Wondering if any of the "gurus" here want to take a stab at looking at this and see if they agree that it says what I think it says (I will be following up with doctor(s) to get their opinion, and I waive all HIPAA rights by allowing this to be seen). (TZ) One suspicious area - lesion size: 2cm x 1.4 cm It has been 2.5 years and the PSA has still not doubled as well. In adjusted models, obtaining a second opinion was not associated with receipt of definitive treatment . During the next 4 weeks I meet with the recommended Radiologist, and the two local surgeons. Noted that some don't even include on report and should be looked as something to note but not obsess about. 3. You may also complete an online appointment request form and we'll respond to schedule an appointment. I'm leaning towards SBRT. Thanks to all of you for sharing! 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. They hesitated calling it a TARGET LESION, but scored it PIRADS 4. curing cancer, prostate cancer questions johns hopkins hospital, josef issels wikipedia, cancer a second opinion a look at book by josef issels, coping with metastatic cancer cancer net, pdf americans health priorities curing cancer and, what is immunotherapy cancer research institute cri, cancer a second opinion a . 6. They may defer to the recommendation of the specialist, or refer you to a doctor with limited prostate cancer experience. Two weeks later I meet with my Johns Hopkins Dr. Ex-Uro wanted to do biopsies and keep doing them until we find "it", even though he didn't know the size of the prostate nor had he ruled out prostatitis. I have developed an "abscess" on my prostate. Consultation with your nurse care manager. 2 of the 12 samples showed High Grade PIN and one area showed "suspicious for low-grade adenocarcinoma". 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. If anyone has used him, please let me know what your experience was like. Primary Gleason grade: 3 What have your doctors told you? Second Opinions An accurate diagnosis is essential to ensure that the correct and most effective treatment is given. * PIRADS v2 Score: 5 I suggest for all that hear, "you have cancer" that you seek more opinions! Prostate Cancer | Johns Hopkins Medicine After much discussion we both agreed that surgery was my best option and that he would do it at the end of July. My plan is to choose quality of treatment over cost of the treatment. They hesitated calling it a TARGET LESION, but scored it PIRADS 4. Getting a second opinion can sometimes lead to a complete change in diagnosis (such as cancerous to benign or vice versa) in non-cancerous growths, inflammatory disorders, infections, cancer and other conditions. Enter the last name, specialty or keyword for your search below. 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. An official website of the United States government. -------------------------------------------------------- Have been told a health condition is not treatable. (I must say that those low numbers concern me a bit.) 7 in 10 PATIENTS WHO GET A SECOND OPINION AT CTCA CHOOSE TO TREAT WITH US Call now to find out why: 800.888.8888 Rosie P. Colorectal Cancer Six weeks later I have the biopsy in his office and a week later I get the results. I recently sent my Pathology Slides to Dr. Epstein for a Second Review. Urologists at the Johns Hopkins Brady Urological Institute can make the difficult process of deciding on a treatment plan easier. If pain is present, a digital rectal examination will reveal hard areas. Thank you, After more than three years on active surveillance, I've pretty much decided to have focal brachytherapy for my prostate cancer. 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. A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. Second Opinions for Cancer Care - UChicago Medicine And luckily I lived in Chattanooga and had mutual friends with Dr. Joe Busch (my Urologist never mentioned him, yet we could almost see his facility from the exam room in which he broke the news. Some men may have an enlarged prostate but not notice it. According to the doctor it is around 3 mm. 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. Getting A Second Opinion On Your Pathology Report - Cancer ABCs You can find out by reviewing your plan or by reaching out to your insurance company. 2. If these do not work, your symptoms could progress and become chronic. Learn MoreFor more information about pathology second opinions, visit pathology.jhu.edu or call 877-546-1872. Hi All, Netto points to prostate cancer as an example: If your diagnosis changes from a higher grade to a lower grade cancer, it could mean having the option to avoid radical treatment.Seeking second opinions is becoming standard practice, and it is mandatory at Johns Hopkins. H. Prostate, lesion #2, core biopsy: He has had a nagging "groin injury" for may years (he played pick up basket ball until he got injured) and we are now wondering if this could be the source of that recurring ache. Thanks, As I said, I am 58, so I would really like to preserve my quality of life for as long as possible, but the genomics report has me concerned. Primary Gleason grade: 3 Diffusely abnormal appearance of the prostate may reflect prostatitis, which can obscure underlying prostate cancer. Being in Wisconsin, my insurance gives me the option of two hospitals to manage me. But you have to do both. 4. Be well. National Library of Medicine Benign prostatic tissue When people recommend going to a Center of Excellence, believe them. The ADT has daunting side-effects but he said offers some improved chances of eradication, any long-term downsides that I should consider? Second opinions not likely to change prostate cancer treatment By basing a treatment Their opinions are widely held to be definitive. The Radiation Oncologist knew of Dr Busch (by now in Alpharetta, GA) and spoke highly of him. My urologist suggested a couple more PSA tests followed by an MRI. It can: Confirm your original diagnosis and treatment plan Give you more detail about the type of breast cancer you have and stage it's in. To learn your stage of prostate cancer, take the staging quiz on keytopc.com. It will be interesting to see, I think. Prostate cancer is a malignant (cancerous) tumor of the prostate, a gland found only in men. In unadjusted analyses, younger men , men with college-level education , and privately insured men and Medicare ) were more likely to obtain second opinions . I trust the second opinion Dr. Bush gave. They replied they are sending the slides but they said they're looking into the DX test and will get back to me once they have that information. 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. 3/3 4K score 19% (high end of intermediate) TZ zone more beneficial, but fairly large compared to whole gland and proximity to capsule edge would likely mean treatment would be suggested. Asking for your comments: 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. However, there are other cases when a second opinion results in a very different diagnosis or set of treatment recommendations. 3T MRI with coil is done initially, along with a TRUS biopsy. With world-renowned expertise, multidisciplinary specialistsand the latest data, we partner with you tomake informed decisions about managing your prostate cancer. Avoiding obsolescence in advanced prostate cancer management: a guide for urologists. 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. This site needs JavaScript to work properly. Second Opinions & Consultations - Brain Tumor | Johns Hopkins Pathology Prostate, left medial base: The urologist/surgeon indicated that other forms of treatment like TULSA are not options since my cancer is multifocal. Jonathan Epstein, M.D. Some specialists have more expertise and more experience than others. My long-term prognosis appears to be good with minimal side effects. Want confirmation about a diagnosis or treatment. * Should still go for a Johns Hopkins second opinion on the pathology or is that overkill since the first one was done at MSKCC? My strong preference would be to do FLA again and monitor. What is NOT OK is quitting or avoiding the bad news, or handing the entire decision over to someone else.Good luck fellas! This may include imaging, blood tests, prior treatment, and pathology reports. Get a Second Opinion | Johns Hopkins Pathology 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. Breast Cancer: When to Get a Second Opinion - WebMD Reasons for obtaining a second opinion from urologists. Two from one lesion were positive as was one of the two from the other. I also learned a lot more about the high undisclosed risk of side effects of various treatment plans. 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. 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. Your current doctor will frequently suggest a second opinion, if only to confirm the recommended course of action.