Didn't know if she had the catheter in far enough and not getting any urine through itwondered if she had inflated the balloon enough and wondering if it was the reason that I have developed an abscess. 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. Dr. Nour is 100% sure that nothing has spread. There is no bony or bulky nodal disease in the pelvis With The Clinic by Cleveland Clinic, patients have access to Cleveland Clinics 3500 specialists. )As for side effectsI occasionally have some urgency/hesitancy having to pee. 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. Experts believe that this study is the first in history to have achieved such results. We surveyed men who were diagnosed with localized prostate cancer in the greater Philadelphia area from 2012 to 2014. LESION 1 Some pathologists have more experience than others. Time moves fast when dealing with cancer, but Doctors dont. He never sought treatment for the injury. My questions are: Netto says patients should be proactive in requesting that doctors take another look. Dont Miss: Screening For Prostate Cancer Icd 10. 8: Prostate, left lateral base 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. Greetings gentlemen! Second Opinions An accurate diagnosis is essential to ensure that the correct and most effective treatment is given. Note respondents were able to, MeSH The Stanford Medicine Online Second Opinion program offers you easy access to our world-class doctors. Had my PSA remained static I'd have remained on AS and had I grown a Target Lesion I'd have sought focal treatment.This science is emerging and only getting better. 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. Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. World J Urol. Is it done through my doctor or do I do it myself with sending CDs of the MRI? A doctor may prescribe surgery or perform an endoscopic procedure. Careers. My strong preference would be to do FLA again and monitor. I question the potential EPE and he said it didn't matter, but went ahead and ordered Oncotype. very activerun/cycle 6 days a week ADC: mean 879 / median 839 / st dev 223 Unlike pathology labs in most hospitals, Jonathan Epstein's lab at Johns Hopkins has pathologists who specialize in reading prostate tissue samples. - T2 = 3/5 * Gleason Score: 3+3 (2 of 6 specimens) Second Opinions & Consultations - Brain Tumor | Johns Hopkins Pathology 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.). In those cases, patients are tremendously grateful for having received the advice and encouragement to get a second opinion, Dr. Matasar adds. Generally, the symptoms can stabilize over time. Im also wondering why no one has scheduled me for MRI to see what biopsy missed. Ask your PCP to refer you to several different types of treating doctors before making a treatment decision. I have completed all that is necessary to enter Johns Hopkins Second opinion and PTEN test program. Clipboard, Search History, and several other advanced features are temporarily unavailable. How much is the fee for an opinion of my recent MRI? - Perineural invasion is present And by FAA Aeromedical Ruling, I'd need a few post procedure reports before being cleared to fly again.) 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. I would love to hear from anyone who has been involved in the Chicago study. With no travel needed and no red tape, its easy to get a second opinion, all from the comfort of your home. Getting a second opinion on a diagnosis can reverse a diagnosis or alter the treatment plan. The results of the MRI said they found a PYRAD 5 lesion, but did not find any cancer outside prostate. 2021 Sep 24;11(9):e044033. __________________________________________________________________________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. But I did speak to an oncologist who wanted to order Oncotype, which I did. This championship swimmer sought a second opinion at Johns Hopkins. decision on a single medical opinion or the first appointment you get, you may In unadjusted analyses, younger men , men with college-level education , and privately insured men and Medicare ) were more likely to obtain second opinions . For cancers that are less common, second opinions can offer more treatment options. You can call and speak with his assistant at: (410) 614-6330. 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. Johns Hopkins is home to many of the world's leaders in Pathology. 2016 American Cancer Society. This kills both birds with a single stone. There is no extraprostatic extension. And it is OK to have paralysis by over-analysis. Getting a second opinion from us is easy, convenient, and all done remotely. In some situations, insurers will even insist on a second opinion. PROSTATE ADDITIONAL FINDINGS: Benign prostatic lesion. Confused about Pathology report and course of action, Phone Number for John's Hopkins Radioogy Second Opinion. Fear, confusion and uncertainty set in. fibromuscular stroma, anterior prostatic contour is smooth. 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. 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. We experienced information overload and decision/analysis paralysis. How could this compare using only partial slide re-reading? A enlarged prostate can also cause blockages in the urethra. 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. Specimens Submitted: More medical freakouts. Discover what's to love about Charm City for yourself. Caused me to bleed heavily. Is there such a thing as having a team that isnt equipped with the best equipment nor the most experienced radiologists? A enlarged prostate can also cause blockages in the urethra. Other labs for second . Us Too Prostate is a great club and many of you have helped me a lot already. First of all we would like to emphasize that the health of our employees, our patients and their relatives is our first priority. Second opinion Johns Hopkins? - Prostate cancer I'm 58 yrs old and had a TRUS random biopsy October 2020 after my PSA continually stayed between 4.4 and 8, and PHI score was 126. His reasoning over the last couple of years is that the suspected lesion was not changing in size at all. In terms of cancer, changes can be from cancer to benign (or vice versa) or from one type of cancer to another, which could . Ask your doctor for a copy of your complete medical record. Overall, obtaining second opinions was not associated with changes in treatment choice or with improvements in how patients viewed their quality of cancer care. Finally, things are set and I know what is going to happen. Benign Processes: However, there are also many more options for treatment and these options are more complicated than in the past. Some specialize in reading only slides that come from a specific organ while others are generalists who read many different pathology slides from many different organ systems. 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.). It hasn't let me down. Background: PMC My diagnosis is T2c, Gleason 7 (3+4). 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. 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. Second Opinions An accurate diagnosis is essential to ensure that the correct and most effective treatment is given. doi: 10.1001/jamanetworkopen.2020.28320. C. Prostate, right apex, core biopsy: Some men have minimal or no symptoms at all. Prostate Cancer Grading: My Oncotype rating was GPS 54, with a 26% chance of metastisis within 10 years. Doctors are skilled at pitching the treatment they specialize in. Epub 2017 Jun 12. However, just to be safe she schedules me for TRUS biopsy with the Urologist in another 6 weeks. With AHN Cancer Institute, you already get a world-class cancer program with leading expertise, care, and outcomes. I made the appointments. The https:// ensures that you are connecting to the Centro Diagnostico Italiano , Milan, Italy, Manfred Dietel, M.D.Institute of Pathology Charit, Humboldt University of Medicine, Berlin, Germany, Jonathan I. Epstein, M.D.The Johns Hopkins Medical Institutions, Baltimore, MD, Robert J. Kurman, M.D.The Johns Hopkins Medical Institutions, Baltimore, MD, Elizabeth Montgomery, M.D.The Johns Hopkins Medical Institutions, Baltimore, MD, Manuel Sobrinho-Simes, M.D.University of Porto, Porto, Portugal, Ronald S. Weinstein, M.D.University of Arizona, Tuscon, AZ, Franco VisinoniMilestone Medical Technologies, Bergamo, Italy, Read Also: Nhs Prostate Cancer Risk Calculator. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. Primary Gleason grade: 3 A 1.4 cm lesion in the left, apex, anterior transition zone demonstrates conflicting T2 and DWI characteristics for PI-RADS classification - an indeterminate lesion. Even if I go the radiation route, should I try for Proton radiation or some other type? Confounding this, I have read that the different genomic tests can disagree with each other, and that Oncotype is usually a more aggressive finding. He turned to the Top Gun of Prostate Pathology: Jonathan Epstein, MD, the guru of Gleason scoring at Johns Hopkins University in Baltimore. So I initially thought this makes me a good candidate for AS. If youve received a new cancer diagnosis or arent seeing results from your current treatment plan, an expert second opinion can help you move forward with confidence. Prior to the results, the oncologist said that the literature shows that a 3+4=7 with less than 5% pattern 4 behaves just like a 3+3=6 and basically is an indolent tumor. The biopsy took 3 samples from the targeted region plus 16 sextant. undefined will no longer be visible to you including posts, replies, and photos. Because physicians may differ in their approach to treating breast cancer, its very important to check with a breast cancer expert to know youre receiving the best treatment for you. I'm leaning towards SBRT. That is literally the first time I heard that term other than seeing it in my pathology report. I had been carefully watching as my PSA increased to 3.2 from 3.9 in summer 2010. 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. Even at the age of 48, he thought I would be a good candidate for AS. The reasons for opting for treatment: the single lesion - previously Gleason 3+4, with a small percentage of pattern 4 - has grown, and according to a biopsy performed March 25, my Gleason 3+4 is now a Gleason 4+3. Seminal vesicles are normal. Are considering a treatment that involves significant risks, such as surgery. Extracapsular extension: The prostatic capsule is preserved. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. 1. However, something is driving my PSA. Some docs say clean up the prostatitis while others tell me to avoid overuse of Cipro as it loses its effectiveness over time. You can find out by reviewing your plan or by reaching out to your insurance company. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. prostate volume). Other Features: Over 80,000 specimen cases are seen at Johns Hopkins each year. Read Also: Long Term Side Effects Of Brachytherapy For Prostate Cancer. 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. After a little experimenting I have been able to achieve a partial erection. Forty percent of the men obtained a second opinion from urologists, most often because they wanted more information about their cancer or wanted to be seen by the best doctor . He also said I would tolerate any option well based on my age and health. 2. I want to insure that the Imaging was read correctly and nothing was overlooked or missed. I still have some urgency and frequency issues, but I am not complaining too bad. Especially opinions other than those of the first Urologist you see. 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.