Even at the age of 48, he thought I would be a good candidate for AS. 2020 Dec 1;3(12):e2028320. If the problem is unresponsive to other treatments, your doctor may suggest a surgical procedure. Second opinions offer different things in different circumstances, Dr. Matasar says. Want confirmation about a diagnosis or treatment. It starts many years ago. I just received a second opinion report from Johns Hopkins. In the United States, prostate cancer is among the most common cancers found in men. Urology. Us Too Prostate is a great club and many of you have helped me a lot already. It may be a new cancer, but it is more likely a recurrence since it is really near the ablation zone. Prostate volume: 17.58 cc It was easy. Numerous publications show the clinical and economic benefits of obtaining a second opinion for Pathology specimens. We are vaccinating all eligible patients. Treatment options include immunotherapy, 8. A PSA test at time of biopsy revealed my PSA had risen to 6.5. One of the bits of advice the group regularly dispenses is for men to get a second and even a third opinion if you have doubts about the first opinions rendered by your urologist, or your pathologist, or your radiologist, its always okay to seek out a second opinion. - DWI-ADC = 4/5 It can be caused by many factors, including infection and inflammation. But you have to do both. So my question for you is have you ever heard of PRECISE and if so what should I make of it? We prioritized treatment as AS, FLA/TULSA (if a lesion ever presented itself), and Proton Beam Radiation. When first diagnosed with prostate cancer, your PCP will generally refer you to a urologist for a biopsy. 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. Similarly, among those who received definitive treatment, second opinions were not associated with receiving surgery. Move ahead to Dec 2020. Thanks, I wish the VA would be more informative about this disease they owe it to our veterans. 7. I trust the second opinion Dr. Bush gave. If the problem is unresponsive to other treatments, your doctor may suggest a surgical procedure. And again, most of you tell me time is on my side, so I am comforted in hearing that. And by FAA Aeromedical Ruling, I'd need a few post procedure reports before being cleared to fly again.) Even if someone is being seen at a different academic center, the trials and other treatment options that we offer here may be different. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. There is no evidence Brachytherapy Experience with Dr. Albert Chang at UCLA? Would it be rational to stay on AS until biopsy results show a higher volume of PCa for sampled cores (i.e. I've had what I would consider a fluctuating PSA since first tested in November 2018. Both Drs and nurses knew what they were doing and had lots of experience. -------------------------------------------------------- We will then prepare a written recommendation regarding your treatment plans or options. You think your doctor is underestimating how serious your cancer is. Thankfully, prostate cancer is extremely slow growing. Four weeks after a radical prostatectomy for prostate cancer, he was back in the pool. Adenocarcinoma: You May Like: Sbrt Radiation Therapy Prostate Cancer. In the United States, studies estimate 72 new cases of PN for every 100,000 people between the ages of 18 and 64 years old. -------------------------------------------------------- Many researchers believe PTEN present is a strong brake on Many health insurance companies will pay for a second opinion, especially if it is for a medically necessary treatment. 7. A biopsy was performed on 2/26. Am I wrong? I am meeting with a multidisciplinary team of docs on March 18 at St. Joe's in Atlanta. They confirm everything except question whether one of the core samples is a 3+3 or 3+ 4. No two cases of prostate cancer are alike and an accurate diagnosisis critical to developing the best treatment plan. The out-of-pocket cost may be in the $300 range (insurance may not cover it), and it is a simple matter to call your urologist to forward the slides to them. 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. I'm Gleason 3+4=7, and I believed only 2 cores tested positive. doi: 10.1002/cncr.30412. Two weeks later I meet with my Johns Hopkins Dr. Diffusely decreased 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. In adjusted models, obtaining a second opinion was not associated with receipt of definitive treatment . Primary Gleason grade: 3 The study included nearly 2,400 men in the Philadelphia area recently diagnosed with localized prostate cancer. When you get a diagnosis of breast cancer from your doctor, its not uncommon to get a second opinion. doi: 10.1001/jamanetworkopen.2020.28320. MRI RE-READ #1 (well known radiologist, but free advice over phone, but no written report): 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. I was on disability from work the entire time (not that I was disabled, but as a pilot, I couldn't very well work and get treatment at the same time. Radhakrishnan A, Grande D, Mitra N, Bekelman J, Stillson C, Pollack CE. Epub 2017 Jun 12. You're also at greater risk of prostate cancer forming before age 50. Prostate Cancer Grading: Getting a second opinion on a diagnosis can reverse a diagnosis or alter the treatment plan. If pain is present, a digital rectal examination will reveal hard areas. 1.Rebecca L. Siegel, Kimberly D. Miller, and Ahmedin Jemal, Cancer Statistics, 2019 CA Cancer J Clin. Dr. Epstein has 744 publications in peer-reviewed literature and has authored 50 book chapters with a H-factor of 118. You receive a secure, private online consultation without leaving home. It was easy. 3. Your email address will not be published. However, many insurance and health care companies do pay for such opinions and acknowledge the importance of second opinions. Identified an approximate 2 cm lesion of mostly Gleason 7 (3+4) with only 20% being 4, contained in prostate. I guess the PET scan will be the next step in what type of treatment options are in store.Has this occurred to anyone else? 5. 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. * Adjacent organ invasion: None. I didn't study for the test and it's possible some morning activities might have affected my test score :) TRANSPERINEAL MRI GUIDED BIOPSY RESULTS My involvement is below maximum of 15% of core. Benign Processes: I want to insure that the Imaging was read correctly and nothing was overlooked or missed. intricate disease and not all doctors have the same amount of experience 5/10 PSA 4.2/fPSA 9% taken at MSKCC (lab #3) Because I had an implant in my ear, they would only give me a 1.5T MRI. Tumor Quantifications: The symptoms of acute bacterial prostatitis are similar to those of CPPS. It is best to begin by talking with the doctor who made your initial prostate cancer diagnosis. This may include imaging, blood tests, prior treatment, and pathology reports. IMPRESSION: Some men have minimal or no symptoms at all. 6. 4. In the mean time my PSA was movingno longer static, but never back up to 6. Masks are required inside all of our care facilities. However, many insurance and health care companies do pay for such opinions and acknowledge the importance of second opinions. 6 A study at the Johns Hopkins Health System found it was 3.4 times more common in Black Americans than in White Americans. Should You Exercise When Youre Expecting? MRI June 2017 again at SMIL. 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. All Gleason 6 (3+3). Federal government websites often end in .gov or .mil. As a Gleason 3 + 3, with 8 of 12 positive cores all with less than 30% cancer, and bilateral spread, I have determined that I cannot trust a blind biopsy in and of itself. My girlfriend lives 2 blocks from the Emory Proton Clinic.We prayed on it and overthought the crap out of it. A. Prostate, right base, core biopsy: I also sent my biopsy slides to Johns Hopkins for a second opinion (Epstein's read was 3+4, but with lower pattern 4 involvement than the local pathologist.). A doctor at MSK can collaborate with another doctor to offer support and help ensure the best outcomes. By taking the extra time to seek a second opinion, you have a better chance at finding the most up-to-date approach and an experienced doctor. government site. An acute bacterial infection can cause a burning sensation. Following application of the relevant exclusion criteria, 2365 respondents remained in the analytical cohort. Using the Bullet Volume gives you gland of 25.55. The more often a doctor diagnoses and treats prostate cancer the more proficient they become. Mohamad Allaf, M.D., answers questions about prostate cancer diagnosis and treatment options and discusses robotic prostatectomy at Johns Hopkins. )I contacted Dr Busch (still in Chattanooga at the time) and he called me directly to talk me off the ledge. By taking the extra time to seek a second opinion, you have a better chance at finding the most up-to-date approach and an experienced doctor. But, after 4 drinks or if I'm tired/jet lagged I find that sleep is more appealing than sex. All views would be appreciated. A second review of Pathology more frequently also brings changes to the cancer grade or stage, which can affect prognosis as well as therapy. A doctor may prescribe surgery or perform an endoscopic procedure. Netto says patients should be proactive in requesting that doctors take another look. If these do not work, your symptoms could progress and become chronic. Research was mixed on PINS, but in those days, many doctors saw them as likely to develop into cancer. However, learning more about prostate cancer and prostate-related health issues can help optimize health. You're at greater risk if you're Black or of African ancestry. As a result, patients struggle to differentiate bias from fact. PSA had increased to 5.4. However, there are other cases when a second opinion results in a very different diagnosis or set of treatment recommendations. The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System. * Membranous urethral length: 1.2 cm 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. Low volume post-void residual urine is present in the bladder. And by FAA Aeromedical Ruling, I'd need a few post procedure reports before being cleared to fly again.) Hello. 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 . My question is regarding the results of an MRI guided biopsy into a distinct tumor vs. subsequent Oncotype Dx Results. However, there are also many more options for treatment and these options are more complicated than in the past. Contact us or find a patient care location. Being in Wisconsin, my insurance gives me the option of two hospitals to manage me. Of course, my old school Urologist recommended surgeryHe, of course, knew the best robotic surgeons around.Anyway. * Location: Left, anterior, base to apex, transition zone Conclusions: There is no extraprostatic extension. I assume the data on gleason scoring is much more robust/reliable than genomics as it has been around longer and used more extensively. I had a follow up 3T MRI guided biopsy on March 18 at Emory. Patients may experience a fever or chills as a result of the infection. lesion.

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