I have selected Focal Laser Ablation as my future (soon) treatment. I will say, the people I dealt with at Johns Hopkins were extremely nice and professional. curing cancer, prostate cancer questions johns hopkins hospital, josef issels wikipedia, cancer a second opinion a look at book by josef issels, coping with metastatic cancer cancer net, pdf americans health priorities curing cancer and, what is immunotherapy cancer research institute cri, cancer a second opinion a . Note respondents were able to choose more than one reason. 1st opinion"PYL PSMA PET/CT scan demonstrating foci of moderate to intense uptake in the prostate gland consistent with known prostatic cancer. Benign Processes: Benign prostatic tissue This is a PI-RADS 5 lesion in Are you sure you want to block this member? 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. Thanks to all of you for sharing! They also determined there was extrapostatic extension because there was some fat in the sample that involved the cancer. MRI June 2017 again at SMIL. No extraprostatic extension. Different institutions have different levels of experience when it comes to analyzing prostate biopsy samples and interpreting imaging results. I'm trying to figure out why the PSA keeps rising. I had my first of those 2 PSA tests last week and it dropped to 4.77. Benign prostatic tissue Our gynecologic pathology team can also help determine if the tumor is localized or has metastasized from another region of the body. 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. Contact us or find a patient care location. With no travel needed and no red tape, its easy to get a second opinion, all from the comfort of your home. At this point Im still ignorant about what I ought to be doing (MRI guided biopsy is what I should have gotten). Here's what JH says (same lesion). * Other 12 slides not sent 3. At this time, I am leaning towards Active Surveillance or FLA. AS would be my choice, except that a total of three lesions, on both sides of Peripheral Zone, makes this controversial. My new Dr however didnt order PSA so I asked him for one. One core had 5%, one 20%, and one 40%. Forty percent of the men obtained a second opinion from urologists, most often because they wanted more information about their cancer or wanted to be seen by the best doctor . MONDAY, Nov. 7, 2016 Second opinions have little impact on prostate cancer patients treatment decisions, new research suggests. If I don't meter fluids before bed, I can expect to get up 3-4 times in the night. Benign prostatic tissue And it is OK to have paralysis by over-analysis. He turned to the Top Gun of Prostate Pathology: Jonathan Epstein, MD, the guru of Gleason scoring at Johns Hopkins University in Baltimore. Thanks, And just this week, 1 YEAR post treatment, it is .46. I now have my list whittled down to 3. I would really love to hear from you. I worked out every day. My question is--what importance do volume levels play in determining when to move from AS to treatment? Consultation with your nurse care manager. Some of the more common treatments that you and your doctor may discuss include: Prostate cancer experts at the Brady Urological Institute have created tools that help patients and doctors across the world assess risk and make treatment decisions. Has anyone sent Radiology (mpMRI) reports and images to Hopkins for Second Opinion Review? In the mean time my PSA was movingno longer static, but never back up to 6. Hoping that after I go through this that my advice to others will be able to guide them and that they can learn from my experience, as I feel I am gaining a solid foundation from both a practical and mental standpoint. Especially opinions other than those of the first Urologist you see. Greetings gentlemen! 4 Get a Second Opinion Dr. Jonathan Epstein explains the benefits of getting a pathology second opinion His second opinion just came back. Patient-initiated second medical consultations-patient characteristics and motivating factors, impact on care and satisfaction: a systematic review. In adjusted models, obtaining a second opinion was not associated with receipt of definitive treatment . )I contacted Dr Busch (still in Chattanooga at the time) and he called me directly to talk me off the ledge. Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. With no travel needed and no red tape, its easy to get a second opinion, all from the comfort of your home. 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. But in the spirit of disclosure for those of you with BPH a TURP can complicate a future Radical Prostatectomy (or possibly Cryo) and increase the risk of side effect risks. If you are diagnosed with a urologic cancer, including but not limited to the prostate, bladder, kidney, and testicular or urinary tract, its important to consider a second opinion. 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. The Johns Hopkins Brady Urological Institute is known around the world for its expertise in diagnosing and treating urologic conditions. Steve, Groucho was wrong when he said "i don't want to belong to any club that would have me as a member." The study was published online Nov. 7 in the journal Cancer. Second Opinion Results, Johns Hopkins biopsy reading of 2 slides sent by Sloan: Receiving a second opinion was not associated with perceived quality of prostate cancer care. During puberty, the body produces semen in a large number of cases, including enlarged prostate. You think your doctor is underestimating how serious your cancer is. 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. Younger men were more likely to cite wanting more information about their cancer and to see the best doctor as the reason to seek a second opinion . OTHER: None. Consult Fees In some cases, additional testing may be required. Two 1cc tumors, gleason score 3+4 each, one in each lobe. There is no extraprostatic extension. Our collaborative processes also extend to our colleagues at Johns Hopkins Medicine, a world-wide leader in cancer research. Does 3+4 at some point typically evolve into 4+3 and also serve as a trigger point for moving from AS to treatment? You receive a secure, private online consultation without leaving home. IMPRESSION: How to Get a Second Opinion Our team at Johns Hopkins has a dedicated service to interpretation of brain tumors and render second opinions on a daily basis. 3. 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. In the rare chance a baby needs highly specialized care, the team at Johns Hopkins is available to treat rare and complex conditions through breakthrough fetal procedures. We will give that a shot and see how it turns out. Treatment decisions for prostate cancer should not be rushed due to a mistaken belief that immediate treatment is required. Any score above 55 has a greater than 50/50 chance of finding clinically significant cancer. Prostate, left lateral apex: Sometimes, you may find out about treatment options you didnt know were available. Second opinions from urologists for prostate cancer: who gets them, why, and their link to treatment . 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. I also changed my diet to plant based food, started juicing, and started taking supplements (think Turmeric, Green Tea, etc.). Clipboard, Search History, and several other advanced features are temporarily unavailable. A second opinion can help you make an informed, confident decision about your medical care. Please don't hesitate to make any observations or ask questions. 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. Y'all are in my prayers! I was on disability from work the entire time (not that I was disabled, but as a pilot, I couldn't very well work and get treatment at the same time. They won't be offended, and they may even be able to recommend a specialist for you to see. Im also wondering why no one has scheduled me for MRI to see what biopsy missed. * Gleason Score: 4+5, Slide 4 (vs. Sloan's 3+4) Thanks, AHN patients have unprecedented access to the Johns Hopkins Center for Fetal Therapy. Accessibility We used multivariable logistic regression models to evaluate the relationship between second opinions and definitive prostate cancer treatment and perceived quality of care. Three lesions: 1) GS 6 involving 30% of one core; 2) GS 6 involving less than 5% in one core; and 3) GS 6 involving less than 5% in another core. You're more likely to develop prostate cancers that are more likely to spread. Radhakrishnan A, Grande D, Mitra N, Pollack CE. First of all we would like to emphasize that the health of our employees, our patients and their relatives is our first priority. My involvement is below maximum of 15% of core. 3. Those readings were reported on a second opinion by Dr. Epstein. Hillen MA, Medendorp NM, Daams JG, Smets EMA. When to move from Active Surveillance to Treatment for Prostate Cancer? Secondary Gleason grade: 4 An accurate diagnosis is essential to ensure the most effective treatment. For men with prostate cancer and who live in the United States, there are some highly regarded pathology labs from which you can obtain your second opinion. The prostate gland is slightly enlarged secondary to transition zone hyperplasia (25cc total) 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. I am already positively surprised that I am still alive 4.5 years after my diagnosis. 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. When people recommend going to a Center of Excellence, believe them. MEASUREMENTS: The percentage of tissue with carcinoma is 70% 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. The James Buchanan Brady Urological Institute, Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov. -------------------------------------------------------- Cleveland Clinics Virtual Second Opinions program connects you to an expert physician who specializes in your specific health needs. 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. 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. Bookshelf To learn more about how to get a Neuropathology second opinion, please visit our Neuropathology Division second opinions website. If pain is present, a digital rectal examination will reveal hard areas. So fingers crossed. ADC: mean 879 / median 839 / st dev 223 My prior Prolaris study (2018) before the FLA was very low risk. 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? I am relatively new to this forum and trying to educate myself as to my best course of treatment. We are vaccinating all eligible patients. Second Opinions An accurate diagnosis is essential to ensure that the correct and most effective treatment is given. 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. 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. Heres What You Need to Know, Prostate Cancer Spotlights in 2020: A Year in Review, Find out about PSMA PET Imaging on Prostate Pros Podcast. He is the past president of the International Society of Urological Pathology. No definitive evidence of distant metastatic disease is seen." I had the MRI in April 2021 and it showed a PI-RADS 4 lesion. So, I asked the Radiologist if she will schedule one for me. 2016 American Cancer Society. Urologists at the Johns Hopkins Brady Urological Institute can make the difficult process of deciding on a treatment plan easier. Epub 2017 Jun 12. My Oncotype rating was GPS 54, with a 26% chance of metastisis within 10 years. Unbelievable that this happened!!! Had third MRI in July 2019 this time at Mayo which I believe does a better job than SMIL. MRI RE-READ #3 (National Cancer Center of Excellence): Remember if you ship them include the following information: You May Like: Blood In Urine After Prostate Biopsy. Getting a second opinion can sometimes lead to a complete change in diagnosis (such as cancerous to benign or vice versa) in non-cancerous growths, inflammatory disorders, infections, cancer and other conditions. My understanding is that brachy is great for efficacy with less risk to the bowel and the same risk for incontinence and ED as other forms of radiation. A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. 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. Ramsey SD, Zeliadt SB, Fedorenko CR, Blough DK, Moinpour CM, Hall IJ, Smith JL, Ekwueme DU, Fairweather ME, Thompson IM, Keane TE, Penson DF. While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. 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. 180 days after treatment PSA was .50. In adjusted analyses, however, only age and education were significantly associated with obtaining second opinions from urologists. 2020 Jul 21;19(1):112. doi: 10.1186/s12904-020-00619-9. Does that mean my Gleason Score based on my biopsy would be less than a Gleason 6? This is the most common urinary tract problem in men under 50, and the third most common in men over 65. 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. E. Prostate, left mid, core biopsy: Let me know what everyone thinks if you see anything interesting or of note here or just have some advice. And it is OK to have paralysis by over-analysis. Experts believe that this study is the first in history to have achieved such results. I luckily found this webpage and I started reading everything I could get my hands on. Maybe lycopene and pomegranate have helped. Results: Ask your doctor for a copy of your complete medical record. BJU Int. Thank you! After a little experimenting I have been able to achieve a partial erection. Be sure to confirm your diagnosis at a center of excellence. Most choose treatment they originally planned to follow, study finds. Pathology reports are the opinion and interpretation of the individual pathologist viewing the tissue samples. Find more COVID-19 testing locations on Maryland.gov.
Bowdon High School Basketball Schedule,
University Of Manchester Summer Internship,
Upper Moreland Police Press Release,
Unsolved Murders In Santa Barbara Ca,
Alice In Wonderland Funeral Reading,
Articles J