)As for side effectsI occasionally have some urgency/hesitancy having to pee. 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. The total number of cores identified is 3 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. Mayo's report came back with the same PI-RADS 4 with the wording that it was more conspicuous but unchanged. sharing sensitive information, make sure youre on a federal He basically said it was possible, but that he did not agree. C. Prostate, right apex, core biopsy: Patients may experience a fever or chills as a result of the infection. 7 People with PN had an increased likelihood of: 6 Eating disorders Self-harm I did ask some questions about the study, if anyone is interested. 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. Find more COVID-19 testing locations on Maryland.gov. Prostate cancer is an * Perineural Invasion detected 1.Rebecca L. Siegel, Kimberly D. Miller, and Ahmedin Jemal, Cancer Statistics, 2019 CA Cancer J Clin. My prior Prolaris study (2018) before the FLA was very low risk. 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). NOTE: THINK THIS LOWERS MY PSA DENSITY SOME IF MY GLAND ISN'T a 17CC PEANUT! Brief MRI history. Family history of prostate cancer. Adenocarcinoma: If a targeted biopsy is planned, this lesion can be sampled at the same time. Here are seven tips for seeking second opinions for prostate cancer: 1. It also rules out Brachytherapy. Dr. Jonathan Epstein of Johns Hopkins University Hospital. 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%). Second opinions from urologists for prostate cancer: who gets them, why, and their link to treatment . 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. 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. We are vaccinating all eligible patients. I fear limiting myself to an inferior treatment because the people I talk to have hammers, therefore everything must be a nail. 8. They also determined there was extrapostatic extension because there was some fat in the sample that involved the cancer. And again, most of you tell me time is on my side, so I am comforted in hearing that. I could not get a definitive answer from them on how much, how many cells, or any information. So, Radiation Oncologist prescribed Cialis 5mg, daily. Anyone else encounter something like this?
Value of Second Opinion in Prostate Cancer Uncertain, Says - AJMC This puts PCPs in a unique position to impact the treatment decisionif they only refer to urologists and not to radiation oncologists or medical oncologistssurgery is a likely treatment outcome. 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. In the mean time my PSA was movingno longer static, but never back up to 6. He has had a nagging "groin injury" for may years (he played pick up basket ball until he got injured) and we are now wondering if this could be the source of that recurring ache. 2017 May-Jun;30(3):298-307. doi: 10.3122/jabfm.2017.03.160359. This fee includes: Recommended Reading: Radiation Therapy For Prostate Cancer. -------------------------------------------------------- Generally, the symptoms can stabilize over time. 3T MRI with coil is done initially, along with a TRUS biopsy. Patient preferences and urologist recommendations among local-stage prostate cancer patients who present for initial consultation and second opinions. According to the doctor it is around 3 mm.
Second Opinion Pathology | MD Anderson Cancer Center Masks are required inside all of our care facilities. World J Urol. That being said, they can be a beneficial member of the treatment team. - DWI-ADC = 4/5 Ask us questions on this webpage. The other samples produced 4 more positive cancer cores for a total of 7 of 12 positives. It hasn't let me down. At the Johns Hopkins Medical Institutions, he is Professor of Pathology, Urology, and Oncology the recipient of the Reinhard Chair of Urological Pathology and Director of Surgical Pathology. However, there are other cases when a second opinion results in a very different diagnosis or set of treatment recommendations. Dr. Dan Sperling - New York. Value of Second Opinion in Prostate Cancer Uncertain, Says Hopkins Study. My family physician for years told me that small increases PSA was common so when it went over 4 it didnt bother me and my Dr who was retiring, didnt say anything either. A doctor may prescribe surgery or perform an endoscopic procedure. 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. I didn't study for the test and it's possible some morning activities might have affected my test score :) 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. It's really that simple! Got the fiducials placed, the Space-OAR gel placed, mold made, and had the pre-treatment MRI and CT Scan.
Why It's Worth Seeking a Second Opinion for Prostate Cancer You know - urinary incontence, erectile dsyfunction, and exhaustion (hormones) are not my cup of tea. My dad 82 was diagnosed last week with prostate cancer with high PSA 100 and GLEASON: ( 4 + 4 ) = 8 / 1 0 , he had the PET Ga-68 PSMA image Friday and today we found out the result is stage 4 Metastatic lesions in the bone pelvic area. It hasn't let me down. 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. 8600 Rockville Pike Epstein, who views about 12,000 slides a year, called for calm in my case and suggested another biopsy in six months. Depending on your location, you may be able to have a telemedicine consultation. 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.Tammy Jiang, Christian H. Stillson, Craig Evan Pollack, Linda Crossette, Miupdachelle Ross, Archana Radhakrishnan, and David Grande, How Men with Prostate Cancer Choose Specialists: A Qualitative Study, Journal of the American Board of Family Medicine: JABFM, 30(2), (2017): 220229. The review process normally takes several days, after which we will send your slides and other materials are returned. You may also complete an online appointment request form and we'll respond to schedule an appointment. Recently diagnosed a Gleason 3 + 3. At a rectal exam 6/20 the urologist told me my prostate felt normal, not enlarged, nor did he feel any tumors. Day 7 after surgery I took my last pain pill. 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. Explore our state-of-the-art patient care facilities in the Sheikh Zayed Tower. JHs just said it was minimal less than 5%. The all-inclusive cost for a virtual second opinion for patients in the U.S. is $1,850. 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. Either the patient or the primary physician can initiate the process of getting a second opinion. (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. However, that information will still be included in details such as numbers of replies. When I read the forums and questions on this site everyone mentions their Gleason Score from their biopsy. Of course, my old school Urologist recommended surgeryHe, of course, knew the best robotic surgeons around.Anyway. Prostate, left medial apex: One of the problems with second opinions is that insurers may not cover the expense. transition zone. peripheral zone signal intensity on T2-weighted images. I sent a message to my urologist requesting my slides be sent to Dr. Epstein at Johns Hopkins for a second opinion and I also requested an Oncotype DX test to get an idea of risk for my low teal or basic teal cancer. The reasons for opting for treatment: the single lesion - previously Gleason 3+4, with a small percentage of pattern 4 - has grown, and according to a biopsy performed March 25, my Gleason 3+4 is now a Gleason 4+3. So fingers crossed. 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 also learned a lot more about the high undisclosed risk of side effects of various treatment plans. Notice of Privacy Practices(Patients & Health Plan Members). 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. 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. 2. Will these places of excellence consider me, or am I bound to my regular doctor for insurance purposes? 4: Prostate, right medial base
Johns Hopkins Prostate Cancer Doctors - HealthyProstateClub.com 1st opinion"Nonspecific sclerotic change of the right pubic bone with low-level radiotracer activity, favor degenerative change rather than osseous metastasis." Therefore, the value of these second opinions remains unknown. Because I had an implant in my ear, they would only give me a 1.5T MRI. Extraprostatic extension: negative They did another 3T-MPMRI (Siemens machine) and it showed a faint area, near the margin, and very close to the down stream sphincter of prostate. P/ 310-827-7707 | F/ 310-574-4002 | MAIL@PROSTATEONCOLOGY.COM. Luckily, his report co-coincided with the original QDx report. I retired as a Dentist at the VA and saw many veterans with a wide range of outcomes as most of them became 100% service connected when diagnosed with prostate Ca due to exposure to Agent Orange if they served in Vietnam. They did another 3T-MPMRI (Siemens machine) and it showed a faint area, near the margin, and very close to the down stream sphincter of prostate. PSA had increased to 5.4. He turned to the Top Gun of Prostate Pathology: Jonathan Epstein, MD, the guru of Gleason scoring at Johns Hopkins University in Baltimore. The biopsy took 3 samples from the targeted region plus 16 sextant. Am I missing anything? * Sloan only sent partial cores, slides 1 and 4. Reasons for obtaining a second opinion from urologists. Shore ND, Karsh L, Gomella LG, Keane TE, Concepcion RS, Crawford ED. You think your doctor is underestimating how serious your cancer is. 7. SMIL radiologist reported nothing found. images and markedly reduced ADC. Reasons for obtaining a second opinion from urologists. I now have my list whittled down to 3. 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. Men often seek second opinions from urologists before they initiate treatment for their newly diagnosed prostate cancer. But, ultimately decided on whole gland treatment using Proton Beam Radiation.So. And it is OK to have paralysis by over-analysis. I would feel much more comfortable, if the numbers stay the same, being involved in a recognized Active Surveillance Program. Utilize your primary care physicians as an un-biased resource to help you get second opinions from a range of specialists. 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. )I contacted Dr Busch (still in Chattanooga at the time) and he called me directly to talk me off the ledge. My urologist has decided we'll go ahead with the MRI due to the continued elevated PSA scores, in addition to the overall PHI score. 3: Prostate, right medial apex So, I asked the Radiologist if she will schedule one for me. However, it also is possible to seek a pathology second opinion on your own, and it does not require an in-person office visit. radiation, active surveillance, surgery, hormone therapy, and more. 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. So off I went to see a community urologist who performed a needle biopsy in his office. So the pathologist suggested a second opinion. the transition zone. Careers. 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. However, he also said it's treatable even at a 2cm size and the transition zone is a favorable spot. I am an airline pilot with exposure to radiation, jet fuels/fumes, etc. This championship swimmer sought a second opinion at Johns Hopkins. This condition causes pain in the lower back and groin area, and may cause urinary retention. And by FAA Aeromedical Ruling, I'd need a few post procedure reports before being cleared to fly again.) If the enlarged prostate is not completely removed, it will shrink. 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. You're also at greater risk of prostate cancer forming before age 50. (TZ) One suspicious area - lesion size: 2cm x 1.4 cm Steve, Groucho was wrong when he said "i don't want to belong to any club that would have me as a member." For these reasons and others, it is advantageous to seek more than one opinion about how your cancer can be treated. 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. We are vaccinating all eligible patients. Recovery from Prostate Cancer | Bills Story. Have you heard of PRECISE follow up score for an MRI? However, older men 75 years were the least likely to report obtaining a second opinion due to dissatisfaction with their initial urologist. Note respondents were able to choose more than one reason. He recommended waiting and watching at that time due to the lower PSA reading. 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. Many health insurance companies will pay for a second opinion, especially if it is for a medically necessary treatment. With world-renowned expertise, multidisciplinary specialistsand the latest data, we partner with you tomake informed decisions about managing your prostate cancer. I luckily found this webpage and I started reading everything I could get my hands on. Johns Hopkins Medical Laboratories 1620 McElderry St. Reed Hall Rm 315 Baltimore, MD 21205 Fax (410) 614-7712 Phone (410) 955-2405 8 am - 5 pm Normal LAB hours are: 5:30 am - 4:30 pm Mon-Fri Receiving a second opinion was not associated with perceived quality of prostate cancer care. We are vaccinating all eligible patients. Knowing your stage and information specific to that stage makes you more medically sophisticated and enables you to navigate through the potential biases of surgeons and radiation therapists. The biopsy disclosed I had some abnormal cells resembling cancer known as PINS, short for prostatic intraepithelial neoplasia. You receive a secure, private online consultation without leaving home. Everything seems to be on track to remove the cancer and be cured!
Second Opinions & Consultations - Johns Hopkins Pathology Dr also stated he was able to totally spare one of my nerves, but to get margin may have damaged one. Similarly, among those who received definitive treatment, second opinions were not associated with receiving surgery. 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. EDI am now 52 and not quite functioning like I did 4+ years ago.