A new study by researchers at the Johns Hopkins University has found that second opinions did not change treatment choice among men diagnosed with low-risk prostate cancer. - Benign prostatic tissue A doctor at MSK can collaborate with another doctor to offer support and help ensure the best outcomes. Low post-void residual volume is We used multivariable logistic regression models to evaluate the relationship between second opinions and definitive prostate cancer treatment and perceived quality of care. Im currently 67 years old. It is OK to be overwhelmed with info. 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. The more often a doctor diagnoses and treats prostate cancer the more proficient they become. I appreciate all the input because I am a little overwhelmed and confused as to the best course of treatment. notable articles of 2016 - Johns Hopkins Bloomberg School of A enlarged prostate can also cause blockages in the urethra. Seeking a Second Opinion - American Cancer Society 2. Second round of Radiation Therapy - t - Advanced Prostate If they have an enlarged colon, their physician can perform a TURP procedure. A second opinion can help you make an informed, confident decision about your medical care. What is NOT OK is quitting or avoiding the bad news, or handing the entire decision over to someone else.Good luck fellas! 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. JHs just said it was minimal less than 5%. - Perineural invasion is present I tried to send the samples out for genetic testing to Prolaris and Decipher, but there was an ordering error and they never went thru. 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. We surveyed men who were diagnosed with localized prostate cancer in the greater Philadelphia area from 2012 to 2014. Johns Hopkins Medicine A commercially available genomic test may help oncologists better determine which patients with recurrent prostate cancer may benefit from hormone therapy, according to new research from the Johns Hopkins Kimmel Cancer Centerand 15 other medical centers. Is it done through my doctor or do I do it myself with sending CDs of the MRI? Cancer. 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? 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. I wish the VA would be more informative about this disease they owe it to our veterans. HMO members may also be discouraged from trying expensive treatments that have only a small chance of success, even if that chance is real. We experienced information overload and decision/analysis paralysis. Y'all are in my prayers! Include Your Primary Care Physician as Member of Your Treatment Team. 1.Rebecca L. Siegel, Kimberly D. Miller, and Ahmedin Jemal, Cancer Statistics, 2019 CA Cancer J Clin. Do second opinions matter in prostate cancer care? - ecancer 5. Second Opinions An accurate diagnosis is essential to ensure that the correct and most effective treatment is given. I have completed all that is necessary to enter Johns Hopkins Second opinion and PTEN test program. When first diagnosed with prostate cancer, your PCP will generally refer you to a urologist for a biopsy. 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. Background: I have actually had a second opinion a while back from Dr. Bush. Benign fibromuscular stroma; no prostatic glands are identified 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. Doctors are skilled at pitching the treatment they specialize in. Their MRI was more sensitive and found there were actually 2 lesions close together that looked like one on the prior MRIs. In the mean time my PSA was movingno longer static, but never back up to 6. About 80 percent of prostate cancers are diagnosed at a localized stage, which means that the cancer hasnt spread outside of the prostate. It is OK to not understand all the terminology. That said, I have some questions that I derived, keeping in mind that 99% of what I have learned since February has come directly from this group: * Seminal vesicle invasion: None. My family doctor was alarmed because such a steep increase in prostate-specific antigen could be a sign of prostate cancer. Check Biopsy and Imaging Results for Accuracy. Prior to the results, the oncologist said that the literature shows that a 3+4=7 with less than 5% pattern 4 behaves just like a 3+3=6 and basically is an indolent tumor. Our collaborative processes also extend to our colleagues at Johns Hopkins Medicine, a world-wide leader in cancer research. Hi All, Seems like a simple request. Pingback: PROSTATE PROS Episode 6: Breakthroughs in Radiation PROSTATE ONCOLOGY SPECIALISTS, Pingback: Like Man, Im Tired (Of Waiting): The How-to Guide for Men with Prostate Cancer PROSTATE ONCOLOGY SPECIALISTS, Your email address will not be published. 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. I still have some urgency and frequency issues, but I am not complaining too bad. Specimens Submitted: prostate cancer; quality of health care; second opinion; specialists; treatment. Experts believe that this study is the first in history to have achieved such results. Find more COVID-19 testing locations on Maryland.gov. Some men have minimal or no symptoms at all. The results of Oncotype came back and it was a bad report. Because every patient is different, there are several ways to approach prostate cancer treatment. I measure PSA frequently, and it is stable and slightly declining with the last score at 5.5. I also sent my biopsy slides to Johns Hopkins for a second opinion (Epstein's read was 3+4, but with lower pattern 4 involvement than the local pathologist.). Generally, the symptoms can stabilize over time. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. Different institutions have different levels of experience when it comes to analyzing prostate biopsy samples and interpreting imaging results. Olver I, Carey M, Bryant J, Boyes A, Evans T, Sanson-Fisher R. BMC Palliat Care. Then about a month later I started 28 fractions of Proton Radiation.It was painless. Mayo's report came back with the same PI-RADS 4 with the wording that it was more conspicuous but unchanged. 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. It is very rare (<3% of all prostrate cancers) and potentially very lethal (one study showed that 59% of men in the study with Gleason scores of 5 had died within 3 years and it had metastasized in 13% of the remaining men). Cancer ABCs recommends: Johns Hopkins Hospital in Baltimore, Maryland, specifically Dr. Jonathan Epstein. It may be a new cancer, but it is more likely a recurrence since it is really near the ablation zone. My diagnosis is T2c, Gleason 7 (3+4). Patients may experience a fever or chills as a result of the infection. transition zone. Prostate, left medial base: In those cases, patients are tremendously grateful for having received the advice and encouragement to get a second opinion, Dr. Matasar adds. I assume the data on gleason scoring is much more robust/reliable than genomics as it has been around longer and used more extensively. Four weeks after a radical prostatectomy for prostate cancer, he was back in the pool. A. Prostate, right base, core biopsy: I was confident I was making the right decision. He schedules appointments with a Radiologist and two local surgeons. When I read the forums and questions on this site everyone mentions their Gleason Score from their biopsy. 1. - DCE = (+) - Perineural invasion is present Second Opinions in Prostate Cancer - American Council on Science and Health I guess TWO national centers of excellence are better than one? Of course, my old school Urologist recommended surgeryHe, of course, knew the best robotic surgeons around.Anyway. Benign Processes: FAX 310-574-4002 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. It has been 2.5 years and the PSA has still not doubled as well. In My Opinion? Get A Second Opinion | ZERO Prostate Cancer One of the problems with second opinions is that insurers may not cover the expense. -------------------------------------------------------- desired outcome. It didnt look at changes of grading of the cancer.The chances for some type of modification based on a second opinion are even greater than the study indicated.Asking for a second opinion could lead to a significant change in surgical or medical intervention, Netto says.Even if the diagnosis error isnt catastrophic, such as advising a patient that he has cancer when he really doesnt, an error in grading can be consequential. Diffuse probable benign peripheral zone changes limit evaluation for With The Clinic by Cleveland Clinic, patients have access to Cleveland Clinics 3500 specialists. First of all we would like to emphasize that the health of our employees, our patients and their relatives is our first priority. Seminal vesicles are normal. * Size: 1.5 cm At that point I agreed to the TRUS biopsy which I had on October 10, 2020. Also these lesions did not abut or touch the wall of the prostate. 4. Does this also include HIFU, Cryoablation? And it is OK to have paralysis by over-analysis. How much is the fee for an opinion of my recent MRI? In general, a second opinion is a good option for people who have recently received a cancer diagnosis but have not started treatment, as well as for people who have already completed chemotherapy or radiation treatment. Avoiding obsolescence in advanced prostate cancer management: a guide for urologists. Caused me to bleed heavily. Benign fibromuscular stroma; no prostatic glands are identified In other words, the cancer is still contained within the prostate. Has anyone else run into this where the gleason score is favorable, but the genomic (specifically Oncotype) test is not? Bethesda, MD 20894, Web Policies Good pathology readings require experience and a high level of expertise. -------------------------------------------------------- Here's what JH says (same lesion). A blocked urethra can also damage the kidneys. Where to start for newly diagnosed advance prostate cancer But, ultimately decided on whole gland treatment using Proton Beam Radiation.So. "We were surprised by the relatively large percentage of men who obtain second opinions for their prostate cancer," said lead author Dr. Archana Radhakrishnan of Johns Hopkins University in . Metastasis. Comments appreciated, There is no one-size-fits-all treatment for prostate cancer. Prostate, right lateral apex: Thanks, BigD. Similarly, among those who received definitive treatment, second opinions were not associated with receiving surgery. PELVIC LYMPH NODES: No adenopathy. The linear amount of tissue with carcinoma is 23 mm The issues in my prostate from the first procedure onward have all been in the same area and the rest of my prostate from the first biopsy and subsequent MRIs onward have never shown any indications of cancer in other areas. 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. The best protection for cancer patients who are Health Maintenance Organization members is to seek a second opinion even if she or he has to pay for it. -------------------------------------------------------- Brief MRI history. Race and ethnicity. Medical record collection from doctors and hospitals. However, learning more about prostate cancer and prostate-related health issues can help optimize health. 7 Tips for Seeking Second Opinions For Men with Prostate Cancer 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. )As for side effectsI occasionally have some urgency/hesitancy having to pee. 4. I luckily found this webpage and I started reading everything I could get my hands on. My long-term prognosis appears to be good with minimal side effects. 4 Get a Second Opinion Dr. Jonathan Epstein explains the benefits of getting a pathology second opinion There are also some cases of the test showing no depletion but being wrong. Prostate, right medial apex: J Am Board Fam Med. 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. My girlfriend lives 2 blocks from the Emory Proton Clinic.We prayed on it and overthought the crap out of it. Instructions for Second Opinion on Pathology (Gleason score) The other samples produced 4 more positive cancer cores for a total of 7 of 12 positives. Associated fees may be incurred up to $1,800 in a minority of more complicated cases requiring special studies. All views would be appreciated. Compared with other men, African-American men and men with a family history of the disease are at higher risk of developing prostate cancer. In adjusted analyses, however, only age and education were significantly associated with obtaining second opinions from urologists. Ozzieville (Michael), Hello All and thanks for being here~This is my first post.My husband was diagnosed with PC (adenocarcinoma with Extensive Intraductal Carcinoma Present) a few weeks ago. 1. At a rectal exam 6/20 the urologist told me my prostate felt normal, not enlarged, nor did he feel any tumors. PSA: 4.7 ng/ml/PSA density: 0.27 ng/ml2 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. Fremont Place Selling Sunset Emily, Articles J
