johns hopkins prostate cancer second opinion

peripheral zone signal intensity on T2-weighted images. A second opinion is part of the education process that is critical for many cancer patients. Prostate, left lateral apex: TZ zone more beneficial, but fairly large compared to whole gland and proximity to capsule edge would likely mean treatment would be suggested. ADC: mean 879 / median 839 / st dev 223 Reinterpretation of imaging scans and lab tests. Getting A Second Opinion On Your Pathology Report - Cancer ABCs Our singular focus on treating cancer, and only cancer, means we have the expertise to confirm a diagnosis or treatment plan and offer options that may not have been considered. I did ask some questions about the study, if anyone is interested. )As for side effectsI occasionally have some urgency/hesitancy having to pee. The neurovascular bundles are intact. The average age at the time of prostate cancer diagnosis is about 66. Johns Hopkins second opinion identified a PI-RADS 4 Mayo Phoenix also reviewed MRI prior to targeted biopsy. Prostate Cancer: Symptoms, Causes & Treatment - Cleveland Clinic Following application of the relevant exclusion criteria, 2365 respondents remained in the analytical cohort. What have your doctors told you? MRI obtained outsideon 04/16/2021. very activerun/cycle 6 days a week Greenfield G, Shmueli L, Harvey A, Quezada-Yamamoto H, Davidovitch N, Pliskin JS, Rawaf S, Majeed A, Hayhoe B. BMJ Open. You May Like: Prostate Cancer External Beam Radiation Side Effects. This fee includes: Studies show the clinical and financial benefits of obtaining a pathology second opinion. This is often the case when the primary physician advises an expensive treatment. P/ 310-827-7707 | F/ 310-574-4002 | MAIL@PROSTATEONCOLOGY.COM. I was confident I was making the right decision. The Journal of the American Board of Family Medicine published a study in 2017 that found that many patients do not get a second opinion outside of their PCPs original referral2. 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. I also learned a lot more about the high undisclosed risk of side effects of various treatment plans. 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? Urologists at the Johns Hopkins Brady Urological Institute can make the difficult process of deciding on a treatment plan easier. Have a condition that isnt improving or is getting worse, despite treatment. Disclaimer. Benign prostatic tissue Same with the amount of how much pattern 4. "We were surprised by the relatively large percentage of men who obtain second opinions for their prostate cancer," said lead author Dr. Archana Radhakrishnan of Johns Hopkins University in . How to Get a Second Opinion Our team at Johns Hopkins has a dedicated service to interpretation of brain tumors and render second opinions on a daily basis. * Extracapsular extension: None. MONDAY, Nov. 7, 2016 Second opinions have little impact on prostate cancer patients treatment decisions, new research suggests. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. A enlarged prostate can also cause blockages in the urethra. Most reputable HMOs can, however, deliver state of the art treatment for most cancers. But was able to walk right into the JH Urology clinic for immediate treatment (flushing of bladder cleared everything up). JHs just said it was minimal less than 5%. I've tried to find out about Dr. Wong but there's very little info on him. Transition Zone: In the left base, mid and apical transition zone there is a large mass measuring 2 cm in size which has 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. Cancer ABCs recommends: Johns Hopkins Hospital in Baltimore, Maryland, specifically Dr. Jonathan Epstein. * Location: Left, anterior, base to apex, transition zone 4: Prostate, right medial base Just got my pathology results. radiation, active surveillance, surgery, hormone therapy, and more. Nor did I have any idea that the 1 core had 20% involvement and <5% pattern 4 involvement. Second Opinions in Prostate Cancer - American Council on Science and Health As evidenced on this site, some studies indicate that GS 6 shouldn't even be classified as PCa and that it isn't aggressive. This urologist can get you in for surgery next week. -------------------------------------------------------- About 80 percent of prostate cancers are diagnosed at a localized stage, which means that the cancer hasnt spread outside of the prostate. The biopsy disclosed I had some abnormal cells resembling cancer known as PINS, short for prostatic intraepithelial neoplasia. 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. 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. 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. Seminal vesicles are normal. First let me just say what so many others have previously stated, the thought of going on this journey alone is frightening, I cant imagine traveling this road alone. Medical record collection from doctors and hospitals. doi: 10.1002/cncr.30412. And by FAA Aeromedical Ruling, I'd need a few post procedure reports before being cleared to fly again.) Extraprostatic extension: negative Because I had an implant in my ear, they would only give me a 1.5T MRI. Dont Miss: Screening For Prostate Cancer Icd 10. I trust the second opinion Dr. Bush gave. Learn more through his bio: Progress in the field.In recent years, advancements in research have changed the way cancer is treated. intricate disease and not all doctors have the same amount of experience There is no one-size-fits-all treatment for prostate cancer. Reasons for obtaining a second opinion from urologists. - Prostatic adenocarcinoma, Gleason score 3+4=7 (grade group 2, pattern 4: 10%) involving 2 of 2 cores (medial core: 0.5 mm, 4%; lateral core: 1.5 mm, 10%), 1 mm to the blue inked tissue edge (the closer) Learn MoreFor more information about pathology second opinions, visit pathology.jhu.edu or call 877-546-1872. I have been drinking out of an information fire hose. Masks are required inside all of our care facilities. * Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project First MRI done in June 2016 by Scottsdale Medical Imaging - nothing found. Last year, Epstein's lab reviewed the pathology reports of 30,000 cases in which patients requested second opinions. It is OK to be scared. asymmetric central zone tissue more pronounced on the left. There are also some cases of the test showing no depletion but being wrong. Most reputable HMOs can, however, deliver state of the art treatment for most cancers. -------------------------------------------------------- MRI June 2017 again at SMIL. When I read the forums and questions on this site everyone mentions their Gleason Score from their biopsy. Lesion 1: Left mid-base transition zone. Dr. Epstein has 744 publications in peer-reviewed literature and has authored 50 book chapters with a H-factor of 118. There is no evidence They may defer to the recommendation of the specialist, or refer you to a doctor with limited prostate cancer experience. And, even working in a fairly technical field myself, I was amazed at the technology and precision of that Proton Machine. - Perineural invasion is present Pathology report indicated additional presence of cells at right apex, but unclear whether intraprostatic incision or extraprostatic extension. curing cancer, prostate cancer questions johns hopkins hospital, josef issels wikipedia, cancer a second opinion a look at book by josef issels, coping with metastatic cancer cancer net, pdf americans health priorities curing cancer and, what is immunotherapy cancer research institute cri, cancer a second opinion a . Men need to be educated on all treatment options to protect themselves from a biased industry. ---------------------------------------------------- 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. Find a doctor at The Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center or Johns Hopkins Community Physicians. Of course, my old school Urologist recommended surgeryHe, of course, knew the best robotic surgeons around.Anyway. When first diagnosed with prostate cancer, your PCP will generally refer you to a urologist for a biopsy. This doctor or team of doctors will review the following: The doctor then communicate their opinion regarding treatment to both the patient and the primary physician. However, it also is possible to seek a pathology second opinion on your own, and it does not require an in-person office visit. Oncologist. -------------------------------------------------------- But, ultimately decided on whole gland treatment using Proton Beam Radiation.So. My thoughts focus on the fact that I have a disabled son who needs my care. I had a very bad experience with an incompetent nurse that did a catheter change. Second Opinion Pathology | MD Anderson Cancer Center 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. Family history of prostate cancer. We surveyed men who were diagnosed with localized prostate cancer in the greater Philadelphia area from 2012 to 2014. When facing an intricate disease like prostate cancer, the above scenario is far too simple to have a promising outcome. Every year I got a PSA and DRE during my annual physical. The primary goal is to be cured with the least toxic, most effective approach. There is no extraprostatic extension. 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. Steve, Groucho was wrong when he said "i don't want to belong to any club that would have me as a member." If pain is present, a digital rectal examination will reveal hard areas. I requested a second opinion from Johns Hopkins and they found 1 lesion was 3+3=6 and the second lesion was 3+4 =7, with less than 5% pattern 4. It has been 2.5 years and the PSA has still not doubled as well. Bookshelf 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 have a consult on Friday with the 1st opinion doc to review all tests. PSA that brought me to this was 7.1. Dr. Erick Walser at University of Texas Medical Center. Of course that was before I found this webpage and I really didn't know what 1 core of 18 samples showing 3+4=7 Gleason meant. Even if someone is being seen at a different academic center, the trials and other treatment options that we offer here may be different. 5: Prostate, left medial apex Confirm biopsy and imaging results with centers of excellence before making any final decisions. The PSA Doubling Time parallels my Urologist Doubling Time (I keep changing Uro until I find one who makes sense)! Grade Group: 2 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. It is OK to be overwhelmed with info. I've also read that some study's have shown that intraductal may be resistant to hormonal therapy, radiation and/or chemo. In adjusted models, obtaining a second opinion was not associated with receipt of definitive treatment . All views would be appreciated. I still have some urgency and frequency issues, but I am not complaining too bad. But, ultimately decided on whole gland treatment using Proton Beam Radiation.So. Fear motivates you to want to treat this as soon as possible. Many thanks for that. Dr. Albert Chang at UCLA appears to be the best in the biz for high dose rate (HDR) focal brachytherapy. 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. 3 months has passed, and its time for a PSA and a plan to have an MRI. 5. Best wishes to all those whose concerns for the day are far more serious than mine. About 80 percent of prostate cancers are diagnosed at a localized stage, which means that the cancer hasn't spread outside of the prostate. The percentage of tissue with carcinoma is 70% 4, Dr. Jonathan Epstein explains the benefits of getting a pathology second opinion. A doctor may prescribe surgery or perform an endoscopic procedure. They agreed with the PI-RADS 4. 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. Need guidance choosing from multiple treatment options. This condition causes pain in the lower back and groin area, and may cause urinary retention. BASE DATA: Last checkup (July 2022) my PSA was .46 and it is currently at .32.I am still eating primarily a plant based diet (only lean meats/cheeses/eggs about 10% of my diet) and maintaining steady weight and I am still quite active physically.As for symptomswith 5mg Daily Cialis the occasional ED symptoms have pretty much gone away. The total number of cores with carcinoma is 3 Prostatic Adenocarcinoma The side effects of the cut, radiate, hormone regime are unacceptable to me. I had a 3T mp MRI with coil bed, without and with contrast, at Emory on March 3. Bones: There is marketed marrow heterogeneity in the pelvic bones are not in the femoral heads. What is NOT OK is quitting or avoiding the bad news, or handing the entire decision over to someone else.Good luck fellas! Jonathan Epstein, MD received his doctorate from Boston University. My question is regarding the results of an MRI guided biopsy into a distinct tumor vs. subsequent Oncotype Dx Results. They also determined there was extrapostatic extension because there was some fat in the sample that involved the cancer. 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. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. I have completed all that is necessary to enter Johns Hopkins Second opinion and PTEN test program. Urologists at the Johns Hopkins Brady Urological Institute can make the difficult process of deciding on a treatment plan easier. Hillen MA, Medendorp NM, Daams JG, Smets EMA. Prostate, right medial base: It is not uncommon that two different pathologists looking at the same slide come to a different interpretation and opinion about what is in their microscope! Not all men with Gleason 8-10 disease are going to do badly after

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