In order to receive appropriate treatment, patients must understand the treatment options that are available. Especially opinions other than those of the first Urologist you see. An acute bacterial infection can cause a burning sensation. __________________________________________________________________________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. Some pathologists have more experience than others. I was offered to have my first biopsy sent to Johns Hopkins for second opinion and said why not? which came back with Gleason 9 three weeks after having the what we thought was G-7 ablated. Grade Group: 2 Methods: Due to the spread of the Coronavirus worldwide and the first confirmed case of the Coronavirus disease in Turkey, the executive team of the Anadolu Medical Center has taken preventive measures to protect the patients and their relatives. Also, Oncotype subsequently invalidated my results because they found in the history that I had a prior FLA. Cancer vaccines.For a long time, the promise of cancer vaccines that would protect healthy people at high risk of cancer has only dangled in front of researchers. I applaud Dr Scholz for his dedication and explanation of such a complex cancer, that has not had his common sense help available for men with prostate cancer. Bethesda, MD 20894, Web Policies Just got my pathology results. Benign prostatic tissue Anyone else encounter something like this? The majority had lower risk tumors and clinical staging of 1 40% sought second opinions with about half having more than one reason Men seeking second opinions tended to be younger and better educated citing the need for more information as their reason. I had my first of those 2 PSA tests last week and it dropped to 4.77. However, there are other cases when a second opinion results in a very different diagnosis or set of treatment recommendations. If I am rested, I find that I am more ready than if I am not. Got my physical and normal DRE with new Dr. No issues identified. 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. During the next 4 weeks I meet with the recommended Radiologist, and the two local surgeons. FAX 310-574-4002 BJU Int. There are so many different departments at Hopkins that I don't know the optimal department to contact. 8. 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. Benign fibromuscular stroma; no prostatic glands are identified Any input on this would really be appreciated. 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. __________________________________________________________________________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. * Gleason Score: 4+5, Slide 4 (vs. Sloan's 3+4) Xia L, Talwar R, Chelluri RR, Guzzo TJ, Lee DJ. Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. Also, infection was noted, so the current PSA is high in part due to prostatitis. They seem to think it'll do the trick.I feel great and I am glad I chose this treatment path. Does 3+4 at some point typically evolve into 4+3 and also serve as a trigger point for moving from AS to treatment? 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. * Seminal vesicle invasion: None. Find more COVID-19 testing locations on Maryland.gov. - Follow-Up Score (PRECISE) for this lesion = Stable MRI appearance: no new focal/diffuse lesions. I'm turning 58 in one week. So the pathologist suggested a second opinion. And by FAA Aeromedical Ruling, I'd need a few post procedure reports before being cleared to fly again.) Had third MRI in July 2019 this time at Mayo which I believe does a better job than SMIL. Potentially inaccurate results can lead to selection of the wrong type of therapy. In adjusted models, obtaining a second opinion was not associated with receipt of definitive treatment . You may be concerned that the cancer will grow rapidly out of control before you are able to get a second opinion. You can call and speak with his assistant at: (410) 614-6330. Are there urologists out there that don't routinely order the DX test to get a better idea of low and intermediate risk cancers? Dr. Epstein has 744 publications in peer-reviewed literature and has authored 50 book chapters with a H-factor of 118. Treatment must be chosen based on stage and your No two cases of prostate cancer are alike and an accurate diagnosisis critical to developing the best treatment plan. 6 A study at the Johns Hopkins Health System found it was 3.4 times more common in Black Americans than in White Americans. Read books and realize as soon as they are published, they are outdated. But you have to do both. However, learning more about prostate cancer and prostate-related health issues can help optimize health. There are also many reasons why you may want to seek another opinion during the course of your cancer care. Two from one lesion were positive as was one of the two from the other. Thanks for considering. A second opinion is a review of the cancer diagnosis and the treatment recommendations of the physician who is treating the cancer by another, independent physician. Even at the age of 48, he thought I would be a good candidate for AS. A biopsy was performed on 2/26. Pathology reports are subjective. Anyhow, as for treatment, yesterday I met with a Dr. William Wong at Mayo Phoenix. Therefore, the value of these second opinions remains unknown. A doctor at MSK can collaborate with another doctor to offer support and help ensure the best outcomes. 6: Prostate, left medial base Radhakrishnan A, Grande D, Ross M, Mitra N, Bekelman J, Stillson C, Pollack CE. Prostate Cancer Grading: I am 62 years old. If these do not work, your symptoms could progress and become chronic. This kills both birds with a single stone. They did another 3T-MPMRI (Siemens machine) and it showed a faint area, near the margin, and very close to the down stream sphincter of prostate. 2017 May-Jun;30(3):298-307. doi: 10.3122/jabfm.2017.03.160359. His reasoning over the last couple of years is that the suspected lesion was not changing in size at all. It got discussions started and questions answered. 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. We have sought a second opinion and all tests are being reviewed by that second team.My question has to do with the symphysis pubis. First MRI done in June 2016 by Scottsdale Medical Imaging - nothing found. He wants me to begin the ADT around 5/1. Same with the amount of how much pattern 4. By choosing the first doctor you speak with to be your treating physician, you may be putting your health in the hands of someone who lacks the expertise to accurately and safely treat your prostate cancer. Utilize your primary care physicians as an un-biased resource to help you get second opinions from a range of specialists. John. 1st opinion"Nonspecific sclerotic change of the right pubic bone with low-level radiotracer activity, favor degenerative change rather than osseous metastasis." EVERY DAY, they'd take a low dose X-RAY and low dose CT to align the fiducials and ensure my bladder was full and the bowel was empty. Confounding this, I have read that the different genomic tests can disagree with each other, and that Oncotype is usually a more aggressive finding. If the problem is unresponsive to other treatments, your doctor may suggest a surgical procedure. Further, the two tumors in question have not really changed much in size for more than 2 years. Eager to hear what everyone thinks or has anything they see in the report I wouldn't have thought of. It was easy. 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. Here are some recent updates: Uterine cancer.Women who use chemical hair straighteners frequently could have a higher risk of developing uterine cancer than women who have never used the products, according to new findings from a national study that has followed nearly 34,000 U.S. women for more than a decade. I did genetic testing and there were no mutations of concern, and everyone agreed that there probably wasn't "enough meat on the bone" to get a good genomic test from the biopsy.After seeing Dr Joe Busch, he said he didn't see any target lesions (PIRADS2), nor did he think I was in any danger. The Journal of the American Board of Family Medicine published a study in 2017 that found that many patients do not get a second opinion outside of their PCPs original referral2. Call us with any questions: 410-955-2405, ext. During puberty, the body produces semen in a large number of cases, including enlarged prostate. Has anyone sent Radiology (mpMRI) reports and images to Hopkins for Second Opinion Review? 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. 2020 Jul 21;19(1):112. doi: 10.1186/s12904-020-00619-9. Explore our state-of-the-art patient care facilities in the Sheikh Zayed Tower. Notice of Privacy Practices(Patients & Health Plan Members). My thoughts focus on the fact that I have a disabled son who needs my care. Video consultation and written report from your expert. * Gleason Score: 3+3, Slide 1 (vs. Sloan's 3+4) My profession for forty years was health actuary consultant, so I have a pretty fair understanding of health data, outcomes, and risks. Slight BPH findings. Would you like email updates of new search results? I then had the PHI test which showed PSA 8.70 and overall PHI 125.9. For a second opinion on the results of your prostate biopsy, there is no place better to get one than from the well known prostate pathologist, Dr. Jonathan Epstein at Johns Hopkins. This has only low-level nonspecific activity with SUV max of 2.05 and may be due to degenerative changes at the symphysis pubis." 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. However, there were no other suspicious areas on MRI. I retired as a Dentist at the VA and saw many veterans with a wide range of outcomes as most of them became 100% service connected when diagnosed with prostate Ca due to exposure to Agent Orange if they served in Vietnam. Thank you! Compared with other men, African-American men and men with a family history of the disease are at higher risk of developing prostate cancer. 2. Greetings gentlemen! EDI am now 52 and not quite functioning like I did 4+ years ago. World J Urol. (Recommended by my oncologist, Dr. Mark Scholz.) Every year I got a PSA and DRE during my annual physical. * Size: 1.1 cm 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. -------------------------------------------------------- A. Prostate, right base, core biopsy: Over 80,000 specimen cases are seen at Johns Hopkins each year. 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. Required fields are marked *, PHONE 310-827-7707 So, I asked the Radiologist if she will schedule one for me. Suspicion for malignancy left anterior base-to-apex transition zone; I had a follow up 3T MRI guided biopsy on March 18 at Emory. Here are the details: Also Check: Prostate Cancer Stage 7 Treatment. Masks are required inside all of our care facilities. This condition causes pain in the lower back and groin area, and may cause urinary retention. asymmetric central zone tissue more pronounced on the left. Hello everyone. Unfortunately, what you do not realize may harm you! Men have plenty of time to seek multiple opinions and thoroughly research each option before making a decision. No extraprostatic extension. 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. In fact, additional biopsies revealed no additional cancer. It can: Confirm your original diagnosis and treatment plan Give you more detail about the type of breast cancer you have and stage it's in. But, ultimately decided on whole gland treatment using Proton Beam Radiation.So. After all, it seems like good idea to deal with your cancer sooner rather than later. -------------------------------------------------------- I fear limiting myself to an inferior treatment because the people I talk to have hammers, therefore everything must be a nail. In adjusted models, obtaining a second opinion was not associated with receipt of definitive treatment . I still have some urgency and frequency issues, but I am not complaining too bad. The only prescriptions I take are for GERD (Protonix), cholesterol (Atvorstatin), and allopurinol for an episode of gout that I got while doing physical rehab for a bad tibia break (I shattered my tibia plateau 2/2020 and have pretty much recovered). One Johns Hopkins study showed that out of 14,000 men who had surgery and were found to have Gleason 6 cancer confined to the prostate, "zero of those 14,000 men had lymph node metastases. I can do radiation as a monotherapy. The neurovascular bundles are intact. Johns Hopkins said I have options of adjuvant radiation approach up to 3-4months or wait to see if there are two successive rises in PSA and then do "salvage" approach. Men often seek second opinions from urologists before they initiate treatment for their newly diagnosed prostate cancer. I now have my list whittled down to 3. Confirm biopsy and imaging results with centers of excellence before making any final decisions. 24.5 BMI 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. The all-inclusive cost for a virtual second opinion for patients in the U.S. is $1,850. * IF ANYONE reading this doesn't believe in the value of MRI first and targeted biopsy next then take note that my systematic biopsy cores showed 0 positive in 8 cores and my MRI guided core samples were 6 for 6 being positive!
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