johns hopkins prostate cancer second opinion

When to move from Active Surveillance to Treatment for Prostate Cancer? They may defer to the recommendation of the specialist, or refer you to a doctor with limited prostate cancer experience. There is no extraprostatic extension. 7 People with PN had an increased likelihood of: 6 Eating disorders Self-harm Send a Consult for Second Opinion | Johns Hopkins Pathology Overall my PSA is between 4 and 10. There is no one-size-fits-all treatment for prostate cancer. 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. He was right. No two cases of prostate cancer are alike and an accurate diagnosisis critical to developing the best treatment plan. 10: Prostate, right anterior MRI lesion Prostate, left anterior MRI lesion: 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. But, ultimately decided on whole gland treatment using Proton Beam Radiation.So. 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. If I don't meter fluids before bed, I can expect to get up 3-4 times in the night.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. 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. PSA that brought me to this was 7.1. 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. Some docs say clean up the prostatitis while others tell me to avoid overuse of Cipro as it loses its effectiveness over time. I've had what I would consider a fluctuating PSA since first tested in November 2018. Cleveland Clinics Virtual Second Opinions program connects you to an expert physician who specializes in your specific health needs. They replied they are sending the slides but they said they're looking into the DX test and will get back to me once they have that information. Read Also: What Are The Signs Of Prostate Infection. The study was published online Nov. 7 in the journal Cancer. We are vaccinating all eligible patients. Thank you! Thanks for considering. It was easy. This fee includes: Studies show the clinical and financial benefits of obtaining a pathology second opinion. Two things you learn here is get a second opinion from Johns Hopkins on biopsy and get treated at Center of Excellence. In 2006 my PSA was .6. Masks are required inside all of our care facilities. Has anyone sent Radiology (mpMRI) reports and images to Hopkins for Second Opinion Review? So the pathologist suggested a second opinion. 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. I just received a second opinion report from Johns Hopkins. If its a common cancer with a well-established standard of care, they can offer insight into clinical trials or novel treatments that may be better than the standard. It is still important to do your own research. have no symptoms, and yet you have cancer? Prostate, right medial base: In fact, additional biopsies revealed no additional cancer. Only took Motrin and Tylenol for pain after release. Another type of prostate issue is chronic prostatitis, or chronic pelvic pain syndrome. Luckily, his report co-coincided with the original QDx report. Finally, things are set and I know what is going to happen. 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. Xia L, Talwar R, Chelluri RR, Guzzo TJ, Lee DJ. 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). Find a doctor at The Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center or Johns Hopkins Community Physicians. I retested in January 2019 and scored 4.20. 2021 Sep 24;11(9):e044033. 8600 Rockville Pike Thanks, BigD. 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. Therefore, the value of these second opinions remains unknown. So, Radiation Oncologist prescribed Cialis 5mg, daily. I am also not comfortable making a decision based upon 1 genomics test, when my other prior test(s) disagrees and the gleason score disagrees. 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. 4 Get a Second Opinion Dr. Jonathan Epstein explains the benefits of getting a pathology second opinion I question the potential EPE and he said it didn't matter, but went ahead and ordered Oncotype. Enter the last name, specialty or keyword for your search below. 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. 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. Got my physical and normal DRE with new Dr. No issues identified. Thankfully, prostate cancer is extremely slow growing. I will say, the people I dealt with at Johns Hopkins were extremely nice and professional. So, I go one better, I call up Johns Hopkins and find a Dr who does DaVinci Prostate Surgery. Second Opinions in Prostate Cancer - American Council on Science and Health Possible additional organ confined malignant lesion in right apex Are considering a treatment that involves significant risks, such as surgery. One of the bits of advice the group regularly dispenses is for men to get a second and even a third opinion if you have doubts about the first opinions rendered by your urologist, or your pathologist, or your radiologist, its always okay to seek out a second opinion. I have posted here before, now with an update. 3. A enlarged prostate can also cause blockages in the urethra. 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. - Perineural invasion is present Which Patients Report That Their Urologists Advised Them to Forgo Initial Treatment for Prostate Cancer? Especially opinions other than those of the first Urologist you see. Get a Second Opinion | Johns Hopkins Pathology ZERO - The End of Prostate Cancer Support Community. And just this week, 1 YEAR post treatment, it is .46. Want confirmation about a diagnosis or treatment. 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. Find more COVID-19 testing locations on Maryland.gov. Thanks! Greatest dimension 0.7cm . There is no bony or bulky nodal disease in the pelvis Two from one lesion were positive as was one of the two from the other. * Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project For cancers that are less common, second opinions can offer more treatment options. 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. I also changed my diet to plant based food, started juicing, and started taking supplements (think Turmeric, Green Tea, etc.). 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. Note respondents were able to, MeSH 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. Epub 2010 Oct 20. However, something is driving my PSA. very activerun/cycle 6 days a week 6 A study at the Johns Hopkins Health System found it was 3.4 times more common in Black Americans than in White Americans. The prostate gland is slightly enlarged secondary to transition zone hyperplasia (25cc total) Blessings. I trust the second opinion Dr. Bush gave. Some men have minimal or no symptoms at all. My diagnosis is T2c, Gleason 7 (3+4). 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. This shows very high signal intensity on the diffusion-weighted Sought Johns Hopkins second opinion of pathology slides. I was on disability from work the entire time (not that I was disabled, but as a pilot, I couldn't very well work and get treatment at the same time. Every year I got a PSA and DRE during my annual physical. * Size: 1.5 cm Shore ND, Karsh L, Gomella LG, Keane TE, Concepcion RS, Crawford ED. 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. Spent the night in hospital with very little pain after the first couple of hrs. radiation, active surveillance, surgery, hormone therapy, and more. :) Ozzieville (Michael), Hello All and thanks for being here~This is my first post.My husband was diagnosed with PC (adenocarcinoma with Extensive Intraductal Carcinoma Present) a few weeks ago. 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. (Recommended by my oncologist, Dr. Mark Scholz.) Unfortunately, the 12/20/20 PSA reading was higher and that led to an MRI on 2/2/21 when two lesions were discovered. 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. official website and that any information you provide is encrypted Comments appreciated, If the problem is unresponsive to other treatments, your doctor may suggest a surgical procedure. During puberty, the body produces semen in a large number of cases, including enlarged prostate. And thanks again for making this such a great support group! 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. Confused about Pathology report and course of action, Phone Number for John's Hopkins Radioogy Second Opinion. When I read the forums and questions on this site everyone mentions their Gleason Score from their biopsy. I have developed an "abscess" on my prostate. 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? Need guidance choosing from multiple treatment options. Careers. has now confirmed this assumption through a careful retrospective analysis of data from > 450 men whose records could be identified in the SEARCH database, all of whom received surgical treatment for Gleason 8 to 10 prostate cancer. Compared with other men, African-American men and men with a family history of the disease are at higher risk of developing prostate cancer. Read books and realize as soon as they are published, they are outdated. In the United States, prostate cancer is among the most common cancers found in men. No extraprostatic extension. Got the fiducials placed, the Space-OAR gel placed, mold made, and had the pre-treatment MRI and CT Scan. Unable to load your collection due to an error, Unable to load your delegates due to an error. Unlike pathology labs in most hospitals, Jonathan Epstein's lab at Johns Hopkins has pathologists who specialize in reading prostate tissue samples. The percentage of tissue with carcinoma is 45% Does that mean my Gleason Score based on my biopsy would be less than a Gleason 6? Even if someone is being seen at a different academic center, the trials and other treatment options that we offer here may be different. Asking for your comments: 4. Peripheral Zone: The peripheral zone is of normal homogeneous prolonged T2 and there are no suspicious focal areas of Caused me to bleed heavily. 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. - Benign prostatic tissue Reinterpretation of imaging scans and lab tests. Urologists at the Johns Hopkins Brady Urological Institute can make the difficult process of deciding on a treatment plan easier. The prostates function is to create some of the fluid that insulates sperm cells found in semen. MRI June 2017 again at SMIL. Extraprostatic extension: negative My goals are to control PCa, to minimize side effects, and to keep options open in the future. 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. Overall, obtaining second opinions was not associated with changes in treatment choice or with improvements in how patients viewed their quality of cancer care. There are so many different departments at Hopkins that I don't know the optimal department to contact. 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 . * IF ANYONE reading this doesn't believe in the value of MRI first and targeted biopsy next then take note that my systematic biopsy cores showed 0 positive in 8 cores and my MRI guided core samples were 6 for 6 being positive! Call us with any questions: 410-955-2405, ext. In some situations, insurers will even insist on a second opinion. Request an Appointment 410-955-6100 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. Getting A Second Opinion On Your Pathology Report - Cancer ABCs Hillen MA, Medendorp NM, Daams JG, Smets EMA. In other words, the cancer is still contained within the prostate. - 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) Stanford Medicine Online Second Opinion Program It works. He turned to the Top Gun of Prostate Pathology: Jonathan Epstein, MD, the guru of Gleason scoring at Johns Hopkins University in Baltimore. (The pathology report from Cedars-Sinai kept my diagnosis at 3+4, but a second opinion at Johns Hopkins upgraded me to 4+3.) Find more COVID-19 testing locations on Maryland.gov. Any input on this would really be appreciated. Your current doctor will frequently suggest a second opinion, if only to confirm the recommended course of action. Low volume post-void residual urine is present in the bladder. 2011 Feb;29(1):3-9. doi: 10.1007/s00345-010-0602-y. This is a PI-RADS 5 lesion in As I said, I am 58, so I would really like to preserve my quality of life for as long as possible, but the genomics report has me concerned. Overall PIRADS Score: 5/5 At Another Johns Hopkins Member Hospital: Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, Prostate Cancer Treatment: What to Know About Active Surveillance. Further, among men with low risk disease, we did not observe a significant association between second opinions and receipt of definitive treatment or surgery. 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. Greetings gentlemen! Wow, I sound like a snob now! Johns Hopkins is home to many of the world's leaders in Pathology. I guess TWO national centers of excellence are better than one? We experienced information overload and decision/analysis paralysis. 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. U.S. News & World Report ranked the institute #7in the country. Prostate, right medial apex: I can do radiation as a monotherapy. At that point I agreed to the TRUS biopsy which I had on October 10, 2020. 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. They also determined there was extrapostatic extension because there was some fat in the sample that involved the cancer. That said, I have some questions that I derived, keeping in mind that 99% of what I have learned since February has come directly from this group: Do second opinions matter in prostate cancer care? - ecancer Benign prostatic tissue - Prostatic adenocarcinoma, Gleason score 3+4=7 (grade group 2, pattern 4: 5%) involving 2 of 2 cores (combined: 10.5 mm, 40%), 0.2 mm to the blue inked tissue edge Yet none of my doctors ever mentioned it! decision on a single medical opinion or the first appointment you get, you may Obviously the Covid 19 issue is playing a part in all of our decisions.

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