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2. I assume it is not free. I sent a message to my urologist requesting my slides be sent to Dr. Epstein at Johns Hopkins for a second opinion and I also requested an Oncotype DX test to get an idea of risk for my low teal or basic teal cancer. What is NOT OK is quitting or avoiding the bad news, or handing the entire decision over to someone else.Good luck fellas! I find that when I'm trapped in the cockpit not able to use the bathroom for a long time is when I experience that most. 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. Now its easier than ever to get the answers you need and peace of mind you deserve. My girlfriend lives 2 blocks from the Emory Proton Clinic.We prayed on it and overthought the crap out of it. Family history of prostate cancer. Pathology reports are the opinion and interpretation of the individual pathologist viewing the tissue samples. I want to insure that the Imaging was read correctly and nothing was overlooked or missed. Masks are required inside all of our care facilities. Following application of the relevant exclusion criteria, 2365 respondents remained in the analytical cohort. 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. Seminal vesicles and other margins are negative for tumor. -------------------------------------------------------- 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). It took me awhile but minutes ago received my second opinion from Johns Hopkins. Your doctor is not sure what is wrong with you. Adenocarcinoma: Although a large proportion of men with localized prostate cancer obtained a second opinion, the reasons for doing so were not associated with treatment choice or perceived quality of cancer care. PSA had increased to 5.4. Therefore, the value of these second opinions remains unknown. Prostate cancer is a slow growing condition. However, there were no other suspicious areas on MRI. But if I include the 3+3=6 cores then 4 cores tested positive and that moves me into the basic teal category and no longer a strong candidate for AS. Overall, nearly 80% of men received definitive treatment 76.5% of men who obtained a second opinion from a urologist received definitive treatment compared to 81.6% who did not . Those readings were reported on a second opinion by Dr. Epstein. 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. 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 . 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. For all other cancer appointments, please call: 1-855-702-8222. PROSTATE PROS Episode 6: Breakthroughs in Radiation PROSTATE ONCOLOGY SPECIALISTS, Like Man, Im Tired (Of Waiting): The How-to Guide for Men with Prostate Cancer PROSTATE ONCOLOGY SPECIALISTS, Considering Prostate Cancer Clinical Trials? HHS Vulnerability Disclosure, Help I was never under the misconception that I'd never have to do something, but I was going to wait until I needed to do something. No two cases of prostate cancer are alike and an accurate diagnosisis critical to developing the best treatment plan. The problem is that all 3 pathologies noted an intraductal component. Benign prostatic tissue In those cases, patients are tremendously grateful for having received the advice and encouragement to get a second opinion, Dr. Matasar adds. 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. SMIL radiologist reported nothing found. If you choose to be treated at Johns Hopkins, you may be able to begin treatment immediately. You May Like: Prostate Cancer External Beam Radiation Side Effects. Men often seek second opinions from urologists before they initiate treatment for their newly diagnosed prostate cancer. Dr. Erick Walser at University of Texas Medical Center. J Am Board Fam Med. Nor did I have any idea that the 1 core had 20% involvement and <5% pattern 4 involvement. Laparoscopic prostatectomy: The prostate is removed with a miniature telescopic instrument, which allows for a quicker recovery, Robotic surgery: This breakthrough technology, which often is used for prostatectomy surgery, requires only a few small incisions. Consultation with your nurse care manager. If you have received a diagnosis or recommendation for treatment and want another opinion, our service can help you make a more informed decision. Diffusely decreased Anyhow, as for treatment, yesterday I met with a Dr. William Wong at Mayo Phoenix. They hesitated calling it a TARGET LESION, but scored it PIRADS 4. 4/16 3T MRI performed (reports/re-reads below) 2 cores from left base of 3+4=7 with only 5% involvement. I assume the data on gleason scoring is much more robust/reliable than genomics as it has been around longer and used more extensively. A second opinion is part of the education process that is critical for many cancer patients. His reasoning over the last couple of years is that the suspected lesion was not changing in size at all. Wondering if any of the "gurus" here want to take a stab at looking at this and see if they agree that it says what I think it says (I will be following up with doctor(s) to get their opinion, and I waive all HIPAA rights by allowing this to be seen). Contact us or find a patient care location. Prostate, right medial base: An official website of the United States government. 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. * Should still go for a Johns Hopkins second opinion on the pathology or is that overkill since the first one was done at MSKCC? There were several areas of interest - but nothing in seminal vesicles, lymph, or bones. Best wishes to all those whose concerns for the day are far more serious than mine. Director of Surgical Pathology- Johns Hopkins, http://pathology.jhu.edu/department/services/secondopinion.cfm, The guy I used along with everyone else is Jonathan Epstein, M.D. My girlfriend lives 2 blocks from the Emory Proton Clinic.We prayed on it and overthought the crap out of it. 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. Thanks, BigD. I am already positively surprised that I am still alive 4.5 years after my diagnosis. Ex-Uro wanted to do biopsies and keep doing them until we find "it", even though he didn't know the size of the prostate nor had he ruled out prostatitis. Has anyone else run into this where the gleason score is favorable, but the genomic (specifically Oncotype) test is not? Studies show the clinical and financial benefits of obtaining a pathology second opinion. I was diagnosed with a 3T MP MRI and a 3T MP MRI guided 4 core biopsy. 2. Interesting differences: This championship swimmer sought a second opinion at Johns Hopkins. Would you like email updates of new search results? I just turned 71 in February. Hi JM "Numerous publications show the clinical and economic benefits of obtaining a second opinion for Pathology specimens. Just took time off and then life happened.Thanks in advance for the insights. Either the patient or the primary physician can initiate the process of getting a second opinion. After a little experimenting I have been able to achieve a partial erection. Youve just been diagnosed with prostate cancer. Over 80,000 specimen cases are seen at Johns Hopkins each year. Cancer 2017;123:1027-34. Diffuse probable benign peripheral zone changes limit evaluation for )I contacted Dr Busch (still in Chattanooga at the time) and he called me directly to talk me off the ledge. Johns Hopkins second opinion - nothing found. The James Buchanan Brady Urological Institute, Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, Precision Medicine Center of Excellence for Prostate Cancer, robotic-assisted radical laparoscopic prostatectomies, The Brady Urological Institute and the Johns Hopkins Kimmel Cancer Center take a, Our urologic surgeons have extensive experience performing, Our surgeons, oncologists and radiologists are also world leaders in prostate cancer research, giving patients access to the latest discoveries and. 4. A man with a father or brother who had prostate cancer is twice as likely to develop the disease. 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. Recovery from Prostate Cancer | Bills Story. Hello. Many men name the diagnosing urologist as their treating doctor and do not seek other opinions. Intensity: min 148 / Max 459 And by FAA Aeromedical Ruling, I'd need a few post procedure reports before being cleared to fly again.) With The Clinic by Cleveland Clinic, patients have access to Cleveland Clinics 3500 specialists. Bladder: Normal. It is best to begin by talking with the doctor who made your initial prostate cancer diagnosis. Unfortunately, the 12/20/20 PSA reading was higher and that led to an MRI on 2/2/21 when two lesions were discovered. They told me to expect a spike in my PSA sometime in the future, and they told me that studies are showing that a slow, steady decline in PSA is often indicative of superior results (whatever that means. Conflicting Prostate Biopsy OpinionsWhat to Do? Background: Conclusions: 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. 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. Using an Ellipsoid Volume the dimensions would give you a volume of 20.44. 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. Benign Processes: 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. While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. I was to follow up with my new Urologist (another surgeon) for 3 months PSA checks and annual 3T-MPMRI.My PSA checks were static and the next year's MRI looked just like the first. Thank you, After more than three years on active surveillance, I've pretty much decided to have focal brachytherapy for my prostate cancer. * Location: Left, anterior, base to apex, transition zone I worked out every day. I frequently make a 2 hour car ride and I have to stop about 25% of the time and when I don't, the urgency is a bit more evident and with the urgency come some hesitancy, but not terrible. - Follow-Up Score (PRECISE) for this lesion = Stable MRI appearance: no new focal/diffuse lesions. I question the potential EPE and he said it didn't matter, but went ahead and ordered Oncotype. But, ultimately decided on whole gland treatment using Proton Beam Radiation.So. Extraprostatic extension: negative Usually, patients obtain a second opinion after being referred to a second physician or to a special team of experts in a cancer center, called a multidisciplinary team.