johns hopkins prostate cancer second opinion

Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. This has only low-level nonspecific activity with SUV max of 2.05 and may be due to degenerative changes at the symphysis pubis." Reinterpretation of imaging scans and lab tests. Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. I am 65 and in excellent general health. Bones: There is marketed marrow heterogeneity in the pelvic bones are not in the femoral heads. 4 Get a Second Opinion Dr. Jonathan Epstein explains the benefits of getting a pathology second opinion With that alone, I would likely be a candidate for continued Active Surveillance. Treatment must be chosen based on stage and your (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. Same with the amount of how much pattern 4. However, there are other cases when a second opinion results in a very different diagnosis or set of treatment recommendations. T2W MRI score= 2, DW MRI score= 3, DCE MRI score=positive He also said perinueral invasion, but not extracapsular extension. the transition zone. Their opinions are widely held to be definitive. Hi JM "Numerous publications show the clinical and economic benefits of obtaining a second opinion for Pathology specimens. Masks are required inside all of our care facilities. 2017 May-Jun;30(3):298-307. doi: 10.3122/jabfm.2017.03.160359. I have seen numerous urologist for their opinion and all of them want to cut and radiate and give me hormones. Surgery seems like overkill for me with too many risks for incontinence and permanent ED, am I overlooking something? 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. * Prostate volume: 22 cc Primary Gleason grade: 3 Because every patient is different, there are several ways to approach prostate cancer treatment. Ask your PCP to refer you to several different types of treating doctors before making a treatment decision. Watch: Are supplements good for prostate health? Surgery took about 3 hrs. decision on a single medical opinion or the first appointment you get, you may Being in Wisconsin, my insurance gives me the option of two hospitals to manage me. Obtaining a second opinion on your pathology report is no different than getting a second doctors opinion, it is a must for all of us. A doctor at MSK can collaborate with another doctor to offer support and help ensure the best outcomes. And again, most of you tell me time is on my side, so I am comforted in hearing that. * Sloan only sent partial cores, slides 1 and 4. Diffuse probable benign peripheral zone changes limit evaluation for Other: There is trace ascites in the mesosigmoid. Lesion 2: Right mid anterior transition zone. In the mean time my PSA was movingno longer static, but never back up to 6. After all, it seems like good idea to deal with your cancer sooner rather than later. What are your opinions of what that is, and where to get it? At this point Im still ignorant about what I ought to be doing (MRI guided biopsy is what I should have gotten). According to The National Institute on Aging, prostate problems are common after age 50. asymmetric central zone tissue more pronounced on the left. 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? BONES: No suspicious osseous Caused me to bleed heavily. Obtaining a second opinion in Pathology can in a small percent of cases lead to a complete change in diagnosis in a wide range of conditions including non-cancerous growths, inflammatory disorders, infections, and cancer. After much discussion we both agreed that surgery was my best option and that he would do it at the end of July. Benign Processes: I luckily found this webpage and I started reading everything I could get my hands on. In fact, additional biopsies revealed no additional cancer. Let me know what everyone thinks if you see anything interesting or of note here or just have some advice. I could not get a definitive answer from them on how much, how many cells, or any information. Most choose treatment they originally planned to follow, study finds. Are there urologists out there that don't routinely order the DX test to get a better idea of low and intermediate risk cancers? We surveyed men who were diagnosed with localized prostate cancer in the greater Philadelphia area from 2012 to 2014. 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. 2 cores from left base of 3+4=7 with only 5% involvement. Johns Hopkins said I have options of adjuvant radiation approach up to 3-4months or wait to see if there are two successive rises in PSA and then do "salvage" approach. information. Types of questions that pathologists often address in our second opinions: About 60% of prostate cancers occur in people older than 65. In adjusted models, obtaining a second opinion was not associated with receipt of definitive treatment . I luckily found this webpage and I started reading everything I could get my hands on. Steve, Groucho was wrong when he said "i don't want to belong to any club that would have me as a member." PSA was 3.0 in 2011 and rose to 6.0 in late 2013. Second opinions are more likely to be comprehensive, or inclusive of every possible perspective, when performed in a cancer center with a multidisciplinary team, which usually includes surgeons, oncologists, radiation therapists, and sub-specialist oncologists. 4. A diagnosis is usually reached within 3-5 days of your slides' arrival at Johns Hopkins. You May Like: Prostate Radiation Treatment Side Effects. 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. The researchers also found that patients who obtained second opinions because they wanted more information, were seeking the best doctor, or had been encouraged to do so by family or friends were more likely to undergo surgery. I have been drinking out of an information fire hose. Dont Miss: Function Of The Prostate Gland And Seminal Vesicles. JHs just said it was minimal less than 5%. Confounding this, I have read that the different genomic tests can disagree with each other, and that Oncotype is usually a more aggressive finding. Hillen MA, Medendorp NM, Daams JG, Smets EMA. I really liked the new group I went to as they identified the lesion right away, unlike the radiologist who performed the first procedure, and they also have a urologist on staff as well monitoring everything. The percentage of tissue with carcinoma is 45% I've tried to find out about Dr. Wong but there's very little info on him. Diffusely abnormal appearance of the prostate may reflect prostatitis, which can obscure underlying prostate cancer. The review process normally takes several days, after which we will send your slides and other materials are returned. In addition to providing a better understanding of your diagnosis, a second opinion can also shed new light on treatment options and give you confidence in how to proceed with your care. Benign prostatic tissue I'm going to reach out to UCLA to see what they can do. The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System. It may be a new cancer, but it is more likely a recurrence since it is really near the ablation zone. Also indicated everything else was "organ confined." Dr. Jonathan Epstein of Johns Hopkins University Hospital. Further, among men with low risk disease, we did not observe a significant association between second opinions and receipt of definitive treatment or surgery. Low post-void residual volume is It is best to begin by talking with the doctor who made your initial prostate cancer diagnosis. Generally, the symptoms can stabilize over time. Find more COVID-19 testing locations on Maryland.gov. 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. Urologists are trained as surgeons, radiation oncologists administer radiation, and medical oncologists provide cognitive oversight and general management of the cancer. We experienced information overload and decision/analysis paralysis. At Another Johns Hopkins Member Hospital: Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, Prostate Cancer Treatment: What to Know About Active Surveillance. I frequently make a 2 hour car ride and I have to stop about 25% of the time and when I don't, the urgency is a bit more evident and with the urgency come some hesitancy, but not terrible. -------------------------------------------------------- Depending on your location, you may be able to have a telemedicine consultation. Please don't hesitate to make any observations or ask questions. You In those cases, patients are tremendously grateful for having received the advice and encouragement to get a second opinion, Dr. Matasar adds. I assume it is not free. Get a Second Opinion What can a second opinion tell me? You think your doctor is underestimating how serious your cancer is. * 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! Axial T1-weighted images of the pelvis show no bony or bulky nodal disease. But I've had trouble getting Dr. Chang's office to provide any patient referrals. The only prescriptions I take are for GERD (Protonix), cholesterol (Atvorstatin), and allopurinol for an episode of gout that I got while doing physical rehab for a bad tibia break (I shattered my tibia plateau 2/2020 and have pretty much recovered). And when I attempt to ask questions about intradcutal, I get responses about how little is known about it because it's so rare or that it is controversial or that they're not familiar with the study I'm referencing. You can call and speak with his assistant at: (410) 614-6330. 2: Prostate, right lateral base Sometimes, you may find out about treatment options you didnt know were available. So I initially thought this makes me a good candidate for AS. 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 . 1: Prostate, right lateral apex 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. An official website of the United States government. 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. Results: Over 80,000 specimen cases are seen at Johns Hopkins each year. The linear amount of tissue with carcinoma is 23 mm 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. Find more COVID-19 testing locations on Maryland.gov. - Johns Hopkins Medicine -- Get a Second Opinion Prostate, right lateral base: 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. Overall PIRADS Score: 5/5 My direct phone (mobile) number is 703-992-3662, or you can private message me via this platform. How much is the fee for an opinion of my recent MRI? Note that I'm trying to get a second opinion from Johns Hopkins but Mayo, where the biopsy was performed, appears incapable of processing my request. 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. Either the patient or the primary physician can initiate the process of getting a second opinion. Both of which are normal volumes, the Bullet Volume is considered more precise in prostates smaller than 55ml. In adjusted analyses, however, only age and education were significantly associated with obtaining second opinions from urologists. 2nd opinion"Sclerotic change at the right pubic bone with max SUV of 1.4." Some men may have an enlarged prostate but not notice it. By choosing the first doctor you speak with to be your treating physician, you may be putting your health in the hands of someone who lacks the expertise to accurately and safely treat your prostate cancer. -------------------------------------------------------- There is hope. With no travel needed and no red tape, its easy to get a second opinion, all from the comfort of your home. Both Drs and nurses knew what they were doing and had lots of experience. prostate cancer; quality of health care; second opinion; specialists; treatment. The researchers did not include more minor errors in rating how fast-growing and how advanced a cancer was. They seem to think it'll do the trick.I feel great and I am glad I chose this treatment path. One of the problems with second opinions is that insurers may not cover the expense. MEASUREMENTS: Men who sought second opinions because they were dissatisfied with their initial urologist were 51 percent less likely to receive definitive treatment, and men who wanted more information about treatment were 30 percent less likely to report excellent quality of cancer care compared with men who did not receive a second opinion. 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. However, that information will still be included in details such as numbers of replies. However, seeing him will be another 8 weeks, but he wants my biopsy slides (second opinion) before we meet. Metastasis. )I contacted Dr Busch (still in Chattanooga at the time) and he called me directly to talk me off the ledge. So my question for you is have you ever heard of PRECISE and if so what should I make of it? Symptoms include leaking and discomfort. 2017 Oct;22(10):1197-1211. doi: 10.1634/theoncologist.2016-0429. Now, I would like to send Radiology for a similar review. present in bladder. My profession for forty years was health actuary consultant, so I have a pretty fair understanding of health data, outcomes, and risks. A second opinion is part of the education process that is critical for many cancer patients. Netto points to prostate cancer as an example: If your diagnosis changes from a higher grade to a lower grade cancer, it could mean having the option to avoid radical treatment.Seeking second opinions is becoming standard practice, and it is mandatory at Johns Hopkins. 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. Who Should Request a Second Opinion? For a second opinion on the results of your prostate biopsy, there is no place better to get one than from the well known prostate pathologist, Dr. Jonathan Epstein at Johns Hopkins. After a second opinion from both Johns Hopkins and Stanford, the two 4+3's were downgraded. But, after 4 drinks or if I'm tired/jet lagged I find that sleep is more appealing than sex. Its in your best interest to ask for another look at a cancer diagnosisIf youve recently been diagnosed with cancer, its wise to ask for a second opinion on your pathology specimen.Johns Hopkins researchers with the Urological Pathology Consult Division, led by Jonathan Epstein, M.D., first reported on biopsy errors a decade ago, when they found a margin of error in prostate cancer diagnoses large enough to give them pause. Just had my appointment today and they are pleased with the results, so far. I have posted here before, now with an update. 1.Rebecca L. Siegel, Kimberly D. Miller, and Ahmedin Jemal, Cancer Statistics, 2019 CA Cancer J Clin. Thank you, After more than three years on active surveillance, I've pretty much decided to have focal brachytherapy for my prostate cancer. Two things you learn here is get a second opinion from Johns Hopkins on biopsy and get treated at Center of Excellence. I just received a second opinion report from Johns Hopkins. And just this week, 1 YEAR post treatment, it is .46. * Extracapsular extension: None. About 80 percent of prostate cancers are diagnosed at a localized stage, which means that the cancer hasnt spread outside of the prostate. My long-term prognosis appears to be good with minimal side effects. And should I treat prostatitis before FLA? PELVIC LYMPH NODES: No adenopathy. As evidenced on this site, some studies indicate that GS 6 shouldn't even be classified as PCa and that it isn't aggressive. My other option for treatment is either LDR or HDR brachytherapy. We will then prepare a written recommendation regarding your treatment plans or options. Youve just been diagnosed with prostate cancer. I'm currently in the process of getting an appointment set up with a Dr. Wang at UCLA. Thanks, BigD. )I contacted Dr Busch (still in Chattanooga at the time) and he called me directly to talk me off the ledge. - Benign prostatic tissue PSA had increased to 5.4. 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. I appreciate all the input because I am a little overwhelmed and confused as to the best course of treatment. Keywords: 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. I now have my list whittled down to 3. When I was diagnosed I really thought that I will live only 2 years. JAMA Netw Open. Thank you for your understanding and cooperation. 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.

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johns hopkins prostate cancer second opinion

johns hopkins prostate cancer second opinion