johns hopkins prostate cancer second opinion johns hopkins prostate cancer second opinion

AHN patients have unprecedented access to the Johns Hopkins Center for Fetal Therapy. Dont Miss: Screening For Prostate Cancer Icd 10. The prostates function is to create some of the fluid that insulates sperm cells found in semen. Most reputable HMOs can, however, deliver state of the art treatment for most cancers. This is not true. I will say, the people I dealt with at Johns Hopkins were extremely nice and professional. FOIA The purpose of starting this discussion is to gather peoples thoughts and opinions and actual experiences with Prostate Focal Laser Ablation. Prostate, left medial base: Even at the age of 48, he thought I would be a good candidate for AS. Second Opinion Results, Johns Hopkins biopsy reading of 2 slides sent by Sloan: Thanks, 2. After extensive discussion of his management options with his local urologist, primary care physician, and radiation oncologist, he also sought a second opinion at the Johns Hopkins Prostate Cancer Multidisciplinary Clinic at Sibley Memorial Hospital.The patient expressed an overwhelming desire to avoid surgery and any other invasive treatments. Allow yourself the time to seek multiple opinions. Seeking second opinions is becoming standard practice, and it is mandatory at Johns Hopkins. In 2006 my PSA was .6. Keep in mind that not all PCPs are knowledgeable about prostate cancer or know the skill levels of all the specialists in the field. 8: Prostate, left lateral base 1. Peripheral Zone: The peripheral zone is of normal homogeneous prolonged T2 and there are no suspicious focal areas of You're also at greater risk of prostate cancer forming before age 50. A man with a father or brother who had prostate cancer is twice as likely to develop the disease. Ramsey SD, Zeliadt SB, Fedorenko CR, Blough DK, Moinpour CM, Hall IJ, Smith JL, Ekwueme DU, Fairweather ME, Thompson IM, Keane TE, Penson DF. No definitive evidence of distant metastatic disease is seen." He schedules appointments with a Radiologist and two local surgeons. Surgery took about 3 hrs. * Extracapsular extension: None. Prostate Cancer Pathology in 2021 | Jonathan Epstein, MD | PCRI 2021 Conference, Why Prostate Cancer Survivor John Shearron Thinks Its Important To Do Your Research | PCRI, John Hopkins Prostate Cancer Second Opinion, a higher risk of developing uterine cancer, surgery may not always be necessary for all breast cancer patients, The cancer vanished in every single participant, Long Term Side Effects Of Brachytherapy For Prostate Cancer, treat rare and complex conditions through breakthrough fetal procedures, Prostate Cancer External Beam Radiation Side Effects, Can Enlarged Prostate Cause Blood Clots In Urine, Life Expectancy Stage 4 Prostate Cancer No Treatment, Prostate Cancer Spread To Skull Prognosis, Diagnostic Procedures For Prostate Cancer. 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. Masks are required inside all of our care facilities. Hopkins states that the one positive core (10% G6) was visualized by the MRI, so I am hoping that this increases our chances of making it through the screening process. So off I went to see a community urologist who performed a needle biopsy in his office. 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. Find more COVID-19 testing locations on Maryland.gov. Do I need a third opinion? However, that information will still be included in details such as numbers of replies. BONES: No suspicious osseous 3T MRI with coil is done initially, along with a TRUS biopsy. Right mid anterior transition zone (PIRADS 2). I am doing one in 6 weeks, regardless. 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. !I'll try editing a previous post and see if it reads like a journal instead of creating a new thread every update.I just got my PSA results and the numbers are still trending in the right direction. E. Prostate, left mid, core biopsy: Both Drs and nurses knew what they were doing and had lots of experience. Careers. Do any of you have an opinion or actual experience with any of the three listed below? When to move from Active Surveillance to Treatment for Prostate Cancer? * Seminal vesicle invasion: None. (I must say that those low numbers concern me a bit.) 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. Im immediately referred to Urologist. Depending on your location, you may be able to have a telemedicine consultation. 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. The all-inclusive cost for a virtual second opinion for patients in the U.S. is $1,850. Question anemia. Last year, Epsteins lab reviewed the pathology reports of 30,000 cases in which patients requested second opinions.Netto says patients should be proactive in requesting that doctors take another look.A second opinion can reverse the diagnosis in up to 5 percent of cases for some types of cancers, he says, like those of the breast and pancreas.Diagnosis Errors by the Numbers. 2018 May;115:133-138. doi: 10.1016/j.urology.2018.01.048. Out of 12 cores, 9 are positive. He said that it will improve in the future due to future improvements in the treatments. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Future study is needed to determine when second opinions contribute to increasing the value of cancer care. Youve just been diagnosed with prostate cancer. - DWI-ADC = 4/5 Background: And should I treat prostatitis before FLA? Netto says patients should be proactive in requesting that doctors take another look. Of course, my old school Urologist recommended surgeryHe, of course, knew the best robotic surgeons around.Anyway. 4. - Perineural invasion is present I made the appointments. I'm turning 58 in one week. undefined will no longer be visible to you including posts, replies, and photos. I worked out every day and it wasn't until the last week did I feel a bit fatiguedand experience a bit of urgency and hesitation having to peeflowmax fixed that right up!90 days after treatment my PSA came in at .56. Here are seven tips for seeking second opinions for prostate cancer: Before getting a second opinion, its important to know your stage of prostate cancer. Does 3+4 at some point typically evolve into 4+3 and also serve as a trigger point for moving from AS to treatment? Can it be salvaged or are the risks of cancer too high? Unable to load your collection due to an error, Unable to load your delegates due to an error. Are you sure you want to block this member? T2W MRI score= 5, DW MRI score= 5, DCE MRI score=positive (I think that it was easier to see because Mayo's MRI technology and procedures are better than SMIL's.) The study was published online Nov. 7 in the journal Cancer. not hear all the viable treatment options or receive the most up to date In severe cases, a catheter may be required to relieve the symptoms. focal peripheral zone lesions. 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. Benign Processes: About 80 percent of prostate cancers are diagnosed at a localized stage, which means that the cancer hasnt spread outside of the prostate. * Perineural Invasion also detected Benign prostatic tissue They want him to start radiation 25 sessions and chemo pills of Casodex 50 mg 28 pills. My most recent biopsy resulted in two cores with Gleason 4+3=7 and one with 3+3=6. 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. There are also many reasons why you may want to seek another opinion during the course of your cancer care. And just this week, 1 YEAR post treatment, it is .46. I am already positively surprised that I am still alive 4.5 years after my diagnosis. Possible additional organ confined malignant lesion in right apex I am unfortunately "officially" joining the club after getting my biopsy results today. It is OK to be scared. Who Should Request a Second Opinion? Hi All, 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 starts many years ago. Overall, obtaining second opinions was not associated with definitive treatment or perceived quality of cancer care. Luckily, his report co-coincided with the original QDx report. SMIL radiologist reported nothing found. This is the most common urinary tract problem in men under 50, and the third most common in men over 65. So I initially thought this makes me a good candidate for AS. This championship swimmer sought a second opinion at Johns Hopkins. At this time, I am leaning towards Active Surveillance or FLA. AS would be my choice, except that a total of three lesions, on both sides of Peripheral Zone, makes this controversial. Just had my appointment today and they are pleased with the results, so far. Atrophy I'm leaning towards SBRT. Four had 60-70%, five have between 5-10%. Negative cancer in lymph nodes, seminal vesicles, and all margins. Benign prostatic tissue 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. 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.). Not all cancers are the same and not all treatment plans are absolutely clear. Benign fibromuscular stroma; no prostatic glands are identified 2. So, Radiation Oncologist prescribed Cialis 5mg, daily. I say bullshit to them. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. HMO members may also be discouraged from trying expensive treatments that have only a small chance of success, even if that chance is real. 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. Expert review of your case by a Cleveland Clinic specialist. * Size: 1.5 cm We prioritized treatment as AS, FLA/TULSA (if a lesion ever presented itself), and Proton Beam Radiation. 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. 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. Anyone else encounter something like this? Your current doctor will frequently suggest a second opinion, if only to confirm the recommended course of action. If they have an enlarged colon, their physician can perform a TURP procedure. He also said I would tolerate any option well based on my age and health. 3. My family physician for years told me that small increases PSA was common so when it went over 4 it didnt bother me and my Dr who was retiring, didnt say anything either. Dr. said pirad-5 and to prepare for bad news and probably around a Gleason 7 and that he is rarely wrong. Cancer vaccines.For a long time, the promise of cancer vaccines that would protect healthy people at high risk of cancer has only dangled in front of researchers. FAX 310-574-4002 JHs just said it was minimal less than 5%. 1. Dr. Nour is 100% sure that nothing has spread. Unbelievable that this happened!!! I requested a second opinion from Johns Hopkins and they found 1 lesion was 3+3=6 and the second lesion was 3+4 =7, with less than 5% pattern 4. It is best to begin by talking with the doctor who made your initial prostate cancer diagnosis. Pingback: PROSTATE PROS Episode 6: Breakthroughs in Radiation PROSTATE ONCOLOGY SPECIALISTS, Pingback: Like Man, Im Tired (Of Waiting): The How-to Guide for Men with Prostate Cancer PROSTATE ONCOLOGY SPECIALISTS, Your email address will not be published. Disclaimer. Using an Ellipsoid Volume the dimensions would give you a volume of 20.44. Federal government websites often end in .gov or .mil. - Benign prostatic tissue Therefore, the value of these second opinions remains unknown. prostate volume). When I was diagnosed I really thought that I will live only 2 years. Nov 7, 2016. PCPs can be a great help to navigate the medical marketplace and provide an unbiased voice of reason when it comes to making hard choices. Dr. Dan Sperling - New York. )I contacted Dr Busch (still in Chattanooga at the time) and he called me directly to talk me off the ledge. A doctor may prescribe surgery or perform an endoscopic procedure. With The Clinic by Cleveland Clinic, patients have access to Cleveland Clinics 3500 specialists. And again, most of you tell me time is on my side, so I am comforted in hearing that. I had a follow up 3T MRI guided biopsy on March 18 at Emory. 2 of the 12 samples showed High Grade PIN and one area showed "suspicious for low-grade adenocarcinoma". 2nd opinionBone Scan:"Mild increased activity is seen in the right symphysis corresponding to the abnormalities on the prior PET/CT examination. 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 total number of cores identified is 3 Second opinion Biopsy came after FLA G-9. 53 years old - PI-RADS for this lesion = 4/5 24.5 BMI What is NOT OK is quitting or avoiding the bad news, or handing the entire decision over to someone else.Good luck fellas! Ask your PCP to refer you to several different types of treating doctors before making a treatment decision. We are vaccinating all eligible patients. It was easy. Visit and Like ZERO - The End of Prostate Cancer on Facebook, Sign up to receive emails and news from ZERO - The End of Prostate Cancer, Search prostate cancer clinical trials and studies. 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. Without your support, I could easily have subjected myself to random biopsies that are risky, don't do a good job of finding lesions, and can mess up the clarity of the prostate for an MRI. My new Dr however didnt order PSA so I asked him for one. * Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project Radhakrishnan A, Grande D, Ross M, Mitra N, Bekelman J, Stillson C, Pollack CE. Metastasis. Clipboard, Search History, and several other advanced features are temporarily unavailable. The ADT has daunting side-effects but he said offers some improved chances of eradication, any long-term downsides that I should consider? An acute bacterial infection can cause a burning sensation. A small early-stage clinical trial found that a carefully selected group of patients who responded remarkably well to chemotherapy could skip surgery altogether. Find more COVID-19 testing locations on Maryland.gov. I'm trying to figure out why the PSA keeps rising. 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. I'm going to reach out to UCLA to see what they can do. No extraprostatic extension. The Stanford Medicine Online Second Opinion program offers you easy access to our world-class doctors. During puberty, the body produces semen in a large number of cases, including enlarged prostate. This Dr is in charge of active surveillance program at JH so I knew that he wouldnt recommend surgery unless it was really needed. It works. This teamwork ensures the best possible patient outcomes. Forty percent of the men obtained a second opinion from urologists, most often because they wanted more information about their cancer or wanted to be seen by the best doctor . Being in Wisconsin, my insurance gives me the option of two hospitals to manage me. I have completed an exhaustive research effort on Prostate Cancer and PCa treatments. In some situations, insurers will even insist on a second opinion. Need guidance choosing from multiple treatment options. Some pathologists have more experience than others. It is OK to be scared. 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. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. Now the oncologist wants to perform a PSMA Pet Scan. But was able to walk right into the JH Urology clinic for immediate treatment (flushing of bladder cleared everything up). Also indicated everything else was "organ confined." Men often seek second opinions from urologists before they initiate treatment for their newly diagnosed prostate cancer. 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. Covid turned the 1 year into 16 months and PSA tested at 7.44 in August 2020, followed by another referral back to the urologist. 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. 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. National Library of Medicine 180 days after treatment PSA was .50. Discover what's to love about Charm City for yourself. More medical freakouts. I question the potential EPE and he said it didn't matter, but went ahead and ordered Oncotype. Their opinions are widely held to be definitive. 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. But, after 4 drinks or if I'm tired/jet lagged I find that sleep is more appealing than sex. But in the spirit of disclosure for those of you with BPH a TURP can complicate a future Radical Prostatectomy (or possibly Cryo) and increase the risk of side effect risks. Overall, obtaining second opinions was not associated with definitive treatment or perceived quality of cancer care. Maybe lycopene and pomegranate have helped. I have had a second opinion from Johns Hopkins that confirmed the initial pathology of gleason 3+4. Radhakrishnan A, Grande D, Mitra N, Bekelman J, Stillson C, Pollack CE. Now, I would like to send Radiology for a similar review. 10: Prostate, right anterior MRI lesion The more often a doctor diagnoses and treats prostate cancer the more proficient they become. The results seemed fairly benign and my urologist and I decided to continue to monitor with 2 more PSA tests and then consider an MRI in April 2021. If youve received a new diagnosis or arent seeing results from your current treatment plan, a second opinion can help you move forward with confidence. PSA: 4.7 ng/ml/PSA density: 0.27 ng/ml2 Diffuse probable benign peripheral zone changes limit evaluation for I am 65 and in excellent general health. My girlfriend lives 2 blocks from the Emory Proton Clinic.We prayed on it and overthought the crap out of it. 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). Accessibility However, it also is possible to seek a pathology second opinion on your own, and it does not require an in-person office visit. Is it done through my doctor or do I do it myself with sending CDs of the MRI? I have selected Focal Laser Ablation as my future (soon) treatment. 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. Y'all are in my prayers! Other labs for second . The average age at the time of prostate cancer diagnosis is about 66. Prostate cancer is the second-most diagnosed cancer in American men. Whether you want expert confirmation, lack understanding or confidence in your treatment plan, have a rare or unusual type of cancer, your cancer isnt responding to current treatment its reassuring to know that you have options through a second opinion. This condition causes pain in the lower back and groin area, and may cause urinary retention. 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. Either the patient or the primary physician can initiate the process of getting a second opinion. Some men may have an enlarged prostate but not notice it. 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. Benign Processes: Getting a second opinion on a diagnosis can reverse a diagnosis or alter the treatment plan. My profession for forty years was health actuary consultant, so I have a pretty fair understanding of health data, outcomes, and risks. F. Prostate, left apex, core biopsy: A new study by researchers at the Johns Hopkins University has found that . You have a rare or unusual cancer. Total Gleason score: 6 Prostate, right medial base: Tumor Quantifications: Learn MoreFor more information about pathology second opinions, visit pathology.jhu.edu or call 877-546-1872. 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 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. 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. * Gleason Score: 3+3, Slide 1 (vs. Sloan's 3+4) One to a 3+4=7 and the other to a 3+3=6. Patients may experience a fever or chills as a result of the infection. I really just want the results of their innovative PTEN test. NOTE: THINK THIS LOWERS MY PSA DENSITY SOME IF MY GLAND ISN'T a 17CC PEANUT! It worked great (with negative pathology of the tissue) and fixed a lot of nasty symptoms and risks. 3. Usually, patients obtain a second opinion after being referred to a second physician or to a special team of experts in a cancer center, called a multidisciplinary team. 2020 Jul 21;19(1):112. doi: 10.1186/s12904-020-00619-9. 4. 2020 Dec 1;3(12):e2028320. 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." Following application of the relevant exclusion criteria, 2365 respondents remained in the analytical cohort. Prostatic Adenocarcinoma Centro Diagnostico Italiano , Milan, Italy, Manfred Dietel, M.D.Institute of Pathology Charit, Humboldt University of Medicine, Berlin, Germany, Jonathan I. Epstein, M.D.The Johns Hopkins Medical Institutions, Baltimore, MD, Robert J. Kurman, M.D.The Johns Hopkins Medical Institutions, Baltimore, MD, Elizabeth Montgomery, M.D.The Johns Hopkins Medical Institutions, Baltimore, MD, Manuel Sobrinho-Simes, M.D.University of Porto, Porto, Portugal, Ronald S. Weinstein, M.D.University of Arizona, Tuscon, AZ, Franco VisinoniMilestone Medical Technologies, Bergamo, Italy, Also Check: How Old Can You Be To Get Prostate Cancer. - T2 = 3/5 I'll post the whole thing, my doc and my own comments, and then cut/paste all my MRI results in case anyone REALLY liked data. Transition Zone: In the left base, mid and apical transition zone there is a large mass measuring 2 cm in size which has The people were great. First let me just say what so many others have previously stated, the thought of going on this journey alone is frightening, I cant imagine traveling this road alone. When I inquired with the oncologist that I had selected for my therapy before receiving the second opinion whether I would be a candidate for Active Surveillance considering the downgrading, she said 'no' due to the intraductal component. 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. About 60% of prostate cancers occur in people older than 65. 4. Over 80,000 specimen cases are seen at Johns Hopkins each year. Didn't know if she had the catheter in far enough and not getting any urine through itwondered if she had inflated the balloon enough and wondering if it was the reason that I have developed an abscess. Before Read books and realize as soon as they are published, they are outdated. 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. Prostate cancer is a slow growing condition. The James Buchanan Brady Urological Institute, Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov. * Adjacent organ invasion: None. Men need to be educated on all treatment options to protect themselves from a biased industry. 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. However, there are other cases when a second opinion results in a very different diagnosis or set of treatment recommendations. 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. Fear, confusion and uncertainty set in. Transurethral microwave thermotherapy : In selected patients, microwave energy helps to restructure prostate tissue and alleviate symptoms such as incontinence and voiding dysfunction, Laparoscopic prostatectomy: The prostate is removed with a miniature telescopic instrument, which allows for a quicker recovery, Robotic surgery: This breakthrough technology, which often is used for prostatectomy surgery, requires only a few small incisions.