We surveyed men who were diagnosed with localized prostate cancer in the greater Philadelphia area from 2012 to 2014. Comments appreciated, Unfortunately, the 12/20/20 PSA reading was higher and that led to an MRI on 2/2/21 when two lesions were discovered. Dont Miss: Is Coffee Bad For Your Prostate. Two things you learn here is get a second opinion from Johns Hopkins on biopsy and get treated at Center of Excellence. Watch: Are supplements good for prostate health? Prostate Cancer Grading: He wants me to begin the ADT around 5/1. Second opinions apply to biopsies and imaging as well. Get a Second Opinion What can a second opinion tell me? Second Opinions An accurate diagnosis is essential to ensure that the correct and most effective treatment is given. My family doctor was alarmed because such a steep increase in prostate-specific antigen could be a sign of prostate cancer. Second opinions are a common practice in any area of medicine that is complex and that has multiple treatment options available. I am relatively new to this forum and trying to educate myself as to my best course of treatment. )As for side effectsI occasionally have some urgency/hesitancy having to pee. They did 9 patients in Phase I and there have been 12 so far in Phase II. There are three main types of doctors that manage prostate cancer: urologists, radiation oncologists, and medical oncologists. Prostate cancer is an PROSTATE LESIONS: Benign Processes: EDI am now 52 and not quite functioning like I did 4+ years ago. Learn MoreFor more information about pathology second opinions, visit pathology.jhu.edu or call 877-546-1872. The main purpose of the prostate is to produce semen, a milky fluid that sperm swims in. Does this also include HIFU, Cryoablation? Last year, Epstein's lab reviewed the pathology reports of 30,000 cases in which patients requested second opinions. We are vaccinating all eligible patients. My girlfriend lives 2 blocks from the Emory Proton Clinic.We prayed on it and overthought the crap out of it. Dont Miss: Can Prostate Problems Cause Burning Urination, Why Prostate Cancer Survivor John Shearron Thinks Its Important To Do Your Research | PCRI, Prostate Cancer Pathology in 2021 | Jonathan Epstein, MD | PCRI 2021 Conference, Johns Hopkins Prostate Cancer Second Opinion, treat rare and complex conditions through breakthrough fetal procedures, Function Of The Prostate Gland And Seminal Vesicles, Best Treatment For Intermediate Prostate Cancer, How Old Can You Be To Get Prostate Cancer, New Treatments For Stage 4 Prostate Cancer, Prostate Radiation Treatment Side Effects, Can Prostate Problems Cause Burning Urination, Prostate Cancer Spread To Skull Prognosis, Life Expectancy Stage 4 Prostate Cancer No Treatment, Diagnostic Procedures For Prostate Cancer. 2. Your Primary Care Physician referred you to your diagnosing urologist whom you now trust. Know Your Stage. - Perineural invasion is present He adds that second opinions also can provide insight into topics like clinical genetics and family risk or issues related to complementary or integrative medicine approaches to manage symptoms. In some situations, insurers will even insist on a second opinion. I then had the PHI test which showed PSA 8.70 and overall PHI 125.9. A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. 2. ---------------------------------------------------- Got the fiducials placed, the Space-OAR gel placed, mold made, and had the pre-treatment MRI and CT Scan. 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. We are vaccinating all eligible patients. There is no extraprostatic extension. Is it done through my doctor or do I do it myself with sending CDs of the MRI? If youve received a new cancer diagnosis or arent seeing results from your current treatment plan, an expert second opinion can help you move forward with confidence. The prostate gland is slightly enlarged secondary to transition zone hyperplasia (25cc total) Unbelievable that this happened!!! He has had a nagging "groin injury" for may years (he played pick up basket ball until he got injured) and we are now wondering if this could be the source of that recurring ache. 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 In adjusted models, obtaining a second opinion was not associated with receipt of definitive treatment . Thanks, The all-inclusive cost for a virtual second opinion for patients in the U.S. is $1,850. Estimated prostate volume of 35 cc with an estimated PSA density of 0.11 ng/mL/cc. Benign Processes: MY THOUGHTS AND ANYTHING DOCTOR NOTED: So my question for you is have you ever heard of PRECISE and if so what should I make of it? Epub 2017 Jun 12. Radiation oncologist of same group of doctors says to do IMRT (using Rapid ARC program) as precautionary treatment, regardless of PSA scores. Following application of the relevant exclusion criteria, 2365 respondents remained in the analytical cohort. A diagnosis is usually reached within 3-5 days of your slides' arrival at Johns Hopkins. 2. Who Should Request a Second Opinion? 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. Anyone else encounter something like this? Compared with other men, African-American men and men with a family history of the disease are at higher risk of developing prostate cancer. I can do radiation as a monotherapy. 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. The site is secure. Benign fibromuscular stroma; no prostatic glands are identified Results: Instead, I did my homework. Especially opinions other than those of the first Urologist you see. If pain is present, a digital rectal examination will reveal hard areas. BONES: No suspicious osseous 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. A blocked urethra can also damage the kidneys. 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. Cancer ABCs recommends: Johns Hopkins Hospital in Baltimore, Maryland, specifically Dr. Jonathan Epstein. Federal government websites often end in .gov or .mil. Had a little complication a day after release, excessive blood/clots in urine. Adenocarcinoma: Second opinions from urologists for prostate cancer: who gets them, why, and their link to treatment . - DCE = (+) Hi All, Nov 7, 2016. Benign prostatic tissue Prostate, right lateral apex: Had third MRI in July 2019 this time at Mayo which I believe does a better job than SMIL. 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. To schedule an in-person visit for a second opinion or to determine if a telemedicine consultation is possible, call: In addition to cancer, our urologic team provides second opinions regarding urinary stone disease, urinary tract reconstruction, incontinence, male infertility and sexual health, and many other urologic conditions or procedures. 8. The results were ambiguous. Potentially inaccurate results can lead to selection of the wrong type of therapy. The total number of cores with carcinoma is 3 We can help with your case. I was on active surveillance after a FLA procedure done in 2018. I was referred to a urologist and tested again in April at 4.40. 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. In other words, the cancer is still contained within the prostate. First MRI done in June 2016 by Scottsdale Medical Imaging - nothing found. I am doing my own research, but I am curious as to thoughts of the best possible MRI to obtain to give me the best chance at finding something the needle biopsy didnt find. There is hope. Benign Processes: If the enlarged prostate is not completely removed, it will shrink. 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. 2018 May;115:133-138. doi: 10.1016/j.urology.2018.01.048. Prostate, right medial base: 1. J Am Board Fam Med. 3. Also, if any of you have a way to get medicare to pay some portion of the cost, please let me know as well. Many thanks for that. Also, infection was noted, so the current PSA is high in part due to prostatitis. By Dec 2019, my PSA reached 4.13. According to the study, one in every 600 diagnoses showed mistakes.This study only addressed major changes in diagnoses, such as a diagnosis of cancer being reversed to no cancer, says Johns Hopkins pathologist George Netto, M.D. Background: Studies show the clinical and financial benefits of obtaining a pathology second opinion. Seminal vesicles are normal. Ask your doctor for a copy of your complete medical record. * Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project HMO members may also be discouraged from trying expensive treatments that have only a small chance of success, even if that chance is real. 4: Prostate, right medial base Men were asked if they obtained a second opinion from a urologist, and the reasons why. However, a new study by researchers at the Johns Hopkins University has found that second opinions did not change treatment choice or the persons perception of the quality of care they receive, at least among low-risk men. information. Patients may experience a fever or chills as a result of the infection. They won't be offended, and they may even be able to recommend a specialist for you to see. Surgical Delay and Pathological Outcomes for Clinically Localized High-Risk Prostate Cancer. - Follow-Up Score (PRECISE) for this lesion = Stable MRI appearance: no new focal/diffuse lesions. Based on this forum, Im very lucky for this outcome. Centro Diagnostico Italiano , Milan, Italy, Manfred Dietel, M.D.Institute of Pathology Charit, Humboldt University of Medicine, Berlin, Germany, Jonathan I. Epstein, M.D.The Johns Hopkins Medical Institutions, Baltimore, MD, Robert J. Kurman, M.D.The Johns Hopkins Medical Institutions, Baltimore, MD, Elizabeth Montgomery, M.D.The Johns Hopkins Medical Institutions, Baltimore, MD, Manuel Sobrinho-Simes, M.D.University of Porto, Porto, Portugal, Ronald S. Weinstein, M.D.University of Arizona, Tuscon, AZ, Franco VisinoniMilestone Medical Technologies, Bergamo, Italy, Also Check: How Old Can You Be To Get Prostate Cancer. focal peripheral zone lesions. When you get a diagnosis of breast cancer from your doctor, its not uncommon to get a second opinion. Several friends rushed towards surgery and now wish they had the information he provides before they decided to go with such care. Every year I got a PSA and DRE during my annual physical. 9: Prostate, left anterior MRI lesion In terms of cancer, changes can be from cancer to benign (or vice versa) or from one type of cancer to another, which could . One to a 3+4=7 and the other to a 3+3=6. Our OB-GYNs, maternal-fetal medicine specialists, and pediatricians collaborate regularly with the Johns Hopkins team getting second opinions and access to hundreds of clinical trials. 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. How could this compare using only partial slide re-reading? Primary Gleason grade: 3 Here are seven tips for seeking second opinions for prostate cancer: 1. When I read the forums and questions on this site everyone mentions their Gleason Score from their biopsy. As some of you may know, I am a moderator for a support group for men on active surveillance for low-risk prostate cancer. Hello, I apologize upfront for the length of this post, but I was recently diagnosed with prostate cancer (T2C) and figure more information is better than not enough. It is OK to be scared. I'm Gleason 3+4=7, and I believed only 2 cores tested positive. The side effects of the cut, radiate, hormone regime are unacceptable to me. 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. Most reputable HMOs can, however, deliver state of the art treatment for most cancers. But I did speak to an oncologist who wanted to order Oncotype, which I did. You May Like: Sbrt Radiation Therapy Prostate Cancer. Our regional community network integrates academic specialty cancer care at Allegheny General Hospital and West Penn Hospital and at more than 20 community cancer centers throughout the region. Extracapsular extension: The prostatic capsule is preserved.