Recovery from Prostate Cancer | Bills Story. In the United States, studies estimate 72 new cases of PN for every 100,000 people between the ages of 18 and 64 years old. Either the patient or the primary physician can initiate the process of getting a second opinion. 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. Value of Second Opinion in Prostate Cancer Uncertain, Says Hopkins Study. PSA that brought me to this was 7.1. -------------------------------------------------------- When to move from Active Surveillance to Treatment for Prostate Cancer? With world-renowned expertise, multidisciplinary specialistsand the latest data, we partner with you tomake informed decisions about managing your prostate cancer. For this study, published in the journal Cancer, 2386 men in the greater Philadelphia area, who were diagnosed with prostate cancer between 2012 and 2014, responded to survey questions. Shore ND, Karsh L, Gomella LG, Keane TE, Concepcion RS, Crawford ED. 1. Where to start for newly diagnosed advance prostate cancer My questions are: 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. He schedules appointments with a Radiologist and two local surgeons. Surgical Delay and Pathological Outcomes for Clinically Localized High-Risk Prostate Cancer. FLA DONE AT FIRST BIOPSY G- 7. Younger men were more likely to cite wanting more information about their cancer and to see the best doctor as the reason to seek a second opinion . Both of which are normal volumes, the Bullet Volume is considered more precise in prostates smaller than 55ml. You think another treatment might be available. A new study by researchers at the Johns Hopkins University has found that . Just had my appointment today and they are pleased with the results, so far. Blessings. Prostate, left anterior MRI lesion: Especially opinions other than those of the first Urologist you see. :) MEASUREMENTS: Seeking second opinions is becoming standard practice, and it is mandatory at Johns Hopkins. He turned to the Top Gun of Prostate Pathology: Jonathan Epstein, MD, the guru of Gleason scoring at Johns Hopkins University in Baltimore. Prostate cancer is the second-most diagnosed cancer in American men. Mayo's report came back with the same PI-RADS 4 with the wording that it was more conspicuous but unchanged. Patient-initiated second medical consultations-patient characteristics and motivating factors, impact on care and satisfaction: a systematic review. So, I go one better, I call up Johns Hopkins and find a Dr who does DaVinci Prostate Surgery. The average age at the time of prostate cancer diagnosis is about 66. This suggests that for some men, second opinions offer a way to pursue the treatment they already planned on, rather than to explore other treatment options, according to study authors Dr. Archana Radhakrishnan, of Johns Hopkins University in Baltimore, and her colleagues. 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). Diffusely abnormal appearance of the prostate may reflect prostatitis, which can obscure underlying prostate cancer. Getting a Second Opinion The best time to seek a second opinion is before you start treatment. I worked out every day and it wasn't until the last week did I feel a bit fatiguedand experience a bit of urgency and hesitation having to peeflowmax fixed that right up!90 days after treatment my PSA came in at .56. Transition Zone: In the left base, mid and apical transition zone there is a large mass measuring 2 cm in size which has Axial T1-weighted images of the pelvis show no bony or bulky nodal disease. We are vaccinating all eligible patients. 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. I was to follow up with my new Urologist (another surgeon) for 3 months PSA checks and annual 3T-MPMRI.My PSA checks were static and the next year's MRI looked just like the first. I can do radiation as a monotherapy. Hello everyone. Find more COVID-19 testing locations on Maryland.gov. Second opinions apply to biopsies and imaging as well. Two 1cc tumors, gleason score 3+4 each, one in each lobe. The review process normally takes several days, after which we will send your slides and other materials are returned. MY THOUGHTS AND ANYTHING DOCTOR NOTED: We are vaccinating all eligible patients. 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. Overall my PSA is between 4 and 10. Obviously the Covid 19 issue is playing a part in all of our decisions. World J Urol. 1. * PIRADS v2 Score: 5 In adjusted models, obtaining a second opinion was not associated with receipt of definitive treatment . 4/16 3T MRI performed (reports/re-reads below) 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. 10: Prostate, right anterior MRI lesion 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). His second opinion just came back. 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. This may include imaging, blood tests, prior treatment, and pathology reports. However, that information will still be included in details such as numbers of replies. We specialize in minimally invasive procedures to treat BPH, including: For selected BPH patients, our specialists also perform transurethral resection of the prostate , a procedure that requires no incisions and has a high rate of success. 2 cores from left base of 3+4=7 with only 5% involvement. of tumor in the rectal prostatic angles. Got the fiducials placed, the Space-OAR gel placed, mold made, and had the pre-treatment MRI and CT Scan. We experienced information overload and decision/analysis paralysis. 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. Two weeks later I meet with my Johns Hopkins Dr. Further, among men with low risk disease, we did not observe a significant association between second opinions and receipt of definitive treatment or surgery. Note respondents were able to, MeSH It works. The Johns Hopkins Brady Urological Institute is known around the world for its expertise in diagnosing and treating urologic conditions. There is no extraprostatic extension. !I've pasted a previous update below for background.I just got my PSA results and the numbers are still trending in the right direction. 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. During puberty, the body produces semen in a large number of cases, including enlarged prostate. Prostate cancer is the second-most diagnosed cancer in American men. Another DRE that results in identifying that my prostate is enlarged, but cant find and nodules. Pathology Second Opinion-J.Epstein,M.D. Pathologist-Johns Hopkins 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. 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. )I contacted Dr Busch (still in Chattanooga at the time) and he called me directly to talk me off the ledge. It starts many years ago. Benign Processes: - PI-RADS for this lesion = 4/5 - T2 = 3/5 While I have three lesions, they are small and, without 3T mp MRI, might not have been discovered. * Location: Right, anterior, apex, peripheral zone If pain is present, a digital rectal examination will reveal hard areas. Associated fees may be incurred up to $1,800 in a minority of more complicated cases requiring special studies. It was easy. Prostatic Adenocarcinoma I requested a second opinion from Johns Hopkins and they found 1 lesion was 3+3=6 and the second lesion was 3+4 =7, with less than 5% pattern 4. As some of you may know, I am a moderator for a support group for men on active surveillance for low-risk prostate cancer. A doctor may prescribe surgery or perform an endoscopic procedure. Johns Hopkins Prostate Cancer Doctors - HealthyProstateClub.com You're also at greater risk of prostate cancer forming before age 50. The people were great. I certainly would - after all, there's a certain brotherhood bond here. Dr stated that after seeing my muscles on the inside during operation he would have predicted this. In the United States, prostate cancer is among the most common cancers found in men. Some docs say clean up the prostatitis while others tell me to avoid overuse of Cipro as it loses its effectiveness over time. I had the MRI in April 2021 and it showed a PI-RADS 4 lesion. 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 . Research was mixed on PINS, but in those days, many doctors saw them as likely to develop into cancer. With no travel needed and no red tape, its easy to get a second opinion, all from the comfort of your home. A blocked urethra can also damage the kidneys. He also said perinueral invasion, but not extracapsular extension. Prostate, left medial base: 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. 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. Unbelievable that this happened!!! Ask your PCP to refer you to several different types of treating doctors before making a treatment decision. This shows very high signal intensity on the diffusion-weighted Benign Processes: EDI am now 52 and not quite functioning like I did 4+ years ago. For these reasons, it is a good idea for HMO members to get a second opinion and make sure they are informed about clinical trials or other promising new treatments. - Follow-Up Score (PRECISE) for this lesion = Stable MRI appearance: no new focal/diffuse lesions. Be sure to confirm your diagnosis at a center of excellence. 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. Estimated prostate volume of 35 cc with an estimated PSA density of 0.11 ng/mL/cc. Biopsy in 12/27/11 showed 3/14 cores, Gleason 6 with PSA of 4.5. The total number of cores identified is 3 I really liked the new group I went to as they identified the lesion right away, unlike the radiologist who performed the first procedure, and they also have a urologist on staff as well monitoring everything. 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. H. Prostate, lesion #2, core biopsy: Finally, things are set and I know what is going to happen. You can find out by reviewing your plan or by reaching out to your insurance company. He wants me to begin the ADT around 5/1. Whats right for you will depend on the stage of the cancer, your level of risk and your general overall health. Seminal vesicles are normal. When you get a diagnosis of breast cancer from your doctor, its not uncommon to get a second opinion. I worked out every day. And just this week, 1 YEAR post treatment, it is .46. Especially opinions other than those of the first Urologist you see. Whether you want expert confirmation, lack understanding or confidence in your treatment plan, have a rare or unusual type of cancer, your cancer isnt responding to current treatment its reassuring to know that you have options through a second opinion. This sounds to me like they're not familiar with the Oncotype DX test and makes me wonder how common is the test. Get a Second Opinion What can a second opinion tell me? It has been 2.5 years and the PSA has still not doubled as well. Read Also: What Are The Signs Of Prostate Infection. In other words, the cancer is still contained within the prostate. Does that mean my Gleason Score based on my biopsy would be less than a Gleason 6? 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. JHs just said it was minimal less than 5%. If I am rested, I find that I am more ready than if I am not. 4 Get a Second Opinion Dr. Jonathan Epstein explains the benefits of getting a pathology second opinion And 2 cores from left apex of 3+3=6 with 10% involvement. -------------------------------------------------------- Second Opinions An accurate diagnosis is essential to ensure that the correct and most effective treatment is given. 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. I assume the data on gleason scoring is much more robust/reliable than genomics as it has been around longer and used more extensively. I luckily found this webpage and I started reading everything I could get my hands on. But I did speak to an oncologist who wanted to order Oncotype, which I did. Potentially inaccurate results can lead to selection of the wrong type of therapy. 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. 1: Prostate, right lateral apex I question the potential EPE and he said it didn't matter, but went ahead and ordered Oncotype. This approach helps to decrease side effects that can affect a patients quality of life, such as erectile dysfunction, incontinence or other urinary-tract symptoms. 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. Unable to load your collection due to an error, Unable to load your delegates due to an error. * Perineural Invasion also detected Therefore, the value of these second opinions remains unknown. I also sent my biopsy slides to Johns Hopkins for a second opinion (Epstein's read was 3+4, but with lower pattern 4 involvement than the local pathologist.). Benign prostatic tissue Expert review of your case by a Cleveland Clinic specialist. This has raised some questions on all the scans so far. Also, if any of you have a way to get medicare to pay some portion of the cost, please let me know as well. How long do you have left? 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. Make an appointment: 410-955-5222 Coordinating with your Treating Physician At the Breast Cancer Program at the Johns Hopkins Kimmel Cancer Center in Baltimore, MD, a second opinion requires only that you or your doctor send us your pathology slides, key medical records and signed paperwork requesting the opinion. * Prostate volume: 22 cc If pain is present, a digital rectal examination will reveal hard areas. Not all cancers are the same and not all treatment plans are absolutely clear. The problem is that all 3 pathologies noted an intraductal component. And by FAA Aeromedical Ruling, I'd need a few post procedure reports before being cleared to fly again.) 7: Prostate, left lateral apex 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. Prostate cancer is a malignant (cancerous) tumor of the prostate, a gland found only in men.
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