He said that it will improve in the future due to future improvements in the treatments. Also, in 2018 I had an exosome Dx test which scored 45.34, but I also retook that test this year and it went down to 30.79. They want him to start radiation 25 sessions and chemo pills of Casodex 50 mg 28 pills. In terms of cancer, changes can be from cancer to benign (or vice versa) or from one type of cancer to another, which could . prostate cancer; quality of health care; second opinion; specialists; treatment. Receiving a second opinion was not associated with perceived quality of prostate cancer care. Grade Group: 2 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. The .gov means its official. In some situations, insurers will even insist on a second opinion. 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. From what I've learned from Dr. Scholz videos at PCRI, and from posts on this site it would lead me to believe the DX test is fairly common knowledge. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. Other: There is trace ascites in the mesosigmoid. Are considering a treatment that involves significant risks, such as surgery. In order to receive appropriate treatment, patients must understand the treatment options that are available. Got the fiducials placed, the Space-OAR gel placed, mold made, and had the pre-treatment MRI and CT Scan. The more often a doctor diagnoses and treats prostate cancer the more proficient they become. To learn your stage of prostate cancer, take the staging quiz on keytopc.com. We are vaccinating all eligible patients. 8. 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. 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. FOIA My biopsy report does not mention a GS and the second opinion from Johns Hopkins did not list a GS either. The biopsy took 3 samples from the targeted region plus 16 sextant. Reason was large volume of cancer (even though most of mine was Gleason 6), presence of Gleason 7 in biopsy and the rapidly increasing PSA. A 1.4 cm lesion in the left, apex, anterior transition zone demonstrates conflicting T2 and DWI characteristics for PI-RADS classification - an indeterminate lesion. 2. It will be interesting to see, I think. 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. However, seeing him will be another 8 weeks, but he wants my biopsy slides (second opinion) before we meet. More medical freakouts. 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. This may include imaging, blood tests, prior treatment, and pathology reports. The Radiation Oncologist said he would be comfortable waiting a little more, but he wasn't confident that I'd grow a target lesion, nor would I be able to wait years before having to do "something." We have a surgery date set up for the end of July at Johns Hopkins (our second opinion team).His stats:63yo, non smoker, 167lbs, Vegetarian/Vegan diet no other known health issuesWalks dogs for a living and cares for our small farmPSA 3.3 (Jumped from 1.6 in a year)Biopsy Scores 3+5, 4+3. Right mid anterior transition zone (PIRADS 2). I've had what I would consider a fluctuating PSA since first tested in November 2018. The percentage of tissue with carcinoma is 70% DIAGNOSIS: Johns Hopkins second opinion identified a PI-RADS 4 Mayo Phoenix also reviewed MRI prior to targeted biopsy. feel the clock ticking. Knowing your stage and information specific to that stage makes you more medically sophisticated and enables you to navigate through the potential biases of surgeons and radiation therapists. * Gleason Score: 3+3 (2 of 6 specimens) 2017 May-Jun;30(3):298-307. doi: 10.3122/jabfm.2017.03.160359. Of course, my old school Urologist recommended surgeryHe, of course, knew the best robotic surgeons around.Anyway. 6: Prostate, left medial base 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. However, many insurance and health care companies do pay for such opinions and acknowledge the importance of second opinions. Prostate, left medial apex: Second Opinions (Adults) For stem cell transplant, please call 1-773-702-1994. Cancer. If a targeted biopsy is planned, this lesion can be sampled at the same time. With no travel needed and no red tape, its easy to get a second opinion, all from the comfort of your home. Generally, the symptoms can stabilize over time. You May Like: Sbrt Radiation Therapy Prostate Cancer. Johns Hopkins Medicine A commercially available genomic test may help oncologists better determine which patients with recurrent prostate cancer may benefit from hormone therapy, according to new research from the Johns Hopkins Kimmel Cancer Centerand 15 other medical centers. Thank you! 4. 6 cancers that are the toughest to diagnose are prostate, bladder, head and neck, soft tissue, skin and lymph system. Before One core had 5%, one 20%, and one 40%. Thank you for your participation! I would appreciate hearing from that 2.8% out there who have an intraductal component. Thanks, BigD. Find more COVID-19 testing locations on Maryland.gov. Bring All Labs/Notes to Each Appointment. 2/23 PSA 4.7/fPSA 12% taken for 4K score (lab #2) Check Biopsy and Imaging Results for Accuracy. mail@prostateoncology.com, 7 Tips for Seeking Second Opinions For Men with Prostate Cancer. Is there such a thing as having a team that isnt equipped with the best equipment nor the most experienced radiologists? But, ultimately decided on whole gland treatment using Proton Beam Radiation.So. 6. Enter the last name, specialty or keyword for your search below. Prostate Cancer Grading: 53 years old I would feel much more comfortable, if the numbers stay the same, being involved in a recognized Active Surveillance Program. A doctor may prescribe surgery or perform an endoscopic procedure. 2 of the 12 samples showed High Grade PIN and one area showed "suspicious for low-grade adenocarcinoma". This fluid causes the prostate to swell and cause a number of bladder-related symptoms. This approach helps to decrease side effects that can affect a patients quality of life, such as erectile dysfunction, incontinence or other urinary-tract symptoms. Men have plenty of time to seek multiple opinions and thoroughly research each option before making a decision. He is the past president of the International Society of Urological Pathology. With that alone, I would likely be a candidate for continued Active Surveillance. Cancer 2017;123:1027-34. Seminal vesicles are normal. My urologist has decided we'll go ahead with the MRI due to the continued elevated PSA scores, in addition to the overall PHI score. We prioritized treatment as AS, FLA/TULSA (if a lesion ever presented itself), and Proton Beam Radiation. He was right. However, before getting a second opinion, its best to check with your insurance company to see if there are any limitations in coverage. I still have some urgency and frequency issues, but I am not complaining too bad. I am unfortunately "officially" joining the club after getting my biopsy results today. Either the patient or the primary physician can initiate the process of getting a second opinion. Cancer. Also, their protocol would be another biopsy, but he was comfortable with the image and velocity of PSA that he didn't have to have one to start treatmentand I was pretty hesitant (given the image and PSA) to take ADT, and didn't see a biopsy changing my mind regarding treatment and/or ADT.Oh. 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. 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. Any input on this would really be appreciated. In the United States, prostate cancer is among the most common cancers found in men. When to move from Active Surveillance to Treatment for Prostate Cancer? The urologist offered surgery and radiation as options on 3/10 when we met. One of the problems with second opinions is that insurers may not cover the expense. Asking for your comments: An acute bacterial infection can cause a burning sensation. When first diagnosed with prostate cancer, your PCP will generally refer you to a urologist for a biopsy. You have a rare or unusual cancer. 2nd opinionBone Scan:"Mild increased activity is seen in the right symphysis corresponding to the abnormalities on the prior PET/CT examination. 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. There is no one-size-fits-all treatment for prostate cancer. Notice of Privacy Practices(Patients & Health Plan Members). Disclaimer. Luckily, his report co-coincided with the original QDx report. 3. 3 months has passed, and its time for a PSA and a plan to have an MRI. And again, most of you tell me time is on my side, so I am comforted in hearing that. How much is the fee for an opinion of my recent MRI? Also indicated everything else was "organ confined." LESION 2 He turned to the Top Gun of Prostate Pathology: Jonathan Epstein, MD, the guru of Gleason scoring at Johns Hopkins University in Baltimore. Ask us questions on this webpage. Surgical Delay and Pathological Outcomes for Clinically Localized High-Risk Prostate Cancer. It hasn't let me down. There is no extraprostatic extension. 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. He said that he saw what JHs was referring to but did not determine EPE for a variety of reasons. Noted that some don't even include on report and should be looked as something to note but not obsess about. 2016 American Cancer Society. Benign Processes: Family history of prostate cancer. Im immediately referred to Urologist. 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. The prostates function is to create some of the fluid that insulates sperm cells found in semen. 1. probably organ confined disease. -------------------------------------------------------- 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. If these do not work, your symptoms could progress and become chronic. I'm currently in the process of getting an appointment set up with a Dr. Wang at UCLA. Call us with any questions: 410-955-2405, ext. And it is OK to have paralysis by over-analysis. Include Your Primary Care Physician as Member of Your Treatment Team. 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. When you review your pathology report and are going to be making important decisions, like treatment decisions, which will be based on the information from the pathology report. I had a follow up 3T MRI guided biopsy on March 18 at Emory. Some men have minimal or no symptoms at all. The peripheral zone has a patchy signal pattern. Let me know what everyone thinks if you see anything interesting or of note here or just have some advice. Please don't hesitate to make any observations or ask questions. It is OK to be scared. I appreciate all the input because I am a little overwhelmed and confused as to the best course of treatment. I personally have benefitted from second opinions on my so-called cancer journey. After extensive discussion of his management options with his local urologist, primary care physician, and radiation oncologist, he also sought a second opinion at the Johns Hopkins Prostate Cancer Multidisciplinary Clinic at Sibley Memorial Hospital.The patient expressed an overwhelming desire to avoid surgery and any other invasive treatments. What is NOT OK is quitting or avoiding the bad news, or handing the entire decision over to someone else.Good luck fellas! With The Clinic by Cleveland Clinic, patients have access to Cleveland Clinics 3500 specialists. 4. My questions are: PSA that brought me to this was 7.1. * Perineural Invasion also detected This fee includes: Studies show the clinical and financial benefits of obtaining a pathology second opinion. Because every patient is different, there are several ways to approach prostate cancer treatment. We are vaccinating all eligible patients. 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. And just this week, 1 YEAR post treatment, it is .46. Benign Processes: Even at the age of 48, he thought I would be a good candidate for AS. A doctor at MSK can collaborate with another doctor to offer support and help ensure the best outcomes. 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. In 2006 my PSA was .6. Prostate dimensions: 4.1 x 2.8 x 3.4 cm With world-renowned expertise, multidisciplinary specialistsand the latest data, we partner with you tomake informed decisions about managing your prostate cancer. It was easy. Greetings gentlemen! However, many insurance and health care companies do pay for such opinions and acknowledge the importance of second opinions. HMO members may also be discouraged from trying expensive treatments that have only a small chance of success, even if that chance is real.
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