johns hopkins prostate cancer second opinion johns hopkins prostate cancer second opinion

In some situations, insurers will even insist on a second opinion. Younger men also sought the 'best' doctor. If I am rested, I find that I am more ready than if I am not. There is no bony or bulky nodal disease in the pelvis Unable to load your collection due to an error, Unable to load your delegates due to an error. 9. * Sloan only sent partial cores, slides 1 and 4. Urology. 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. However, many insurance and health care companies do pay for such opinions and acknowledge the importance of second opinions. Here are seven tips for seeking second opinions for prostate cancer: 1. * Other 12 slides not sent Men often seek second opinions from urologists before they initiate treatment for their newly diagnosed prostate cancer. Expert review of your case by a Cleveland Clinic specialist. I have completed an exhaustive research effort on Prostate Cancer and PCa treatments. The issues in my prostate from the first procedure onward have all been in the same area and the rest of my prostate from the first biopsy and subsequent MRIs onward have never shown any indications of cancer in other areas. My profession for forty years was health actuary consultant, so I have a pretty fair understanding of health data, outcomes, and risks. You can find out by reviewing your plan or by reaching out to your insurance company. They hesitated calling it a TARGET LESION, but scored it PIRADS 4. Men who sought second opinions because they were dissatisfied with their initial urologist were 51 percent less likely to receive definitive treatment, and men who wanted more information about treatment were 30 percent less likely to report excellent quality of cancer care compared with men who did not receive a second opinion. 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. It got discussions started and questions answered. However, learning more about prostate cancer and prostate-related health issues can help optimize health. Three lesions: 1) GS 6 involving 30% of one core; 2) GS 6 involving less than 5% in one core; and 3) GS 6 involving less than 5% in another core. My Oncotype rating was GPS 54, with a 26% chance of metastisis within 10 years. Surgery took about 3 hrs. (Recommended by my oncologist, Dr. Mark Scholz.) Because every patient is different, there are several ways to approach prostate cancer treatment. For men with prostate cancer and who live in the United States, there are some highly regarded pathology labs from which you can obtain your second opinion. 7 People with PN had an increased likelihood of: 6 Eating disorders Self-harm Be sure to confirm your diagnosis at a center of excellence. Hi All, But, after 4 drinks or if I'm tired/jet lagged I find that sleep is more appealing than sex. About 80 percent of prostate cancers are diagnosed at a localized stage, which means that the cancer hasnt spread outside of the prostate. In adjusted models, obtaining a second opinion was not associated with receipt of definitive treatment . Thank you! My PSA over time has been creeping up over time (1.8 - 5/16, 1.0 8/17, 2.68 8/18, 2.9 12/18, 3.28 2/19, 3.01 8/19, 3.65 2/20, 3.31 6/20, 3.88 12/20) but I was frankly a bit shocked when I received word that I have cancer. How long do you have left? * PIRADS v2 Score: 3 We used multivariable logistic regression models to evaluate the relationship between second opinions and definitive prostate cancer treatment and perceived quality of care. Two things you learn here is get a second opinion from Johns Hopkins on biopsy and get treated at Center of Excellence. 4. Dont Miss: Bladder Control After Prostate Surgery. I certainly would - after all, there's a certain brotherhood bond here. Some specialists have more expertise and more experience than others. One of the problems with second opinions is that insurers may not cover the expense. You think another treatment might be available. Johns Hopkins second opinion - nothing found. Other: There is trace ascites in the mesosigmoid. He wants me to begin the ADT around 5/1. Benign prostatic tissue 8. Cancer ABCs recommends: Johns Hopkins Hospital in Baltimore, Maryland, specifically Dr. Jonathan Epstein. BJU Int. He adds that second opinions also can provide insight into topics like clinical genetics and family risk or issues related to complementary or integrative medicine approaches to manage symptoms. All views would be appreciated. 5. Benign prostatic tissue Men often seek second opinions from urologists before they initiate treatment for their newly diagnosed prostate cancer. It was easy. * Gleason Score: 3+3, Slide 1 (vs. Sloan's 3+4) Slightly Diffusely abnormal appearance of the prostate may reflect prostatitis, which can obscure underlying prostate cancer. Low post-void residual volume is This may include imaging, blood tests, prior treatment, and pathology reports. 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. I wanted to keep my options open. Even if I go the radiation route, should I try for Proton radiation or some other type? A new study by researchers at the Johns Hopkins University has found that . Prostate, right lateral base: I am relatively new to this forum and trying to educate myself as to my best course of treatment. * Perineural Invasion also detected Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. 2018 May;115:133-138. doi: 10.1016/j.urology.2018.01.048. Bring All Labs/Notes to Each Appointment. During the next 4 weeks I meet with the recommended Radiologist, and the two local surgeons. Dr. Jonathan Epstein of Johns Hopkins University Hospital. Keywords: I was confident I was making the right decision. * Gleason Score: 3+3 (2 of 6 specimens) The biopsy took 3 samples from the targeted region plus 16 sextant. This Dr is in charge of active surveillance program at JH so I knew that he wouldnt recommend surgery unless it was really needed. PCPs can be a great help to navigate the medical marketplace and provide an unbiased voice of reason when it comes to making hard choices. Benign Processes: ---------------------------------------------------------- While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. 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 . 2021 Sep 24;11(9):e044033. He turned to the Top Gun of Prostate Pathology: Jonathan Epstein, MD, the guru of Gleason scoring at Johns Hopkins University in Baltimore. -------------------------------------------------------- In unadjusted analyses, younger men , men with college-level education , and privately insured men and Medicare ) were more likely to obtain second opinions . The prostates function is to create some of the fluid that insulates sperm cells found in semen. Over 80,000 specimen cases are seen at Johns Hopkins each year. 4: Prostate, right medial base NONE of the many radiation oncologists, surgeons or urologists I've spoken with in my journey have ever mentioned the term to me so I had to look it up. We prioritized treatment as AS, FLA/TULSA (if a lesion ever presented itself), and Proton Beam Radiation. 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. Explore our state-of-the-art patient care facilities in the Sheikh Zayed Tower. It is OK to be overwhelmed with info. Masks are required inside all of our care facilities. 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). Get directions, important phone numbers, locations and more. Us Too Prostate is a great club and many of you have helped me a lot already. Further, among men with low risk disease, we did not observe a significant association between second opinions and receipt of definitive treatment or surgery. Medical record collection from doctors and hospitals. So my question for you is have you ever heard of PRECISE and if so what should I make of it? No extraprostatic extension. 2019 Jan;69(1):7-34. doi: 10.3322/caac.21551. But was able to walk right into the JH Urology clinic for immediate treatment (flushing of bladder cleared everything up). (TZ) One suspicious area - lesion size: 2cm x 1.4 cm The average age at the time of prostate cancer diagnosis is about 66. Then about a month later I started 28 fractions of Proton Radiation.It was painless. DIAGNOSIS: I've tried to find out about Dr. Wong but there's very little info on him. Everything seems to be on track to remove the cancer and be cured! undefined will no longer be visible to you including posts, replies, and photos. 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. Associated fees may be incurred up to $1,800 in a minority of more complicated cases requiring special studies. Note respondents were able to choose more than one reason. 1. And should I treat prostatitis before FLA? MY THOUGHTS AND ANYTHING DOCTOR NOTED: So, I also sent this MRI result to Johns Hopkins for a second opinion. This is not true. 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. I've also read that some study's have shown that intraductal may be resistant to hormonal therapy, radiation and/or chemo. He has had a nagging "groin injury" for may years (he played pick up basket ball until he got injured) and we are now wondering if this could be the source of that recurring ache. After sending off all of our records, CD of MRI and path reports, my husband is booked for screening in December. -------------------------------------------------------- And thanks again for making this such a great support group! He was right. Some men may have an enlarged prostate but not notice it. Is the destruction of my prostate inevitable and necessary for my survival (my understanding is that both surgery and radiation will do this)? 4 Get a Second Opinion Dr. Jonathan Epstein explains the benefits of getting a pathology second opinion Benign fibromuscular stroma; no prostatic glands are identified 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. 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. 180 days after treatment PSA was .50. Biopsy in 12/27/11 showed 3/14 cores, Gleason 6 with PSA of 4.5. I'm leaning towards SBRT. I also changed my diet to plant based food, started juicing, and started taking supplements (think Turmeric, Green Tea, etc.). Obtaining a second opinion in Pathology can in a small percent of cases lead to a complete change in diagnosis in a wide range of conditions including non-cancerous growths, inflammatory disorders, infections, and cancer. * Should still go for a Johns Hopkins second opinion on the pathology or is that overkill since the first one was done at MSKCC? EDI am now 52 and not quite functioning like I did 4+ years ago. Here are seven tips for seeking second opinions for prostate cancer: Before getting a second opinion, its important to know your stage of prostate cancer. Last checkup (July 2022) my PSA was .46 and it is currently at .32.I am still eating primarily a plant based diet (only lean meats/cheeses/eggs about 10% of my diet) and maintaining steady weight and I am still quite active physically.As for symptomswith 5mg Daily Cialis the occasional ED symptoms have pretty much gone away. Other Features: 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. I don't know if the FLA could affect the results, or if it was just done because it was not in the study parameters of the test. They seem to think it'll do the trick.I feel great and I am glad I chose this treatment path. 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. 8: Prostate, left lateral base Have a condition that isnt improving or is getting worse, despite treatment. It starts many years ago. 1. 6 cancers that are the toughest to diagnose are prostate, bladder, head and neck, soft tissue, skin and lymph system. Of course, my old school Urologist recommended surgeryHe, of course, knew the best robotic surgeons around.Anyway. I question the potential EPE and he said it didn't matter, but went ahead and ordered Oncotype. If you are considering undergoing a specialized treatment, such as cancer surgery, within your HMO, it is important to inquire about the number of such procedures performed each year by the HMO and the results. * Membranous urethral length: 1.2 cm The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System. A doctor at MSK can collaborate with another doctor to offer support and help ensure the best outcomes. Right mid anterior transition zone (PIRADS 2). Epstein, who views about 12,000 slides a year, called for calm in my case and suggested another biopsy in six months. Benign Processes: At Johns Hopkins, you can feel confident knowing our multidisciplinary cancer clinics combine the very best resources and specialists all within in a single location for a highly coordinated experience that delivers exceptional care while conserving time, money and energy. Metastatic disease considered less likely for this pattern. My long-term prognosis appears to be good with minimal side effects. However, something is driving my PSA. 6. Lesions are all small or very small. However, before getting a second opinion, its best to check with your insurance company to see if there are any limitations in coverage. A enlarged prostate can also cause blockages in the urethra. I have completed all that is necessary to enter Johns Hopkins Second opinion and PTEN test program. My question is--what importance do volume levels play in determining when to move from AS to treatment? 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. Peripheral Zone: The peripheral zone is of normal homogeneous prolonged T2 and there are no suspicious focal areas of Y'all are in my prayers! Even if someone is being seen at a different academic center, the trials and other treatment options that we offer here may be different. Am I wrong? With no travel needed and no red tape, its easy to get a second opinion, all from the comfort of your home. 1. I also had my PTEN test by META-MARK ( I don't have much to say about how I was treated by MM, but I won't be using their services again). Fear, confusion and uncertainty set in. 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. 4, Dr. Jonathan Epstein explains the benefits of getting a pathology second opinion. 2: Prostate, right lateral base But you have to do both. It is OK to be scared. This site needs JavaScript to work properly. Prostate, right lateral apex: Pathology reports are subjective. Seems like a simple request. If you have received a diagnosis or recommendation for treatment and want another opinion, our service can help you make a more informed decision. Greenfield G, Shmueli L, Harvey A, Quezada-Yamamoto H, Davidovitch N, Pliskin JS, Rawaf S, Majeed A, Hayhoe B. BMJ Open. He said that he saw what JHs was referring to but did not determine EPE for a variety of reasons. Consultation with your nurse care manager. Nor did I have any idea that the 1 core had 20% involvement and <5% pattern 4 involvement.