johns hopkins prostate cancer second opinionjohns hopkins prostate cancer second opinion

Methods: His most-frequently cited first or last authored publications is Pathological and Clinical Findings to Predict Tumor Extent of Nonpalpable Prostate Cancer, published in JAMA, which established the criteria for active surveillance. Anything I am overlooking or need to add to my list of considerations? First of all we would like to emphasize that the health of our employees, our patients and their relatives is our first priority. The study included nearly 2,400 men in the Philadelphia area recently diagnosed with localized prostate cancer. The PSA Doubling Time parallels my Urologist Doubling Time (I keep changing Uro until I find one who makes sense)! 6 A study at the Johns Hopkins Health System found it was 3.4 times more common in Black Americans than in White Americans. LESION 1 desired outcome. A blocked urethra can also damage the kidneys. 5/10 PSA 4.2/fPSA 9% taken at MSKCC (lab #3) Other: There is trace ascites in the mesosigmoid. Second opinion Johns Hopkins? - Prostate cancer I have actually had a second opinion a while back from Dr. Bush. A doctor may prescribe surgery or perform an endoscopic procedure. Keywords: I just received a second opinion report from Johns Hopkins. (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. J Am Board Fam Med. Prurigo Nodularis Cancer: What's the Link? - Verywell Health Results: Thanks to all of you for sharing! Our gynecologic pathology team can also help determine if the tumor is localized or has metastasized from another region of the body. 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. Therefore, the value of these second opinions remains unknown. According to the study, one in every 600 diagnoses showed mistakes.This study only addressed major changes in diagnoses, such as a diagnosis of cancer being reversed to no cancer, says Johns Hopkins pathologist George Netto, M.D. With no travel needed and no red tape, its easy to get a second opinion, all from the comfort of your home. Yet none of my doctors ever mentioned it! Find more COVID-19 testing locations on Maryland.gov. Bookshelf This suggests that for some men, second opinions offer a way to pursue the treatment they already planned on, rather than to explore other treatment options, according to study authors Dr. Archana Radhakrishnan, of Johns Hopkins University in Baltimore, and her colleagues. Anyone else encounter something like this? 1. We experienced information overload and decision/analysis paralysis. A enlarged prostate can also cause blockages in the urethra. (Recommended by my oncologist, Dr. Mark Scholz.) See this image and copyright information in PMC. I've been on AS since April 2016. Want confirmation about a diagnosis or treatment. My plan is to choose quality of treatment over cost of the treatment. Many health insurance companies will pay for a second opinion, especially if it is for a medically necessary treatment. It also rules out Brachytherapy. 1st opinion. My new Dr however didnt order PSA so I asked him for one. 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. government site. Because I had an implant in my ear, they would only give me a 1.5T MRI. It is best to begin by talking with the doctor who made your initial prostate cancer diagnosis. Johns Hopkins is home to many of the world's leaders in Pathology. Our collaborative processes also extend to our colleagues at Johns Hopkins Medicine, a world-wide leader in cancer research. -------------------------------------------------------- Biopsy in 12/27/11 showed 3/14 cores, Gleason 6 with PSA of 4.5. Last year, Epstein's lab reviewed the pathology reports of 30,000 cases in which patients requested second opinions. Got the fiducials placed, the Space-OAR gel placed, mold made, and had the pre-treatment MRI and CT Scan. Seminal vesicles are normal. Expert review of your case by a Cleveland Clinic specialist. Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. 2/23 PSA 4.7/fPSA 12% taken for 4K score (lab #2) Am I missing anything? Epstein, who views about 12,000 slides a year, called for calm in my case and suggested another biopsy in six months. When I read the forums and questions on this site everyone mentions their Gleason Score from their biopsy. Also, infection was noted, so the current PSA is high in part due to prostatitis. The treatment of prostate cancer has evolved tremendously. 2016 American Cancer Society. An acute bacterial infection can cause a burning sensation. Johns Hopkins Prostate Cancer Doctors - HealthyProstateClub.com I had a very bad experience with an incompetent nurse that did a catheter change. In fact, additional biopsies revealed no additional cancer. Radhakrishnan A, Grande D, Ross M, Mitra N, Bekelman J, Stillson C, Pollack CE. )I contacted Dr Busch (still in Chattanooga at the time) and he called me directly to talk me off the ledge. He wants me to begin the ADT around 5/1. The James Buchanan Brady Urological Institute, Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov. I really just want the results of their innovative PTEN test. Who should I contact at Johns Hopkins to get a second opinion on a biopsy? Therefore, the value of these second opinions remains unknown. Hi JM "Numerous publications show the clinical and economic benefits of obtaining a second opinion for Pathology specimens. 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. After extensive discussion of his management options with his local urologist, primary care physician, and radiation oncologist, he also sought a second opinion at the Johns Hopkins Prostate Cancer Multidisciplinary Clinic at Sibley Memorial Hospital.The patient expressed an overwhelming desire to avoid surgery and any other invasive treatments. Some men have minimal or no symptoms at all. From what I've learned from Dr. Scholz videos at PCRI, and from posts on this site it would lead me to believe the DX test is fairly common knowledge. If I don't meter fluids before bed, I can expect to get up 3-4 times in the night. Now its easier than ever to get the answers you need and peace of mind you deserve. I would appreciate hearing from that 2.8% out there who have an intraductal component. 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. The problem is that all 3 pathologies noted an intraductal component. Some men have minimal or no symptoms at all. Benign Processes: The peripheral zone has a patchy signal pattern. And, even working in a fairly technical field myself, I was amazed at the technology and precision of that Proton Machine. I say bullshit to them. And in some cases, the information you gain during a second opinion consultation can even change your diagnosis. They told me to expect a spike in my PSA sometime in the future, and they told me that studies are showing that a slow, steady decline in PSA is often indicative of superior results (whatever that means. PI-RADS v2 score: 5. Prostate Cancer Grading: 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. A second opinion can accomplish a number of things. 24.5 BMI Ask us questions on this webpage. Good Luck and God Bless everyone. Thanks for Everyone's Help, He never sought treatment for the injury. I am at that critical juncture in which I at least need to formalize a plan, select a doctor/facility to work with, and continue my testing to make sure I have what I think I have. 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. Im also wondering why no one has scheduled me for MRI to see what biopsy missed. The percentage of Gleason grade 4 and/or 5 is 5 % Negative cancer in lymph nodes, seminal vesicles, and all margins. -------------------------------------------------------- Doctors can review their peers treatment suggestions and explain why they agree or disagree. 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 was to follow up with my new Urologist (another surgeon) for 3 months PSA checks and annual 3T-MPMRI.My PSA checks were static and the next year's MRI looked just like the first. - High grade prostatic intraepithelial neoplasia (HGPIN) 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. Can it be salvaged or are the risks of cancer too high? 5. Find more COVID-19 testing locations on Maryland.gov. Dont Miss: Function Of The Prostate Gland And Seminal Vesicles. It will be interesting to see, I think. Peripheral Zone: The peripheral zone is of normal homogeneous prolonged T2 and there are no suspicious focal areas of As a result, patients struggle to differentiate bias from fact. 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. Allow yourself the time to seek multiple opinions. I had been carefully watching as my PSA increased to 3.2 from 3.9 in summer 2010. Second Opinion For Cancer Treatment And Care | CTCA | City of Hope Surgery took about 3 hrs. Cancer 2017;123:1027-34. The Radiation Oncologist knew of Dr Busch (by now in Alpharetta, GA) and spoke highly of him. Second opinions are a common practice in any area of medicine that is complex and that has multiple treatment options available. And by FAA Aeromedical Ruling, I'd need a few post procedure reports before being cleared to fly again.) So the pathologist suggested a second opinion. There is hope. I question the potential EPE and he said it didn't matter, but went ahead and ordered Oncotype. And thanks again for making this such a great support group! Treatment options include immunotherapy, Symptoms include leaking and discomfort. Comments appreciated, Specimens Submitted: My profession for forty years was health actuary consultant, so I have a pretty fair understanding of health data, outcomes, and risks. In 2006 my PSA was .6. 9. Brief MRI history. In the United States, prostate cancer is among the most common cancers found in men. I am unfortunately "officially" joining the club after getting my biopsy results today. MEASUREMENTS: Those readings were reported on a second opinion by Dr. Epstein. Y'all are in my prayers! Seeking a Second Opinion - American Cancer Society 2. 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. Following application of the relevant exclusion criteria, 2365 respondents remained in the analytical cohort. He recommended waiting and watching at that time due to the lower PSA reading. But I don't want to do a radical prostatectomy or radiation that would have large side effects now if the laser is a viable option given my data set. Also, Oncotype subsequently invalidated my results because they found in the history that I had a prior FLA. My direct phone (mobile) number is 703-992-3662, or you can private message me via this platform. The urologist/surgeon indicated that other forms of treatment like TULSA are not options since my cancer is multifocal. One to a 3+4=7 and the other to a 3+3=6. Then about a month later I started 28 fractions of Proton Radiation.It was painless. Director of Surgical Pathology- Johns Hopkins, http://pathology.jhu.edu/department/services/secondopinion.cfm, The guy I used along with everyone else is Jonathan Epstein, M.D. 5. Conclusions: Masks are required inside all of our care facilities. However, just to be safe she schedules me for TRUS biopsy with the Urologist in another 6 weeks. The study was published online Nov. 7 in the journal Cancer. The all-inclusive cost for a virtual second opinion for patients in the U.S. is $1,850. 2. P/ 310-827-7707 | F/ 310-574-4002 | MAIL@PROSTATEONCOLOGY.COM. prostate cancer; quality of health care; second opinion; specialists; treatment. World J Urol. This has only low-level nonspecific activity with SUV max of 2.05 and may be due to degenerative changes at the symphysis pubis." EDI am now 52 and not quite functioning like I did 4+ years ago. Is the destruction of my prostate inevitable and necessary for my survival (my understanding is that both surgery and radiation will do this)? Prostate Cancer News, Reviews & Views: Second opinions And it is OK to have paralysis by over-analysis. The linear amount of tissue with carcinoma is 23 mm * Gleason Score: 4+5, Slide 4 (vs. Sloan's 3+4) Our team approach brings together highly experienced prostate cancer experts from across disciplines to collaborate on each patients total care, from diagnosis through treatment and recovery. An accurate diagnosis is essential to ensure the most effective treatment. I'm Gleason 3+4=7, and I believed only 2 cores tested positive. Based on the results, our experts can provide you with an individualized treatment plan before you leave. It got discussions started and questions answered. My urologist suggested a couple more PSA tests followed by an MRI. BONES: No suspicious osseous - Benign prostatic tissue These findings are suspicious for degenerative changes however a subtle/early metastatic lesion cannot be excluded and continued periodic follow-up is recommended." I had the slides reviewed at Johns Hopkins and 1 of the HG PIN cores was changed to suspicious for adenocarcinoma while another HG PIN core was changed to benign. * Size: 1.5 cm Hi All, 2020 Dec 1;3(12):e2028320. Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. Extracapsular extension: The prostatic capsule is preserved. Patient-initiated second medical consultations-patient characteristics and motivating factors, impact on care and satisfaction: a systematic review. It is OK to be scared. Noted that some don't even include on report and should be looked as something to note but not obsess about. Because every patient is different, there are several ways to approach prostate cancer treatment. Using an Ellipsoid Volume the dimensions would give you a volume of 20.44. I was confident I was making the right decision. The urologist offered surgery and radiation as options on 3/10 when we met. You think another treatment might be available. 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. Receiving a second opinion was not associated with perceived quality of prostate cancer care. Did robotic radical prostatectomy 1/25/12. 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. 1. The prostate gland is slightly enlarged secondary to transition zone hyperplasia (25cc total) asymmetric central zone tissue more pronounced on the left. ---------------------------------------------------- No definitive evidence of distant metastatic disease is seen." Secondary Gleason grade: 4 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 It hasn't let me down. This teamwork ensures the best possible patient outcomes. Some specialists have more expertise and more experience than others. I did genetic testing and there were no mutations of concern, and everyone agreed that there probably wasn't "enough meat on the bone" to get a good genomic test from the biopsy.After seeing Dr Joe Busch, he said he didn't see any target lesions (PIRADS2), nor did he think I was in any danger. poorly defined margins and intermediate to low T2. 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. 1: Prostate, right lateral apex Overall PIRADS Score: 5/5 If I am rested, I find that I am more ready than if I am not. 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. Most reputable HMOs can, however, deliver state of the art treatment for most cancers. Do any of you have an opinion or actual experience with any of the three listed below? There is no evidence Cancer. lesion. I wish the VA would be more informative about this disease they owe it to our veterans. Generally, the symptoms can stabilize over time. This is why the prostate is important to the body. 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. Thank you, After more than three years on active surveillance, I've pretty much decided to have focal brachytherapy for my prostate cancer. - PI-RADS for this lesion = 4/5 The results were ambiguous. They also determined there was extrapostatic extension because there was some fat in the sample that involved the cancer. Reasons for obtaining a second opinion from urologists. However, before getting a second opinion, its best to check with your insurance company to see if there are any limitations in coverage. But I did speak to an oncologist who wanted to order Oncotype, which I did. not hear all the viable treatment options or receive the most up to date PSA had increased to 5.4. 2/13 PSA 5.2/fPSA 12.5% taken AFTER DRE (negative DRE) (lab #1) Where to start for newly diagnosed advance prostate cancer Second Opinions An accurate diagnosis is essential to ensure that the correct and most effective treatment is given. The other samples produced 4 more positive cancer cores for a total of 7 of 12 positives. Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, The Sidney Kimmel Comprehensive Cancer Center. So now things are getting exciting. The side effects of the cut, radiate, hormone regime are unacceptable to me. Second Opinions for Cancer Care - UChicago Medicine We prioritized treatment as AS, FLA/TULSA (if a lesion ever presented itself), and Proton Beam Radiation. Prostate, right medial apex: Benign prostatic tissue doi: 10.1001/jamanetworkopen.2020.28320. Bring All Labs/Notes to Each Appointment. Reinterpretation of imaging scans and lab tests. 53 years old * Gleason Score: 3+3, Slide 1 (vs. Sloan's 3+4) Prostate cancer is a malignant (cancerous) tumor of the prostate, a gland found only in men. - One separate small tissue fragment with prostatic adenocarcinoma, 0.5 mm in linear length Bethesda, MD 20894, Web Policies Just got my pathology results. The .gov means its official. 7 in 10 PATIENTS WHO GET A SECOND OPINION AT CTCA CHOOSE TO TREAT WITH US Call now to find out why: 800.888.8888 Rosie P. Colorectal Cancer When you get a diagnosis of breast cancer from your doctor, its not uncommon to get a second opinion. Benign fibromuscular stroma; no prostatic glands are identified We have a surgery date set up for the end of July at Johns Hopkins (our second opinion team).His stats:63yo, non smoker, 167lbs, Vegetarian/Vegan diet no other known health issuesWalks dogs for a living and cares for our small farmPSA 3.3 (Jumped from 1.6 in a year)Biopsy Scores 3+5, 4+3. Men often seek second opinions from urologists before they initiate treatment for their newly diagnosed prostate cancer. This fee includes: Recommended Reading: Radiation Therapy For Prostate Cancer. 2017 Oct;22(10):1197-1211. doi: 10.1634/theoncologist.2016-0429. 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. Now, though, encouraging animal data and preliminary studies in human patients are making some doctors feel optimistic. Have you heard of PRECISE follow up score for an MRI? ZERO - The End of Prostate Cancer Support Community.

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