johns hopkins prostate cancer second opinion

Research was mixed on PINS, but in those days, many doctors saw them as likely to develop into cancer. You're more likely to develop prostate cancers that are more likely to spread. Have been diagnosed with a serious or rare health condition. The review process normally takes several days, after which we will send your slides and other materials are returned. Total Gleason score: 7 curing cancer, prostate cancer questions johns hopkins hospital, josef issels wikipedia, cancer a second opinion a look at book by josef issels, coping with metastatic cancer cancer net, pdf americans health priorities curing cancer and, what is immunotherapy cancer research institute cri, cancer a second opinion a . The results were ambiguous. Allow yourself the time to seek multiple opinions. Many thanks for that. Second Opinions An accurate diagnosis is essential to ensure that the correct and most effective treatment is given. They basically said it didn't matter. 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. The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System. J Am Board Fam Med. Recovery from Prostate Cancer | Bills Story. You have a rare or unusual cancer. Did robotic radical prostatectomy 1/25/12. 8. Primary Gleason grade: 3 Blessings. 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. Lesion #1 (index): PI-RADS v2.1 score 4, lesion measuring 10 mm centered at the right mid/apex posteromedial peripheral zone; findings equivocal for extraprostatic extension; no evidence of seminal vesicle invasion; The low ADC value in this lesion increases the likelihood of Gleason grade group 2 or higher. Im immediately referred to Urologist. For this study, published in the journal Cancer, 2386 men in the greater Philadelphia area, who were diagnosed with prostate cancer between 2012 and 2014, responded to survey questions. 2011 Feb;29(1):3-9. doi: 10.1007/s00345-010-0602-y. Some docs say clean up the prostatitis while others tell me to avoid overuse of Cipro as it loses its effectiveness over time. The PSA Doubling Time parallels my Urologist Doubling Time (I keep changing Uro until I find one who makes sense)! A doctor may prescribe surgery or perform an endoscopic procedure. 1st opinion"PYL PSMA PET/CT scan demonstrating foci of moderate to intense uptake in the prostate gland consistent with known prostatic cancer. My prior Prolaris study (2018) before the FLA was very low risk. Greetings gentlemen! Being in Wisconsin, my insurance gives me the option of two hospitals to manage me. Biopsy in 12/27/11 showed 3/14 cores, Gleason 6 with PSA of 4.5. The people were great. Surgery took about 3 hrs. A biopsy was performed on 2/26. There is no bony or bulky nodal disease in the pelvis Bring All Labs/Notes to Each Appointment. 1. No two cases of prostate cancer are alike and an accurate diagnosisis critical to developing the best treatment plan. Benign prostatic tissue He said that it will improve in the future due to future improvements in the treatments. * Location: Right, anterior, apex, peripheral zone A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. * Size: 1.1 cm If these do not work, your symptoms could progress and become chronic. 4. Estimated prostate volume of 35 cc with an estimated PSA density of 0.11 ng/mL/cc. By Dec 2019, my PSA reached 4.13. The more often a doctor diagnoses and treats prostate cancer the more proficient they become. Of course, my old school Urologist recommended surgeryHe, of course, knew the best robotic surgeons around.Anyway. Video consultation and written report from your expert. Brachytherapy Experience with Dr. Albert Chang at UCLA? He basically said it was possible, but that he did not agree. Prostate, right medial base: Will these places of excellence consider me, or am I bound to my regular doctor for insurance purposes? Conclusions: Second Opinions in Prostate Cancer - American Council on Science and Health 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. You receive a secure, private online consultation without leaving home. 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. 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. Nor did I have any idea that the 1 core had 20% involvement and <5% pattern 4 involvement. Obviously the Covid 19 issue is playing a part in all of our decisions. The urologist/surgeon indicated that other forms of treatment like TULSA are not options since my cancer is multifocal. - 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 Dont Miss: New Treatments For Stage 4 Prostate Cancer. My most recent biopsy resulted in two cores with Gleason 4+3=7 and one with 3+3=6. Call us with any questions: 410-955-2405, ext. They did 9 patients in Phase I and there have been 12 so far in Phase II. * Both Sloan and Johns Hopkins admit that large discrepancies are unusual, yet both stand by their opinions. Hi JM "Numerous publications show the clinical and economic benefits of obtaining a second opinion for Pathology specimens. Do any of you have an opinion or actual experience with any of the three listed below? 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. Compared with other men, African-American men and men with a family history of the disease are at higher risk of developing prostate cancer. Dont Miss: Is Coffee Bad For Your Prostate. Different institutions have different levels of experience when it comes to analyzing prostate biopsy samples and interpreting imaging results. peripheral zone signal intensity on T2-weighted images. 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. BONES: No suspicious osseous 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. 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. I just turned 71 in February. 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 . Am I wrong? Asking for your comments: In unadjusted analyses, younger men , men with college-level education , and privately insured men and Medicare ) were more likely to obtain second opinions . 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. I have been drinking out of an information fire hose. They also determined there was extrapostatic extension because there was some fat in the sample that involved the cancer. E. Prostate, left mid, core biopsy: Also Check: Prostate Cancer Stage 7 Treatment. Brief MRI history. So the pathologist suggested a second opinion. The neurovascular bundles are intact. I asked the urologist who did our Second Opinion at Johns Hopkins and although he thinks RP is the way to go (due to higher PSA of 10.18), he highly recommended Dr. Eggenger (Chicago). Unfortunately, monetary incentives create biases that can work against patients best interests. Here are some recent updates: Uterine cancer.Women who use chemical hair straighteners frequently could have a higher risk of developing uterine cancer than women who have never used the products, according to new findings from a national study that has followed nearly 34,000 U.S. women for more than a decade. Epub 2010 Oct 20. 4. 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. 2. focal peripheral zone lesions. Our collaborative processes also extend to our colleagues at Johns Hopkins Medicine, a world-wide leader in cancer research. Benign Processes: Overall PIRADS Score: 2/5 By seeking second opinions and hearing the benefits and drawbacks of a range of treatment options for your specific stage, you will be more equipped to make educated decisions. Only one core was diagnosed with a small amount of 3+3 (it was one of the three targeted cores). A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. 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. Urologists at the Johns Hopkins Brady Urological Institute can make the difficult process of deciding on a treatment plan easier. The peripheral zone has a patchy signal pattern. -------------------------------------------------------- Future study is needed to determine when second opinions contribute to increasing the value of cancer care. 1. Urologists are trained as surgeons, radiation oncologists administer radiation, and medical oncologists provide cognitive oversight and general management of the cancer. Have a condition that isnt improving or is getting worse, despite treatment. Six weeks later I have the biopsy in his office and a week later I get the results. And in some cases, the information you gain during a second opinion consultation can even change your diagnosis. Video consultation and written report from your expert. However, seeing him will be another 8 weeks, but he wants my biopsy slides (second opinion) before we meet. Secondary Gleason grade: 4 I have searched the country for intervential radiologist that perform FLA on the prostate. If pain is present, a digital rectal examination will reveal hard areas. Emotional outlook is fragile at times and straight clinical approach of doctors does not help. Expert review of your case by a Cleveland Clinic specialist. P/ 310-827-7707 | F/ 310-574-4002 | MAIL@PROSTATEONCOLOGY.COM. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. Epstein, who views about 12,000 slides a year, called for calm in my case and suggested another biopsy in six months. * Size: 1.5 cm Other labs for second . The linear amount of tissue with carcinoma is 11 mm With AHN Cancer Institute, you already get a world-class cancer program with leading expertise, care, and outcomes. Second opinions not likely to change prostate cancer treatment No extraprostatic extension. Last checkup (July 2022) my PSA was .46 and it is currently at .32.I am still eating primarily a plant based diet (only lean meats/cheeses/eggs about 10% of my diet) and maintaining steady weight and I am still quite active physically.As for symptomswith 5mg Daily Cialis the occasional ED symptoms have pretty much gone away. 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. My PSA went up from 3.5 post FLA (It was 7.2 pre-procedure) to 6.7 in 2021, so I went to another radiologist to do an MRI guided biopsy of the suspected area that was near the prior ablation zone. Unbelievable that this happened!!! Possible additional organ confined malignant lesion in right apex - 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 intricate disease and not all doctors have the same amount of experience 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." My profession for forty years was health actuary consultant, so I have a pretty fair understanding of health data, outcomes, and risks. Anything I am overlooking or need to add to my list of considerations? Why It's Worth Seeking a Second Opinion for Prostate Cancer A blocked urethra can also damage the kidneys. Because I had an implant in my ear, they would only give me a 1.5T MRI. Cancer patients are encouraged to obtain second opinions before starting treatment. In some situations, insurers will even insist on a second opinion. 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? I had a follow up 3T MRI guided biopsy on March 18 at Emory. Both of which are normal volumes, the Bullet Volume is considered more precise in prostates smaller than 55ml. He wants me to begin the ADT around 5/1. Find more COVID-19 testing locations on Maryland.gov. 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. 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). So, I go one better, I call up Johns Hopkins and find a Dr who does DaVinci Prostate Surgery. Metastatic disease considered less likely for this pattern. Overall, obtaining second opinions was not associated with definitive treatment or perceived quality of cancer care. Axial T1-weighted images of the pelvis show no bony or bulky nodal disease. Some men may have an enlarged prostate but not notice it. 3. His reasoning over the last couple of years is that the suspected lesion was not changing in size at all. Am I missing anything? I had been carefully watching as my PSA increased to 3.2 from 3.9 in summer 2010. (Scores above 55 have a greater than 50% chance of finding clinically significant cancer on a biopsy) The biopsy showed 2 or 3 cores containing HG PIN but no cancer. Masks are required inside all of our care facilities. However, a new study by researchers at the Johns Hopkins University has found that second opinions did not change treatment choice or the persons perception of the quality of care they receive, at least among low-risk men. The .gov means its official. - One separate small tissue fragment with prostatic adenocarcinoma, 0.5 mm in linear length Generally, the symptoms can stabilize over time. !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. If you are considering undergoing a specialized treatment, such as cancer surgery, within your HMO, it is important to inquire about the number of such procedures performed each year by the HMO and the results. Reasons for getting a second opinion include: You want to be sure you have explored all options. Both Drs and nurses knew what they were doing and had lots of experience. He is the past president of the International Society of Urological Pathology. Just had my appointment today and they are pleased with the results, so far. I worked out every day. - Perineural invasion is present I am meeting with a multidisciplinary team of docs on March 18 at St. Joe's in Atlanta. No extraprostatic extension. I am 58 and in very good health otherwise. TZ zone more beneficial, but fairly large compared to whole gland and proximity to capsule edge would likely mean treatment would be suggested. Especially opinions other than those of the first Urologist you see. The Johns Hopkins Brady Urological Institute is known around the world for its expertise in diagnosing and treating urologic conditions. 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. Benign Processes: They hesitated calling it a TARGET LESION, but scored it PIRADS 4. Compared to younger men, men 70-74 years old and men 75 years were less likely to obtain a second opinion whereas men with college graduate level education or beyond were more likely compared to men with less than high school level education. However, learning more about prostate cancer and prostate-related health issues can help optimize health. Benign prostatic tissue Epub 2018 Mar 28. In the United States, studies estimate 72 new cases of PN for every 100,000 people between the ages of 18 and 64 years old. Question anemia. Has anyone sent Radiology (mpMRI) reports and images to Hopkins for Second Opinion Review? It took me awhile but minutes ago received my second opinion from Johns Hopkins. Youve just been diagnosed with prostate cancer. 5. Bethesda, MD 20894, Web Policies Instead, I did my homework. If anyone has used him, please let me know what your experience was like. Second Opinions & Consultations - Johns Hopkins Pathology BASE DATA: Thanks, BigD. Second Opinions An accurate diagnosis is essential to ensure that the correct and most effective treatment is given. The total number of cores with carcinoma is 3 feel the clock ticking. 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. So fingers crossed. 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.

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