johns hopkins prostate cancer second opinion

prostate cancer; quality of health care; second opinion; specialists; treatment. At that point I agreed to the TRUS biopsy which I had on October 10, 2020. BJU Int. Last year, Epstein's lab reviewed the pathology reports of 30,000 cases in which patients requested second opinions. Second Opinions for Cancer Care - UChicago Medicine Overall, obtaining second opinions was not associated with definitive treatment or perceived quality of cancer care. Hello everyone. Asking for your comments: Second opinion Biopsy came after FLA G-9. Treatment decisions for prostate cancer should not be rushed due to a mistaken belief that immediate treatment is required. Centro Diagnostico Italiano , Milan, Italy, Manfred Dietel, M.D.Institute of Pathology Charit, Humboldt University of Medicine, Berlin, Germany, Jonathan I. Epstein, M.D.The Johns Hopkins Medical Institutions, Baltimore, MD, Robert J. Kurman, M.D.The Johns Hopkins Medical Institutions, Baltimore, MD, Elizabeth Montgomery, M.D.The Johns Hopkins Medical Institutions, Baltimore, MD, Manuel Sobrinho-Simes, M.D.University of Porto, Porto, Portugal, Ronald S. Weinstein, M.D.University of Arizona, Tuscon, AZ, Franco VisinoniMilestone Medical Technologies, Bergamo, Italy, Read Also: Nhs Prostate Cancer Risk Calculator. Second opinions from urologists for prostate cancer: who gets them, why, and their link to treatment . - Benign prostatic tissue I luckily found this webpage and I started reading everything I could get my hands on. 2011 Feb;29(1):3-9. doi: 10.1007/s00345-010-0602-y. You're more likely to develop prostate cancers that are more likely to spread. Doctors are skilled at pitching the treatment they specialize in. Learn more through his bio: Progress in the field.In recent years, advancements in research have changed the way cancer is treated. I'll post the whole thing, my doc and my own comments, and then cut/paste all my MRI results in case anyone REALLY liked data. Not all cancers are the same and not all treatment plans are absolutely clear. Unable to load your collection due to an error, Unable to load your delegates due to an error. Four had 60-70%, five have between 5-10%. T2W MRI score= 2, DW MRI score= 3, DCE MRI score=positive The percentage of tissue with carcinoma is 70% Brachytherapy Experience with Dr. Albert Chang at UCLA? You May Like: Prostate Radiation Treatment Side Effects. Second round of Radiation Therapy - t - Advanced Prostate The review process normally takes several days, after which we will send your slides and other materials are returned. 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. FOIA Two 1cc tumors, gleason score 3+4 each, one in each lobe. Study after study confirms that doctors favor the treatment they are trained to do urologists typically recommend surgery and radiation oncologists recommend radiation. Time moves fast when dealing with cancer, but Doctors dont. Why It's Worth Seeking a Second Opinion for Prostate Cancer The ADT has daunting side-effects but he said offers some improved chances of eradication, any long-term downsides that I should consider? The lesion also shows focal increased permeability. I had FLA done after first biopsy which staged me at 3+4 = 7. Many thanks for that. Experts believe that this study is the first in history to have achieved such results. 7 Tips for Seeking Second Opinions For Men with Prostate Cancer Dr also stated he was able to totally spare one of my nerves, but to get margin may have damaged one. The TRUS biopsy is behind me, the second opinion from Johns Hopkins is behind me, and its time for next steps. SMIL radiologist reported nothing found. It got discussions started and questions answered. Tumor Quantifications: There are also many reasons why you may want to seek another opinion during the course of your cancer care. * Gleason Score: 3+4 (4 of 6 specimens), 14 specimens taken 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. This condition causes pain in the lower back and groin area, and may cause urinary retention. However, there are also many more options for treatment and these options are more complicated than in the past. Olver I, Carey M, Bryant J, Boyes A, Evans T, Sanson-Fisher R. BMC Palliat Care. The primary goal is to be cured with the least toxic, most effective approach. Axial T1-weighted images of the pelvis show no bony or bulky nodal disease. 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. We experienced information overload and decision/analysis paralysis. Netto points to prostate cancer as an example: If your diagnosis changes from a higher grade to a lower grade cancer, it could mean having the option to avoid radical treatment.Seeking second opinions is becoming standard practice, and it is mandatory at Johns Hopkins. Second opinion Johns Hopkins? - Prostate cancer Prostate dimensions: 4.1 x 2.8 x 3.4 cm My girlfriend lives 2 blocks from the Emory Proton Clinic.We prayed on it and overthought the crap out of it. Because every patient is different, there are several ways to approach prostate cancer treatment. The treatment of prostate cancer has evolved tremendously. We are vaccinating all eligible patients. You may be concerned that the cancer will grow rapidly out of control before you are able to get a second opinion. About 60% of prostate cancers occur in people older than 65. His reasoning over the last couple of years is that the suspected lesion was not changing in size at all. Possible additional organ confined malignant lesion in right apex Some men will have a very enlarged prostate, whereas others will have a mild enlargement. Explore our state-of-the-art patient care facilities in the Sheikh Zayed Tower. 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. FAX 310-574-4002 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). Assessment categories for this lesion: Luckily, his report co-coincided with the original QDx report. Therefore, the value of these second opinions remains unknown. Dr. Epstein has 744 publications in peer-reviewed literature and has authored 50 book chapters with a H-factor of 118. This is the most common urinary tract problem in men under 50, and the third most common in men over 65. Get a Second Opinion Masks are required inside all of our care facilities. As a Gleason 3 + 3, with 8 of 12 positive cores all with less than 30% cancer, and bilateral spread, I have determined that I cannot trust a blind biopsy in and of itself. Peripheral Zone: The peripheral zone is of normal homogeneous prolonged T2 and there are no suspicious focal areas of Now the oncologist wants to perform a PSMA Pet Scan. Get a Urology Second Opinion | Johns Hopkins Brady - Hopkins Medicine We are vaccinating all eligible patients. Receiving a second opinion was not associated with perceived quality of prostate cancer care. However, seeing him will be another 8 weeks, but he wants my biopsy slides (second opinion) before we meet. Other labs for second . Over kill and redundancy I know, but it's my money, my prerogative. I had the slides reviewed at Johns Hopkins and 1 of the HG PIN cores was changed to suspicious for adenocarcinoma while another HG PIN core was changed to benign. After sending off all of our records, CD of MRI and path reports, my husband is booked for screening in December. Consultation with your nurse care manager. Reinterpretation of imaging scans and lab tests. 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. has now confirmed this assumption through a careful retrospective analysis of data from > 450 men whose records could be identified in the SEARCH database, all of whom received surgical treatment for Gleason 8 to 10 prostate cancer. Careers. Johns Hopkins Prostate Cancer Doctors - HealthyProstateClub.com 2/13 PSA 5.2/fPSA 12.5% taken AFTER DRE (negative DRE) (lab #1) 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. Every year I got a PSA and DRE during my annual physical. If I am rested, I find that I am more ready than if I am not. 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. Getting a second opinion on a diagnosis can reverse a diagnosis or alter the treatment plan. Since I have gotten so much out of this forum, I thought Id provide my story to help others. One of the problems with second opinions is that insurers may not cover the expense. Getting a second opinion on a diagnosis can reverse a diagnosis or alter the treatment plan. 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. We surveyed men who were diagnosed with localized prostate cancer in the greater Philadelphia area from 2012 to 2014. Even if someone is being seen at a different academic center, the trials and other treatment options that we offer here may be different. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. * Sloan only sent partial cores, slides 1 and 4. But I've had trouble getting Dr. Chang's office to provide any patient referrals. In adjusted models, obtaining a second opinion was not associated with receipt of definitive treatment . 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. (Recommended by my oncologist, Dr. Mark Scholz.) Cleveland Clinics Virtual Second Opinions program connects you to an expert physician who specializes in your specific health needs. They did 9 patients in Phase I and there have been 12 so far in Phase II. doi: 10.1136/bmjopen-2020-044033. If these do not work, your symptoms could progress and become chronic. 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. - 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 Value of Second Opinion in Prostate Cancer Uncertain, Says - AJMC While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. Then about a month later I started 28 fractions of Proton Radiation.It was painless. No extraprostatic extension. I still have some urgency and frequency issues, but I am not complaining too bad. * Location: Right, anterior, apex, peripheral zone 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. 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. - DCE = (+) 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. Some pathologists have more experience than others. 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. Even if someone is being seen at a different academic center, the trials and other treatment options that we offer here may be different. But, ultimately decided on whole gland treatment using Proton Beam Radiation.So. Is there such a thing as having a team that isnt equipped with the best equipment nor the most experienced radiologists? Some men have minimal or no symptoms at all. Metastasis. There is no bony or bulky nodal disease in the pelvis Will these places of excellence consider me, or am I bound to my regular doctor for insurance purposes? BASE DATA: And thanks again for making this such a great support group! Prostate, right lateral base: 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. Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. Benign Processes: Many researchers believe PTEN present is a strong brake on Diffuse probable benign peripheral zone changes limit evaluation for Following application of the relevant exclusion criteria, 2365 respondents remained in the analytical cohort. It is best to begin by talking with the doctor who made your initial prostate cancer diagnosis. P/ 310-827-7707 | F/ 310-574-4002 | MAIL@PROSTATEONCOLOGY.COM. - Prostatic adenocarcinoma, Gleason score 3+4=7 (grade group 2, pattern 4: 10%) involving 2 of 2 cores (medial core: 0.5 mm, 4%; lateral core: 1.5 mm, 10%), 1 mm to the blue inked tissue edge (the closer) I appreciate any comments or insight that anyone wants to share. Men often seek second opinions from urologists before they initiate treatment for their newly diagnosed prostate cancer. HMO members may also be discouraged from trying expensive treatments that have only a small chance of success, even if that chance is real. 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. Second Opinions & Consultations - Johns Hopkins Pathology I worked out every day. And it is OK to have paralysis by over-analysis. Remember if you ship them include the following information: You May Like: Blood In Urine After Prostate Biopsy. Prostate cancer is the second-most diagnosed cancer in American men. Second opinions from urologists for prostate cancer: Who gets - PubMed There are so many different departments at Hopkins that I don't know the optimal department to contact. * Prostate volume: 22 cc With no travel needed and no red tape, its easy to get a second opinion, all from the comfort of your home. If the enlarged prostate is not completely removed, it will shrink. While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. Based on the results, our experts can provide you with an individualized treatment plan before you leave.

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