This teamwork ensures the best possible patient outcomes. After a little experimenting I have been able to achieve a partial erection. 6 cancers that are the toughest to diagnose are prostate, bladder, head and neck, soft tissue, skin and lymph system. We used multivariable logistic regression models to evaluate the relationship between second opinions and definitive prostate cancer treatment and perceived quality of care. 2. My first PSA was 8.03. That being said, they can be a beneficial member of the treatment team. I opted to waive the biopsy, wait 1 year and test again. I'm Gleason 3+4=7, and I believed only 2 cores tested positive. We can help with your case. 1. A enlarged prostate can also cause blockages in the urethra. It is OK to be overwhelmed with info. We experienced information overload and decision/analysis paralysis. An increase of 1.1 in 3 months is not good news. First 6 week PSA is undetectable. Prostate, right medial apex: Mohamad Allaf, M.D., answers questions about prostate cancer diagnosis and treatment options and discusses robotic prostatectomy at Johns Hopkins. Recovery from Prostate Cancer | Bills Story. A fusion biopsy was performed in late May and I just received those results last Thursday. -------------------------------------------------------- Also, in 2018 I had an exosome Dx test which scored 45.34, but I also retook that test this year and it went down to 30.79. - Prostatic adenocarcinoma, Gleason score 3+4=7 (grade group 2, pattern 4: 10%) involving 2 of 2 cores (medial core: 0.5 mm, 4%; lateral core: 1.5 mm, 10%), 1 mm to the blue inked tissue edge (the closer) information. Good pathology readings require experience and a high level of expertise. We provide second opinions on the full range of gynecologic cancers: Ovarian Uterine Cervical Vulvar Vaginal Fallopian tube Placental tumors Some peritoneal cancers Immediate means 6 weeks just to see his NP. Urologists at the Johns Hopkins Brady Urological Institute can make the difficult process of deciding on a treatment plan easier. 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. 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." 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. Unfortunately, what you do not realize may harm you! Thank you for your participation! * Should still go for a Johns Hopkins second opinion on the pathology or is that overkill since the first one was done at MSKCC? Epub 2018 Mar 28. * 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! Four had 60-70%, five have between 5-10%. Peripheral Zone: The peripheral zone is of normal homogeneous prolonged T2 and there are no suspicious focal areas of 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. Second opinions apply to biopsies and imaging as well. Fear motivates you to want to treat this as soon as possible. Benign fibromuscular stroma; no prostatic glands are identified Your doctor is not sure what is wrong with you. 2. Have been told a health condition is not treatable. 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. An accurate diagnosis is essential to ensure the most effective treatment. And just this week, 1 YEAR post treatment, it is .46. Find more COVID-19 testing locations on Maryland.gov. If I am rested, I find that I am more ready than if I am not. PELVIC LYMPH NODES: No adenopathy. I'm leaning towards SBRT. SMIL radiologist reported nothing found. Using an Ellipsoid Volume the dimensions would give you a volume of 20.44. The purpose of starting this discussion is to gather peoples thoughts and opinions and actual experiences with Prostate Focal Laser Ablation. 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. 10: Prostate, right anterior MRI lesion Video consultation and written report from your expert. 3. 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? Our regional community network integrates academic specialty cancer care at Allegheny General Hospital and West Penn Hospital and at more than 20 community cancer centers throughout the region. Following application of the relevant exclusion criteria, 2365 respondents remained in the analytical cohort. Treatment must be chosen based on stage and your I suggest for all that hear, "you have cancer" that you seek more opinions! sharing sensitive information, make sure youre on a federal Intensity: min 148 / Max 459 Two from one lesion were positive as was one of the two from the other. Benign fibromuscular stroma; no prostatic glands are identified Prostatic Adenocarcinoma AHN patients have unprecedented access to the Johns Hopkins Center for Fetal Therapy. It got discussions started and questions answered. 2 of the 12 samples showed High Grade PIN and one area showed "suspicious for low-grade adenocarcinoma". Either the patient or the primary physician can initiate the process of getting a second opinion. 1. Masks are required inside all of our care facilities. Any score above 55 has a greater than 50/50 chance of finding clinically significant cancer. According to the doctor it is around 3 mm. I also changed my diet to plant based food, started juicing, and started taking supplements (think Turmeric, Green Tea, etc.). BJU Int. J Am Board Fam Med. Clipboard, Search History, and several other advanced features are temporarily unavailable. Who should I contact at Johns Hopkins to get a second opinion on a biopsy? At this point Im still ignorant about what I ought to be doing (MRI guided biopsy is what I should have gotten). It was easy. Total Gleason score: 7 Make an appointment: 410-955-5222 Coordinating with your Treating Physician 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. asymmetric central zone tissue more pronounced on the left. However, there are other cases when a second opinion results in a very different diagnosis or set of treatment recommendations. Second opinions offer different things in different circumstances, Dr. Matasar says. This urologist can get you in for surgery next week. 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. Benign fibromuscular stroma; no prostatic glands are identified I've had what I would consider a fluctuating PSA since first tested in November 2018. A week later had catheter removed and had no bladder leakage problems. Many researchers believe PTEN present is a strong brake on We specialize in minimally invasive procedures to treat BPH, including: For selected BPH patients, our specialists also perform transurethral resection of the prostate , a procedure that requires no incisions and has a high rate of success. Different institutions have different levels of experience when it comes to analyzing prostate biopsy samples and interpreting imaging results. Watch: Are supplements good for prostate health? Radhakrishnan A, Grande D, Ross M, Mitra N, Bekelman J, Stillson C, Pollack CE. Day 7 after surgery I took my last pain pill. However, before getting a second opinion, its best to check with your insurance company to see if there are any limitations in coverage. 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. Contact us or find a patient care location. And 2 cores from left apex of 3+3=6 with 10% involvement. Thanks, What is NOT OK is quitting or avoiding the bad news, or handing the entire decision over to someone else.Good luck fellas! 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. 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. I am also doing a vegan diet with additional complementary substances. Lymph nodes: There is no suspicious lymphadenopathy in the pelvis. EVERY DAY, they'd take a low dose X-RAY and low dose CT to align the fiducials and ensure my bladder was full and the bowel was empty. Many thanks for that. This teamwork ensures the best possible patient outcomes. the transition zone. You May Like: Best Treatment For Intermediate Prostate Cancer. This may include imaging, blood tests, prior treatment, and pathology reports. Does this also include HIFU, Cryoablation? Noted that some don't even include on report and should be looked as something to note but not obsess about. One core had 5%, one 20%, and one 40%. - T2 = 3/5 There are three main types of doctors that manage prostate cancer: urologists, radiation oncologists, and medical oncologists. The prostate gland is slightly enlarged secondary to transition zone hyperplasia (25cc total) Prostate, left medial base: There is hope. 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. 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. !I've pasted a previous update below for background.I just got my PSA results and the numbers are still trending in the right direction. His second opinion just came back. Overall, obtaining second opinions was not associated with definitive treatment or perceived quality of cancer care. I'd like to talk with former patients who have gone through the procedure. Total Gleason score: 6 Radhakrishnan A, Grande D, Mitra N, Bekelman J, Stillson C, Pollack CE. As some of you may know, I am a moderator for a support group for men on active surveillance for low-risk prostate cancer. Getting a Second Opinion The best time to seek a second opinion is before you start treatment. Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. Only one core was diagnosed with a small amount of 3+3 (it was one of the three targeted cores). However, it also is possible to seek a pathology second opinion on your own, and it does not require an in-person office visit. I am 58 and in very good health otherwise. My Oncotype rating was GPS 54, with a 26% chance of metastisis within 10 years. 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. Primary Gleason grade: 3 Because every patient is different, there are several ways to approach prostate cancer treatment. 9. I had no idea there were second opinions and I didn't have a clue about Genomic testing, or even genetic testing. I question the potential EPE and he said it didn't matter, but went ahead and ordered Oncotype. 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. * Gleason Score: 4+5, Slide 4 (vs. Sloan's 3+4) Cancer. So, I believe I made the right choice. Dr stated that after seeing my muscles on the inside during operation he would have predicted this. They also determined there was extrapostatic extension because there was some fat in the sample that involved the cancer. 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. 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. This condition causes pain in the lower back and groin area, and may cause urinary retention. Metastatic disease considered less likely for this pattern. Has anyone sent Radiology (mpMRI) reports and images to Hopkins for Second Opinion Review? Cancer ABCs recommends: Johns Hopkins Hospital in Baltimore, Maryland, specifically Dr. Jonathan Epstein. Unable to load your collection due to an error, Unable to load your delegates due to an error. At Johns Hopkins, you can feel confident knowing our multidisciplinary cancer clinics combine the very best resources and specialists all within in a single location for a highly coordinated experience that delivers exceptional care while conserving time, money and energy. B. Prostate, right mid, core biopsy: not hear all the viable treatment options or receive the most up to date It was easy. A PSA test at time of biopsy revealed my PSA had risen to 6.5. - PI-RADS for this lesion = 4/5 He said that he saw what JHs was referring to but did not determine EPE for a variety of reasons. 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. In some situations, insurers will even insist on a second opinion. Thanks, I had my first of those 2 PSA tests last week and it dropped to 4.77. With no travel needed and no red tape, its easy to get a second opinion, all from the comfort of your home. The Stanford Medicine Online Second Opinion program offers you easy access to our world-class doctors. 3. At a rectal exam 6/20 the urologist told me my prostate felt normal, not enlarged, nor did he feel any tumors. Now the oncologist wants to perform a PSMA Pet Scan. And by FAA Aeromedical Ruling, I'd need a few post procedure reports before being cleared to fly again.) 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. Confounding this, I have read that the different genomic tests can disagree with each other, and that Oncotype is usually a more aggressive finding. He was right. The .gov means its official. Since I have gotten so much out of this forum, I thought Id provide my story to help others. Dr. Nour is 100% sure that nothing has spread. A small early-stage clinical trial found that a carefully selected group of patients who responded remarkably well to chemotherapy could skip surgery altogether. All Gleason 6 (3+3). I've tried to find out about Dr. Wong but there's very little info on him. * Both Sloan and Johns Hopkins admit that large discrepancies are unusual, yet both stand by their opinions. But, ultimately decided on whole gland treatment using Proton Beam Radiation.So. This fee includes: Studies show the clinical and financial benefits of obtaining a pathology second opinion. 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. 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. This Dr is in charge of active surveillance program at JH so I knew that he wouldnt recommend surgery unless it was really needed. The review process normally takes several days, after which we will send your slides and other materials are returned. The results of the MRI said they found a PYRAD 5 lesion, but did not find any cancer outside prostate. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. Anyway, would appreciate knowing how to contact Johns Hopkins. 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. 5: Prostate, left medial apex It is OK to be overwhelmed with info. When to move from Active Surveillance to Treatment for Prostate Cancer? Surabhi Dangi-Garimella, PhD. Jonathan Epstein, M.D. Details are here: __________________________________________________________________________July 2022I've neglected to make journal entries for a couple years, so I will recap below and continue with what I have done and what I have learned.In 2018, at the age of 48, after a routine physical that showed a PSA of (4.X) and after a TRUS biopsy, I was diagnosed with PCa. Xia L, Talwar R, Chelluri RR, Guzzo TJ, Lee DJ. Read Also: What Are The Signs Of Prostate Infection. My involvement is below maximum of 15% of core. 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. I have requested a second pathologist's opinion from Johns Hopkins based on feedback from this forum. Good Luck and God Bless everyone. An acute bacterial infection can cause a burning sensation. 2017 Oct;22(10):1197-1211. doi: 10.1634/theoncologist.2016-0429. 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. Blessings. They confirm everything except question whether one of the core samples is a 3+3 or 3+ 4. mail@prostateoncology.com, 7 Tips for Seeking Second Opinions For Men with Prostate Cancer. Avoiding obsolescence in advanced prostate cancer management: a guide for urologists. Benign prostatic tissue However, there were no other suspicious areas on MRI. 4 Get a Second Opinion Dr. Jonathan Epstein explains the benefits of getting a pathology second opinion 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. 24.5 BMI 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. Further, the two tumors in question have not really changed much in size for more than 2 years. Caused me to bleed heavily. A doctor may prescribe surgery or perform an endoscopic procedure. Find more COVID-19 testing locations on Maryland.gov. Prostate, left medial apex: probably organ confined disease. Whats right for you will depend on the stage of the cancer, your level of risk and your general overall health. - Follow-Up Score (PRECISE) for this lesion = Stable MRI appearance: no new focal/diffuse lesions. 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. We can help with your case. )I contacted Dr Busch (still in Chattanooga at the time) and he called me directly to talk me off the ledge. There is no evidence No definitive evidence of distant metastatic disease is seen." They are not objective. PMC So, Radiation Oncologist prescribed Cialis 5mg, daily. Not all cancers are the same and not all treatment plans are absolutely clear. At that point I agreed to the TRUS biopsy which I had on October 10, 2020. * Seminal vesicle invasion: None. I have actually had a second opinion a while back from Dr. Bush. Even if someone is being seen at a different academic center, the trials and other treatment options that we offer here may be different. An official website of the United States government. Which Patients Report That Their Urologists Advised Them to Forgo Initial Treatment for Prostate Cancer? Bookshelf The percentage of tissue with carcinoma is 70% 4. 3: Prostate, right medial apex Being in Wisconsin, my insurance gives me the option of two hospitals to manage me. I now have my list whittled down to 3. Johns Hopkins Medicine A commercially available genomic test may help oncologists better determine which patients with recurrent prostate cancer may benefit from hormone therapy, according to new research from the Johns Hopkins Kimmel Cancer Centerand 15 other medical centers. MY THOUGHTS AND ANYTHING DOCTOR NOTED: Our OB-GYNs, maternal-fetal medicine specialists, and pediatricians collaborate regularly with the Johns Hopkins team getting second opinions and access to hundreds of clinical trials. I'm trying to figure out why the PSA keeps rising. Prostate Cancer Grading: In order to receive appropriate treatment, patients must understand the treatment options that are available. 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 . More medical freakouts. Disclaimer. One of the problems with second opinions is that insurers may not cover the expense. Brachytherapy Experience with Dr. Albert Chang at UCLA? 2nd opinionBone Scan:"Mild increased activity is seen in the right symphysis corresponding to the abnormalities on the prior PET/CT examination. I have had a second opinion from Johns Hopkins that confirmed the initial pathology of gleason 3+4. The James Buchanan Brady Urological Institute, Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, Precision Medicine Center of Excellence for Prostate Cancer, robotic-assisted radical laparoscopic prostatectomies, The Brady Urological Institute and the Johns Hopkins Kimmel Cancer Center take a, Our urologic surgeons have extensive experience performing, Our surgeons, oncologists and radiologists are also world leaders in prostate cancer research, giving patients access to the latest discoveries and.
When A Guy Says Sounds Like A Plan,
Can You Reverse On A Motorway In Romania,
How Has Technology Changed Acting,
Mexican Radio Stations In Los Angeles,
Recent Pictures Of Joan Blackman,
Articles J
