Everything seems to be on track to remove the cancer and be cured! The study was published online Nov. 7 in the journal Cancer. If the problem is unresponsive to other treatments, your doctor may suggest a surgical procedure. 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. Radhakrishnan A, Grande D, Mitra N, Bekelman J, Stillson C, Pollack CE. Other labs for second . They may defer to the recommendation of the specialist, or refer you to a doctor with limited prostate cancer experience. By Dec 2019, my PSA reached 4.13. 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. * Gleason Score: 3+3, Slide 1 (vs. Sloan's 3+4) (I must say that those low numbers concern me a bit.) Dont Miss: Bladder Control After Prostate Surgery. In 2006 my PSA was .6. Over kill and redundancy I know, but it's my money, my prerogative. MRI RE-READ #2 (VERY VERY well respected radiologist): And just this week, 1 YEAR post treatment, it is .46. Men often seek second opinions from urologists before they initiate treatment for their newly diagnosed prostate cancer. He said that it will improve in the future due to future improvements in the treatments. Given that some 3+4 is now evident, I can no longer say that all my PCa is all 3+3 and that I can stay on AS for an extended period. intricate disease and not all doctors have the same amount of experience I retired as a Dentist at the VA and saw many veterans with a wide range of outcomes as most of them became 100% service connected when diagnosed with prostate Ca due to exposure to Agent Orange if they served in Vietnam. Because physicians may differ in their approach to treating breast cancer, its very important to check with a breast cancer expert to know youre receiving the best treatment for you. Overall, obtaining second opinions was not associated with definitive treatment or perceived quality of cancer care. 2/23 PSA 4.7/fPSA 12% taken for 4K score (lab #2) This fee includes: Recommended Reading: Radiation Therapy For Prostate Cancer. Oncologist. 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. 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 . Is the destruction of my prostate inevitable and necessary for my survival (my understanding is that both surgery and radiation will do this)? This condition causes pain in the lower back and groin area, and may cause urinary retention. 2016 American Cancer Society. I was offered to have my first biopsy sent to Johns Hopkins for second opinion and said why not? which came back with Gleason 9 three weeks after having the what we thought was G-7 ablated. My girlfriend lives 2 blocks from the Emory Proton Clinic.We prayed on it and overthought the crap out of it. Both Drs and nurses knew what they were doing and had lots of experience. 5. Men have plenty of time to seek multiple opinions and thoroughly research each option before making a decision. Either the patient or the primary physician can initiate the process of getting a second opinion. Before My question is regarding the results of an MRI guided biopsy into a distinct tumor vs. subsequent Oncotype Dx Results. John. Asking for your comments: In the rare chance a baby needs highly specialized care, the team at Johns Hopkins is available to treat rare and complex conditions through breakthrough fetal procedures. The issues in my prostate from the first procedure onward have all been in the same area and the rest of my prostate from the first biopsy and subsequent MRIs onward have never shown any indications of cancer in other areas. With AHN Cancer Institute, you already get a world-class cancer program with leading expertise, care, and outcomes. 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. He also said perinueral invasion, but not extracapsular extension. This may cause a conflict of interest between the patient and the HMO, especially if very expensive treatment is only available outside the HMO system. Want confirmation about a diagnosis or treatment. 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? Video consultation and written report from your expert. 2. 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. They won't be offended, and they may even be able to recommend a specialist for you to see. I have requested a second pathologist's opinion from Johns Hopkins based on feedback from this forum. Youve just been diagnosed with prostate cancer. 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. Lymph nodes: There is no suspicious lymphadenopathy in the pelvis. I wish the VA would be more informative about this disease they owe it to our veterans. I am at that critical juncture in which I at least need to formalize a plan, select a doctor/facility to work with, and continue my testing to make sure I have what I think I have. Similarly, among those who received definitive treatment, second opinions were not associated with receiving surgery. (TZ) One suspicious area - lesion size: 2cm x 1.4 cm Thankfully, prostate cancer is extremely slow growing. 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. It hasn't let me down. It is very rare (<3% of all prostrate cancers) and potentially very lethal (one study showed that 59% of men in the study with Gleason scores of 5 had died within 3 years and it had metastasized in 13% of the remaining men). Find a doctor at The Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center or Johns Hopkins Community Physicians. Studies show the clinical and financial benefits of obtaining a pathology second opinion. doi: 10.1002/cncr.30412. Now its easier than ever to get the answers you need and peace of mind you deserve. 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. Surgical Delay and Pathological Outcomes for Clinically Localized High-Risk Prostate Cancer. According to the doctor it is around 3 mm. Benign prostatic tissue of tumor in the rectal prostatic angles. They replied they are sending the slides but they said they're looking into the DX test and will get back to me once they have that information. Two 1cc tumors, gleason score 3+4 each, one in each lobe. __________________________________________________________________________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. 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. )I contacted Dr Busch (still in Chattanooga at the time) and he called me directly to talk me off the ledge. This is a PI-RADS 5 lesion in Being in Wisconsin, my insurance gives me the option of two hospitals to manage me. 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. My PSA over time has been creeping up over time (1.8 - 5/16, 1.0 8/17, 2.68 8/18, 2.9 12/18, 3.28 2/19, 3.01 8/19, 3.65 2/20, 3.31 6/20, 3.88 12/20) but I was frankly a bit shocked when I received word that I have cancer. present in bladder. Bring All Labs/Notes to Each Appointment. Future study is needed to determine when second opinions contribute to increasing the value of cancer care. Depending on your location, you may be able to have a telemedicine consultation. -------------------------------------------------------- I luckily found this webpage and I started reading everything I could get my hands on. Thanks to all of you for sharing! Obviously the Covid 19 issue is playing a part in all of our decisions. Need guidance choosing from multiple treatment options. 10. This condition causes pain in the lower back and groin area, and may cause urinary retention. Surgery seems like overkill for me with too many risks for incontinence and permanent ED, am I overlooking something? I am also talking with Dr Nour and Dr. Walser and possibly others to see if I am a good candidate for Focal Laser Ablation. The James Buchanan Brady Urological Institute, Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov. You However, something is driving my PSA. And just this week, 1 YEAR post treatment, it is .46. 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). Left mid-base transition zone (PIRADS 5). Noted that some don't even include on report and should be looked as something to note but not obsess about. Prostate dimensions: 4.1 x 2.8 x 3.4 cm E. Prostate, left mid, core biopsy: I'm currently in the process of getting an appointment set up with a Dr. Wang at UCLA. Had my PSA remained static I'd have remained on AS and had I grown a Target Lesion I'd have sought focal treatment.This science is emerging and only getting better. Many researchers believe PTEN present is a strong brake on 2 of the 12 samples showed High Grade PIN and one area showed "suspicious for low-grade adenocarcinoma". Is it done through my doctor or do I do it myself with sending CDs of the MRI? There is no evidence - Benign prostatic tissue Grade Group: 1 I have completed an exhaustive research effort on Prostate Cancer and PCa treatments. Consult Fees In some cases, additional testing may be required. Thanks, With world-renowned expertise, multidisciplinary specialists and the latest data, we partner with you to make informed decisions about managing your prostate cancer. -------------------------------------------------------- Unlike pathology labs in most hospitals, Jonathan Epstein's lab at Johns Hopkins has pathologists who specialize in reading prostate tissue samples. not hear all the viable treatment options or receive the most up to date A PSA test at time of biopsy revealed my PSA had risen to 6.5. You have a rare or unusual cancer. 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. I also learned a lot more about the high undisclosed risk of side effects of various treatment plans. I had FLA done after first biopsy which staged me at 3+4 = 7. We have a consult on Friday with the 1st opinion doc to review all tests. There is hope. Tumor Quantifications: 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. The total number of cores with carcinoma is 3 doi: 10.1001/jamanetworkopen.2020.28320. Generally, the symptoms can stabilize over time. Yet none of my doctors ever mentioned it! 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. A report with the diagnosis will be faxed to your doctor. The .gov means its official. Got the fiducials placed, the Space-OAR gel placed, mold made, and had the pre-treatment MRI and CT Scan. Visit and Like ZERO - The End of Prostate Cancer on Facebook, Sign up to receive emails and news from ZERO - The End of Prostate Cancer, Search prostate cancer clinical trials and studies. Many men name the diagnosing urologist as their treating doctor and do not seek other opinions. They agreed with the PI-RADS 4. If you choose to be treated at Johns Hopkins, you may be able to begin treatment immediately. I would really love to hear from you. ADC: mean 879 / median 839 / st dev 223 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 appreciate all the input because I am a little overwhelmed and confused as to the best course of treatment.

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