons learned on the forum. He also said I would tolerate any option well based on my age and health. About 80 percent of prostate cancers are diagnosed at a localized stage, which means that the cancer hasnt spread outside of the prostate. However, there are other cases when a second opinion results in a very different diagnosis or set of treatment recommendations. A second review of Pathology more frequently also brings changes to the cancer grade or stage, which can affect prognosis as well as therapy. The total number of cores identified is 3 But you have to do both. Not all cancers are the same and not all treatment plans are absolutely clear. My local urologist didnt want to schedule one because it he said it wouldnt change my treatment options, radiation or surgery. In terms of cancer, changes can be from cancer to benign (or vice versa) or from one type of cancer to another, which could . Getting A Second Opinion On Your Pathology Report - Cancer ABCs Notice of Privacy Practices(Patients & Health Plan Members). However, before getting a second opinion, its best to check with your insurance company to see if there are any limitations in coverage. Two 1cc tumors, gleason score 3+4 each, one in each lobe. Does that mean my Gleason Score based on my biopsy would be less than a Gleason 6? Men with a college education or beyond also were more likely to cite wanting more information about their cancer as a motivation for a second opinion . 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. * Prostate volume: 22 cc 30%/40% or higher)? Therefore, the value of these second opinions remains unknown. 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).

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