johns hopkins prostate cancer second opinion10 marca 2023
Olver I, Carey M, Bryant J, Boyes A, Evans T, Sanson-Fisher R. BMC Palliat Care. Am I wrong? Prostatic Adenocarcinoma The neurovascular bundles are intact. IMPRESSION: Allow yourself the time to seek multiple opinions. Research was mixed on PINS, but in those days, many doctors saw them as likely to develop into cancer. 2nd opinionBone Scan:"Mild increased activity is seen in the right symphysis corresponding to the abnormalities on the prior PET/CT examination. During your visit, our specialists will review your medical records, diagnostic tests and other information provided by you or your current physician. You think your doctor is underestimating how serious your cancer is. B. Prostate, right mid, core biopsy: On the first scan (post FLA) a lesion was identified by the local radiologist that performed the scan, but the FLA radiologist that performed my procedure was over reading and monitoring my care and stated strongly that there was no cancer. Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. In unadjusted analyses, younger men , men with college-level education , and privately insured men and Medicare ) were more likely to obtain second opinions . He turned to the Top Gun of Prostate Pathology: Jonathan Epstein, MD, the guru of Gleason scoring at Johns Hopkins University in Baltimore. 2 of the 12 samples showed High Grade PIN and one area showed "suspicious for low-grade adenocarcinoma". 9: Prostate, left anterior MRI lesion Your Primary Care Physician referred you to your diagnosing urologist whom you now trust. Dont Miss: Bladder Control After Prostate Surgery. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. In circumstances where there may not be a single established standard of care, we can ensure the treatment plan integrates the most current, up-to-date data, Dr. Matasar says. PSA was 3.0 in 2011 and rose to 6.0 in late 2013. 4 Get a Second Opinion Dr. Jonathan Epstein explains the benefits of getting a pathology second opinion Peripheral Zone: The peripheral zone is of normal homogeneous prolonged T2 and there are no suspicious focal areas of A PSA test at time of biopsy revealed my PSA had risen to 6.5. 1st opinion"PYL PSMA PET/CT scan demonstrating foci of moderate to intense uptake in the prostate gland consistent with known prostatic cancer. Thank you! Low post-void residual volume is 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. If you are considering undergoing a specialized treatment, such as cancer surgery, within your HMO, it is important to inquire about the number of such procedures performed each year by the HMO and the results. However, there are also many more options for treatment and these options are more complicated than in the past. * Adjacent organ invasion: None. Keeping a timeline and organized medical records is important because it can contribute to your treatment plan. Several friends rushed towards surgery and now wish they had the information he provides before they decided to go with such care. Note respondents were able to choose more than one reason. 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. Further, among men with low risk disease, we did not observe a significant association between second opinions and receipt of definitive treatment or surgery. Learn MoreFor more information about pathology second opinions, visit pathology.jhu.edu or call 877-546-1872. Got my physical and normal DRE with new Dr. No issues identified. Prostate, left medial base: radiation, active surveillance, surgery, hormone therapy, and more. Men have plenty of time to seek multiple opinions and thoroughly research each option before making a decision. doi: 10.1002/cncr.30412. LESION 1 Reasons for obtaining a second opinion from urologists. 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. So my question for you is have you ever heard of PRECISE and if so what should I make of it? A fusion biopsy was performed in late May and I just received those results last Thursday. Our collaborative processes also extend to our colleagues at Johns Hopkins Medicine, a world-wide leader in cancer research. 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. John. We provide second opinions on the full range of gynecologic cancers: Ovarian Uterine Cervical Vulvar Vaginal Fallopian tube Placental tumors Some peritoneal cancers Note that I'm trying to get a second opinion from Johns Hopkins but Mayo, where the biopsy was performed, appears incapable of processing my request. I was offered to have my first biopsy sent to Johns Hopkins for second opinion and said why not? which came back with Gleason 9 three weeks after having the what we thought was G-7 ablated. P/ 310-827-7707 | F/ 310-574-4002 | MAIL@PROSTATEONCOLOGY.COM. I am doing my own research, but I am curious as to thoughts of the best possible MRI to obtain to give me the best chance at finding something the needle biopsy didnt find. In 2006 my PSA was .6. Not all cancers are the same and not all treatment plans are absolutely clear. My long-term prognosis appears to be good with minimal side effects. However, he also said it's treatable even at a 2cm size and the transition zone is a favorable spot. We can help with your case. In the United States, studies estimate 72 new cases of PN for every 100,000 people between the ages of 18 and 64 years old. Extracapsular extension: The prostatic capsule is preserved. 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. I was on active surveillance after a FLA procedure done in 2018. Compared to younger men, men 70-74 years old and men 75 years were less likely to obtain a second opinion whereas men with college graduate level education or beyond were more likely compared to men with less than high school level education. Without the genomic test I have I lesion 3+3=6 and another, 3+4=7, with less than 5% pattern 4, and an MRI that shows no ECE, no other suspicious lesions and questionable cellular EPE based upon disagreement of pathologists. One Johns Hopkins study showed that out of 14,000 men who had surgery and were found to have Gleason 6 cancer confined to the prostate, "zero of those 14,000 men had lymph node metastases. Jonathan Epstein, MD received his doctorate from Boston University. Cancer patients are encouraged to obtain second opinions before starting treatment. 6: Prostate, left medial base 1. 2016 American Cancer Society. Which Patients Report That Their Urologists Advised Them to Forgo Initial Treatment for Prostate Cancer? He recommended waiting and watching at that time due to the lower PSA reading. * Prostate size: 3.9 x 2.8 x 3. cm Confused about Pathology report and course of action, Phone Number for John's Hopkins Radioogy Second Opinion. PROSTATE ADDITIONAL FINDINGS: Benign prostatic lesion. and I have already proven to myself that my body is good at cell mutation, so I wanted to be careful.At the 3 year mark (6 months after last MRI), my PSA spiked to > 6. 1.Rebecca L. Siegel, Kimberly D. Miller, and Ahmedin Jemal, Cancer Statistics, 2019 CA Cancer J Clin. Didn't know if she had the catheter in far enough and not getting any urine through itwondered if she had inflated the balloon enough and wondering if it was the reason that I have developed an abscess. Masks are required inside all of our care facilities. But I refuse to sit still, I continue to research and to plan, as best I can. 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. 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. With world-renowned expertise, multidisciplinary specialists and the latest data, we partner with you to make informed decisions about managing your prostate cancer. Your current doctor will frequently suggest a second opinion, if only to confirm the recommended course of action. Keywords: 2011 Feb;29(1):3-9. doi: 10.1007/s00345-010-0602-y. Benign Processes: )As for side effectsI occasionally have some urgency/hesitancy having to pee. Get a Second Opinion What can a second opinion tell me? 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. Bookshelf It is still important to do your own research. 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? Those readings were reported on a second opinion by Dr. Epstein. Based on the results, our experts can provide you with an individualized treatment plan before you leave. Johns Hopkins second opinion identified a PI-RADS 4 Mayo Phoenix also reviewed MRI prior to targeted biopsy. After much discussion we both agreed that surgery was my best option and that he would do it at the end of July. Dr. Jonathan Epstein of Johns Hopkins University Hospital. They are not objective. -------------------------------------------------------- Grade Group: 1 Of course, my old school Urologist recommended surgeryHe, of course, knew the best robotic surgeons around.Anyway. ---------------------------------------------------------- Recovery from Prostate Cancer | Bills Story. Also these lesions did not abut or touch the wall of the prostate. So, I believe I made the right choice. Caused me to bleed heavily. Thanks, 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. 1. I could not get a definitive answer from them on how much, how many cells, or any information. To learn your stage of prostate cancer, take the staging quiz on keytopc.com. 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. Low volume post-void residual urine is present in the bladder. 180 days after treatment PSA was .50. AHN patients have unprecedented access to the Johns Hopkins Center for Fetal Therapy. There is no one-size-fits-all treatment for prostate cancer. Noted that some don't even include on report and should be looked as something to note but not obsess about. 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." Remember if you ship them include the following information: You May Like: Blood In Urine After Prostate Biopsy. However, something is driving my PSA. Greetings gentlemen! Avoiding obsolescence in advanced prostate cancer management: a guide for urologists. Careers. Unfortunately, the 12/20/20 PSA reading was higher and that led to an MRI on 2/2/21 when two lesions were discovered. Men often seek second opinions from urologists before they initiate treatment for their newly diagnosed prostate cancer. Benign Processes: The prostate gland is slightly enlarged secondary to transition zone hyperplasia (25cc total) This condition causes pain in the lower back and groin area, and may cause urinary retention. Be well. 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 . 6. I choose surgery over radiation because you can do surgery and then radiation, but it is almost impossible to do it the other way around. 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. And it is OK to have paralysis by over-analysis. 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. Surgery seems like overkill for me with too many risks for incontinence and permanent ED, am I overlooking something? 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. Sought Johns Hopkins second opinion of pathology slides. 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. Conflicting Prostate Biopsy OpinionsWhat to Do? One core had 5%, one 20%, and one 40%. Prostate, left anterior MRI lesion: Also, Oncotype subsequently invalidated my results because they found in the history that I had a prior FLA.