In the mean time my PSA was movingno longer static, but never back up to 6. 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. Prostate volume: 17.58 cc Need guidance choosing from multiple treatment options. No extraprostatic extension. Visit and Like ZERO - The End of Prostate Cancer on Facebook, Sign up to receive emails and news from ZERO - The End of Prostate Cancer, Search prostate cancer clinical trials and studies. Y'all are in my prayers! Diffusely abnormal appearance of the prostate may reflect prostatitis, which can obscure underlying prostate cancer. * Prostate volume: 22 cc 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. A total of 2386 men responded to the survey (adjusted response rate, 51.1%). Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. I am 65 and in excellent general health. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Cleveland Clinics Virtual Second Opinions program connects you to an expert physician who specializes in your specific health needs. I have completed an exhaustive research effort on Prostate Cancer and PCa treatments. Getting A Second Opinion On Your Pathology Report - Cancer ABCs 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. First let me just say what so many others have previously stated, the thought of going on this journey alone is frightening, I cant imagine traveling this road alone. Second opinion Biopsy came after FLA G-9. Second Opinion Pathology | MD Anderson Cancer Center 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. * Should still go for a Johns Hopkins second opinion on the pathology or is that overkill since the first one was done at MSKCC? 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. Especially opinions other than those of the first Urologist you see. Slight BPH findings. Our gynecologic pathology team can also help determine if the tumor is localized or has metastasized from another region of the body. Dr also stated he was able to totally spare one of my nerves, but to get margin may have damaged one. Johns Hopkins said I have options of adjuvant radiation approach up to 3-4months or wait to see if there are two successive rises in PSA and then do "salvage" approach. 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%). Another DRE that results in identifying that my prostate is enlarged, but cant find and nodules. Asking for your comments: Second opinions from urologists for prostate cancer: who gets them, why, and their link to treatment . In adjusted models, obtaining a second opinion was not associated with receipt of definitive treatment . Men with a college education or beyond also were more likely to cite wanting more information about their cancer as a motivation for a second opinion . 1st opinion. In fact, additional biopsies revealed no additional cancer. Do I need a third opinion? I could not get a definitive answer from them on how much, how many cells, or any information. Surgical Delay and Pathological Outcomes for Clinically Localized High-Risk Prostate Cancer. Benign Processes: not hear all the viable treatment options or receive the most up to date ---------------------------------------------------- present in bladder. Patients are often under the mistaken notion that they have to pick between their oncologist and MSK, but thats often not the case, Dr. Matasar explains. Now its easier than ever to get the answers you need and peace of mind you deserve. I asked the urologist who did our Second Opinion at Johns Hopkins and although he thinks RP is the way to go (due to higher PSA of 10.18), he highly recommended Dr. Eggenger (Chicago). A second opinion is a review of the cancer diagnosis and the treatment recommendations of the physician who is treating the cancer by another, independent physician. 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. Sometimes, you may find out about treatment options you didnt know were available. A blocked urethra can also damage the kidneys. Benign Processes: Extracapsular extension: The prostatic capsule is preserved. There are three main types of doctors that manage prostate cancer: urologists, radiation oncologists, and medical oncologists. I have searched the country for intervential radiologist that perform FLA on the prostate. Based on the results, our experts can provide you with an individualized treatment plan before you leave. 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. FYI-We are also considering the trial at Princess Margaret Hospital in Toronto. You're also at greater risk of prostate cancer forming before age 50. Dont Miss: Can Prostate Problems Cause Burning Urination, Why Prostate Cancer Survivor John Shearron Thinks Its Important To Do Your Research | PCRI, Prostate Cancer Pathology in 2021 | Jonathan Epstein, MD | PCRI 2021 Conference, Johns Hopkins Prostate Cancer Second Opinion, treat rare and complex conditions through breakthrough fetal procedures, Function Of The Prostate Gland And Seminal Vesicles, Best Treatment For Intermediate Prostate Cancer, How Old Can You Be To Get Prostate Cancer, New Treatments For Stage 4 Prostate Cancer, Prostate Radiation Treatment Side Effects, Can Prostate Problems Cause Burning Urination, Prostate Cancer Spread To Skull Prognosis, Life Expectancy Stage 4 Prostate Cancer No Treatment, Diagnostic Procedures For Prostate Cancer. Benign prostatic tissue (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. Some men have minimal or no symptoms at all. Enter the last name, specialty or keyword for your search below. Medical record collection from doctors and hospitals. In terms of cancer, changes can be from cancer to benign (or vice versa) or from one type of cancer to another, which could have a significant impact on treatment and prognosis. NOTE: THINK THIS LOWERS MY PSA DENSITY SOME IF MY GLAND ISN'T a 17CC PEANUT! Patient-initiated second medical consultations-patient characteristics and motivating factors, impact on care and satisfaction: a systematic review. (I think that it was easier to see because Mayo's MRI technology and procedures are better than SMIL's.) Good pathology readings require experience and a high level of expertise. * Perineural Invasion detected Overall, obtaining second opinions was not associated with definitive treatment or perceived quality of cancer care. I would really love to hear from you. !I'll try editing a previous post and see if it reads like a journal instead of creating a new thread every update.I just got my PSA results and the numbers are still trending in the right direction. 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. And again, most of you tell me time is on my side, so I am comforted in hearing that. Any input on this would really be appreciated. 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. One to a 3+4=7 and the other to a 3+3=6. So, I made an appointment at Emory Proton Center (Atlanta, GA) and got their opinion. Also Check: Prostate Cancer Stage 7 Treatment. And just this week, 1 YEAR post treatment, it is .46. Seminal vesicles: The seminal vesicles are normal and symmetrical bilaterally. My urologist suggested a couple more PSA tests followed by an MRI. For all other cancer appointments, please call: 1-855-702-8222. Maybe lycopene and pomegranate have helped. My other option for treatment is either LDR or HDR brachytherapy. * Extracapsular extension: Possible involvement of the anterior probably organ confined disease. Now, though, encouraging animal data and preliminary studies in human patients are making some doctors feel optimistic. The treatment of prostate cancer has evolved tremendously. A second opinion can help you make an informed, confident decision about your medical care. More medical freakouts. 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. It is best to begin by talking with the doctor who made your initial prostate cancer diagnosis. These findings are suspicious for degenerative changes however a subtle/early metastatic lesion cannot be excluded and continued periodic follow-up is recommended." Depending on your location, you may be able to have a telemedicine consultation. With The Clinic by Cleveland Clinic, patients have access to Cleveland Clinics 3,500 specialists with extensive experience in all types of cancers. 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. Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, The Sidney Kimmel Comprehensive Cancer Center. It was easy. Prostate cancer is a malignant (cancerous) tumor of the prostate, a gland found only in men. Most people believe that pathology reports are always correct, accurate and that what the report says is carved in stone. There is hope. However, something is driving my PSA. Methods: In addition to providing a better understanding of your diagnosis, a second opinion can also shed new light on treatment options and give you confidence in how to proceed with your care. * Other 12 slides not sent It hasn't let me down. Similarly, among those who received definitive treatment, second opinions were not associated with receiving surgery. Tumor Quantifications: Johns Hopkins is home to many of the world's leaders in Pathology. Any score above 55 has a greater than 50/50 chance of finding clinically significant cancer. 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. Now Im still ignorant and dont really know a Gleason from a Duck, so when the Dr says your treatment is radiation or surgery Im devastated. - High grade prostatic intraepithelial neoplasia (HGPIN) He said that he saw what JHs was referring to but did not determine EPE for a variety of reasons. One of the problems with second opinions is that insurers may not cover the expense. My involvement is below maximum of 15% of core. Recovery from Prostate Cancer | Bills Story. Prostate, right lateral apex: I would love to hear from anyone who has been involved in the Chicago study. Asking about other experience with conflicting Prostate Biopsy Opinions. She put me in the hospital. Treatment decisions for prostate cancer should not be rushed due to a mistaken belief that immediate treatment is required. Extraprostatic extension: negative 7: Prostate, left lateral apex You receive a secure, private online consultation without leaving home. 2 cores from left base of 3+4=7 with only 5% involvement. No extraprostatic extension. I appreciate all the input because I am a little overwhelmed and confused as to the best course of treatment. My plan is to choose quality of treatment over cost of the treatment. If they have an enlarged colon, their physician can perform a TURP procedure. Thank you, After more than three years on active surveillance, I've pretty much decided to have focal brachytherapy for my prostate cancer. 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. undefined will no longer be visible to you including posts, replies, and photos. My PSA over time has been creeping up over time (1.8 - 5/16, 1.0 8/17, 2.68 8/18, 2.9 12/18, 3.28 2/19, 3.01 8/19, 3.65 2/20, 3.31 6/20, 3.88 12/20) but I was frankly a bit shocked when I received word that I have cancer. I did ask some questions about the study, if anyone is interested. The results of the MRI said they found a PYRAD 5 lesion, but did not find any cancer outside prostate. Just took time off and then life happened.Thanks in advance for the insights. Anyway, I'm reaching out to this group to see if anyone would be willing to chat with me about their brachytherapy experience at UCLA (even to talk me out of it). Some men may have an enlarged prostate but not notice it. Benign prostatic tissue First of all we would like to emphasize that the health of our employees, our patients and their relatives is our first priority. Laparoscopic prostatectomy: The prostate is removed with a miniature telescopic instrument, which allows for a quicker recovery, Robotic surgery: This breakthrough technology, which often is used for prostatectomy surgery, requires only a few small incisions. Find more COVID-19 testing locations on Maryland.gov. PELVIC LYMPH NODES: No adenopathy. At this point Im still ignorant about what I ought to be doing (MRI guided biopsy is what I should have gotten). John. Four weeks after a radical prostatectomy for prostate cancer, he was back in the pool. Some men may have an enlarged prostate but not notice it. radiation, active surveillance, surgery, hormone therapy, and more. 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. This site needs JavaScript to work properly. Seeking second opinions is becoming standard practice, and it is mandatory at Johns Hopkins. 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. Johns Hopkins Prostate Cancer Second Opinion government site. Metastasis. I would feel much more comfortable, if the numbers stay the same, being involved in a recognized Active Surveillance Program. I hope my story helps anyone out there just starting the process. 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, Also Check: How Old Can You Be To Get Prostate Cancer. 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. Remember if you ship them include the following information: You May Like: Blood In Urine After Prostate Biopsy. 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. I didn't study for the test and it's possible some morning activities might have affected my test score :) Thanks for Everyone's Help, Results: Prostate, left anterior MRI lesion: Is it done through my doctor or do I do it myself with sending CDs of the MRI? -------------------------------------------------------- Johns Hopkins Precision Medicine Center of Excellence for Prostate Cancer, Schaufeld Program for Prostate Cancer in Black Men, Read about the latest prostate cancer discoveries by our world-renowned researchers, Learn more about prostate cancer in our health library, Watch: What to expect during your post-surgery hospital stay. My new Dr however didnt order PSA so I asked him for one. You may also complete an online appointment request form and we'll respond to schedule an appointment. He also said I would tolerate any option well based on my age and health. Prostatic Adenocarcinoma So, I made an appointment at Emory Proton Center (Atlanta, GA) and got their opinion. Compared with other men, African-American men and men with a family history of the disease are at higher risk of developing prostate cancer. My biopsy report does not mention a GS and the second opinion from Johns Hopkins did not list a GS either. It is OK to not understand all the terminology. transition zone. There is no bony or bulky nodal disease in the pelvis Johns Hopkins Medical Laboratories 1620 McElderry St. Reed Hall Rm 315 Baltimore, MD 21205 Fax (410) 614-7712 Phone (410) 955-2405 8 am - 5 pm Normal LAB hours are: 5:30 am - 4:30 pm Mon-Fri More medical freakouts. When you review your pathology report and are going to be making important decisions, like treatment decisions, which will be based on the information from the pathology report. 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. 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've been on AS since April 2016. Seek Perspective from a Range of Specialists. I am at that critical juncture in which I at least need to formalize a plan, select a doctor/facility to work with, and continue my testing to make sure I have what I think I have. 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. ZERO - The End of Prostate Cancer Support Community. I had the MRI in April 2021 and it showed a PI-RADS 4 lesion. Epub 2018 Mar 28. I had a very bad experience with an incompetent nurse that did a catheter change. Bladder: Normal. Low post-void residual volume is ---------------------------------------------------------- In severe cases, a catheter may be required to relieve the symptoms. Masks are required inside all of our care facilities. Know Your Stage. John Hopkins Prostate Cancer Second Opinion I luckily found this webpage and I started reading everything I could get my hands on. Would you like email updates of new search results? Masks are required inside all of our care facilities. Even if someone is being seen at a different academic center, the trials and other treatment options that we offer here may be different. Epub 2017 Jun 12. Bethesda, MD 20894, Web Policies * Gleason Score: 3+4 (4 of 6 specimens), 14 specimens taken The site is secure. * 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! Comments appreciated, Generally, the symptoms can stabilize over time. If the problem is unresponsive to other treatments, your doctor may suggest a surgical procedure. Patient preferences and urologist recommendations among local-stage prostate cancer patients who present for initial consultation and second opinions. Second opinion on biopsy slides - malecare.org Here are seven tips for seeking second opinions for prostate cancer: 1. My most recent biopsy resulted in two cores with Gleason 4+3=7 and one with 3+3=6. Thank you! 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? The primary goal is to be cured with the least toxic, most effective approach. 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. Allow yourself the time to seek multiple opinions. 5. As soon as pathology slides were ready, Emory sent them to Dr. Epstein at Johns Hopkins. 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. 10. 8: Prostate, left lateral base * Seminal vesicle invasion: None. Your current doctor will frequently suggest a second opinion, if only to confirm the recommended course of action. 6. Prostate, left lateral apex: 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. Dr. Erick Walser at University of Texas Medical Center. Dr. Nour is 100% sure that nothing has spread. However, there are other cases when a second opinion results in a very different diagnosis or set of treatment recommendations. He was right. 2nd opinionBone Scan:"Mild increased activity is seen in the right symphysis corresponding to the abnormalities on the prior PET/CT examination. But if I include the 3+3=6 cores then 4 cores tested positive and that moves me into the basic teal category and no longer a strong candidate for AS. 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. One of the bits of advice the group regularly dispenses is for men to get a second and even a third opinion if you have doubts about the first opinions rendered by your urologist, or your pathologist, or your radiologist, its always okay to seek out a second opinion. Two 1cc tumors, gleason score 3+4 each, one in each lobe. 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. The people were great. And by FAA Aeromedical Ruling, I'd need a few post procedure reports before being cleared to fly again.) 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. 2. Two things you learn here is get a second opinion from Johns Hopkins on biopsy and get treated at Center of Excellence. Secondary Gleason grade: 4 intricate disease and not all doctors have the same amount of experience 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 second opinion is part of the education process that is critical for many cancer patients. Second opinions not likely to change prostate cancer treatment * Size: 1.1 cm 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. 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. If pain is present, a digital rectal examination will reveal hard areas. Greetings gentlemen! In order to give treatment for each patient with utmost security we would like to announce that currently there will be no visitors allowed.Please note that only one attendant per in-patients is permitted. In addition to providing a better understanding of your diagnosis, a second opinion can also shed new light on treatment options and give you confidence in how to proceed with your care. The researchers also found that patients who obtained second opinions because they wanted more information, were seeking the best doctor, or had been encouraged to do so by family or friends were more likely to undergo surgery. doi: 10.1001/jamanetworkopen.2020.28320. 4: Prostate, right medial base Tumor Quantifications:
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