3. Men often seek second opinions from urologists before they initiate treatment for their newly diagnosed prostate cancer. Because I had an implant in my ear, they would only give me a 1.5T MRI. Read Also: Long Term Side Effects Of Brachytherapy For Prostate Cancer. Another type of prostate issue is chronic prostatitis, or chronic pelvic pain syndrome. 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. There is no extraprostatic extension. In severe cases, a catheter may be required to relieve the symptoms. Benign Processes: 1st opinion"PYL PSMA PET/CT scan demonstrating foci of moderate to intense uptake in the prostate gland consistent with known prostatic cancer. 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. It hasn't let me down. * Gleason Score: 3+4 (4 of 6 specimens), 14 specimens taken Using the Bullet Volume gives you gland of 25.55. He said that he saw what JHs was referring to but did not determine EPE for a variety of reasons. Your doctor is not a specialist in your type of . Request an Appointment 410-955-6100 Surabhi Dangi-Garimella, PhD. 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. - PI-RADS for this lesion = 4/5 In those cases, patients are tremendously grateful for having received the advice and encouragement to get a second opinion, Dr. Matasar adds. It is OK to not understand all the terminology. MRI RE-READ #2 (VERY VERY well respected radiologist): * Both Sloan and Johns Hopkins admit that large discrepancies are unusual, yet both stand by their opinions. This is the most common urinary tract problem in men under 50, and the third most common in men over 65. That is literally the first time I heard that term other than seeing it in my pathology report. I'm Gleason 3+4=7, and I believed only 2 cores tested positive. I would feel much more comfortable, if the numbers stay the same, being involved in a recognized Active Surveillance Program. Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. 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. Good Luck and God Bless everyone. Greatest dimension 2cm. 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. He wants me to begin the ADT around 5/1. However, that information will still be included in details such as numbers of replies. Slightly Two things you learn here is get a second opinion from Johns Hopkins on biopsy and get treated at Center of Excellence. The all-inclusive cost for a virtual second opinion for patients in the U.S. is $1,850. Epub 2017 Jun 12. What are you doing about it? 2: Prostate, right lateral base I have completed an exhaustive research effort on Prostate Cancer and PCa treatments. BASE DATA: Instead, I did my homework. Axial T1-weighted images of the pelvis show no bony or bulky nodal disease. Overall my PSA is between 4 and 10. He said that it will improve in the future due to future improvements in the treatments. 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. He also said perinueral invasion, but not extracapsular extension. Details are here: Two 1cc tumors, gleason score 3+4 each, one in each lobe. It can be caused by many factors, including infection and inflammation. Other labs for second . While I have three lesions, they are small and, without 3T mp MRI, might not have been discovered. However, it also is possible to seek a pathology second opinion on your own, and it does not require an in-person office visit. So, I go one better, I call up Johns Hopkins and find a Dr who does DaVinci Prostate Surgery. Learn more through his bio: Progress in the field.In recent years, advancements in research have changed the way cancer is treated. The prostates function is to create some of the fluid that insulates sperm cells found in semen. And again, most of you tell me time is on my side, so I am comforted in hearing that. 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. I can do radiation as a monotherapy. You feel healthy, you arent in pain, you But, ultimately decided on whole gland treatment using Proton Beam Radiation.So. Greetings gentlemen! Immediate means 6 weeks just to see his NP. Though, for the most part the reports seem encouraging.I am curious if anyone has had something similar. 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. Total Gleason score: 7 Thanks, Lesion 1: Left mid-base transition zone. Urologists at the Johns Hopkins Brady Urological Institute can make the difficult process of deciding on a treatment plan easier. 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. __________________________________________________________________________July 2022I've neglected to make journal entries for a couple years, so I will recap below and continue with what I have done and what I have learned.In 2018, at the age of 48, after a routine physical that showed a PSA of (4.X) and after a TRUS biopsy, I was diagnosed with PCa. 2019 Jan;69(1):7-34. doi: 10.3322/caac.21551. 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. Treatment decisions for prostate cancer should not be rushed due to a mistaken belief that immediate treatment is required. In terms of cancer, changes can be from cancer to benign (or vice versa) or from one type of cancer to another, which could . Also, a second opinion provides the opportunity to get information from someone other than the physician who will be directing treatment, which is usually the main source of information for most patients. Following application of the relevant exclusion criteria, 2365 respondents remained in the analytical cohort. An accurate diagnosis is essential to ensure the most effective treatment. For cancers that are less common, second opinions can offer more treatment options. PROSTATE ADDITIONAL FINDINGS: Benign prostatic lesion. The ADT has daunting side-effects but he said offers some improved chances of eradication, any long-term downsides that I should consider? 2. I had my first of those 2 PSA tests last week and it dropped to 4.77. Some men have minimal or no symptoms at all. This championship swimmer sought a second opinion at Johns Hopkins. Check Biopsy and Imaging Results for Accuracy. Grade Group: 1 The James Buchanan Brady Urological Institute, Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, Precision Medicine Center of Excellence for Prostate Cancer, robotic-assisted radical laparoscopic prostatectomies, The Brady Urological Institute and the Johns Hopkins Kimmel Cancer Center take a, Our urologic surgeons have extensive experience performing, Our surgeons, oncologists and radiologists are also world leaders in prostate cancer research, giving patients access to the latest discoveries and. 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. 3. Every year I got a PSA and DRE during my annual physical. 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. They may defer to the recommendation of the specialist, or refer you to a doctor with limited prostate cancer experience. 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. Request an Appointment 410-955-6100 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.
Second Opinions & Consultations - Johns Hopkins Pathology Studies show the clinical and financial benefits of obtaining a pathology second opinion. Many health insurance companies will pay for a second opinion, especially if it is for a medically necessary treatment. Depending on your location, you may be able to have a telemedicine consultation. 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. So my question for you is have you ever heard of PRECISE and if so what should I make of it? 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. Greenfield G, Shmueli L, Harvey A, Quezada-Yamamoto H, Davidovitch N, Pliskin JS, Rawaf S, Majeed A, Hayhoe B. BMJ Open. Hi JM "Numerous publications show the clinical and economic benefits of obtaining a second opinion for Pathology specimens. 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. Avoiding obsolescence in advanced prostate cancer management: a guide for urologists.
Second Opinions in Prostate Cancer - American Council on Science and Health Jonathan Epstein, MD received his doctorate from Boston University. Cancer 2017;123:1027-34. information. DRE is always normal. Prostate cancer is the second-most diagnosed cancer in American men. I did ask some questions about the study, if anyone is interested. Getting a Second Opinion The best time to seek a second opinion is before you start treatment. 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. You May Like: Best Treatment For Intermediate Prostate Cancer. They told me to expect a spike in my PSA sometime in the future, and they told me that studies are showing that a slow, steady decline in PSA is often indicative of superior results (whatever that means. Hi All, 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.
Prostate Cancer News, Reviews & Views: Second opinions Unlike pathology labs in most hospitals, Jonathan Epstein's lab at Johns Hopkins has pathologists who specialize in reading prostate tissue samples. 180 days after treatment PSA was .50. Also, infection was noted, so the current PSA is high in part due to prostatitis. This site needs JavaScript to work properly. After much discussion we both agreed that surgery was my best option and that he would do it at the end of July.
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