doi: 10.1002/cncr.30412. I didn't study for the test and it's possible some morning activities might have affected my test score :) Same with the amount of how much pattern 4. Im currently 67 years old. 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 . Urology. 1. Anyone else encounter something like this? Am I missing anything? John. Thank you for your participation! Now the oncologist wants to perform a PSMA Pet Scan. I can do radiation as a monotherapy. When I read the forums and questions on this site everyone mentions their Gleason Score from their biopsy. By basing a treatment My direct phone (mobile) number is 703-992-3662, or you can private message me via this platform. The Radiation Oncologist knew of Dr Busch (by now in Alpharetta, GA) and spoke highly of him. - DWI-ADC = 4/5
To learn more about how to get a Neuropathology second opinion, please visit our Neuropathology Division second opinions website. Low post-void residual volume is LESION 1 We experienced information overload and decision/analysis paralysis. 2017 May-Jun;30(3):298-307. doi: 10.3122/jabfm.2017.03.160359. About 80 percent of prostate cancers are diagnosed at a localized stage, which means that the cancer hasnt spread outside of the prostate. - DCE = (+) I've also read that some study's have shown that intraductal may be resistant to hormonal therapy, radiation and/or chemo. Best practices dictate that you obtain a second confirmatory pathology evaluation. information. 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%). 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. Overall, obtaining second opinions was not associated with changes in treatment choice or with improvements in how patients viewed their quality of cancer care. 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. I am an airline pilot with exposure to radiation, jet fuels/fumes, etc. * Sloan only sent partial cores, slides 1 and 4. Required fields are marked *, PHONE 310-827-7707 - High grade prostatic intraepithelial neoplasia (HGPIN) Does this also include HIFU, Cryoablation? FOIA That being said, they can be a beneficial member of the treatment team. I am 65 and in excellent general health. Notice of Privacy Practices(Patients & Health Plan Members). The majority had lower risk tumors and clinical staging of 1 40% sought second opinions with about half having more than one reason Men seeking second opinions tended to be younger and better educated citing the need for more information as their reason. It is still important to do your own research. There is no extraprostatic extension. Some men have minimal or no symptoms at all. When I inquired with the oncologist that I had selected for my therapy before receiving the second opinion whether I would be a candidate for Active Surveillance considering the downgrading, she said 'no' due to the intraductal component. Thankfully, prostate cancer is extremely slow growing. -------------------------------------------------------- If its a common cancer with a well-established standard of care, they can offer insight into clinical trials or novel treatments that may be better than the standard. He also said I would tolerate any option well based on my age and health. Accessibility Patient-Driven Second Opinions in Oncology: A Systematic Review. An accurate diagnosis is essential to ensure the most effective treatment. Slightly It is OK to not understand all the terminology. Both of which are normal volumes, the Bullet Volume is considered more precise in prostates smaller than 55ml. 4. P/ 310-827-7707 | F/ 310-574-4002 | MAIL@PROSTATEONCOLOGY.COM. One core had 5%, one 20%, and one 40%. It works. Urologists at the Johns Hopkins Brady Urological Institute can make the difficult process of deciding on a treatment plan easier. One of the problems with second opinions is that insurers may not cover the expense. Suspicion for malignancy left anterior base-to-apex transition zone; Secondary Gleason grade: 4
Do second opinions matter in prostate cancer care? - ecancer Who should I contact at Johns Hopkins to get a second opinion on a biopsy? They did 9 patients in Phase I and there have been 12 so far in Phase II. mail@prostateoncology.com, 7 Tips for Seeking Second Opinions For Men with Prostate Cancer. Thanks to all of you for sharing! Medical record collection from doctors and hospitals. Getting a second opinion on a diagnosis can reverse a diagnosis or alter the treatment plan. 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. Ask us questions on this webpage. 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. What are you doing about it? An official website of the United States government. In severe cases, a catheter may be required to relieve the symptoms. Axial T1-weighted images of the pelvis show no bony or bulky nodal disease. Get a Second Opinion What can a second opinion tell me? Olver I, Carey M, Bryant J, Boyes A, Evans T, Sanson-Fisher R. BMC Palliat Care. Bookshelf I am 62 years old. We are vaccinating all eligible patients. There is no extraprostatic extension. I am doing one in 6 weeks, regardless. We will then prepare a written recommendation regarding your treatment plans or options. They hesitated calling it a TARGET LESION, but scored it PIRADS 4. So, I also sent this MRI result to Johns Hopkins for a second opinion. 2. 3. 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.
Prostate Cancer | Johns Hopkins Brady Urological Institute 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." The total number of cores with carcinoma is 3 My diagnosis is T2c, Gleason 7 (3+4). MRI RE-READ #1 (well known radiologist, but free advice over phone, but no written report): National Library of Medicine IMPRESSION: Nor did I have any idea that the 1 core had 20% involvement and <5% pattern 4 involvement. Two from one lesion were positive as was one of the two from the other. Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, The Sidney Kimmel Comprehensive Cancer Center. So, I asked the Radiologist if she will schedule one for me. C. Prostate, right apex, core biopsy: Greatest dimension 0.7cm . There are also many reasons why you may want to seek another opinion during the course of your cancer care. Lesion 1: Left mid-base transition zone. * Seminal vesicle invasion: None. Here are the details: asymmetric central zone tissue more pronounced on the left. Because every patient is different, there are several ways to approach prostate cancer treatment. The out-of-pocket cost may be in the $300 range (insurance may not cover it), and it is a simple matter to call your urologist to forward the slides to them. Benign prostatic tissue 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. __________________________________________________________________________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. 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. NONE of the many radiation oncologists, surgeons or urologists I've spoken with in my journey have ever mentioned the term to me so I had to look it up. The peripheral zone has a patchy signal pattern. 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. While I have three lesions, they are small and, without 3T mp MRI, might not have been discovered. Please enable it to take advantage of the complete set of features! Blessings. 2020 Dec 1;3(12):e2028320. They agreed with the PI-RADS 4. * He said probably not candidate for watchful waiting because of tumor volume shown and seen on MRI. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. Many researchers believe PTEN present is a strong brake on Some men have minimal or no symptoms at all. I still have some urgency and frequency issues, but I am not complaining too bad. doi: 10.1002/cncr.30412. Cancer patients are encouraged to obtain second opinions before starting treatment. The percentage of tissue with carcinoma is 45% I am already positively surprised that I am still alive 4.5 years after my diagnosis. 1. government site. If I am rested, I find that I am more ready than if I am not. He also said perinueral invasion, but not extracapsular extension. 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. This has raised some questions on all the scans so far. Whats right for you will depend on the stage of the cancer, your level of risk and your general overall health.
Second round of Radiation Therapy - t - Advanced Prostate PROSTATE LESIONS: NOTE: THINK THIS LOWERS MY PSA DENSITY SOME IF MY GLAND ISN'T a 17CC PEANUT! A doctor may prescribe surgery or perform an endoscopic procedure. * IF ANYONE reading this doesn't believe in the value of MRI first and targeted biopsy next then take note that my systematic biopsy cores showed 0 positive in 8 cores and my MRI guided core samples were 6 for 6 being positive! While I now concluded we need to find "it", I researched the best approach to see what is really going on and to do this safely. Overall, nearly 80% of men received definitive treatment 76.5% of men who obtained a second opinion from a urologist received definitive treatment compared to 81.6% who did not . Intensity: min 148 / Max 459 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. 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. Details are here: Many men name the diagnosing urologist as their treating doctor and do not seek other opinions. 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. Symptoms include leaking and discomfort. sharing sensitive information, make sure youre on a federal Total Gleason score: 7 Either the patient or the primary physician can initiate the process of getting a second opinion. I am also not comfortable making a decision based upon 1 genomics test, when my other prior test(s) disagrees and the gleason score disagrees. 2. Has anyone sent Radiology (mpMRI) reports and images to Hopkins for Second Opinion Review? Research was mixed on PINS, but in those days, many doctors saw them as likely to develop into cancer. There is no bony or bulky nodal disease in the pelvis After applying exclusion criteria, the final analytic cohort included 2365 respondents. EVERY DAY, they'd take a low dose X-RAY and low dose CT to align the fiducials and ensure my bladder was full and the bowel was empty. They seem to think it'll do the trick.I feel great and I am glad I chose this treatment path. 3. If its a common cancer with a well-established standard of care, they can offer insight into clinical trials or novel treatments that may be better than the standard. Grade Group: 1 Prostate, left anterior MRI lesion: But was able to walk right into the JH Urology clinic for immediate treatment (flushing of bladder cleared everything up). Following application of the relevant exclusion criteria, 2365 respondents remained in the analytical cohort. 1. 5/10 PSA 4.2/fPSA 9% taken at MSKCC (lab #3) Thanks, Remember if you ship them include the following information: You May Like: Blood In Urine After Prostate Biopsy. We surveyed men who were diagnosed with localized prostate cancer in the greater Philadelphia area from 2012 to 2014. Prostate cancer is the second-most diagnosed cancer in American men. I luckily found this webpage and I started reading everything I could get my hands on. Conflicting Prostate Biopsy OpinionsWhat to Do? 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. Also Check: Prostate Cancer Stage 7 Treatment. Pathology reports are subjective. This condition causes pain in the lower back and groin area, and may cause urinary retention. It will be interesting to see, I think. 2/23 PSA 4.7/fPSA 12% taken for 4K score (lab #2) Surgeon wants next PSA in 3 months. Treatment options include immunotherapy, 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. Below is the link with instructions and the authorization form for you to use with your doctor. This championship swimmer sought a second opinion at Johns Hopkins. And, even working in a fairly technical field myself, I was amazed at the technology and precision of that Proton Machine. * Gleason Score: 4+5, Slide 4 (vs. Sloan's 3+4) Biopsy in 12/27/11 showed 3/14 cores, Gleason 6 with PSA of 4.5.
Second Opinions in Prostate Cancer - American Council on Science and Health If you have received a diagnosis or recommendation for treatment and want another opinion, our service can help you make a more informed decision. But, ultimately decided on whole gland treatment using Proton Beam Radiation.So. Only one core was diagnosed with a small amount of 3+3 (it was one of the three targeted cores). Dr. Dan Sperling - New York. Extracapsular extension: The prostatic capsule is preserved. Family history of prostate cancer. I am meeting with a multidisciplinary team of docs on March 18 at St. Joe's in Atlanta. Another DRE that results in identifying that my prostate is enlarged, but cant find and nodules. 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. So the pathologist suggested a second opinion. Of course that was before I found this webpage and I really didn't know what 1 core of 18 samples showing 3+4=7 Gleason meant. SO. 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. Last year, Epstein's lab reviewed the pathology reports of 30,000 cases in which patients requested second opinions. And again, most of you tell me time is on my side, so I am comforted in hearing that. feel the clock ticking. The people were great. )I contacted Dr Busch (still in Chattanooga at the time) and he called me directly to talk me off the ledge. Dr stated that after seeing my muscles on the inside during operation he would have predicted this. I frequently make a 2 hour car ride and I have to stop about 25% of the time and when I don't, the urgency is a bit more evident and with the urgency come some hesitancy, but not terrible. Even at the age of 48, he thought I would be a good candidate for AS. I have had a second opinion from Johns Hopkins that confirmed the initial pathology of gleason 3+4.