";s:4:"text";s:15999:"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. You feel healthy, you arent in pain, you Below is the link with instructions and the authorization form for you to use with your doctor. 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. Director of Surgical Pathology- Johns Hopkins, http://pathology.jhu.edu/department/services/secondopinion.cfm, The guy I used along with everyone else is Jonathan Epstein, M.D. Following his residency in anatomic pathology at The Johns Hopkins Hospital in Baltimore, Maryland, and a fellowship in oncologic pathology at Memorial Sloan Kettering Cancer Center in New York., he then joined the staff at The Johns Hopkins Hospital and has been there his entire career. Based on the results, our experts can provide you with an individualized treatment plan before you leave. I suggest for all that hear, "you have cancer" that you seek more opinions! lesion. E. Prostate, left mid, core biopsy: 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. PREVIOUS MRI RESULTS (LOTS of them) My profession for forty years was health actuary consultant, so I have a pretty fair understanding of health data, outcomes, and risks. Over 80,000 specimen cases are seen at Johns Hopkins each year. Asking for your comments: Background: A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. You can call and speak with his assistant at: (410) 614-6330. At Another Johns Hopkins Member Hospital: Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, Prostate Cancer Treatment: What to Know About Active Surveillance. Fear, confusion and uncertainty set in. 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. 5. Prostate, left lateral base: This teamwork ensures the best possible patient outcomes. Who Should Request a Second Opinion? And just this week, 1 YEAR post treatment, it is .46. I appreciate any comments or insight that anyone wants to share. Whats right for you will depend on the stage of the cancer, your level of risk and your general overall health. I hope my story helps anyone out there just starting the process. 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. I have had a second opinion from Johns Hopkins that confirmed the initial pathology of gleason 3+4. 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? Cancer 2017;123:1027-34. Overall my PSA is between 4 and 10. This urologist can get you in for surgery next week. 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. The linear amount of tissue with carcinoma is 23 mm 4, Dr. Jonathan Epstein explains the benefits of getting a pathology second opinion. Dont Miss: Bladder Control After Prostate Surgery. Pathology reports are the opinion and interpretation of the individual pathologist viewing the tissue samples. Diffuse probable benign peripheral zone changes limit evaluation for 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. transition zone. I am unfortunately "officially" joining the club after getting my biopsy results today. 6 A study at the Johns Hopkins Health System found it was 3.4 times more common in Black Americans than in White Americans. Unbelievable that this happened!!! They are not objective. 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. Urologists are trained as surgeons, radiation oncologists administer radiation, and medical oncologists provide cognitive oversight and general management of the cancer. 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. 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. government site. Comments appreciated, As evidenced on this site, some studies indicate that GS 6 shouldn't even be classified as PCa and that it isn't aggressive. * Gleason Score: 3+3 (2 of 6 specimens) Using the Bullet Volume gives you gland of 25.55. It is best to begin by talking with the doctor who made your initial prostate cancer diagnosis. TRANSPERINEAL MRI GUIDED BIOPSY RESULTS With no travel needed and no red tape, its easy to get a second opinion, all from the comfort of your home. * Gleason Score: 4+5, Slide 4 (vs. Sloan's 3+4) The issues in my prostate from the first procedure onward have all been in the same area and the rest of my prostate from the first biopsy and subsequent MRIs onward have never shown any indications of cancer in other areas. However, many insurance and health care companies do pay for such opinions and acknowledge the importance of second opinions. This is why the prostate is important to the body. It starts many years ago. Similarly, among those who received definitive treatment, second opinions were not associated with receiving surgery. 2. PMC This fluid causes the prostate to swell and cause a number of bladder-related symptoms. Dr. Nour - Emory in Atlanta. His most-frequently cited first or last authored publications is Pathological and Clinical Findings to Predict Tumor Extent of Nonpalpable Prostate Cancer, published in JAMA, which established the criteria for active surveillance. We have a surgery date set up for the end of July at Johns Hopkins (our second opinion team).His stats:63yo, non smoker, 167lbs, Vegetarian/Vegan diet no other known health issuesWalks dogs for a living and cares for our small farmPSA 3.3 (Jumped from 1.6 in a year)Biopsy Scores 3+5, 4+3. - 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 Many researchers believe PTEN present is a strong brake on 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%). More medical freakouts. 1st opinion"Nonspecific sclerotic change of the right pubic bone with low-level radiotracer activity, favor degenerative change rather than osseous metastasis." It's a bit confusing since most experts now don't consider Gleason 6 to be a true cancer, so did i test positive in 2 cores or 4? Results: Epub 2018 Mar 28. All Gleason 6 (3+3). The Johns Hopkins Brady Urological Institute is known around the world for its expertise in diagnosing and treating urologic conditions. My question is regarding the results of an MRI guided biopsy into a distinct tumor vs. subsequent Oncotype Dx Results. The survey asked the men if they had opted for a second opinion from a urologist following their diagnosis of prostate cancer, and the reasons for the second opinion. 2: Prostate, right lateral base They won't be offended, and they may even be able to recommend a specialist for you to see. Identified an approximate 2 cm lesion of mostly Gleason 7 (3+4) with only 20% being 4, contained in prostate. Little is known about men with localized prostate cancer who seek second opinions, the reasons why, and the association with treatment and quality of care. B. Prostate, right mid, core biopsy: Surgical Delay and Pathological Outcomes for Clinically Localized High-Risk Prostate Cancer. Accessibility And by FAA Aeromedical Ruling, I'd need a few post procedure reports before being cleared to fly again.) I find that when I'm trapped in the cockpit not able to use the bathroom for a long time is when I experience that most. If the enlarged prostate is not completely removed, it will shrink. Negative cancer in lymph nodes, seminal vesicles, and all margins. First 6 week PSA is undetectable. It may be a new cancer, but it is more likely a recurrence since it is really near the ablation zone. Reasons for getting a second opinion include: You want to be sure you have explored all options. Based on this forum, Im very lucky for this outcome. Three lesions: 1) GS 6 involving 30% of one core; 2) GS 6 involving less than 5% in one core; and 3) GS 6 involving less than 5% in another core. Reinterpretation of imaging scans and lab tests. present in bladder. ADC: mean 879 / median 839 / st dev 223 In the mean time my PSA was movingno longer static, but never back up to 6. 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 . At that point I agreed to the TRUS biopsy which I had on October 10, 2020. Greatest dimension 2cm. At the Johns Hopkins Medical Institutions, he is Professor of Pathology, Urology, and Oncology the recipient of the Reinhard Chair of Urological Pathology and Director of Surgical Pathology. IMPRESSION: Your current doctor will frequently suggest a second opinion, if only to confirm the recommended course of action. 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. A biopsy was performed on 2/26. I am 58 and in very good health otherwise. Clipboard, Search History, and several other advanced features are temporarily unavailable. I had no idea there were second opinions and I didn't have a clue about Genomic testing, or even genetic testing. Urologists at the Johns Hopkins Brady Urological Institute can make the difficult process of deciding on a treatment plan easier. Discover what's to love about Charm City for yourself. Being in Wisconsin, my insurance gives me the option of two hospitals to manage me. fibromuscular stroma, anterior prostatic contour is smooth. I am an airline pilot with exposure to radiation, jet fuels/fumes, etc. My biopsy report does not mention a GS and the second opinion from Johns Hopkins did not list a GS either. In other words, the cancer is still contained within the prostate. BONES: No suspicious osseous Keeping a timeline and organized medical records is important because it can contribute to your treatment plan. Video consultation and written report from your expert. 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. No one at Hopkins has ever died of prostate cancer if he had Gleason 3 + 3 cancer." Greetings gentlemen! To learn your stage of prostate cancer, take the staging quiz on keytopc.com. - 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 Recently diagnosed a Gleason 3 + 3. There is no bony or bulky nodal disease in the pelvis Some of the more common treatments that you and your doctor may discuss include: Prostate cancer experts at the Brady Urological Institute have created tools that help patients and doctors across the world assess risk and make treatment decisions. 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. 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. One of the problems with second opinions is that insurers may not cover the expense. Race and ethnicity. I applaud Dr Scholz for his dedication and explanation of such a complex cancer, that has not had his common sense help available for men with prostate cancer. Dr. Albert Chang at UCLA appears to be the best in the biz for high dose rate (HDR) focal brachytherapy. They also determined there was extrapostatic extension because there was some fat in the sample that involved the cancer. I was confident I was making the right decision. Did robotic radical prostatectomy 1/25/12. I would feel much more comfortable, if the numbers stay the same, being involved in a recognized Active Surveillance Program. The presence of any G4 has been my trigger to seek treatment. There were several areas of interest - but nothing in seminal vesicles, lymph, or bones. Radiation oncologist of same group of doctors says to do IMRT (using Rapid ARC program) as precautionary treatment, regardless of PSA scores. 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. At this time, I am leaning towards Active Surveillance or FLA. AS would be my choice, except that a total of three lesions, on both sides of Peripheral Zone, makes this controversial. Does this also include HIFU, Cryoablation? Seek Perspective from a Range of Specialists. Lesion 2: Right mid anterior transition zone. My girlfriend lives 2 blocks from the Emory Proton Clinic.We prayed on it and overthought the crap out of it. Second opinions are more likely to be comprehensive, or inclusive of every possible perspective, when performed in a cancer center with a multidisciplinary team, which usually includes surgeons, oncologists, radiation therapists, and sub-specialist oncologists. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. Both Drs and nurses knew what they were doing and had lots of experience. I had two no-risk, non-invasive tests: a Free PSA with an adverse score of 9% and a PCA3 test with a disappointing 41. He was right. Am I missing anything? Some specialists have more expertise and more experience than others. Expert review of your case by a Cleveland Clinic specialist. Masks are required inside all of our care facilities. It also rules out Brachytherapy. The https:// ensures that you are connecting to the Unlike pathology labs in most hospitals, Jonathan Epstein's lab at Johns Hopkins has pathologists who specialize in reading prostate tissue samples. * Seminal vesicle invasion: None. 2.Tammy Jiang, Christian H. Stillson, Craig Evan Pollack, Linda Crossette, Miupdachelle Ross, Archana Radhakrishnan, and David Grande, How Men with Prostate Cancer Choose Specialists: A Qualitative Study, Journal of the American Board of Family Medicine: JABFM, 30(2), (2017): 220229. Over kill and redundancy I know, but it's my money, my prerogative. THANKS! The only prescriptions I take are for GERD (Protonix), cholesterol (Atvorstatin), and allopurinol for an episode of gout that I got while doing physical rehab for a bad tibia break (I shattered my tibia plateau 2/2020 and have pretty much recovered). I also had my PTEN test by META-MARK ( I don't have much to say about how I was treated by MM, but I won't be using their services again). ";s:7:"keyword";s:44:"johns hopkins prostate cancer second opinion";s:5:"links";s:189:"Richard Widmark Grandchildren,
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