johns hopkins prostate cancer second opinion

My first PSA was 8.03. 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. 1: Prostate, right lateral apex 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: 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. Sometimes, you may find out about treatment options you didnt know were available. The prostate gland is slightly enlarged secondary to transition zone hyperplasia (25cc total) (Recommended by my oncologist, Dr. Mark Scholz.) We are vaccinating all eligible patients. * Gleason Score: 3+3 (2 of 6 specimens) 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. 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. 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. 2018 May;115:133-138. doi: 10.1016/j.urology.2018.01.048. First 6 week PSA is undetectable. For a second opinion on the results of your prostate biopsy, there is no place better to get one than from the well known prostate pathologist, Dr. Jonathan Epstein at Johns Hopkins. Greatest dimension 0.7cm . 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%). This fluid causes the prostate to swell and cause a number of bladder-related symptoms. Benign prostatic tissue I had a telemed session with Dr. Chang, and it sounds like a pretty simple procedure, with urinary side effects that resolve pretty quickly. It can be caused by many factors, including infection and inflammation. Learn more through his bio: Progress in the field.In recent years, advancements in research have changed the way cancer is treated. Ask us questions on this webpage. He said that it will improve in the future due to future improvements in the treatments. PROSTATE LESIONS: Emotional outlook is fragile at times and straight clinical approach of doctors does not help. PSA: 4.7 ng/ml/PSA density: 0.27 ng/ml2 Different institutions have different levels of experience when it comes to analyzing prostate biopsy samples and interpreting imaging results. Good Morning Brothers- And it is OK to have paralysis by over-analysis. My understanding is that brachy is great for efficacy with less risk to the bowel and the same risk for incontinence and ED as other forms of radiation. My involvement is below maximum of 15% of core. An accurate diagnosis is essential to ensure the most effective treatment. 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. Yet none of my doctors ever mentioned it! Slight BPH findings. G. Prostate, lesion #1, core biopsy: Asking about other experience with conflicting Prostate Biopsy Opinions. 5. 8. Olver I, Carey M, Bryant J, Boyes A, Evans T, Sanson-Fisher R. BMC Palliat Care. Masks are required inside all of our care facilities. - Benign prostatic tissue Sought Johns Hopkins second opinion of pathology slides. The ADT has daunting side-effects but he said offers some improved chances of eradication, any long-term downsides that I should consider? * Seminal vesicle invasion: None. Seminal vesicles are normal. Fear, confusion and uncertainty set in. The margin of error is 1.4 percent, which is equivalent to 30,000 cancer diagnosis mistakes annually in the U.S. Of 6,171 biopsy slides sent since late 2008 for a second review at Johns Hopkins, pathologists disagreed with the diagnosis on 86 of them. Prostate, right medial base: 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. So the pathologist suggested a second opinion. 5. 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. Biopsy in 12/27/11 showed 3/14 cores, Gleason 6 with PSA of 4.5. Last year, Epstein's lab reviewed the pathology reports of 30,000 cases in which patients requested second opinions. My profession for forty years was health actuary consultant, so I have a pretty fair understanding of health data, outcomes, and risks. * Asked and Dr. said he isn't overly concerned about perineural finding with the grade and it won't impact treatment options or overall prognosis. 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. A second opinion can help you make an informed, confident decision about your medical care. Specimens Submitted: -------------------------------------------------------- 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. Lymph nodes: There is no suspicious lymphadenopathy in the pelvis. MRI RE-READ #1 (well known radiologist, but free advice over phone, but no written report): Day 7 after surgery I took my last pain pill. When I inquired with the oncologist that I had selected for my therapy before receiving the second opinion whether I would be a candidate for Active Surveillance considering the downgrading, she said 'no' due to the intraductal component. After a second opinion from both Johns Hopkins and Stanford, the two 4+3's were downgraded. My girlfriend lives 2 blocks from the Emory Proton Clinic.We prayed on it and overthought the crap out of it. Value of Second Opinion in Prostate Cancer Uncertain, Says Hopkins Study. Negative cancer in lymph nodes, seminal vesicles, and all margins. 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. 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. My question is--what importance do volume levels play in determining when to move from AS to treatment? However, before getting a second opinion, its best to check with your insurance company to see if there are any limitations in coverage. Cancer 2017;123:1027-34. 7: Prostate, left lateral apex * Location: Left, anterior, base to apex, transition zone I have selected Focal Laser Ablation as my future (soon) treatment. In unadjusted analyses, younger men , men with college-level education , and privately insured men and Medicare ) were more likely to obtain second opinions . We provide second opinions on the full range of gynecologic cancers: Ovarian Uterine Cervical Vulvar Vaginal Fallopian tube Placental tumors Some peritoneal cancers -------------------------------------------------------- The best protection for cancer patients who are Health Maintenance Organization members is to seek a second opinion even if she or he has to pay for it. It didnt look at changes of grading of the cancer.The chances for some type of modification based on a second opinion are even greater than the study indicated.Asking for a second opinion could lead to a significant change in surgical or medical intervention, Netto says.Even if the diagnosis error isnt catastrophic, such as advising a patient that he has cancer when he really doesnt, an error in grading can be consequential. 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. They confirm everything except question whether one of the core samples is a 3+3 or 3+ 4. There is no one-size-fits-all treatment for prostate cancer. I had been carefully watching as my PSA increased to 3.2 from 3.9 in summer 2010. 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. Getting a second opinion on a diagnosis can reverse a diagnosis or alter the treatment plan. I guess TWO national centers of excellence are better than one? 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. Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, The Sidney Kimmel Comprehensive Cancer Center. * PIRADS v2 Score: 3 It would be more convenient to use Mayo but I want the best practitioner regardless. Below is the link with instructions and the authorization form for you to use with your doctor. LESION 2 They hesitated calling it a TARGET LESION, but scored it PIRADS 4. Even if someone is being seen at a different academic center, the trials and other treatment options that we offer here may be different. 7. Recently diagnosed a Gleason 3 + 3. He also stated that he would ONLY recommend FLA if done within a trial. Got my physical and normal DRE with new Dr. No issues identified. * Prostate size: 3.9 x 2.8 x 3. cm Overall, obtaining second opinions was not associated with changes in treatment choice or with improvements in how patients viewed their quality of cancer care. Masks are required inside all of our care facilities. The all-inclusive cost for a virtual second opinion for patients in the U.S. is $1,850. 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. 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 wish the VA would be more informative about this disease they owe it to our veterans. What have your doctors told you? I am meeting with a multidisciplinary team of docs on March 18 at St. Joe's in Atlanta. During your visit, our specialists will review your medical records, diagnostic tests and other information provided by you or your current physician. Our collaborative processes also extend to our colleagues at Johns Hopkins Medicine, a world-wide leader in cancer research. 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. Im immediately referred to Urologist. Our OB-GYNs, maternal-fetal medicine specialists, and pediatricians collaborate regularly with the Johns Hopkins team getting second opinions and access to hundreds of clinical trials. I have posted here before, now with an update. But I refuse to sit still, I continue to research and to plan, as best I can. Prostate Cancer Grading: Prostate, right lateral base: Benign prostatic tissue 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. The Stanford Medicine Online Second Opinion program offers you easy access to our world-class doctors. The study included nearly 2,400 men in the Philadelphia area recently diagnosed with localized prostate cancer. Men were asked if they obtained a second opinion from a urologist, and the reasons why. 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. Everything seems to be on track to remove the cancer and be cured! 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. Last year, Epsteins lab reviewed the pathology reports of 30,000 cases in which patients requested second opinions.Netto says patients should be proactive in requesting that doctors take another look.A second opinion can reverse the diagnosis in up to 5 percent of cases for some types of cancers, he says, like those of the breast and pancreas.Diagnosis Errors by the Numbers. 2019 Jan;69(1):7-34. doi: 10.3322/caac.21551. I have completed all that is necessary to enter Johns Hopkins Second opinion and PTEN test program. Reinterpretation of imaging scans and lab tests. Mohamad Allaf, M.D., answers questions about prostate cancer diagnosis and treatment options and discusses robotic prostatectomy at Johns Hopkins. AHN patients have unprecedented access to the Johns Hopkins Center for Fetal Therapy. His reasoning over the last couple of years is that the suspected lesion was not changing in size at all. It will be interesting to see, I think. 1st opinion. Accessibility For all other cancer appointments, please call: 1-855-702-8222. This has raised some questions on all the scans so far. __________________________________________________________________________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. Surgical Delay and Pathological Outcomes for Clinically Localized High-Risk Prostate Cancer. 1. We will then prepare a written recommendation regarding your treatment plans or options. Especially opinions other than those of the first Urologist you see. I certainly would - after all, there's a certain brotherhood bond here. I really just want the results of their innovative PTEN test. Benign Processes: the transition zone. * Gleason Score: 3+3, Slide 1 (vs. Sloan's 3+4) * Seminal vesicle invasion: None. If pain is present, a digital rectal examination will reveal hard areas.

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