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So fingers crossed. With The Clinic by Cleveland Clinic, patients have access to Cleveland Clinics 3500 specialists. I would love to hear from anyone who has been involved in the Chicago study. Recently diagnosed a Gleason 3 + 3. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. * He said probably not candidate for watchful waiting because of tumor volume shown and seen on MRI. 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. My only concerned was heavy metal poisoning and didn't know how long AS would be beneficial since I was starting at a young age. But you have to do both. My experience at Johns Hopkins was awesome. Prostate cancer is the second-most diagnosed cancer in American men. Surgery seems like overkill for me with too many risks for incontinence and permanent ED, am I overlooking something? A second opinion can help you make an informed, confident decision about your medical care. But if I include the 3+3=6 cores then 4 cores tested positive and that moves me into the basic teal category and no longer a strong candidate for AS. 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. He schedules appointments with a Radiologist and two local surgeons. Of these, 40% obtained second opinions, most commonly because they wanted more information about their cancer (50.8%) and wanted to be seen by the best doctor (46.3%). It works. Be sure to ask about and research the skills and experience a doctor has with treating prostate cancer. Ramsey SD, Zeliadt SB, Fedorenko CR, Blough DK, Moinpour CM, Hall IJ, Smith JL, Ekwueme DU, Fairweather ME, Thompson IM, Keane TE, Penson DF. - 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) An accurate diagnosis is essential to ensure the most effective treatment. 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. The linear amount of tissue with carcinoma is 11 mm You May Like: Prostate Cancer External Beam Radiation Side Effects. Anyway, would appreciate knowing how to contact Johns Hopkins. government site. Benign prostatic tissue 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. Radhakrishnan A, Grande D, Mitra N, Bekelman J, Stillson C, Pollack CE. That being said, they can be a beneficial member of the treatment team. 2. The study included nearly 2,400 men in the Philadelphia area recently diagnosed with localized prostate cancer. I can do radiation as a monotherapy. 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. Following application of the relevant exclusion criteria, 2365 respondents remained in the analytical cohort. But I did speak to an oncologist who wanted to order Oncotype, which I did. 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." He never sought treatment for the injury. Through the AHN Cancer Institute, you benefit from personalized treatment in your community, close to home, from your dedicated care team. I have had a CT of the pelvic area - negative and a whole body bone scan - negative. - One separate small tissue fragment with prostatic adenocarcinoma, 0.5 mm in linear length 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. Low post-void residual volume is About 60% of prostate cancers occur in people older than 65. Getting a second opinion on a diagnosis can reverse a diagnosis or alter the treatment plan. Generally, the symptoms can stabilize over time. Thank you for your understanding and cooperation. Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. Because every patient is different, there are several ways to approach prostate cancer treatment. I tried to send the samples out for genetic testing to Prolaris and Decipher, but there was an ordering error and they never went thru. Anything I am overlooking or need to add to my list of considerations? Request an Appointment 410-955-6100 One of the problems with second opinions is that insurers may not cover the expense. I did a book review with his first book for several veterans groups including the Americal Division Veterans Organization which with I served at age 19. We experienced information overload and decision/analysis paralysis. Seeking second opinions is becoming standard practice, and it is mandatory at Johns Hopkins. The study was published online Nov. 7 in the journal Cancer. By Dec 2019, my PSA reached 4.13. Grade Group: 1 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. Prostate cancer is a slow growing condition. Two 1cc tumors, gleason score 3+4 each, one in each lobe. 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. 180 days after treatment PSA was .50. Second Opinions for Cancer Care - UChicago Medicine Methods: 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. * Sloan only sent partial cores, slides 1 and 4. 8. Obviously the Covid 19 issue is playing a part in all of our decisions. P60 MD006900/MD/NIMHD NIH HHS/United States, T32 HL007180/HL/NHLBI NIH HHS/United States, K07 CA151910/CA/NCI NIH HHS/United States, P30 CA016520/CA/NCI NIH HHS/United States, K07 CA163616/CA/NCI NIH HHS/United States. 3. Benign Processes: Another type of prostate issue is chronic prostatitis, or chronic pelvic pain syndrome. Men were asked if they obtained a second opinion from a urologist, and the reasons why. 2. Unfortunately, the 12/20/20 PSA reading was higher and that led to an MRI on 2/2/21 when two lesions were discovered. -------------------------------------------------------- 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. 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. Cancer. Had a little complication a day after release, excessive blood/clots in urine. Do second opinions matter in prostate cancer care? - ecancer I had a 3T mp MRI with coil bed, without and with contrast, at Emory on March 3. Oncologist. Johns Hopkins is home to many of the world's leaders in Pathology. ---------------------------------------------------------- We are vaccinating all eligible patients. Not all cancers are the same and not all treatment plans are absolutely clear. 4. Most choose treatment they originally planned to follow, study finds. The total number of cores with carcinoma is 3 Targeted MR/Fusion biopsy of one 4x8 mm lesion on Right side showed 3+3 in 2 of 5 cores (20% of total volume), and random Right side: 1 core 3+4 (10%, 20% on second opinion from Johns Hopkins) and 1 core 3+3 (10% volume) ; Left Side 1 core 3+3 (10%, no PCa on second opinion from Johns Hopkins). I also changed my diet to plant based food, started juicing, and started taking supplements (think Turmeric, Green Tea, etc.). I have been drinking out of an information fire hose. Best wishes to all those whose concerns for the day are far more serious than mine. Symptoms include leaking and discomfort. Dr. Erick Walser at University of Texas Medical Center. Note respondents were able to choose more than one reason. Reasons for obtaining a second opinion from urologists. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. IMPRESSION: Surgery took about 3 hrs. The results of Oncotype came back and it was a bad report. When you get a diagnosis of breast cancer from your doctor, its not uncommon to get a second opinion. Need guidance choosing from multiple treatment options. Men often seek second opinions from urologists before they initiate treatment for their newly diagnosed prostate cancer. - DWI-ADC = 4/5 Study after study confirms that doctors favor the treatment they are trained to do urologists typically recommend surgery and radiation oncologists recommend radiation. 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. * Gleason Score: 3+3, Slide 1 (vs. Sloan's 3+4) Benign prostatic tissue Proton Therapy Case Study - Prostate Cancer - Johns Hopkins Medicine MRI RE-READ #2 (VERY VERY well respected radiologist): 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. How to Get a Second Opinion Our team at Johns Hopkins has a dedicated service to interpretation of brain tumors and render second opinions on a daily basis. It is OK to not understand all the terminology. 4: Prostate, right medial base I have actually had a second opinion a while back from Dr. Bush. Dr stated that after seeing my muscles on the inside during operation he would have predicted this. 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. I'd like to talk with former patients who have gone through the procedure. They may defer to the recommendation of the specialist, or refer you to a doctor with limited prostate cancer experience. Find more COVID-19 testing locations on Maryland.gov. When facing an intricate disease like prostate cancer, the above scenario is far too simple to have a promising outcome. The all-inclusive cost for a virtual second opinion for patients in the U.S. is $1,850. It hasn't let me down. 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. This sounds to me like they're not familiar with the Oncotype DX test and makes me wonder how common is the test. The other samples produced 4 more positive cancer cores for a total of 7 of 12 positives. Even if someone is being seen at a different academic center, the trials and other treatment options that we offer here may be different. My new Dr however didnt order PSA so I asked him for one. There are lots of lessons learned on the forum. 2. Greetings gentlemen! Without the genomic test I have I lesion 3+3=6 and another, 3+4=7, with less than 5% pattern 4, and an MRI that shows no ECE, no other suspicious lesions and questionable cellular EPE based upon disagreement of pathologists. * Membranous urethral length: 1.2 cm 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. Further, among men with low risk disease, we did not observe a significant association between second opinions and receipt of definitive treatment or surgery. - High grade prostatic intraepithelial neoplasia (HGPIN) In adjusted models, obtaining a second opinion was not associated with receipt of definitive treatment . 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. 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 contacted Dr Busch (still in Chattanooga at the time) and he called me directly to talk me off the ledge. Diffuse probable benign peripheral zone changes limit evaluation for I have a history where Foley catheters were unable to be placed going back to 2005 for unknown reasons. Had third MRI in July 2019 this time at Mayo which I believe does a better job than SMIL. Any score above 55 has a greater than 50/50 chance of finding clinically significant cancer. The best protection for cancer patients who are Health Maintenance Organization members is to seek a second opinion even if she or he has to pay for it. If pain is present, a digital rectal examination will reveal hard areas. This fluid causes the prostate to swell and cause a number of bladder-related symptoms. Your Primary Care Physician referred you to your diagnosing urologist whom you now trust. You May Like: Prostate Radiation Treatment Side Effects. JHs just said it was minimal less than 5%. I made the appointments. I was disappointed that only TRUS was being used, but I did find out that this was for screening only and IF you pass screeningthey use MRI guided biopsy for post-ablation follow up. -------------------------------------------------------- Second Opinions - Bladder Cancer | Johns Hopkins Pathology Biopsy in 12/27/11 showed 3/14 cores, Gleason 6 with PSA of 4.5. We experienced information overload and decision/analysis paralysis. Dont Miss: Is Coffee Bad For Your Prostate. 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. Does this also include HIFU, Cryoablation? If these do not work, your symptoms could progress and become chronic. The issues in my prostate from the first procedure onward have all been in the same area and the rest of my prostate from the first biopsy and subsequent MRIs onward have never shown any indications of cancer in other areas. 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. AHN patients have unprecedented access to the Johns Hopkins Center for Fetal Therapy. 30%/40% or higher)? 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. 2017 Oct;22(10):1197-1211. doi: 10.1634/theoncologist.2016-0429. Urology. I'm Gleason 3+4=7, and I believed only 2 cores tested positive. In adjusted analyses, however, only age and education were significantly associated with obtaining second opinions from urologists. I was on active surveillance after a FLA procedure done in 2018. We have sought a second opinion and all tests are being reviewed by that second team.My question has to do with the symphysis pubis. Overall PIRADS Score: 2/5 Someone advised to always get my PSA checked at the same facility in order to make sure the same protocol and lab is used, is that critical? While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. * Location: Right, anterior, apex, peripheral zone Radhakrishnan A, Grande D, Mitra N, Pollack CE. Two weeks later I meet with my Johns Hopkins Dr. When to move from Active Surveillance to Treatment for Prostate Cancer? He basically said it was possible, but that he did not agree. 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. A doctor at MSK can collaborate with another doctor to offer support and help ensure the best outcomes. Move ahead to Dec 2020. Prostate, right lateral apex: Greenfield G, Shmueli L, Harvey A, Quezada-Yamamoto H, Davidovitch N, Pliskin JS, Rawaf S, Majeed A, Hayhoe B. BMJ Open. They hesitated calling it a TARGET LESION, but scored it PIRADS 4. Not all men with Gleason 8-10 disease are going to do badly after We prioritized treatment as AS, FLA/TULSA (if a lesion ever presented itself), and Proton Beam Radiation. * PIRADS v2 Score: 5 I didn't study for the test and it's possible some morning activities might have affected my test score :) Also, if any of you have a way to get medicare to pay some portion of the cost, please let me know as well. Get a Second Opinion | Johns Hopkins Pathology First 6 week PSA is undetectable. Ask us questions on this webpage. My prior Prolaris study (2018) before the FLA was very low risk. - 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 F. Prostate, left apex, core biopsy: Same with the amount of how much pattern 4. An accurate diagnosis is essential to ensure the most effective treatment. 4. Family history of prostate cancer. Hoping that after I go through this that my advice to others will be able to guide them and that they can learn from my experience, as I feel I am gaining a solid foundation from both a practical and mental standpoint. FOIA When people recommend going to a Center of Excellence, believe them. They won't be offended, and they may even be able to recommend a specialist for you to see. We are vaccinating all eligible patients. (I must say that those low numbers concern me a bit.) The survey asked the men if they had opted for a second opinion from a urologist following their diagnosis of prostate cancer, and the reasons for the second opinion. I want to insure that the Imaging was read correctly and nothing was overlooked or missed. Using an Ellipsoid Volume the dimensions would give you a volume of 20.44. * Gleason Score: 3+4 (4 of 6 specimens), 14 specimens taken This shows very high signal intensity on the diffusion-weighted Ask your doctor for a copy of your complete medical record. 2. Wondering if any of the "gurus" here want to take a stab at looking at this and see if they agree that it says what I think it says (I will be following up with doctor(s) to get their opinion, and I waive all HIPAA rights by allowing this to be seen). My Oncotype rating was GPS 54, with a 26% chance of metastisis within 10 years. 1. __________________________________________________________________________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. 2020 Jul 21;19(1):112. doi: 10.1186/s12904-020-00619-9. Prostate cancer is the second-most diagnosed cancer in American men. Prostate Cancer Grading: Johns Hopkins Health - Second Opinions, Second Chances, Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, High Blood Pressure May Take Its Toll on Your Kidneys. SMIL radiologist reported nothing found. 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. There is hope. 4. I guess the PET scan will be the next step in what type of treatment options are in store.Has this occurred to anyone else? Wow, I sound like a snob now! I'm currently in the process of getting an appointment set up with a Dr. Wang at UCLA. * Both Sloan and Johns Hopkins admit that large discrepancies are unusual, yet both stand by their opinions. undefined will no longer be visible to you including posts, replies, and photos. 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. LESION 1 My urologist suggested a couple more PSA tests followed by an MRI. Then about a month later I started 28 fractions of Proton Radiation.It was painless. - T2 = 3/5 There is no bony or bulky nodal disease in the pelvis It may be a new cancer, but it is more likely a recurrence since it is really near the ablation zone.

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