johns hopkins prostate cancer second opinion

Epub 2018 Mar 28. - Perineural invasion is present Prostate, right lateral apex: This sounds to me like they're not familiar with the Oncotype DX test and makes me wonder how common is the test. My urologist suggested a couple more PSA tests followed by an MRI. I will say, the people I dealt with at Johns Hopkins were extremely nice and professional. Two things you learn here is get a second opinion from Johns Hopkins on biopsy and get treated at Center of Excellence. Some pathologists have more experience than others. The margin of error is 1.4 percent, which is equivalent to 30,000 cancer diagnosis mistakes annually in the U.S. Of 6,171 biopsy slides sent since late 2008 for a second review at Johns Hopkins, pathologists disagreed with the diagnosis on 86 of them. After a little experimenting I have been able to achieve a partial erection. They are not objective. 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. Didn't know if she had the catheter in far enough and not getting any urine through itwondered if she had inflated the balloon enough and wondering if it was the reason that I have developed an abscess. A. Prostate, right base, core biopsy: That is literally the first time I heard that term other than seeing it in my pathology report. Men need to be educated on all treatment options to protect themselves from a biased industry. This teamwork ensures the best possible patient outcomes. Then about a month later I started 28 fractions of Proton Radiation.It was painless. And in some cases, the information you gain during a second opinion consultation can even change your diagnosis. 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. The prostates function is to create some of the fluid that insulates sperm cells found in semen. It is OK to be scared. 1st opinion"PYL PSMA PET/CT scan demonstrating foci of moderate to intense uptake in the prostate gland consistent with known prostatic cancer. He never sought treatment for the injury. 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. We will give that a shot and see how it turns out. 2018 May;115:133-138. doi: 10.1016/j.urology.2018.01.048. Last year, Epsteins lab reviewed the pathology reports of 30,000 cases in which patients requested second opinions.Netto says patients should be proactive in requesting that doctors take another look.A second opinion can reverse the diagnosis in up to 5 percent of cases for some types of cancers, he says, like those of the breast and pancreas.Diagnosis Errors by the Numbers. 3. Following his residency in anatomic pathology at The Johns Hopkins Hospital in Baltimore, Maryland, and a fellowship in oncologic pathology at Memorial Sloan Kettering Cancer Center in New York., he then joined the staff at The Johns Hopkins Hospital and has been there his entire career. Following the advice of all on here, I need a team of doctors to manage my care. Benign Processes: The neurovascular bundles are intact. This is why the prostate is important to the body. Prostate, right anterior MRI lesion: SMIL radiologist reported nothing found. If pain is present, a digital rectal examination will reveal hard areas. So, I believe I made the right choice. 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. How long do you have left? Unable to load your collection due to an error, Unable to load your delegates due to an error. Many researchers believe PTEN present is a strong brake on - Benign prostatic tissue 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. I still have some urgency and frequency issues, but I am not complaining too bad. 2020 Jul 21;19(1):112. doi: 10.1186/s12904-020-00619-9. Dr. Albert Chang at UCLA appears to be the best in the biz for high dose rate (HDR) focal brachytherapy. However, seeing him will be another 8 weeks, but he wants my biopsy slides (second opinion) before we meet. My prior Prolaris study (2018) before the FLA was very low risk. It's a bit confusing since most experts now don't consider Gleason 6 to be a true cancer, so did i test positive in 2 cores or 4? When people recommend going to a Center of Excellence, believe them. 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. 2015 Feb;115(2):188-97. doi: 10.1111/bju.12665. Second Opinions An accurate diagnosis is essential to ensure that the correct and most effective treatment is given. 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. 4. So, Radiation Oncologist prescribed Cialis 5mg, daily. I opted to waive the biopsy, wait 1 year and test again. * PIRADS v2 Score: 3 6: Prostate, left medial base There is no evidence Cancer ABCs recommends: Johns Hopkins Hospital in Baltimore, Maryland, specifically Dr. Jonathan Epstein. Benign fibromuscular stroma; no prostatic glands are identified Greenfield G, Shmueli L, Harvey A, Quezada-Yamamoto H, Davidovitch N, Pliskin JS, Rawaf S, Majeed A, Hayhoe B. BMJ Open. radiation, active surveillance, surgery, hormone therapy, and more. It is OK to not understand all the terminology. Cleveland Clinics Virtual Second Opinions program connects you to an expert physician who specializes in your specific health needs. Our team approach brings together highly experienced prostate cancer experts from across disciplines to collaborate on each patients total care, from diagnosis through treatment and recovery. JAMA Netw Open. A second opinion can help you make an informed, confident decision about your medical care. 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 hasn't let me down. A enlarged prostate can also cause blockages in the urethra. Treatment Advice: Sloans radiation oncologist says radiation treatment will likely be the same whichever pathologist report prevails, but may add hormone therapy for about 2 months. Further, among men with low risk disease, we did not observe a significant association between second opinions and receipt of definitive treatment or surgery. Of course, my old school Urologist recommended surgeryHe, of course, knew the best robotic surgeons around.Anyway. Suspicion for malignancy left anterior base-to-apex transition zone; 3+4, 4+3, 4+3, 4+5 (1st read)Both docs are recommending surgery.PSMA CT Scan report:"BONES/BONE MARROW: There are sclerotic changes in the right pubic bone adjacent to the symphysis pubis and to lesser extent in the left pubic bone. It is OK to be overwhelmed with info. I have actually had a second opinion a while back from Dr. Bush. 3T MRI with coil is done initially, along with a TRUS biopsy. Value of Second Opinion in Prostate Cancer Uncertain, Says Hopkins Study. Find more COVID-19 testing locations on Maryland.gov. I had a telemed session with Dr. Chang, and it sounds like a pretty simple procedure, with urinary side effects that resolve pretty quickly. Benign Processes: I made the appointments. Overall, obtaining second opinions was not associated with changes in treatment choice or with improvements in how patients viewed their quality of cancer care. He turned to the Top Gun of Prostate Pathology: Jonathan Epstein, MD, the guru of Gleason scoring at Johns Hopkins University in Baltimore. )As for side effectsI occasionally have some urgency/hesitancy having to pee. 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. 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. peripheral zone signal intensity on T2-weighted images. With world-renowned expertise, multidisciplinary specialistsand the latest data, we partner with you tomake informed decisions about managing your prostate cancer. Johns Hopkins Precision Medicine Center of Excellence for Prostate Cancer, Schaufeld Program for Prostate Cancer in Black Men, Read about the latest prostate cancer discoveries by our world-renowned researchers, Learn more about prostate cancer in our health library, Watch: What to expect during your post-surgery hospital stay. 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. - Prostatic adenocarcinoma, Gleason score 3+4=7 (grade group 2, pattern 4: 5%) involving 1 of 2 cores (lateral core: 4 mm, 35%), 0.1 mm to the blue inked tissue edge John, I was diagnosed on 11 December, 2013. Hope to hear from a bunch of people. A second opinion is part of the education process that is critical for many cancer patients. 8: Prostate, left lateral base Spent the night in hospital with very little pain after the first couple of hrs. Using an Ellipsoid Volume the dimensions would give you a volume of 20.44. Be sure to ask about and research the skills and experience a doctor has with treating prostate cancer. Anyhow, as for treatment, yesterday I met with a Dr. William Wong at Mayo Phoenix. At the Johns Hopkins Medical Institutions, he is Professor of Pathology, Urology, and Oncology the recipient of the Reinhard Chair of Urological Pathology and Director of Surgical Pathology. Would you like email updates of new search results? However, older men 75 years were the least likely to report obtaining a second opinion due to dissatisfaction with their initial urologist. Enter the last name, specialty or keyword for your search below. -------------------------------------------------------- Thanks, PI-RADS v2 score: 5. Visit and Like ZERO - The End of Prostate Cancer on Facebook, Sign up to receive emails and news from ZERO - The End of Prostate Cancer, Search prostate cancer clinical trials and studies. We can help with your case. Also, if any of you have a way to get medicare to pay some portion of the cost, please let me know as well. Dr. Nour is 100% sure that nothing has spread. Wow, I sound like a snob now! MRI RE-READ #1 (well known radiologist, but free advice over phone, but no written report): At the Breast Cancer Program at the Johns Hopkins Kimmel Cancer Center in Baltimore, MD, a second opinion requires only that you or your doctor send us your pathology slides, key medical records and signed paperwork requesting the opinion. While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. Benign prostatic tissue Mohamad Allaf, M.D., answers questions about prostate cancer diagnosis and treatment options and discusses robotic prostatectomy at Johns Hopkins. Surgeon wants next PSA in 3 months. 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. Epub 2017 Jun 12. 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. 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. With world-renowned expertise, multidisciplinary specialists and the latest data, we partner with you to make informed decisions about managing your prostate cancer. You feel healthy, you arent in pain, you 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. * Extracapsular extension: Possible involvement of the anterior 4, Dr. Jonathan Epstein explains the benefits of getting a pathology second opinion. He wants me to begin the ADT around 5/1. We are vaccinating all eligible patients. Men who sought second opinions because they were dissatisfied with their initial urologist were less likely to receive definitive treatment (odds ratio, 0.49; 95% confidence interval, 0.32-0.73), and men who wanted more information about treatment were less likely to report excellent quality of cancer care (odds ratio, 0.70; 95% confidence interval, 0.49-0.99) compared with men who did not receive a second opinion.

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