Starbound Carbon Dioxide, Bahamas Fishing Lodge For Sale, Joe Fresh Goods New Balance Replica, Articles J

The more often a doctor diagnoses and treats prostate cancer the more proficient they become. Urology. Second opinions from urologists for prostate cancer: who gets them, why, and their link to treatment . Nor did I have any idea that the 1 core had 20% involvement and <5% pattern 4 involvement. Prostatic Adenocarcinoma Treatment must be chosen based on stage and your 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. I measure PSA frequently, and it is stable and slightly declining with the last score at 5.5. Younger men also sought the 'best' doctor. National Library of Medicine 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. 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. 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. Surgical Delay and Pathological Outcomes for Clinically Localized High-Risk Prostate Cancer. We can help with your case. Many researchers believe PTEN present is a strong brake on AHN patients have unprecedented access to the Johns Hopkins Center for Fetal Therapy. And it is OK to have paralysis by over-analysis. I hope my story helps anyone out there just starting the process. 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. Overall, obtaining second opinions was not associated with definitive treatment or perceived quality of cancer care. John. Want confirmation about a diagnosis or treatment. I have selected Focal Laser Ablation as my future (soon) treatment. When Primary Care Providers (PCPs) Help Patients Choose Prostate Cancer Treatment. Based on this forum, Im very lucky for this outcome. The Stanford Medicine Online Second Opinion program offers you easy access to our world-class doctors. For cancers that are less common, second opinions can offer more treatment options. 2/23 PSA 4.7/fPSA 12% taken for 4K score (lab #2) Through the AHN Cancer Institute, you benefit from personalized treatment in your community, close to home, from your dedicated care team. 4: Prostate, right medial base 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. I did a book review with his first book for several veterans groups including the Americal Division Veterans Organization which with I served at age 19. I had a follow up 3T MRI guided biopsy on March 18 at Emory. I was confident I was making the right decision. Thanks, If I don't meter fluids before bed, I can expect to get up 3-4 times in the night.At this point, I am convinced I made the right treatment choiceOHFOR THOSE THAT DON'T KNOW, THE VA HAS MADE REPRODUCTIVE CANCERS A PRESUMPTIVE CONDITION FOR THOSE THAT SERVED IN MOST OF THE WAR ON TERROR LOCATIONS.Good luck fellas and my prayers are with all of you having to contend with this disease. Six weeks later I have the biopsy in his office and a week later I get the results. 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. 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. That is literally the first time I heard that term other than seeing it in my pathology report. Another type of prostate issue is chronic prostatitis, or chronic pelvic pain syndrome. Call us with any questions: 410-955-2405, ext. Interesting differences: (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. There are three main types of doctors that manage prostate cancer: urologists, radiation oncologists, and medical oncologists. It got discussions started and questions answered. PROSTATE LESIONS: Finally, things are set and I know what is going to happen. Radhakrishnan A, Grande D, Ross M, Mitra N, Bekelman J, Stillson C, Pollack CE. Prurigo Nodularis Cancer: What's the Link? - Verywell Health With AHN Cancer Institute, you already get a world-class cancer program with leading expertise, care, and outcomes. Both of which are normal volumes, the Bullet Volume is considered more precise in prostates smaller than 55ml. I assume it is not free. My most recent biopsy resulted in two cores with Gleason 4+3=7 and one with 3+3=6. When you get a diagnosis of breast cancer from your doctor, its not uncommon to get a second opinion. However, something is driving my PSA. The Radiation Oncologist said he would be comfortable waiting a little more, but he wasn't confident that I'd grow a target lesion, nor would I be able to wait years before having to do "something." Men often seek second opinions from urologists before they initiate treatment for their newly diagnosed prostate cancer. Getting a Second Opinion The best time to seek a second opinion is before you start treatment. * Membranous urethral length: 1.2 cm MRI obtained outsideon 04/16/2021. Second Opinions & Consultations - Brain Tumor | Johns Hopkins Pathology You receive a secure, private online consultation without leaving home. I worked out every day and it wasn't until the last week did I feel a bit fatiguedand experience a bit of urgency and hesitation having to peeflowmax fixed that right up!90 days after treatment my PSA came in at .56. This is often the case when the primary physician advises an expensive treatment. In the mean time my PSA was movingno longer static, but never back up to 6. How long do you have left? He said that he saw what JHs was referring to but did not determine EPE for a variety of reasons. It can: Confirm your original diagnosis and treatment plan Give you more detail about the type of breast cancer you have and stage it's in. Wow, I sound like a snob now! Overall, obtaining second opinions was not associated with definitive treatment or perceived quality of cancer care. Prostate Cancer | Johns Hopkins Brady Urological Institute Abstract Context: In men who develop an elevated serum prostate-specific antigen level (PSA) after having undergone a radical prostatectomy, the natural history of progression to distant metastases and death due to prostate cancer is unknown. I've been on AS for two years after my initial TRUS biopsy showed 3 cores 3+3 (10% volume) on Right side, and 2 cores 3+3 on Left side. Second opinions offer different things in different circumstances, Dr. Matasar says. They may defer to the recommendation of the specialist, or refer you to a doctor with limited prostate cancer experience. My plan is to choose quality of treatment over cost of the treatment. They agreed with the PI-RADS 4. Ex-Uro wanted to do biopsies and keep doing them until we find "it", even though he didn't know the size of the prostate nor had he ruled out prostatitis. Some specialize in reading only slides that come from a specific organ while others are generalists who read many different pathology slides from many different organ systems. In severe cases, a catheter may be required to relieve the symptoms. However, seeing him will be another 8 weeks, but he wants my biopsy slides (second opinion) before we meet. Epstein, who views about 12,000 slides a year, called for calm in my case and suggested another biopsy in six months. There is hope. Y'all are in my prayers! DIAGNOSIS: And again, most of you tell me time is on my side, so I am comforted in hearing that. There is no extraprostatic extension. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. Got the fiducials placed, the Space-OAR gel placed, mold made, and had the pre-treatment MRI and CT Scan. The purpose of starting this discussion is to gather peoples thoughts and opinions and actual experiences with Prostate Focal Laser Ablation. Have been diagnosed with a serious or rare health condition. 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? Seminal vesicles are normal. We have a consult on Friday with the 1st opinion doc to review all tests. 4. The James Buchanan Brady Urological Institute, Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, Precision Medicine Center of Excellence for Prostate Cancer, robotic-assisted radical laparoscopic prostatectomies, The Brady Urological Institute and the Johns Hopkins Kimmel Cancer Center take a, Our urologic surgeons have extensive experience performing, Our surgeons, oncologists and radiologists are also world leaders in prostate cancer research, giving patients access to the latest discoveries and. He adds that second opinions also can provide insight into topics like clinical genetics and family risk or issues related to complementary or integrative medicine approaches to manage symptoms. Everything seems to be on track to remove the cancer and be cured! Bethesda, MD 20894, Web Policies Further, among men with low risk disease, we did not observe a significant association between second opinions and receipt of definitive treatment or surgery. Benign prostatic tissue )I contacted Dr Busch (still in Chattanooga at the time) and he called me directly to talk me off the ledge. My experience at Johns Hopkins was awesome. 2016 American Cancer Society. 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. If you're seeking a second opinion on treatment (see below), the specialist you choose often will be able to order a pathology second opinion for you, through his or her hospital's pathology department. 3 months has passed, and its time for a PSA and a plan to have an MRI. Race and ethnicity. Also, infection was noted, so the current PSA is high in part due to prostatitis. Find more COVID-19 testing locations on Maryland.gov. The main purpose of the prostate is to produce semen, a milky fluid that sperm swims in. - Prostatic adenocarcinoma, Gleason score 3+4=7 (grade group 2, pattern 4: 5%) involving 2 of 2 cores (medial core: 3.5 mm, 30%; lateral core: 2.5 mm, 20%), 0.5 mm to the blue inked tissue edge (the closer) Eager to hear what everyone thinks or has anything they see in the report I wouldn't have thought of. So, Radiation Oncologist prescribed Cialis 5mg, daily. Your doctor is not a specialist in your type of . You're at greater risk if you're Black or of African ancestry. He also said perinueral invasion, but not extracapsular extension. If these do not work, your symptoms could progress and become chronic. __________________________________________________________________________July 2022I've neglected to make journal entries for a couple years, so I will recap below and continue with what I have done and what I have learned.In 2018, at the age of 48, after a routine physical that showed a PSA of (4.X) and after a TRUS biopsy, I was diagnosed with PCa. I have searched the country for intervential radiologist that perform FLA on the prostate. -------------------------------------------------------- In some situations, insurers will even insist on a second opinion. Second opinions offer different things in different circumstances, Dr. Matasar says. 3: Prostate, right medial apex 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. 2020 Dec 1;3(12):e2028320. That's the good news. mail@prostateoncology.com, 7 Tips for Seeking Second Opinions For Men with Prostate Cancer. 2nd opinionBone Scan:"Mild increased activity is seen in the right symphysis corresponding to the abnormalities on the prior PET/CT examination. The all-inclusive cost for a virtual second opinion for patients in the U.S. is $1,850. 1. A PSA test at time of biopsy revealed my PSA had risen to 6.5. Emotional outlook is fragile at times and straight clinical approach of doctors does not help. As some of you may know, I am a moderator for a support group for men on active surveillance for low-risk prostate cancer. That being said, they can be a beneficial member of the treatment team. Some men have minimal or no symptoms at all. Dr. Epstein has 744 publications in peer-reviewed literature and has authored 50 book chapters with a H-factor of 118. They seem to think it'll do the trick.I feel great and I am glad I chose this treatment path. A blocked urethra can also damage the kidneys. You think your doctor is underestimating how serious your cancer is. 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. Find more COVID-19 testing locations on Maryland.gov. Similarly, among those who received definitive treatment, second opinions were not associated with receiving surgery. My strong preference would be to do FLA again and monitor. 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. 2. When to move from Active Surveillance to Treatment for Prostate Cancer? Here are seven tips for seeking second opinions for prostate cancer: Before getting a second opinion, its important to know your stage of prostate cancer. 4. It was easy. He never sought treatment for the injury. What are you doing about it? With no travel needed and no red tape, its easy to get a second opinion, all from the comfort of your home. * Size: 1.1 cm Got the fiducials placed, the Space-OAR gel placed, mold made, and had the pre-treatment MRI and CT Scan. - DWI-ADC = 4/5 As I said, I am 58, so I would really like to preserve my quality of life for as long as possible, but the genomics report has me concerned. This condition causes pain in the lower back and groin area, and may cause urinary retention. 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. 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. Pathology reports are subjective. Only one core was diagnosed with a small amount of 3+3 (it was one of the three targeted cores). When I read the forums and questions on this site everyone mentions their Gleason Score from their biopsy. You can find out by reviewing your plan or by reaching out to your insurance company. Here are seven tips for seeking second opinions for prostate cancer: 1. Cancer. JAMA Netw Open. Ask us questions on this webpage. I am also doing a vegan diet with additional complementary substances. :) 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. 3. I had a very bad experience with an incompetent nurse that did a catheter change. 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. I could not get a definitive answer from them on how much, how many cells, or any information. Bookshelf 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. This doctor or team of doctors will review the following: The doctor then communicate their opinion regarding treatment to both the patient and the primary physician. 1: Prostate, right lateral apex And 2 cores from left apex of 3+3=6 with 10% involvement. ZERO - The End of Prostate Cancer Support Community. 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. (PZ) - normal * Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project SMIL radiologist reported nothing found. 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. Breast Cancer: When to Get a Second Opinion - WebMD In other words, the cancer is still contained within the prostate. 53 years old For this study, published in the journal Cancer, 2386 men in the greater Philadelphia area, who were diagnosed with prostate cancer between 2012 and 2014, responded to survey questions. You're also at greater risk of prostate cancer forming before age 50. I also changed my diet to plant based food, started juicing, and started taking supplements (think Turmeric, Green Tea, etc.). Prostate volume: 17.58 cc But I've had trouble getting Dr. Chang's office to provide any patient referrals. 3. By basing a treatment Other labs for second . Breast cancer.A new study suggests surgery may not always be necessary for all breast cancer patients. Greetings gentlemen! Im immediately referred to Urologist. I worked out every day. You May Like: Prostate Cancer External Beam Radiation Side Effects. Getting a second opinion on a diagnosis can reverse a diagnosis or alter the treatment plan. 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. * Asked and Dr. said he isn't overly concerned about perineural finding with the grade and it won't impact treatment options or overall prognosis. Following the advice of all on here, I need a team of doctors to manage my care. Receiving a second opinion was not associated with perceived quality of prostate cancer care. Does this also include HIFU, Cryoablation? 2011 Feb;29(1):3-9. doi: 10.1007/s00345-010-0602-y. - Perineural invasion is present Instructions for Second Opinion on Pathology (Gleason score) Secondary Gleason grade: 3 * Seminal vesicle invasion: None. I also had my PTEN test by META-MARK ( I don't have much to say about how I was treated by MM, but I won't be using their services again). Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. Prostate Cancer | Johns Hopkins Medicine 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. The problem is that all 3 pathologies noted an intraductal component. The ADT has daunting side-effects but he said offers some improved chances of eradication, any long-term downsides that I should consider? !I've pasted a previous update below for background.I just got my PSA results and the numbers are still trending in the right direction. Also indicated everything else was "organ confined." 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. We will give that a shot and see how it turns out. No one at Hopkins has ever died of prostate cancer if he had Gleason 3 + 3 cancer." Johns Hopkins Health - Second Opinions, Second Chances - Hopkins Medicine My question is--what importance do volume levels play in determining when to move from AS to treatment? I've been on AS since April 2016. Radiation oncologist of same group of doctors says to do IMRT (using Rapid ARC program) as precautionary treatment, regardless of PSA scores. Radhakrishnan A, Grande D, Mitra N, Bekelman J, Stillson C, Pollack CE. Four had 60-70%, five have between 5-10%. I then had the PHI test which showed PSA 8.70 and overall PHI 125.9. 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. 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. Enter the last name, specialty or keyword for your search below. Even at the age of 48, he thought I would be a good candidate for AS. Dr. Dan Sperling - New York. 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. Following application of the relevant exclusion criteria, 2365 respondents remained in the analytical cohort. Unfortunately, what you do not realize may harm you! Adenocarcinoma: Out of 12 cores, 9 are positive. I don't know if the FLA could affect the results, or if it was just done because it was not in the study parameters of the test. The TRUS biopsy is behind me, the second opinion from Johns Hopkins is behind me, and its time for next steps. My involvement is below maximum of 15% of core. * Gleason Score: 4+5, Slide 4 (vs. Sloan's 3+4) A small early-stage clinical trial found that a carefully selected group of patients who responded remarkably well to chemotherapy could skip surgery altogether. 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. The urologist offered surgery and radiation as options on 3/10 when we met. I applaud Dr Scholz for his dedication and explanation of such a complex cancer, that has not had his common sense help available for men with prostate cancer. 30%/40% or higher)? 1. Good Morning Brothers- The study included nearly 2,400 men in the Philadelphia area recently diagnosed with localized prostate cancer. Epub 2010 Oct 20. Prostate, right lateral apex: Prostate Cancer News, Reviews & Views: Second opinions 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. Lesion 1: Left mid-base transition zone. Consultation with your nurse care manager. 4, Dr. Jonathan Epstein explains the benefits of getting a pathology second opinion. IMPRESSION: Anyone with insight into this and advice? 3. About 80 percent of prostate cancers are diagnosed at a localized stage, which means that the cancer hasnt spread outside of the prostate. Second Opinion For Cancer Treatment And Care | CTCA | City of Hope How much is the fee for an opinion of my recent MRI? Getting A Second Opinion On Your Pathology Report - Cancer ABCs Benign prostatic tissue I guess TWO national centers of excellence are better than one? 2. I had no idea there were second opinions and I didn't have a clue about Genomic testing, or even genetic testing. Men have plenty of time to seek multiple opinions and thoroughly research each option before making a decision. First of all we would like to emphasize that the health of our employees, our patients and their relatives is our first priority. My long-term prognosis appears to be good with minimal side effects. Sought Johns Hopkins second opinion of pathology slides. Surabhi Dangi-Garimella, PhD. For this study, published in the journal Cancer, 2386 men in the greater Philadelphia area, who were diagnosed with prostate cancer between 2012 and 2014, responded to survey questions. After all, it seems like good idea to deal with your cancer sooner rather than later. The average age at the time of prostate cancer diagnosis is about 66. Your email address will not be published. MRI RE-READ #2 (VERY VERY well respected radiologist): Fear, confusion and uncertainty set in. * Gleason Score: 3+3 (2 of 6 specimens) When you get a diagnosis of breast cancer from your doctor, its not uncommon to get a second opinion. decision on a single medical opinion or the first appointment you get, you may Surprisingly, while one in nine men will get diagnosed with prostate cancer in their lifetime1, there are very few doctors who specialize exclusively in treating prostate cancer. But, ultimately decided on whole gland treatment using Proton Beam Radiation.So. I officially joined the club with diagnosis on March 21: three small lesions with a GS 6 on one side and both a GS 6 and a GS (3+4) 7 on the other side. - Prostatic adenocarcinoma, Gleason score 3+4=7 (grade group 2, pattern 4: 5%) involving 2 of 2 cores (combined: 10.5 mm, 40%), 0.2 mm to the blue inked tissue edge I wish the VA would be more informative about this disease they owe it to our veterans. The primary goal is to be cured with the least toxic, most effective approach. It will be interesting to see, I think. 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. Have you heard of PRECISE follow up score for an MRI? Not all men with Gleason 8-10 disease are going to do badly after Depending on your location, you may be able to have a telemedicine consultation. According to the doctor it is around 3 mm. No two cases of prostate cancer are alike and an accurate diagnosisis critical to developing the best treatment plan. 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. Utilize your primary care physicians as an un-biased resource to help you get second opinions from a range of specialists. Generally, the symptoms can stabilize over time. Axial T1-weighted images of the pelvis show no bony or bulky nodal disease.