Should You Exercise When Youre Expecting? This fluid causes the prostate to swell and cause a number of bladder-related symptoms. MONDAY, Nov. 7, 2016 Second opinions have little impact on prostate cancer patients treatment decisions, new research suggests. 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. Although a large proportion of men with localized prostate cancer obtained a second opinion, the reasons for doing so were not associated with treatment choice or perceived quality of cancer care. 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. I have developed an "abscess" on my prostate. I'd like to talk with former patients who have gone through the procedure. I also changed my diet to plant based food, started juicing, and started taking supplements (think Turmeric, Green Tea, etc.). Specimens Submitted: However, there are other cases when a second opinion results in a very different diagnosis or set of treatment recommendations. Methods: The Stanford Medicine Online Second Opinion program offers you easy access to our world-class doctors. His most-frequently cited first or last authored publications is Pathological and Clinical Findings to Predict Tumor Extent of Nonpalpable Prostate Cancer, published in JAMA, which established the criteria for active surveillance. Lesion #1 (index): PI-RADS v2.1 score 4, lesion measuring 10 mm centered at the right mid/apex posteromedial peripheral zone; findings equivocal for extraprostatic extension; no evidence of seminal vesicle invasion; The low ADC value in this lesion increases the likelihood of Gleason grade group 2 or higher. My long-term prognosis appears to be good with minimal side effects. 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. 4. First let me just say what so many others have previously stated, the thought of going on this journey alone is frightening, I cant imagine traveling this road alone. 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. __________________________________________________________________________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. Y'all are in my prayers! 5. 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. Hello. E. Prostate, left mid, core biopsy: A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. My plan is to choose quality of treatment over cost of the treatment. MM, Much to my dismay my 4th targeted biopsy Oct 12 revealed 5% G4 (upgraded from Grade Group 1 to 2 (Gleason 3+4 intermediate/favorable). 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. Confused about Pathology report and course of action, Phone Number for John's Hopkins Radioogy Second Opinion. 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. The local pathologist read the biopsy and said 3+4=7 10% pattern 4 for both lesions.
Doctors are skilled at pitching the treatment they specialize in. Generally, the symptoms can stabilize over time. My goals are to control PCa, to minimize side effects, and to keep options open in the future. This is why the prostate is important to the body. Radhakrishnan A, Grande D, Mitra N, Pollack CE. To learn more about how to get a Neuropathology second opinion, please visit our Neuropathology Division second opinions website. Getting a second opinion from Johns Hopkins, is it free or does one have to pay for it? Here are seven tips for seeking second opinions for prostate cancer: 1. F. Prostate, left apex, core biopsy: Do any of you have an opinion or actual experience with any of the three listed below? AHN patients have unprecedented access to the Johns Hopkins Center for Fetal Therapy. This has raised some questions on all the scans so far. Transition Zone: In the left base, mid and apical transition zone there is a large mass measuring 2 cm in size which has Though, for the most part the reports seem encouraging.I am curious if anyone has had something similar. My only concerned was heavy metal poisoning and didn't know how long AS would be beneficial since I was starting at a young age. Greetings gentlemen! 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. Even if someone is being seen at a different academic center, the trials and other treatment options that we offer here may be different. It worked great (with negative pathology of the tissue) and fixed a lot of nasty symptoms and risks. Of course, my old school Urologist recommended surgeryHe, of course, knew the best robotic surgeons around.Anyway. We are vaccinating all eligible patients.
Second Opinion Pathology | MD Anderson Cancer Center Does every biopsy provide a Gleason Score? During your visit, our specialists will review your medical records, diagnostic tests and other information provided by you or your current physician. I would love to hear from anyone who has been involved in the Chicago study. Same with the amount of how much pattern 4. If pain is present, a digital rectal examination will reveal hard areas. (I must say that those low numbers concern me a bit.) Is it done through my doctor or do I do it myself with sending CDs of the MRI? Surgical Delay and Pathological Outcomes for Clinically Localized High-Risk Prostate Cancer. We will then prepare a written recommendation regarding your treatment plans or options. And if so, what does being accepted in a AS program look like, do I need to be present at their location? Unfortunately, the 12/20/20 PSA reading was higher and that led to an MRI on 2/2/21 when two lesions were discovered. Both Drs and nurses knew what they were doing and had lots of experience. In the United States, prostate cancer is among the most common cancers found in men. Am I missing anything? Seminal vesicles are normal. 1. I can do radiation as a monotherapy. Adenocarcinoma: * Extracapsular extension: Possible involvement of the anterior J Am Board Fam Med. It hasn't let me down. (The pathology report from Cedars-Sinai kept my diagnosis at 3+4, but a second opinion at Johns Hopkins upgraded me to 4+3.) I just turned 71 in February. 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. Benign prostatic tissue My new Dr however didnt order PSA so I asked him for one. Biopsy in 12/27/11 showed 3/14 cores, Gleason 6 with PSA of 4.5. P60 MD006900/MD/NIMHD NIH HHS/United States, T32 HL007180/HL/NHLBI NIH HHS/United States, K07 CA151910/CA/NCI NIH HHS/United States, P30 CA016520/CA/NCI NIH HHS/United States, K07 CA163616/CA/NCI NIH HHS/United States. The symptoms of acute bacterial prostatitis are similar to those of CPPS. Bethesda, MD 20894, Web Policies The Radiation Oncologist said he would be comfortable waiting a little more, but he wasn't confident that I'd grow a target lesion, nor would I be able to wait years before having to do "something." Masks are required inside all of our care facilities. The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System. 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. Hillen MA, Medendorp NM, Daams JG, Smets EMA. My strong preference would be to do FLA again and monitor. It's really that simple! Of course, my old school Urologist recommended surgeryHe, of course, knew the best robotic surgeons around.Anyway. We prioritized treatment as AS, FLA/TULSA (if a lesion ever presented itself), and Proton Beam Radiation. Overall, obtaining second opinions was not associated with changes in treatment choice or with improvements in how patients viewed their quality of cancer care. In order to give treatment for each patient with utmost security we would like to announce that currently there will be no visitors allowed.Please note that only one attendant per in-patients is permitted. -------------------------------------------------------- Many health insurance companies will pay for a second opinion, especially if it is for a medically necessary treatment. Reinterpretation of imaging scans and lab tests. 9: Prostate, left anterior MRI lesion The Radiation Oncologist knew of Dr Busch (by now in Alpharetta, GA) and spoke highly of him. 2nd opinion"Sclerotic change at the right pubic bone with max SUV of 1.4." I have actually had a second opinion a while back from Dr. Bush. But I refuse to sit still, I continue to research and to plan, as best I can. 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. Pathology report indicated additional presence of cells at right apex, but unclear whether intraprostatic incision or extraprostatic extension. All views would be appreciated. If the problem is unresponsive to other treatments, your doctor may suggest a surgical procedure. * Adjacent organ invasion: None. In unadjusted analyses, younger men , men with college-level education , and privately insured men and Medicare ) were more likely to obtain second opinions . This championship swimmer sought a second opinion at Johns Hopkins. Note respondents were able to, MeSH What are your opinions of what that is, and where to get it? 2 of the 12 samples showed High Grade PIN and one area showed "suspicious for low-grade adenocarcinoma". Second opinion Biopsy came after FLA G-9. I would feel much more comfortable, if the numbers stay the same, being involved in a recognized Active Surveillance Program. THANKS! Eager to hear what everyone thinks or has anything they see in the report I wouldn't have thought of. Second opinions offer different things in different circumstances, Dr. Matasar says. It has been 2.5 years and the PSA has still not doubled as well. 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. Prostate, left lateral apex: P/ 310-827-7707 | F/ 310-574-4002 | MAIL@PROSTATEONCOLOGY.COM. You think your doctor is underestimating how serious your cancer is. Patients may experience a fever or chills as a result of the infection.
John Hopkins Prostate Cancer Second Opinion I was confident I was making the right decision. For these reasons and others, it is advantageous to seek more than one opinion about how your cancer can be treated. !I'll try editing a previous post and see if it reads like a journal instead of creating a new thread every update.I just got my PSA results and the numbers are still trending in the right direction. He spent an hour on the phone reassuring me that I didn't need to rush into anything, and they he'd love to scan me 6-8 weeks after my TRUS Biopsyhave to let the trauma and all the blood leave the prostate for a good image.