Surabhi Dangi-Garimella, PhD. Unfortunately, what you do not realize may harm you! The results seemed fairly benign and my urologist and I decided to continue to monitor with 2 more PSA tests and then consider an MRI in April 2021. Anyone else encounter something like this? __________________________________________________________________________July 2022I've neglected to make journal entries for a couple years, so I will recap below and continue with what I have done and what I have learned.In 2018, at the age of 48, after a routine physical that showed a PSA of (4.X) and after a TRUS biopsy, I was diagnosed with PCa. Using the Bullet Volume gives you gland of 25.55. Second Opinions An accurate diagnosis is essential to ensure that the correct and most effective treatment is given. An accurate diagnosis is essential to ensure the most effective treatment. Second Opinions & Consultations - Brain Tumor | Johns Hopkins Pathology - High grade prostatic intraepithelial neoplasia (HGPIN) For cancers that are less common, second opinions can offer more treatment options. Prostate, right lateral base: Ask us questions on this webpage. I will say, the people I dealt with at Johns Hopkins were extremely nice and professional. restricted diffusion. When I read the forums and questions on this site everyone mentions their Gleason Score from their biopsy. 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. My strong preference would be to do FLA again and monitor. Benign fibromuscular stroma; no prostatic glands are identified Find more COVID-19 testing locations on Maryland.gov. 2019 Jan;69(1):7-34. doi: 10.3322/caac.21551. poorly defined margins and intermediate to low T2. Most people believe that pathology reports are always correct, accurate and that what the report says is carved in stone. I wish the VA would be more informative about this disease they owe it to our veterans. have no symptoms, and yet you have cancer? But I did speak to an oncologist who wanted to order Oncotype, which I did. * Extracapsular extension: None. radiation, active surveillance, surgery, hormone therapy, and more. Some men may have an enlarged prostate but not notice it. Numerous publications show the clinical and economic benefits of obtaining a second opinion for Pathology specimens. Have a condition that isnt improving or is getting worse, despite treatment. Axial T1-weighted images of the pelvis show no bony or bulky nodal disease. Good Day Everyone. Move ahead to Dec 2020. I worked out every day. 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. Prostate, right medial base: Hello everyone. Prostate, right lateral apex: Atrophy 4 Get a Second Opinion Dr. Jonathan Epstein explains the benefits of getting a pathology second opinion The only prescriptions I take are for GERD (Protonix), cholesterol (Atvorstatin), and allopurinol for an episode of gout that I got while doing physical rehab for a bad tibia break (I shattered my tibia plateau 2/2020 and have pretty much recovered). Fear, confusion and uncertainty set in. In circumstances where there may not be a single established standard of care, we can ensure the treatment plan integrates the most current, up-to-date data, Dr. Matasar says. I have requested a second pathologist's opinion from Johns Hopkins based on feedback from this forum. 4. 5. You may be concerned that the cancer will grow rapidly out of control before you are able to get a second opinion. I assume the data on gleason scoring is much more robust/reliable than genomics as it has been around longer and used more extensively. 7 in 10 PATIENTS WHO GET A SECOND OPINION AT CTCA CHOOSE TO TREAT WITH US Call now to find out why: 800.888.8888 Rosie P. Colorectal Cancer I fear limiting myself to an inferior treatment because the people I talk to have hammers, therefore everything must be a nail. Johns Hopkins Prostate Cancer Second Opinion Both Drs and nurses knew what they were doing and had lots of experience. My dad 82 was diagnosed last week with prostate cancer with high PSA 100 and GLEASON: ( 4 + 4 ) = 8 / 1 0 , he had the PET Ga-68 PSMA image Friday and today we found out the result is stage 4 Metastatic lesions in the bone pelvic area. Greetings gentlemen! The researchers did not include more minor errors in rating how fast-growing and how advanced a cancer was. My question is regarding the results of an MRI guided biopsy into a distinct tumor vs. subsequent Oncotype Dx Results. An acute bacterial infection can cause a burning sensation. Not all cancers are the same and not all treatment plans are absolutely clear. Grade Group: 1 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. Get directions, important phone numbers, locations and more. Reinterpretation of imaging scans and lab tests. I asked the urologist who did our Second Opinion at Johns Hopkins and although he thinks RP is the way to go (due to higher PSA of 10.18), he highly recommended Dr. Eggenger (Chicago). I have developed an "abscess" on my prostate. Prostate cancer is an This has raised some questions on all the scans so far. Second opinions apply to biopsies and imaging as well. 9. Then about a month later I started 28 fractions of Proton Radiation.It was painless. 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. Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. What is NOT OK is quitting or avoiding the bad news, or handing the entire decision over to someone else.Good luck fellas! Patient-initiated second medical consultations-patient characteristics and motivating factors, impact on care and satisfaction: a systematic review. Thanks for Everyone's Help, * Extracapsular extension: Possible involvement of the anterior 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.). And by FAA Aeromedical Ruling, I'd need a few post procedure reports before being cleared to fly again.) The peripheral zone has a patchy signal pattern. A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. A blocked urethra can also damage the kidneys. Benign Processes: The study included nearly 2,400 men in the Philadelphia area recently diagnosed with localized prostate cancer. This urologist can get you in for surgery next week. Research was mixed on PINS, but in those days, many doctors saw them as likely to develop into cancer. 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. I had a telemed session with Dr. Chang, and it sounds like a pretty simple procedure, with urinary side effects that resolve pretty quickly. Because every patient is different, there are several ways to approach prostate cancer treatment. Surgical Delay and Pathological Outcomes for Clinically Localized High-Risk Prostate Cancer. - Perineural invasion is present Got my physical and normal DRE with new Dr. No issues identified. Please enable it to take advantage of the complete set of features! I question the potential EPE and he said it didn't matter, but went ahead and ordered Oncotype. The Radiation Oncologist knew of Dr Busch (by now in Alpharetta, GA) and spoke highly of him. 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. We provide second opinions on the full range of gynecologic cancers: Ovarian Uterine Cervical Vulvar Vaginal Fallopian tube Placental tumors Some peritoneal cancers They hesitated calling it a TARGET LESION, but scored it PIRADS 4. * Membranous urethral length: 1.2 cm Prurigo Nodularis Cancer: What's the Link? - Verywell Health 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. The treatment of prostate cancer has evolved tremendously. 3: Prostate, right medial apex Men often seek second opinions from urologists before they initiate treatment for their newly diagnosed prostate cancer. Read books and realize as soon as they are published, they are outdated. H. Prostate, lesion #2, core biopsy: I really liked the new group I went to as they identified the lesion right away, unlike the radiologist who performed the first procedure, and they also have a urologist on staff as well monitoring everything. Surgery took about 3 hrs. IMPRESSION: My mind goes all over the place as to why this is. Men with a college education or beyond also were more likely to cite wanting more information about their cancer as a motivation for a second opinion . Only took Motrin and Tylenol for pain after release. The results were ambiguous. Grade Group: 2 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. When to move from Active Surveillance to Treatment for Prostate Cancer? Benign fibromuscular stroma; no prostatic glands are identified Check Biopsy and Imaging Results for Accuracy. Identified an approximate 2 cm lesion of mostly Gleason 7 (3+4) with only 20% being 4, contained in prostate. J Am Board Fam Med. Six weeks later I have the biopsy in his office and a week later I get the results. And when I attempt to ask questions about intradcutal, I get responses about how little is known about it because it's so rare or that it is controversial or that they're not familiar with the study I'm referencing. I am 58 and in very good health otherwise. * Sloan only sent partial cores, slides 1 and 4. Benign Processes: Netto says patients should be proactive in requesting that doctors take another look. 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. Second opinions offer different things in different circumstances, Dr. Matasar says.
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