The problem is that all 3 pathologies noted an intraductal component. 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. How long do you have left? 3. However, there were no other suspicious areas on MRI. In the mean time my PSA was movingno longer static, but never back up to 6. Four had 60-70%, five have between 5-10%. Even if someone is being seen at a different academic center, the trials and other treatment options that we offer here may be different. It also rules out Brachytherapy. Steve, Groucho was wrong when he said "i don't want to belong to any club that would have me as a member." 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. You feel healthy, you arent in pain, you 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. - 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 Be well. 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. Thank you! In the mean time my PSA was movingno longer static, but never back up to 6. In My Opinion? Get A Second Opinion | ZERO Prostate Cancer * Prostate size: 3.9 x 2.8 x 3. cm 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. Any score above 55 has a greater than 50/50 chance of finding clinically significant cancer. Symptoms include leaking and discomfort. MRI June 2017 again at SMIL. If anyone has used him, please let me know what your experience was like. THANKS! Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. Find a doctor at The Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center or Johns Hopkins Community Physicians. Further, the two tumors in question have not really changed much in size for more than 2 years. Here are seven tips for seeking second opinions for prostate cancer: 1. Second Opinions (Adults) For stem cell transplant, please call 1-773-702-1994. 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. If you choose to be treated at Johns Hopkins, you may be able to begin treatment immediately. These results, if validated in other studies, justify additional investigation on how second opinions can contribute to increasing the value of cancer care, the authors concluded. 2. Biopsy in 12/27/11 showed 3/14 cores, Gleason 6 with PSA of 4.5. Benign prostatic tissue I'm going to reach out to UCLA to see what they can do. Prostate, left medial apex: Being in Wisconsin, my insurance gives me the option of two hospitals to manage me. And, even working in a fairly technical field myself, I was amazed at the technology and precision of that Proton Machine. 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. information. PDF Cancer A Second Opinion A Look At Understanding Controlling And Curing Other labs for second . 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. Further, among men with low risk disease, we did not observe a significant association between second opinions and receipt of definitive treatment or surgery. I assume the data on gleason scoring is much more robust/reliable than genomics as it has been around longer and used more extensively. That's the good news. Radiation oncologist of same group of doctors says to do IMRT (using Rapid ARC program) as precautionary treatment, regardless of PSA scores. Studies show the clinical and financial benefits of obtaining a pathology second opinion. A 1.4 cm lesion in the left, apex, anterior transition zone demonstrates conflicting T2 and DWI characteristics for PI-RADS classification - an indeterminate lesion. Have you heard of PRECISE follow up score for an MRI? My girlfriend lives 2 blocks from the Emory Proton Clinic.We prayed on it and overthought the crap out of it. Medical record collection from doctors and hospitals. I was confident I was making the right decision. Masks are required inside all of our care facilities. Getting a second opinion on a diagnosis can reverse a diagnosis or alter the treatment plan. The total number of cores with carcinoma is 3 Treatment must be chosen based on stage and your 4. Another type of prostate issue is chronic prostatitis, or chronic pelvic pain syndrome. He said that JHs said that it was 2 cores, but it was actually a fragmented core, that the fat did not present on the right place on the slide, that prior FLA (partial hemi-ablation) could affect the results, the MRI did not support, etc. Johns Hopkins Prostate Cancer Second Opinion Even if someone is being seen at a different academic center, the trials and other treatment options that we offer here may be different. (I think that it was easier to see because Mayo's MRI technology and procedures are better than SMIL's.) Many thanks for that. Consultation with your nurse care manager. I have selected Focal Laser Ablation as my future (soon) treatment. While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. I luckily found this webpage and I started reading everything I could get my hands on. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. 2. I talked with Dr. Epstein who expressed Johns Hopkins' conservative views to not underestimate GS 6 and to consider surgery and/or radiation that have been used successfully for many years in saving lives. However, older men 75 years were the least likely to report obtaining a second opinion due to dissatisfaction with their initial urologist. It got discussions started and questions answered. Using the Bullet Volume gives you gland of 25.55. Federal government websites often end in .gov or .mil. In order to give treatment for each patient with utmost security we would like to announce that currently there will be no visitors allowed.Please note that only one attendant per in-patients is permitted. Unbelievable that this happened!!! 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. Lesions are all small or very small. MY THOUGHTS AND ANYTHING DOCTOR NOTED: Want confirmation about a diagnosis or treatment. I made the appointments. A enlarged prostate can also cause blockages in the urethra. notable articles of 2016 - Johns Hopkins Bloomberg School of Second opinion on biopsy slides - malecare.org I appreciate any comments or insight that anyone wants to share. Thanks, A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. I had been carefully watching as my PSA increased to 3.2 from 3.9 in summer 2010. The out-of-pocket cost may be in the $300 range (insurance may not cover it), and it is a simple matter to call your urologist to forward the slides to them. A newly published paper by Fischer et al. Where Should I Go for a Second Opinion? - breast cancer This is often the case when the primary physician advises an expensive treatment. I am an airline pilot with exposure to radiation, jet fuels/fumes, etc. Find more COVID-19 testing locations on Maryland.gov. Adenocarcinoma: 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. Remember if you ship them include the following information: You May Like: Blood In Urine After Prostate Biopsy. Does that mean my Gleason Score based on my biopsy would be less than a Gleason 6? Extraprostatic extension: negative Second Opinions An accurate diagnosis is essential to ensure that the correct and most effective treatment is given. My involvement is below maximum of 15% of core. 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, Read Also: Nhs Prostate Cancer Risk Calculator. Abstract Context: In men who develop an elevated serum prostate-specific antigen level (PSA) after having undergone a radical prostatectomy, the natural history of progression to distant metastases and death due to prostate cancer is unknown. By basing a treatment Prostate Cancer Grading: 3T MRI with coil is done initially, along with a TRUS biopsy. Both of which are normal volumes, the Bullet Volume is considered more precise in prostates smaller than 55ml. * Perineural Invasion detected MRI RE-READ #1 (well known radiologist, but free advice over phone, but no written report): Read Also: What Are The Signs Of Prostate Infection. I'm turning 58 in one week. Who should I contact at Johns Hopkins to get a second opinion on a biopsy? Now, I would like to send Radiology for a similar review. Also, their protocol would be another biopsy, but he was comfortable with the image and velocity of PSA that he didn't have to have one to start treatmentand I was pretty hesitant (given the image and PSA) to take ADT, and didn't see a biopsy changing my mind regarding treatment and/or ADT.Oh. Is it done through my doctor or do I do it myself with sending CDs of the MRI? 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. All rights reserved. Therefore, the value of these second opinions remains unknown. He turned to the Top Gun of Prostate Pathology: Jonathan Epstein, MD, the guru of Gleason scoring at Johns Hopkins University in Baltimore. An increase of 1.1 in 3 months is not good news. Conflicting Prostate Biopsy OpinionsWhat to Do? 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. Prostatic Adenocarcinoma When I read the forums and questions on this site everyone mentions their Gleason Score from their biopsy. - Johns Hopkins Medicine -- Get a Second Opinion doi: 10.1136/bmjopen-2020-044033. Getting a second opinion can sometimes lead to a complete change in diagnosis in non-cancerous growths, inflammatory disorders, infections, cancer and other conditions. He said that it will improve in the future due to future improvements in the treatments. I suggest for all that hear, "you have cancer" that you seek more opinions! But, ultimately decided on whole gland treatment using Proton Beam Radiation.So. Slightly EDI am now 52 and not quite functioning like I did 4+ years ago. Also, Oncotype subsequently invalidated my results because they found in the history that I had a prior FLA. (I must say that those low numbers concern me a bit.) Prostate volume: 17.58 cc Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, The Sidney Kimmel Comprehensive Cancer Center. The average age at the time of prostate cancer diagnosis is about 66. undefined will no longer be visible to you including posts, replies, and photos. I have had a CT of the pelvic area - negative and a whole body bone scan - negative. We had the 3T MRI (no coil) and MRI guided biopsy at Sperling in NY, and then had a 2nd Opinion done by Johns Hopkins. However, there are other cases when a second opinion results in a very different diagnosis or set of treatment recommendations. fibromuscular stroma, anterior prostatic contour is smooth. I'm leaning towards SBRT. Given that some 3+4 is now evident, I can no longer say that all my PCa is all 3+3 and that I can stay on AS for an extended period.
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