Getting a Second Opinion The best time to seek a second opinion is before you start treatment. John, I was diagnosed on 11 December, 2013. With The Clinic by Cleveland Clinic, patients have access to Cleveland Clinics 3,500 specialists with extensive experience in all types of cancers. My girlfriend lives 2 blocks from the Emory Proton Clinic.We prayed on it and overthought the crap out of it. 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. Research was mixed on PINS, but in those days, many doctors saw them as likely to develop into cancer. Now its easier than ever to get the answers you need and peace of mind you deserve. 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. I want to insure that the Imaging was read correctly and nothing was overlooked or missed. Wow, I sound like a snob now! And it is OK to have paralysis by over-analysis. The urologist offered surgery and radiation as options on 3/10 when we met. J Am Board Fam Med. Does 3+4 at some point typically evolve into 4+3 and also serve as a trigger point for moving from AS to treatment? Now, though, encouraging animal data and preliminary studies in human patients are making some doctors feel optimistic. Your email address will not be published. By seeking second opinions and hearing the benefits and drawbacks of a range of treatment options for your specific stage, you will be more equipped to make educated decisions. However, something is driving my PSA. I would love to hear from anyone who has been involved in the Chicago study. With The Clinic by Cleveland Clinic, patients have access to Cleveland Clinics 3500 specialists. My family physician for years told me that small increases PSA was common so when it went over 4 it didnt bother me and my Dr who was retiring, didnt say anything either. I'll post the whole thing, my doc and my own comments, and then cut/paste all my MRI results in case anyone REALLY liked data. Extracapsular extension: The prostatic capsule is preserved. Receiving a second opinion was not associated with perceived quality of prostate cancer care. T2W MRI score= 5, DW MRI score= 5, DCE MRI score=positive You receive a secure, private online consultation without leaving home. I've also read that some study's have shown that intraductal may be resistant to hormonal therapy, radiation and/or chemo. 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, Also Check: How Old Can You Be To Get Prostate Cancer. Disclaimer. 2nd opinion"Sclerotic change at the right pubic bone with max SUV of 1.4." It may be a new cancer, but it is more likely a recurrence since it is really near the ablation zone. Prostate Cancer Grading: 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. Their MRI was more sensitive and found there were actually 2 lesions close together that looked like one on the prior MRIs. MONDAY, Nov. 7, 2016 Second opinions have little impact on prostate cancer patients treatment decisions, new research suggests. 2015 Feb;115(2):188-97. doi: 10.1111/bju.12665. I guess the PET scan will be the next step in what type of treatment options are in store.Has this occurred to anyone else? Similarly, among those who received definitive treatment, second opinions were not associated with receiving surgery. Do second opinions matter in prostate cancer care? - ecancer Here are seven tips for seeking second opinions for prostate cancer: 1. Thanks for considering. Second opinions from urologists for prostate cancer: who gets them, why, and their link to treatment . Second Opinions (Adults) For stem cell transplant, please call 1-773-702-1994. 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. 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. Our regional community network integrates academic specialty cancer care at Allegheny General Hospital and West Penn Hospital and at more than 20 community cancer centers throughout the region. Not all cancers are the same and not all treatment plans are absolutely clear. I fear limiting myself to an inferior treatment because the people I talk to have hammers, therefore everything must be a nail. What is NOT OK is quitting or avoiding the bad news, or handing the entire decision over to someone else.Good luck fellas! By taking the extra time to seek a second opinion, you have a better chance at finding the most up-to-date approach and an experienced doctor. Getting A Second Opinion On Your Pathology Report - Cancer ABCs This may include imaging, blood tests, prior treatment, and pathology reports. 1: Prostate, right lateral apex 1. Hopkins states that the one positive core (10% G6) was visualized by the MRI, so I am hoping that this increases our chances of making it through the screening process. Brachytherapy Experience with Dr. Albert Chang at UCLA? Are there urologists out there that don't routinely order the DX test to get a better idea of low and intermediate risk cancers? 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. Radiation oncologist of same group of doctors says to do IMRT (using Rapid ARC program) as precautionary treatment, regardless of PSA scores. First of all we would like to emphasize that the health of our employees, our patients and their relatives is our first priority. Have been told a health condition is not treatable. Without the genomic test I have I lesion 3+3=6 and another, 3+4=7, with less than 5% pattern 4, and an MRI that shows no ECE, no other suspicious lesions and questionable cellular EPE based upon disagreement of pathologists. They are not objective. Symptoms include leaking and discomfort. PELVIC LYMPH NODES: No adenopathy. At this point Im still ignorant about what I ought to be doing (MRI guided biopsy is what I should have gotten). One of the problems with second opinions is that insurers may not cover the expense. 6 cancers that are the toughest to diagnose are prostate, bladder, head and neck, soft tissue, skin and lymph system. When facing an intricate disease like prostate cancer, the above scenario is far too simple to have a promising outcome. Anything I am overlooking or need to add to my list of considerations? 7. Second opinions from urologists for prostate cancer: who gets them, why, and their link to treatment . Need guidance choosing from multiple treatment options. 2nd opinionBone Scan:"Mild increased activity is seen in the right symphysis corresponding to the abnormalities on the prior PET/CT examination. * Gleason Score: 3+4 (4 of 6 specimens), 14 specimens taken Please don't hesitate to make any observations or ask questions. 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. Will these places of excellence consider me, or am I bound to my regular doctor for insurance purposes? I had a very bad experience with an incompetent nurse that did a catheter change. LESION 1 National Library of Medicine He said that he saw what JHs was referring to but did not determine EPE for a variety of reasons. 3. A total of 2386 men responded to the survey (adjusted response rate, 51.1%). * Sloan only sent partial cores, slides 1 and 4. My question is regarding the results of an MRI guided biopsy into a distinct tumor vs. subsequent Oncotype Dx Results. 2. 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. Are you sure you want to block this member? Abstract Context: In men who develop an elevated serum prostate-specific antigen level (PSA) after having undergone a radical prostatectomy, the natural history of progression to distant metastases and death due to prostate cancer is unknown. radiation, active surveillance, surgery, hormone therapy, and more. intricate disease and not all doctors have the same amount of experience After a little experimenting I have been able to achieve a partial erection. The lesion also shows focal increased permeability. Seems like a simple request. He said that JHs said that it was 2 cores, but it was actually a fragmented core, that the fat did not present on the right place on the slide, that prior FLA (partial hemi-ablation) could affect the results, the MRI did not support, etc. A doctor may prescribe surgery or perform an endoscopic procedure. * Extracapsular extension: Possible involvement of the anterior This shows very high signal intensity on the diffusion-weighted An acute bacterial infection can cause a burning sensation. However, there are other cases when a second opinion results in a very different diagnosis or set of treatment recommendations. Asking for your comments: As a result, patients struggle to differentiate bias from fact. In the mean time my PSA was movingno longer static, but never back up to 6. 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. If they do not cover this cost and you must pay out of pocket, keep in mind that a second opinion could save you from having to pay (financially and physically) for additional treatment down the line. An acute bacterial infection can cause a burning sensation. This teamwork ensures the best possible patient outcomes. A fusion biopsy was performed in late May and I just received those results last Thursday. This condition causes pain in the lower back and groin area, and may cause urinary retention. PI-RADS v2 score: 5. Slight BPH findings. Metastasis. Dr stated that after seeing my muscles on the inside during operation he would have predicted this. More medical freakouts. 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. Some men have minimal or no symptoms at all. 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. Find a doctor at The Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center or Johns Hopkins Community Physicians. Thank you for your participation! Benign prostatic tissue 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. -------------------------------------------------------- Another type of prostate issue is chronic prostatitis, or chronic pelvic pain syndrome. Utilize your primary care physicians as an un-biased resource to help you get second opinions from a range of specialists. Not all men with Gleason 8-10 disease are going to do badly after And just this week, 1 YEAR post treatment, it is .46. 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%). It can be caused by many factors, including infection and inflammation. 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. Thanks, 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. 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. 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 . Accessibility Johns Hopkins Health - Second Opinions, Second Chances, Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, High Blood Pressure May Take Its Toll on Your Kidneys. A man with a father or brother who had prostate cancer is twice as likely to develop the disease. Get a Second Opinion Right mid anterior transition zone (PIRADS 2). I appreciate any comments or insight that anyone wants to share. So, Radiation Oncologist prescribed Cialis 5mg, daily. HHS Vulnerability Disclosure, Help * Gleason Score: 3+3, Slide 1 (vs. Sloan's 3+4) I trust the second opinion Dr. Bush gave. Time moves fast when dealing with cancer, but Doctors dont. Watch: Are supplements good for prostate health? * Perineural Invasion also detected The total number of cores with carcinoma is 3 * Seminal vesicle invasion: None. Primary Gleason grade: 3 I was on active surveillance after a FLA procedure done in 2018. Our collaborative processes also extend to our colleagues at Johns Hopkins Medicine, a world-wide leader in cancer research. desired outcome. PSA was 3.0 in 2011 and rose to 6.0 in late 2013. Medical record collection from doctors and hospitals. Little is known about men with localized prostate cancer who seek second opinions, the reasons why, and the association with treatment and quality of care. Masks are required inside all of our care facilities. A diagnosis is usually reached within 3-5 days of your slides' arrival at Johns Hopkins. * Gleason Score: 4+5, Slide 4 (vs. Sloan's 3+4) 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. 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. Overall, nearly 80% of men received definitive treatment 76.5% of men who obtained a second opinion from a urologist received definitive treatment compared to 81.6% who did not . I am 62 years old. 2. Men often seek second opinions from urologists before they initiate treatment for their newly diagnosed prostate cancer. As evidenced on this site, some studies indicate that GS 6 shouldn't even be classified as PCa and that it isn't aggressive. Hello, I apologize upfront for the length of this post, but I was recently diagnosed with prostate cancer (T2C) and figure more information is better than not enough. (Scores above 55 have a greater than 50% chance of finding clinically significant cancer on a biopsy) The biopsy showed 2 or 3 cores containing HG PIN but no cancer. Move ahead to Dec 2020. Required fields are marked *, PHONE 310-827-7707 Most reputable HMOs can, however, deliver state of the art treatment for most cancers. So, I also sent this MRI result to Johns Hopkins for a second opinion. 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. What is NOT OK is quitting or avoiding the bad news, or handing the entire decision over to someone else.Good luck fellas! And when I attempt to ask questions about intradcutal, I get responses about how little is known about it because it's so rare or that it is controversial or that they're not familiar with the study I'm referencing. Find more COVID-19 testing locations on Maryland.gov. Five years ago I had a TURP. Who Should Request a Second Opinion? It is OK to be scared. I also learned a lot more about the high undisclosed risk of side effects of various treatment plans. An official website of the United States government. 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. The results of Oncotype came back and it was a bad report. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. Dont Miss: Can Prostate Problems Cause Burning Urination, Why Prostate Cancer Survivor John Shearron Thinks Its Important To Do Your Research | PCRI, Prostate Cancer Pathology in 2021 | Jonathan Epstein, MD | PCRI 2021 Conference, Johns Hopkins Prostate Cancer Second Opinion, treat rare and complex conditions through breakthrough fetal procedures, Function Of The Prostate Gland And Seminal Vesicles, Best Treatment For Intermediate Prostate Cancer, How Old Can You Be To Get Prostate Cancer, New Treatments For Stage 4 Prostate Cancer, Prostate Radiation Treatment Side Effects, Can Prostate Problems Cause Burning Urination, Prostate Cancer Spread To Skull Prognosis, Life Expectancy Stage 4 Prostate Cancer No Treatment, Diagnostic Procedures For Prostate Cancer.
Cinespace Chicago News,
Strongest Beer At Publix,
Stockholders Employees, And Environmentalists Are Examples Of Various,
Articles J