Cooper Kupp Family, Herriman High School Wrestling, Religious Abuse Statistics, Articles J

This championship swimmer sought a second opinion at Johns Hopkins. 2. 1. Ask your PCP to refer you to several different types of treating doctors before making a treatment decision. Prostate volume: 17.58 cc - Follow-Up Score (PRECISE) for this lesion = Stable MRI appearance: no new focal/diffuse lesions. Get directions, important phone numbers, locations and more. 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. An accurate diagnosis is essential to ensure the most effective treatment. We are vaccinating all eligible patients. - 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) Seminal vesicles are normal. In other words, can I have a team here in Wisconsin yet travel elsewhere to get my MRI? have no symptoms, and yet you have cancer? The TRUS biopsy is behind me, the second opinion from Johns Hopkins is behind me, and its time for next steps. Second opinions not likely to change prostate cancer treatment FAX 310-574-4002 This kills both birds with a single stone. The biopsy took 3 samples from the targeted region plus 16 sextant. He also stated that he would ONLY recommend FLA if done within a trial. See this image and copyright information in PMC. 6 A study at the Johns Hopkins Health System found it was 3.4 times more common in Black Americans than in White Americans. My question is regarding the results of an MRI guided biopsy into a distinct tumor vs. subsequent Oncotype Dx Results. PSA that brought me to this was 7.1. And it is OK to have paralysis by over-analysis. This site needs JavaScript to work properly. Overall, obtaining second opinions was not associated with changes in treatment choice or with improvements in how patients viewed their quality of cancer care. After a little experimenting I have been able to achieve a partial erection. And just this week, 1 YEAR post treatment, it is .46. With no travel needed and no red tape, its easy to get a second opinion, all from the comfort of your home. I worked out every day. Value of Second Opinion in Prostate Cancer Uncertain, Says Hopkins Study. He never sought treatment for the injury. Bring All Labs/Notes to Each Appointment. However, seeing him will be another 8 weeks, but he wants my biopsy slides (second opinion) before we meet. 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. The results of Oncotype came back and it was a bad report. Six weeks later I have the biopsy in his office and a week later I get the results. I worked out every day and it wasn't until the last week did I feel a bit fatiguedand experience a bit of urgency and hesitation having to peeflowmax fixed that right up!90 days after treatment my PSA came in at .56. Many thanks for that. Masks are required inside all of our care facilities. Doctors can review their peers treatment suggestions and explain why they agree or disagree. I opted to waive the biopsy, wait 1 year and test again. As a result, patients struggle to differentiate bias from fact. A doctor may prescribe surgery or perform an endoscopic procedure. Men have plenty of time to seek multiple opinions and thoroughly research each option before making a decision. After extensive discussion of his management options with his local urologist, primary care physician, and radiation oncologist, he also sought a second opinion at the Johns Hopkins Prostate Cancer Multidisciplinary Clinic at Sibley Memorial Hospital.The patient expressed an overwhelming desire to avoid surgery and any other invasive treatments. Peripheral Zone: The peripheral zone is of normal homogeneous prolonged T2 and there are no suspicious focal areas of They basically said it didn't matter. 1. The main purpose of the prostate is to produce semen, a milky fluid that sperm swims in. Just got my pathology results. Confirm biopsy and imaging results with centers of excellence before making any final decisions. 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. Prostate Cancer | Johns Hopkins Brady Urological Institute * Extracapsular extension: None. Symptoms include leaking and discomfort. The primary goal is to be cured with the least toxic, most effective approach. Thanks, Johns Hopkins Prostate Cancer Second Opinion Lesions are all small or very small. Of these, 40% obtained second opinions, most commonly because they wanted more information about their cancer (50.8%) and wanted to be seen by the best doctor (46.3%). If I am rested, I find that I am more ready than if I am not. Radhakrishnan A, Grande D, Mitra N, Bekelman J, Stillson C, Pollack CE. 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. Send a Consult for Second Opinion | Johns Hopkins Pathology Some men will have a very enlarged prostate, whereas others will have a mild enlargement. Has anyone sent Radiology (mpMRI) reports and images to Hopkins for Second Opinion Review? We had the 3T MRI (no coil) and MRI guided biopsy at Sperling in NY, and then had a 2nd Opinion done by Johns Hopkins. Primary Gleason grade: 3 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. Treatment options include immunotherapy, 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. Natural history of progression after PSA elevation following radical My profession for forty years was health actuary consultant, so I have a pretty fair understanding of health data, outcomes, and risks. 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. BASE DATA: - Prostatic adenocarcinoma, Gleason score 3+4=7 (grade group 2, pattern 4: 5%) involving 2 of 2 cores (medial core: 3.5 mm, 30%; lateral core: 2.5 mm, 20%), 0.5 mm to the blue inked tissue edge (the closer) A second opinion can accomplish a number of things. Wow, I sound like a snob now! Will these places of excellence consider me, or am I bound to my regular doctor for insurance purposes? In terms of cancer, changes can be from cancer to benign (or vice versa) or from one type of cancer to another, which could have a significant impact on treatment and prognosis. Most reputable HMOs can, however, deliver state of the art treatment for most cancers. Usually, patients obtain a second opinion after being referred to a second physician or to a special team of experts in a cancer center, called a multidisciplinary team. PREVIOUS MRI RESULTS (LOTS of them) 3. Patients are often under the mistaken notion that they have to pick between their oncologist and MSK, but thats often not the case, Dr. Matasar explains. Prostate, right lateral apex: The symptoms of acute bacterial prostatitis are similar to those of CPPS. (PZ) - normal I am already positively surprised that I am still alive 4.5 years after my diagnosis. radiation, active surveillance, surgery, hormone therapy, and more. 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. If you choose to be treated at Johns Hopkins, you may be able to begin treatment immediately. According to the doctor it is around 3 mm. Us Too Prostate is a great club and many of you have helped me a lot already. Have been diagnosed with a serious or rare health condition. Breast cancer.A new study suggests surgery may not always be necessary for all breast cancer patients. PROSTATE LESIONS: It will be interesting to see, I think. Get a Second Opinion: Johns Hopkins Kimmel Cancer Center The reasons for opting for treatment: the single lesion - previously Gleason 3+4, with a small percentage of pattern 4 - has grown, and according to a biopsy performed March 25, my Gleason 3+4 is now a Gleason 4+3. Anything I am overlooking or need to add to my list of considerations? Therefore, the value of these second opinions remains unknown. doi: 10.1136/bmjopen-2020-044033. Surgeon wants next PSA in 3 months. Note respondents were able to, MeSH Total Gleason score: 7 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. The majority had lower risk tumors and clinical staging of 1 40% sought second opinions with about half having more than one reason Men seeking second opinions tended to be younger and better educated citing the need for more information as their reason. 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. Comments appreciated, No one at Hopkins has ever died of prostate cancer if he had Gleason 3 + 3 cancer." Patient-initiated second medical consultations-patient characteristics and motivating factors, impact on care and satisfaction: a systematic review. I say bullshit to them. Johns Hopkins Prostate Cancer Doctors - HealthyProstateClub.com * Seminal vesicle invasion: None. Thanks, BigD. A week later had catheter removed and had no bladder leakage problems. Some specialize in reading only slides that come from a specific organ while others are generalists who read many different pathology slides from many different organ systems. If they do not cover this cost and you must pay out of pocket, keep in mind that a second opinion could save you from having to pay (financially and physically) for additional treatment down the line. It hasn't let me down. Generally, the symptoms can stabilize over time. Time moves fast when dealing with cancer, but Doctors dont. I had FLA done after first biopsy which staged me at 3+4 = 7. I then had the PHI test which showed PSA 8.70 and overall PHI 125.9. The researchers also found that patients who obtained second opinions because they wanted more information, were seeking the best doctor, or had been encouraged to do so by family or friends were more likely to undergo surgery. 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. The more often a doctor diagnoses and treats prostate cancer the more proficient they become. prostate cancer; quality of health care; second opinion; specialists; treatment. He also said perinueral invasion, but not extracapsular extension. Wondering if any of the "gurus" here want to take a stab at looking at this and see if they agree that it says what I think it says (I will be following up with doctor(s) to get their opinion, and I waive all HIPAA rights by allowing this to be seen). I am relatively new to this forum and trying to educate myself as to my best course of treatment. If you are considering undergoing a specialized treatment, such as cancer surgery, within your HMO, it is important to inquire about the number of such procedures performed each year by the HMO and the results. C. Prostate, right apex, core biopsy: Dr also stated he was able to totally spare one of my nerves, but to get margin may have damaged one. Nor did I have any idea that the 1 core had 20% involvement and <5% pattern 4 involvement. PDF Cancer A Second Opinion A Look At Understanding Controlling And Curing * Sloan only sent partial cores, slides 1 and 4. HHS Vulnerability Disclosure, Help 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. Cancer patients are encouraged to obtain second opinions before starting treatment. I have developed an "abscess" on my prostate. Spent the night in hospital with very little pain after the first couple of hrs. World J Urol. 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. But, after 4 drinks or if I'm tired/jet lagged I find that sleep is more appealing than sex. These so-called grading and staging errors are more common and can affect how aggressively a patient is treated. Some specialists have more expertise and more experience than others. This fee includes: Recommended Reading: Radiation Therapy For Prostate Cancer. The people were great. I did a book review with his first book for several veterans groups including the Americal Division Veterans Organization which with I served at age 19. I am also not comfortable making a decision based upon 1 genomics test, when my other prior test(s) disagrees and the gleason score disagrees. He also said I would tolerate any option well based on my age and health. The Johns Hopkins Brady Urological Institute is known around the world for its expertise in diagnosing and treating urologic conditions. These findings are suspicious for degenerative changes however a subtle/early metastatic lesion cannot be excluded and continued periodic follow-up is recommended." You AHN patients have unprecedented access to the Johns Hopkins Center for Fetal Therapy. I am an airline pilot with exposure to radiation, jet fuels/fumes, etc. Thank you! Axial T1-weighted images of the pelvis show no bony or bulky nodal disease. While I now concluded we need to find "it", I researched the best approach to see what is really going on and to do this safely. 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. MEASUREMENTS: Pathology reports are the opinion and interpretation of the individual pathologist viewing the tissue samples. Prostate, right medial apex: In the United States, prostate cancer is among the most common cancers found in men. T2W MRI score= 2, DW MRI score= 3, DCE MRI score=positive I made the appointments. 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. I will say, the people I dealt with at Johns Hopkins were extremely nice and professional. 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. First of all we would like to emphasize that the health of our employees, our patients and their relatives is our first priority. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. Utilize your primary care physicians as an un-biased resource to help you get second opinions from a range of specialists. Where Should I Go for a Second Opinion? - breast cancer ADC: mean 879 / median 839 / st dev 223 * Other 12 slides not sent If the problem is unresponsive to other treatments, your doctor may suggest a surgical procedure. NONE of the many radiation oncologists, surgeons or urologists I've spoken with in my journey have ever mentioned the term to me so I had to look it up. Oncologist. 2. I can do radiation as a monotherapy. I am 62 years old. Benign prostatic tissue Shore ND, Karsh L, Gomella LG, Keane TE, Concepcion RS, Crawford ED. While I have three lesions, they are small and, without 3T mp MRI, might not have been discovered. It was easy. The average age at the time of prostate cancer diagnosis is about 66. As I said, I am 58, so I would really like to preserve my quality of life for as long as possible, but the genomics report has me concerned. I'm trying to figure out why the PSA keeps rising. 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. Overall, obtaining second opinions was not associated with definitive treatment or perceived quality of cancer care. Make an appointment: 410-955-5222 Coordinating with your Treating Physician At the Breast Cancer Program at the Johns Hopkins Kimmel Cancer Center in Baltimore, MD, a second opinion requires only that you or your doctor send us your pathology slides, key medical records and signed paperwork requesting the opinion. I fear limiting myself to an inferior treatment because the people I talk to have hammers, therefore everything must be a nail. The urologist offered surgery and radiation as options on 3/10 when we met. Second opinions from urologists for prostate cancer: who gets them, why, and their link to treatment . There is no extraprostatic extension. 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 enlarged prostate can also cause blockages in the urethra. -------------------------------------------------------- There is no one-size-fits-all treatment for prostate cancer. Secondary Gleason grade: 4 Greatest dimension 2cm. Prurigo Nodularis Cancer: What's the Link? - Verywell Health You know - urinary incontence, erectile dsyfunction, and exhaustion (hormones) are not my cup of tea. Further, among men with low risk disease, we did not observe a significant association between second opinions and receipt of definitive treatment or surgery. Other: There is trace ascites in the mesosigmoid. Identified an approximate 2 cm lesion of mostly Gleason 7 (3+4) with only 20% being 4, contained in prostate. Prostatic Adenocarcinoma But, ultimately decided on whole gland treatment using Proton Beam Radiation.So. Bones: There is marketed marrow heterogeneity in the pelvic bones are not in the femoral heads. 2019 Jan;69(1):7-34. doi: 10.3322/caac.21551. desired outcome. I had a telemed session with Dr. Chang, and it sounds like a pretty simple procedure, with urinary side effects that resolve pretty quickly. Benign prostatic tissue 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. The best protection for cancer patients who are Health Maintenance Organization members is to seek a second opinion even if she or he has to pay for it. * Membranous urethral length: 1.2 cm Some men may have an enlarged prostate but not notice it. doi: 10.1002/cncr.30412. Benign fibromuscular stroma; no prostatic glands are identified 1. ---------------------------------------------------- One core had 5%, one 20%, and one 40%. Second Opinions for Cancer Care - UChicago Medicine Urologists at the Johns Hopkins Brady Urological Institute can make the difficult process of deciding on a treatment plan easier. You May Like: Prostate Cancer External Beam Radiation Side Effects. I have had a second opinion from Johns Hopkins that confirmed the initial pathology of gleason 3+4. Prostate cancer is a slow growing condition. Most people believe that pathology reports are always correct, accurate and that what the report says is carved in stone. 7. * Location: Left, anterior, base to apex, transition zone So off I went to see a community urologist who performed a needle biopsy in his office. Get a Second Opinion What can a second opinion tell me? If these do not work, your symptoms could progress and become chronic. That's the good news. Obtaining a second opinion in Pathology can in a small percent of cases lead to a complete change in diagnosis in a wide range of conditions including non-cancerous growths, inflammatory disorders, infections, and cancer. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. In other words, the cancer is still contained within the prostate. AHN patients have unprecedented access to the Johns Hopkins Center for Fetal Therapy. 5/10 PSA 4.2/fPSA 9% taken at MSKCC (lab #3) I had the MRI in April 2021 and it showed a PI-RADS 4 lesion. 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. The James Buchanan Brady Urological Institute, Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, Precision Medicine Center of Excellence for Prostate Cancer, robotic-assisted radical laparoscopic prostatectomies, The Brady Urological Institute and the Johns Hopkins Kimmel Cancer Center take a, Our urologic surgeons have extensive experience performing, Our surgeons, oncologists and radiologists are also world leaders in prostate cancer research, giving patients access to the latest discoveries and. 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. Second opinion Biopsy came after FLA G-9. He said that JHs said that it was 2 cores, but it was actually a fragmented core, that the fat did not present on the right place on the slide, that prior FLA (partial hemi-ablation) could affect the results, the MRI did not support, etc. If I don't meter fluids before bed, I can expect to get up 3-4 times in the night.At this point, I am convinced I made the right treatment choiceOHFOR THOSE THAT DON'T KNOW, THE VA HAS MADE REPRODUCTIVE CANCERS A PRESUMPTIVE CONDITION FOR THOSE THAT SERVED IN MOST OF THE WAR ON TERROR LOCATIONS.Good luck fellas and my prayers are with all of you having to contend with this disease. * Adjacent organ invasion: None. Especially opinions other than those of the first Urologist you see. * Seminal vesicle invasion: None. Notice of Privacy Practices(Patients & Health Plan Members). Jonathan Epstein, MD received his doctorate from Boston University. 7 People with PN had an increased likelihood of: 6 Eating disorders Self-harm 4. 7: Prostate, left lateral apex "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 . This condition causes pain in the lower back and groin area, and may cause urinary retention. Following application of the relevant exclusion criteria, 2365 respondents remained in the analytical cohort. But you have to do both. Conflicting Prostate Biopsy OpinionsWhat to Do? 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 neurovascular bundles are intact. Getting a second opinion on a diagnosis can reverse a diagnosis or alter the treatment plan. For cancers that are less common, second opinions can offer more treatment options. For these reasons and others, it is advantageous to seek more than one opinion about how your cancer can be treated. Olver I, Carey M, Bryant J, Boyes A, Evans T, Sanson-Fisher R. BMC Palliat Care. Prostate Cancer News, Reviews & Views: Second opinions Now, though, encouraging animal data and preliminary studies in human patients are making some doctors feel optimistic. the transition zone. 2nd opinionBone Scan:"Mild increased activity is seen in the right symphysis corresponding to the abnormalities on the prior PET/CT examination.