Thomas Dubois Hormel, Mini Mandalorian Helmet, Katie Mccoy Net Worth, Articles J

MONDAY, Nov. 7, 2016 Second opinions have little impact on prostate cancer patients treatment decisions, new research suggests. Several friends rushed towards surgery and now wish they had the information he provides before they decided to go with such care. Without your support, I could easily have subjected myself to random biopsies that are risky, don't do a good job of finding lesions, and can mess up the clarity of the prostate for an MRI. transition zone. Dr. Nour is 100% sure that nothing has spread. Xia L, Talwar R, Chelluri RR, Guzzo TJ, Lee DJ. My mind goes all over the place as to why this is. More medical freakouts. By Dec 2019, my PSA reached 4.13. The results seemed fairly benign and my urologist and I decided to continue to monitor with 2 more PSA tests and then consider an MRI in April 2021. Diffusely decreased They seem to think it'll do the trick.I feel great and I am glad I chose this treatment path. The treatment of prostate cancer has evolved tremendously. Shore ND, Karsh L, Gomella LG, Keane TE, Concepcion RS, Crawford ED. 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. Ask your doctor for a copy of your complete medical record. P60 MD006900/MD/NIMHD NIH HHS/United States, T32 HL007180/HL/NHLBI NIH HHS/United States, K07 CA151910/CA/NCI NIH HHS/United States, P30 CA016520/CA/NCI NIH HHS/United States, K07 CA163616/CA/NCI NIH HHS/United States. John, I was diagnosed on 11 December, 2013. A. Prostate, right base, core biopsy: EDI am now 52 and not quite functioning like I did 4+ years ago. In those cases, patients are tremendously grateful for having received the advice and encouragement to get a second opinion, Dr. Matasar adds. 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. Over 80,000 specimen cases are seen at Johns Hopkins each year. Methods: Based on this forum, Im very lucky for this outcome. Men need to be educated on all treatment options to protect themselves from a biased industry. 5. 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. Also, their protocol would be another biopsy, but he was comfortable with the image and velocity of PSA that he didn't have to have one to start treatmentand I was pretty hesitant (given the image and PSA) to take ADT, and didn't see a biopsy changing my mind regarding treatment and/or ADT.Oh. 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. Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, The Sidney Kimmel Comprehensive Cancer Center. OTHER: None. Even if someone is being seen at a different academic center, the trials and other treatment options that we offer here may be different. No two cases of prostate cancer are alike and an accurate diagnosisis critical to developing the best treatment plan. Due to the spread of the Coronavirus worldwide and the first confirmed case of the Coronavirus disease in Turkey, the executive team of the Anadolu Medical Center has taken preventive measures to protect the patients and their relatives. Pathology report indicated additional presence of cells at right apex, but unclear whether intraprostatic incision or extraprostatic extension. (The pathology report from Cedars-Sinai kept my diagnosis at 3+4, but a second opinion at Johns Hopkins upgraded me to 4+3.) This is often the case when the primary physician advises an expensive treatment. A doctor at MSK can collaborate with another doctor to offer support and help ensure the best outcomes. I have had a CT of the pelvic area - negative and a whole body bone scan - negative. You receive a secure, private online consultation without leaving home. Second Opinions (Adults) For stem cell transplant, please call 1-773-702-1994. First 6 week PSA is undetectable. Are considering a treatment that involves significant risks, such as surgery. During puberty, the body produces semen in a large number of cases, including enlarged prostate. Also, their protocol would be another biopsy, but he was comfortable with the image and velocity of PSA that he didn't have to have one to start treatmentand I was pretty hesitant (given the image and PSA) to take ADT, and didn't see a biopsy changing my mind regarding treatment and/or ADT.Oh. I would appreciate hearing from that 2.8% out there who have an intraductal component. It is OK to not understand all the terminology. The primary goal is to be cured with the least toxic, most effective approach. The average age at the time of prostate cancer diagnosis is about 66. 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. What are your opinions of what that is, and where to get it? Getting a second opinion on a diagnosis can reverse a diagnosis or alter the treatment plan. My girlfriend lives 2 blocks from the Emory Proton Clinic.We prayed on it and overthought the crap out of it. Immediate means 6 weeks just to see his NP. It got discussions started and questions answered. But, after 4 drinks or if I'm tired/jet lagged I find that sleep is more appealing than sex. Epub 2018 Mar 28. Two 1cc tumors, gleason score 3+4 each, one in each lobe. His reasoning over the last couple of years is that the suspected lesion was not changing in size at all. 7. Are you sure you want to block this member? - Prostatic adenocarcinoma, Gleason score 3+4=7 (grade group 2, pattern 4: 5%) involving 1 of 2 cores (lateral core: 4 mm, 35%), 0.1 mm to the blue inked tissue edge With no travel needed and no red tape, its easy to get a second opinion, all from the comfort of your home. A biopsy was performed on 2/26. Your doctor is not sure what is wrong with you. Medical record collection from doctors and hospitals. Seems like a simple request. When people recommend going to a Center of Excellence, believe them. Cancer 2017;123:1027-34. 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. Covid turned the 1 year into 16 months and PSA tested at 7.44 in August 2020, followed by another referral back to the urologist. Lesions are all small or very small. You may choose to consider a second opinion if you: 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. He said that he saw what JHs was referring to but did not determine EPE for a variety of reasons. Many researchers believe PTEN present is a strong brake on Prostate volume: 17.58 cc I was on active surveillance after a FLA procedure done in 2018. The Johns Hopkins Brady Urological Institute is known around the world for its expertise in diagnosing and treating urologic conditions. When you get a diagnosis of breast cancer from your doctor, its not uncommon to get a second opinion. 4: Prostate, right medial base !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. Since I have gotten so much out of this forum, I thought Id provide my story to help others. 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. When first diagnosed with prostate cancer, your PCP will generally refer you to a urologist for a biopsy. Value of Second Opinion in Prostate Cancer Uncertain, Says Hopkins Study. Learn MoreFor more information about pathology second opinions, visit pathology.jhu.edu or call 877-546-1872. 5. Seminal vesicles: The seminal vesicles are normal and symmetrical bilaterally. I would really love to hear from you. sharing sensitive information, make sure youre on a federal Even if I go the radiation route, should I try for Proton radiation or some other type? Five years ago I had a TURP. Compared with other men, African-American men and men with a family history of the disease are at higher risk of developing prostate cancer. 2020 Dec 1;3(12):e2028320. There is no extraprostatic extension. We specialize in minimally invasive procedures to treat BPH, including: For selected BPH patients, our specialists also perform transurethral resection of the prostate , a procedure that requires no incisions and has a high rate of success. Second opinion Biopsy came after FLA G-9. * Perineural Invasion detected Being in Wisconsin, my insurance gives me the option of two hospitals to manage me. I've had what I would consider a fluctuating PSA since first tested in November 2018. Your current doctor will frequently suggest a second opinion, if only to confirm the recommended course of action. Jonathan Epstein, MD received his doctorate from Boston University. According to the study, one in every 600 diagnoses showed mistakes.This study only addressed major changes in diagnoses, such as a diagnosis of cancer being reversed to no cancer, says Johns Hopkins pathologist George Netto, M.D. I have searched the country for intervential radiologist that perform FLA on the prostate. 2016 American Cancer Society. I worked out every day. 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. Radhakrishnan A, Grande D, Mitra N, Pollack CE. I tried to send the samples out for genetic testing to Prolaris and Decipher, but there was an ordering error and they never went thru. Tumor Quantifications: Right mid anterior transition zone (PIRADS 2). Our gynecologic pathology team can also help determine if the tumor is localized or has metastasized from another region of the body. 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. doi: 10.1002/cncr.30412. (TZ) One suspicious area - lesion size: 2cm x 1.4 cm I'm trying to figure out why the PSA keeps rising. I talked with Dr. Epstein who expressed Johns Hopkins' conservative views to not underestimate GS 6 and to consider surgery and/or radiation that have been used successfully for many years in saving lives. Please enable it to take advantage of the complete set of features! The average age at the time of prostate cancer diagnosis is about 66. Benign Processes: He basically said it was possible, but that he did not agree. If the enlarged prostate is not completely removed, it will shrink. )As for side effectsI occasionally have some urgency/hesitancy having to pee. PROSTATE PROS Episode 6: Breakthroughs in Radiation PROSTATE ONCOLOGY SPECIALISTS, Like Man, Im Tired (Of Waiting): The How-to Guide for Men with Prostate Cancer PROSTATE ONCOLOGY SPECIALISTS, Considering Prostate Cancer Clinical Trials? Olver I, Carey M, Bryant J, Boyes A, Evans T, Sanson-Fisher R. BMC Palliat Care. They find that one of my 5-10% Gleason 6 core is actually a 50% Gleason 7(3+4) and the MRI was so cloudy with blood from original biopsy they said they couldnt determine much. -------------------------------------------------------- I suggest for all that hear, "you have cancer" that you seek more opinions! During your visit, our specialists will review your medical records, diagnostic tests and other information provided by you or your current physician. I sent a message to my urologist requesting my slides be sent to Dr. Epstein at Johns Hopkins for a second opinion and I also requested an Oncotype DX test to get an idea of risk for my low teal or basic teal cancer. Prostate, left medial base: My Oncotype rating was GPS 54, with a 26% chance of metastisis within 10 years. So the pathologist suggested a second opinion. Johns Hopkins Health - Second Opinions, Second Chances, Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, High Blood Pressure May Take Its Toll on Your Kidneys. Men often seek second opinions from urologists before they initiate treatment for their newly diagnosed prostate cancer. MM, Much to my dismay my 4th targeted biopsy Oct 12 revealed 5% G4 (upgraded from Grade Group 1 to 2 (Gleason 3+4 intermediate/favorable). 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. However, older men 75 years were the least likely to report obtaining a second opinion due to dissatisfaction with their initial urologist. 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. But I don't want to do a radical prostatectomy or radiation that would have large side effects now if the laser is a viable option given my data set. My only concerned was heavy metal poisoning and didn't know how long AS would be beneficial since I was starting at a young age. Luckily, his report co-coincided with the original QDx report. A enlarged prostate can also cause blockages in the urethra. Specimens Submitted: The other samples produced 4 more positive cancer cores for a total of 7 of 12 positives. undefined will no longer be visible to you including posts, replies, and photos. I made the appointments. Greatest dimension 0.7cm . 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. 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. Below is the link with instructions and the authorization form for you to use with your doctor. Epstein, who views about 12,000 slides a year, called for calm in my case and suggested another biopsy in six months. 3. For cancers that are less common, second opinions can offer more treatment options. One of the problems with second opinions is that insurers may not cover the expense. To schedule an in-person visit for a second opinion or to determine if a telemedicine consultation is possible, call: In addition to cancer, our urologic team provides second opinions regarding urinary stone disease, urinary tract reconstruction, incontinence, male infertility and sexual health, and many other urologic conditions or procedures. In some situations, insurers will even insist on a second opinion. Total Gleason score: 7 Patient preferences and urologist recommendations among local-stage prostate cancer patients who present for initial consultation and second opinions. Axial T1-weighted images of the pelvis show no bony or bulky nodal disease. 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. I am unfortunately "officially" joining the club after getting my biopsy results today. 2. 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? Expert review of your case by a Cleveland Clinic specialist. The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System. The Journal of the American Board of Family Medicine published a study in 2017 that found that many patients do not get a second opinion outside of their PCPs original referral2. The biopsy took 3 samples from the targeted region plus 16 sextant. That said, I have some questions that I derived, keeping in mind that 99% of what I have learned since February has come directly from this group: It hasn't let me down. HMOs usually try to diagnose and treat patients within their system because the more money the HMO spends on second opinions and treatment outside the HMO, the less money there is available for operation costs and profits. This teamwork ensures the best possible patient outcomes. Overall my PSA is between 4 and 10. I followed up with the original pathologist to compare and he was more forthcoming. Explore our state-of-the-art patient care facilities in the Sheikh Zayed Tower. MEASUREMENTS: About this time, I started reading this forum and my ignorance starts going away. Cancer. While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. So my question for you is have you ever heard of PRECISE and if so what should I make of it? And it is OK to have paralysis by over-analysis. The lesion also shows focal increased permeability. Have been diagnosed with a serious or rare health condition. Anyone else encounter something like this? 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. - T2 = 3/5 3/3 4K score 19% (high end of intermediate) Because every patient is different, there are several ways to approach prostate cancer treatment. Good Morning Brothers- Hello, I apologize upfront for the length of this post, but I was recently diagnosed with prostate cancer (T2C) and figure more information is better than not enough. We had the 3T MRI (no coil) and MRI guided biopsy at Sperling in NY, and then had a 2nd Opinion done by Johns Hopkins. With that alone, I would likely be a candidate for continued Active Surveillance. Negative cancer in lymph nodes, seminal vesicles, and all margins. It is not uncommon that two different pathologists looking at the same slide come to a different interpretation and opinion about what is in their microscope! )I contacted Dr Busch (still in Chattanooga at the time) and he called me directly to talk me off the ledge. They basically said it didn't matter. 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. Most reputable HMOs can, however, deliver state of the art treatment for most cancers. If pain is present, a digital rectal examination will reveal hard areas. Steve, Groucho was wrong when he said "i don't want to belong to any club that would have me as a member." This puts PCPs in a unique position to impact the treatment decisionif they only refer to urologists and not to radiation oncologists or medical oncologistssurgery is a likely treatment outcome. My profession for forty years was health actuary consultant, so I have a pretty fair understanding of health data, outcomes, and risks. First MRI done in June 2016 by Scottsdale Medical Imaging - nothing found. 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. I would love to hear from anyone who has been involved in the Chicago study. * 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! 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. Reasons for getting a second opinion include: You want to be sure you have explored all options. 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. Would it be rational to stay on AS until biopsy results show a higher volume of PCa for sampled cores (i.e.