Reinterpretation of imaging scans and lab tests. Just had my appointment today and they are pleased with the results, so far. The study was published online Nov. 7 in the journal Cancer. All wanted to do what they do, schedule treatment which at this time is only Gleason 6 which I now know is not life threating. I made the appointments. One of the problems with second opinions is that insurers may not cover the expense. For this study, published in the journal Cancer, 2386 men in the greater Philadelphia area, who were diagnosed with prostate cancer between 2012 and 2014, responded to survey questions. Prostate cancer is a malignant (cancerous) tumor of the prostate, a gland found only in men. Reasons for getting a second opinion include: You want to be sure you have explored all options. The researchers did not include more minor errors in rating how fast-growing and how advanced a cancer was. U.S. News & World Report ranked the institute #7in the country. Know Your Stage. A week later had catheter removed and had no bladder leakage problems. I am meeting with a multidisciplinary team of docs on March 18 at St. Joe's in Atlanta. 6. Dr. Dan Sperling - New York. In some situations, insurers will even insist on a second opinion. Consultation with your nurse care manager. Even for men with faster growing, more aggressive prostate cancer, taking the time to seek a second opinion should be a priority. I am 58 and in very good health otherwise. Future study is needed to determine when second opinions contribute to increasing the value of cancer care. Though, for the most part the reports seem encouraging.I am curious if anyone has had something similar. My long-term prognosis appears to be good with minimal side effects. What is NOT OK is quitting or avoiding the bad news, or handing the entire decision over to someone else.Good luck fellas! Getting a Second Opinion The best time to seek a second opinion is before you start treatment. Tumor Quantifications: Instead, I did my homework. 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. I want to insure that the Imaging was read correctly and nothing was overlooked or missed. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. Dr. Epstein has 744 publications in peer-reviewed literature and has authored 50 book chapters with a H-factor of 118. The TRUS biopsy is behind me, the second opinion from Johns Hopkins is behind me, and its time for next steps. Johns Hopkins second opinion identified a PI-RADS 4 Mayo Phoenix also reviewed MRI prior to targeted biopsy. Prostate, left lateral base: I have had a second opinion from Johns Hopkins that confirmed the initial pathology of gleason 3+4. The neurovascular bundles are intact. - One separate small tissue fragment with prostatic adenocarcinoma, 0.5 mm in linear length Radhakrishnan A, Grande D, Ross M, Mitra N, Bekelman J, Stillson C, Pollack CE. poorly defined margins and intermediate to low T2. Note that I'm trying to get a second opinion from Johns Hopkins but Mayo, where the biopsy was performed, appears incapable of processing my request. A PSA test at time of biopsy revealed my PSA had risen to 6.5. I opted to waive the biopsy, wait 1 year and test again. 4. Check Biopsy and Imaging Results for Accuracy. In adjusted analyses, however, only age and education were significantly associated with obtaining second opinions from urologists. Even at the age of 48, he thought I would be a good candidate for AS. Get a Second Opinion | Johns Hopkins Pathology Perineural invasion is identified 1st opinion. The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System. That's the good news. 5. Patients may experience a fever or chills as a result of the infection. This urologist can get you in for surgery next week. What are you doing about it? 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. It has been 2.5 years and the PSA has still not doubled as well. With world-renowned expertise, multidisciplinary specialists and the latest data, we partner with you to make informed decisions about managing your prostate cancer. These results, if validated in other studies, justify additional investigation on how second opinions can contribute to increasing the value of cancer care, the authors concluded. 4. Men often seek second opinions from urologists before they initiate treatment for their newly diagnosed prostate cancer. Based on the results, our experts can provide you with an individualized treatment plan before you leave. Out of 12 cores, 9 are positive. 7. I had the MRI in April 2021 and it showed a PI-RADS 4 lesion. doi: 10.1136/bmjopen-2020-044033. No extraprostatic extension. A blocked urethra can also damage the kidneys. Either the patient or the primary physician can initiate the process of getting a second opinion. intricate disease and not all doctors have the same amount of experience When I inquired with the oncologist that I had selected for my therapy before receiving the second opinion whether I would be a candidate for Active Surveillance considering the downgrading, she said 'no' due to the intraductal component. 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. I am an airline pilot with exposure to radiation, jet fuels/fumes, etc. 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. And, even working in a fairly technical field myself, I was amazed at the technology and precision of that Proton Machine. * Both Sloan and Johns Hopkins admit that large discrepancies are unusual, yet both stand by their opinions. 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. 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. If I don't meter fluids before bed, I can expect to get up 3-4 times in the night.At this point, I am convinced I made the right treatment choiceOHFOR THOSE THAT DON'T KNOW, THE VA HAS MADE REPRODUCTIVE CANCERS A PRESUMPTIVE CONDITION FOR THOSE THAT SERVED IN MOST OF THE WAR ON TERROR LOCATIONS.Good luck fellas and my prayers are with all of you having to contend with this disease. So, Radiation Oncologist prescribed Cialis 5mg, daily. EDI am now 52 and not quite functioning like I did 4+ years ago. The results seemed fairly benign and my urologist and I decided to continue to monitor with 2 more PSA tests and then consider an MRI in April 2021. Another DRE that results in identifying that my prostate is enlarged, but cant find and nodules. Request an Appointment 410-955-6100 Thanks for Everyone's Help, An accurate diagnosis is essential to ensure the most effective treatment. H. Prostate, lesion #2, core biopsy: Johns Hopkins Medical Laboratories 1620 McElderry St. Reed Hall Rm 315 Baltimore, MD 21205 Fax (410) 614-7712 Phone (410) 955-2405 8 am - 5 pm Normal LAB hours are: 5:30 am - 4:30 pm Mon-Fri A blocked urethra can also damage the kidneys. Does every biopsy provide a Gleason Score? The average age at the time of prostate cancer diagnosis is about 66. The primary goal is to be cured with the least toxic, most effective approach. 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. Medical record collection from doctors and hospitals. Had my PSA remained static I'd have remained on AS and had I grown a Target Lesion I'd have sought focal treatment.This science is emerging and only getting better. Slightly About 60% of prostate cancers occur in people older than 65. "We were surprised by the relatively large percentage of men who obtain second opinions for their prostate cancer," said lead author Dr. Archana Radhakrishnan of Johns Hopkins University in . 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. Am I wrong? The total number of cores identified is 3 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. restricted diffusion. I assume the data on gleason scoring is much more robust/reliable than genomics as it has been around longer and used more extensively. Patient-Driven Second Opinions in Oncology: A Systematic Review. Also Check: Prostate Cancer Stage 7 Treatment. They seem to think it'll do the trick.I feel great and I am glad I chose this treatment path. -------------------------------------------------------- Does this also include HIFU, Cryoablation? Do I need a third opinion? PROSTATE LESIONS: Urology. Being in Wisconsin, my insurance gives me the option of two hospitals to manage me. Benign Processes: * PIRADS v2 Score: 3 If a targeted biopsy is planned, this lesion can be sampled at the same time. And again, most of you tell me time is on my side, so I am comforted in hearing that. 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. 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). The results of the MRI said they found a PYRAD 5 lesion, but did not find any cancer outside prostate. We specialize in minimally invasive treatments for prostate cancer such as: We place a high priority on sparing the nerves and tissue around the prostate whenever possible. However, learning more about prostate cancer and prostate-related health issues can help optimize health. In adjusted models, obtaining a second opinion was not associated with receipt of definitive treatment . For this study, published in the journal Cancer, 2386 men in the greater Philadelphia area, who were diagnosed with prostate cancer between 2012 and 2014, responded to survey questions. First of all we would like to emphasize that the health of our employees, our patients and their relatives is our first priority. Even if I go the radiation route, should I try for Proton radiation or some other type? Have been diagnosed with a serious or rare health condition. You think your doctor is underestimating how serious your cancer is. Be sure to confirm your diagnosis at a center of excellence. Advances in our understanding of breast cancer have opened up new treatment options or clinical trial opportunities, including targeted drug therapies and tissue-conserving procedures proven to greatly reduce pain and nausea.