With The Clinic by Cleveland Clinic, patients have access to Cleveland Clinics 3500 specialists. 4. While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. I didn't study for the test and it's possible some morning activities might have affected my test score :) I appreciate any comments or insight that anyone wants to share. Second opinion Biopsy came after FLA G-9. Depending on your location, you may be able to have a telemedicine consultation. Second Opinion Results, Johns Hopkins biopsy reading of 2 slides sent by Sloan: This is often the case when the primary physician advises an expensive treatment. But, after 4 drinks or if I'm tired/jet lagged I find that sleep is more appealing than sex. As soon as pathology slides were ready, Emory sent them to Dr. Epstein at Johns Hopkins. ---------------------------------------------------- Seminal vesicles are normal. With The Clinic by Cleveland Clinic, patients have access to Cleveland Clinics 3,500 specialists with extensive experience in all types of cancers. The results were ambiguous. 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. Men often seek second opinions from urologists before they initiate treatment for their newly diagnosed prostate cancer. 5: Prostate, left medial apex I would feel much more comfortable, if the numbers stay the same, being involved in a recognized Active Surveillance Program. But I've had trouble getting Dr. Chang's office to provide any patient referrals. The side effects of the cut, radiate, hormone regime are unacceptable to me. T2W MRI score= 2, DW MRI score= 3, DCE MRI score=positive Jonathan Epstein, MD received his doctorate from Boston University. The primary goal is to be cured with the least toxic, most effective approach. And collaborating with Johns Hopkins Medicine means we can provide you with second opinions, streamlined and guided access to clinical trials, and a proven track record of excellence in care. Second Opinions & Consultations - Brain Tumor | Johns Hopkins Pathology But was able to walk right into the JH Urology clinic for immediate treatment (flushing of bladder cleared everything up). MRI obtained outsideon 04/16/2021. MEASUREMENTS: Methods: T2W MRI score= 5, DW MRI score= 5, DCE MRI score=positive Adenocarcinoma: Hillen MA, Medendorp NM, Daams JG, Smets EMA. Ask your doctor for a copy of your complete medical record. But I don't want to do a radical prostatectomy or radiation that would have large side effects now if the laser is a viable option given my data set. 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 can sometimes lead to a complete change in diagnosis in non-cancerous growths, inflammatory disorders, infections, cancer and other conditions. A new study by researchers at the Johns Hopkins University has found that . My urologist suggested a couple more PSA tests followed by an MRI. The all-inclusive cost for a virtual second opinion for patients in the U.S. is $1,850. I am doing my own research, but I am curious as to thoughts of the best possible MRI to obtain to give me the best chance at finding something the needle biopsy didnt find. Xia L, Talwar R, Chelluri RR, Guzzo TJ, Lee DJ. IMPRESSION: My family doctor was alarmed because such a steep increase in prostate-specific antigen could be a sign of prostate cancer. Get a Urology Second Opinion | Johns Hopkins Brady - Hopkins Medicine EDI am now 52 and not quite functioning like I did 4+ years ago. I am also talking with Dr Nour and Dr. Walser and possibly others to see if I am a good candidate for Focal Laser Ablation. Johns Hopkins is home to many of the world's leaders in Pathology. 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 have requested a second pathologist's opinion from Johns Hopkins based on feedback from this forum. Greetings gentlemen! Find more COVID-19 testing locations on Maryland.gov. EDI am now 52 and not quite functioning like I did 4+ years ago. of tumor in the rectal prostatic angles. Bring All Labs/Notes to Each Appointment. But I refuse to sit still, I continue to research and to plan, as best I can. However, many insurance and health care companies do pay for such opinions and acknowledge the importance of second opinions. Expert review of your case by a Cleveland Clinic specialist. We had the 3T MRI (no coil) and MRI guided biopsy at Sperling in NY, and then had a 2nd Opinion done by Johns Hopkins. In terms of cancer, changes can be from cancer to benign (or vice versa) or from one type of cancer to another, which could have a significant impact on treatment and prognosis. * Should still go for a Johns Hopkins second opinion on the pathology or is that overkill since the first one was done at MSKCC? If these do not work, your symptoms could progress and become chronic. I tried to send the samples out for genetic testing to Prolaris and Decipher, but there was an ordering error and they never went thru. If pain is present, a digital rectal examination will reveal hard areas. Include Your Primary Care Physician as Member of Your Treatment Team. You receive a secure, private online consultation without leaving home. HMO members may also be discouraged from trying expensive treatments that have only a small chance of success, even if that chance is real. Lesions are all small or very small. Obviously the Covid 19 issue is playing a part in all of our decisions. AHN patients have unprecedented access to the Johns Hopkins Center for Fetal Therapy. Generally, the symptoms can stabilize over time. At this point Im still ignorant about what I ought to be doing (MRI guided biopsy is what I should have gotten). Be sure to ask about and research the skills and experience a doctor has with treating prostate cancer. Many thanks for that. Ask your PCP to refer you to several different types of treating doctors before making a treatment decision. 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. Where Should I Go for a Second Opinion? - breast cancer Research was mixed on PINS, but in those days, many doctors saw them as likely to develop into cancer. I was confident I was making the right decision. HHS Vulnerability Disclosure, Help So, I also sent this MRI result to Johns Hopkins for a second opinion. advising or treating it. 2. (I think that it was easier to see because Mayo's MRI technology and procedures are better than SMIL's.) * Adjacent organ invasion: None. The ADT has daunting side-effects but he said offers some improved chances of eradication, any long-term downsides that I should consider? PROSTATE ADDITIONAL FINDINGS: Benign prostatic lesion. Watch: Are supplements good for prostate health? They won't be offended, and they may even be able to recommend a specialist for you to see. My girlfriend lives 2 blocks from the Emory Proton Clinic.We prayed on it and overthought the crap out of it. 1. D. Prostate, left base, core biopsy: 4 Get a Second Opinion Dr. Jonathan Epstein explains the benefits of getting a pathology second opinion Even if someone is being seen at a different academic center, the trials and other treatment options that we offer here may be different. Prostate Cancer Pathology in 2021 | Jonathan Epstein, MD | PCRI 2021 Conference, Why Prostate Cancer Survivor John Shearron Thinks Its Important To Do Your Research | PCRI, John Hopkins Prostate Cancer Second Opinion, a higher risk of developing uterine cancer, surgery may not always be necessary for all breast cancer patients, The cancer vanished in every single participant, Long Term Side Effects Of Brachytherapy For Prostate Cancer, treat rare and complex conditions through breakthrough fetal procedures, Prostate Cancer External Beam Radiation Side Effects, Can Enlarged Prostate Cause Blood Clots In Urine, Life Expectancy Stage 4 Prostate Cancer No Treatment, Prostate Cancer Spread To Skull Prognosis, Diagnostic Procedures For Prostate Cancer. Call us with any questions: 410-955-2405, ext. The PSA Doubling Time parallels my Urologist Doubling Time (I keep changing Uro until I find one who makes sense)! Six weeks later I have the biopsy in his office and a week later I get the results. It works. Prostatic Adenocarcinoma I made the appointments. Seems like a simple request. Two 1cc tumors, gleason score 3+4 each, one in each lobe. PELVIC LYMPH NODES: No adenopathy. Reinterpretation of imaging scans and lab tests. I opted to waive the biopsy, wait 1 year and test again. A second opinion is part of the education process that is critical for many cancer patients. 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. It is OK to not understand all the terminology. ---------------------------------------------------------- Slight BPH findings. When I read the forums and questions on this site everyone mentions their Gleason Score from their biopsy. Based on the results, our experts can provide you with an individualized treatment plan before you leave. Pingback: PROSTATE PROS Episode 6: Breakthroughs in Radiation PROSTATE ONCOLOGY SPECIALISTS, Pingback: Like Man, Im Tired (Of Waiting): The How-to Guide for Men with Prostate Cancer PROSTATE ONCOLOGY SPECIALISTS, Your email address will not be published. Expert review of your case by a Cleveland Clinic specialist. very activerun/cycle 6 days a week Does 3+4 at some point typically evolve into 4+3 and also serve as a trigger point for moving from AS to treatment? After a second opinion from both Johns Hopkins and Stanford, the two 4+3's were downgraded. ZERO - The End of Prostate Cancer Support Community. Overall, obtaining second opinions was not associated with definitive treatment or perceived quality of cancer care. In general, a second opinion is a good option for people who have recently received a cancer diagnosis but have not started treatment, as well as for people who have already completed chemotherapy or radiation treatment. 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. 6. (Recommended by my oncologist, Dr. Mark Scholz.) I could not get a definitive answer from them on how much, how many cells, or any information. decision on a single medical opinion or the first appointment you get, you may Ramsey SD, Zeliadt SB, Fedorenko CR, Blough DK, Moinpour CM, Hall IJ, Smith JL, Ekwueme DU, Fairweather ME, Thompson IM, Keane TE, Penson DF. 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 . As a Gleason 3 + 3, with 8 of 12 positive cores all with less than 30% cancer, and bilateral spread, I have determined that I cannot trust a blind biopsy in and of itself. It may be a new cancer, but it is more likely a recurrence since it is really near the ablation zone. 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. 2020 Dec 1;3(12):e2028320. * Asked and Dr. said he isn't overly concerned about perineural finding with the grade and it won't impact treatment options or overall prognosis. Benign prostatic tissue I guess TWO national centers of excellence are better than one? Overall, obtaining second opinions was not associated with changes in treatment choice or with improvements in how patients viewed their quality of cancer care. If these do not work, your symptoms could progress and become chronic. I'd like to talk with former patients who have gone through the procedure. Second opinions from urologists for prostate cancer: Who gets - PubMed I just turned 71 in February. This may include imaging, blood tests, prior treatment, and pathology reports. One of the bits of advice the group regularly dispenses is for men to get a second and even a third opinion if you have doubts about the first opinions rendered by your urologist, or your pathologist, or your radiologist, its always okay to seek out a second opinion. U.S. News & World Report ranked the institute #7in the country. 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. 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.