johns hopkins prostate cancer second opinion
So my question for you is have you ever heard of PRECISE and if so what should I make of it? 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. Unfortunately, monetary incentives create biases that can work against patients best interests. Dr. Erick Walser at University of Texas Medical Center. Following application of the relevant exclusion criteria, 2365 respondents remained in the analytical cohort. My diagnosis is T2c, Gleason 7 (3+4). 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. Any input on this would really be appreciated. First MRI done in June 2016 by Scottsdale Medical Imaging - nothing found. In the mean time my PSA was movingno longer static, but never back up to 6. Fear, confusion and uncertainty set in. 5. Patient preferences and urologist recommendations among local-stage prostate cancer patients who present for initial consultation and second opinions. She put me in the hospital. They told me to expect a spike in my PSA sometime in the future, and they told me that studies are showing that a slow, steady decline in PSA is often indicative of superior results (whatever that means. Keep in mind that not all PCPs are knowledgeable about prostate cancer or know the skill levels of all the specialists in the field. I had my first of those 2 PSA tests last week and it dropped to 4.77. Reasons for obtaining a second opinion from urologists. Dr. Epstein has 744 publications in peer-reviewed literature and has authored 50 book chapters with a H-factor of 118. 9: Prostate, left anterior MRI lesion I have had a second opinion from Johns Hopkins that confirmed the initial pathology of gleason 3+4. Got the fiducials placed, the Space-OAR gel placed, mold made, and had the pre-treatment MRI and CT Scan. Keeping a timeline and organized medical records is important because it can contribute to your treatment plan. Similarly, among those who received definitive treatment, second opinions were not associated with receiving surgery. 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. Consultation with your nurse care manager. H. Prostate, lesion #2, core biopsy: I was referred to a urologist and tested again in April at 4.40. During the next 4 weeks I meet with the recommended Radiologist, and the two local surgeons. Nor did I have any idea that the 1 core had 20% involvement and <5% pattern 4 involvement. Asking for your comments: Unable to load your collection due to an error, Unable to load your delegates due to an error. I am an airline pilot with exposure to radiation, jet fuels/fumes, etc. - 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) It's really that simple! My prior Prolaris study (2018) before the FLA was very low risk. restricted diffusion. In adjusted models, obtaining a second opinion was not associated with receipt of definitive treatment . Greatest dimension 2cm. Ask us questions on this webpage. Axial T1-weighted images of the pelvis show no bony or bulky nodal disease. 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. decision on a single medical opinion or the first appointment you get, you may Men who sought second opinions because they were dissatisfied with their initial urologist were less likely to receive definitive treatment (odds ratio, 0.49; 95% confidence interval, 0.32-0.73), and men who wanted more information about treatment were less likely to report excellent quality of cancer care (odds ratio, 0.70; 95% confidence interval, 0.49-0.99) compared with men who did not receive a second opinion. Studies show the clinical and financial benefits of obtaining a pathology second opinion. My goals are to control PCa, to minimize side effects, and to keep options open in the future. My profession for forty years was health actuary consultant, so I have a pretty fair understanding of health data, outcomes, and risks. Get a Urology Second Opinion | Johns Hopkins Brady - Hopkins Medicine HMO members may also be discouraged from trying expensive treatments that have only a small chance of success, even if that chance is real. IMPRESSION: However, he also said it's treatable even at a 2cm size and the transition zone is a favorable spot. Thank you for your understanding and cooperation. A doctor may prescribe surgery or perform an endoscopic procedure. If they have an enlarged colon, their physician can perform a TURP procedure. Two from one lesion were positive as was one of the two from the other. I'm going to reach out to UCLA to see what they can do. 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! 8600 Rockville Pike 4/16 3T MRI performed (reports/re-reads below) The symptoms of acute bacterial prostatitis are similar to those of CPPS. Treatment decisions for prostate cancer should not be rushed due to a mistaken belief that immediate treatment is required. Right mid anterior transition zone (PIRADS 2). 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. 180 days after treatment PSA was .50. It is OK to be scared. Jonathan Epstein, MD received his doctorate from Boston University. I didn't study for the test and it's possible some morning activities might have affected my test score :) Second round of Radiation Therapy - t - Advanced Prostate I made the appointments. By choosing the first doctor you speak with to be your treating physician, you may be putting your health in the hands of someone who lacks the expertise to accurately and safely treat your prostate cancer. To learn your stage of prostate cancer, take the staging quiz on keytopc.com. Intensity: min 148 / Max 459 But was able to walk right into the JH Urology clinic for immediate treatment (flushing of bladder cleared everything up). 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 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. 10. Treatment must be chosen based on stage and your 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. PSA that brought me to this was 7.1. Our gynecologic pathology team can also help determine if the tumor is localized or has metastasized from another region of the body. Hopkins states that the one positive core (10% G6) was visualized by the MRI, so I am hoping that this increases our chances of making it through the screening process. This is often the case when the primary physician advises an expensive treatment. Dr. Dan Sperling - New York. FLA DONE AT FIRST BIOPSY G- 7. 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. We are vaccinating all eligible patients. About 60% of prostate cancers occur in people older than 65. Following his residency in anatomic pathology at The Johns Hopkins Hospital in Baltimore, Maryland, and a fellowship in oncologic pathology at Memorial Sloan Kettering Cancer Center in New York., he then joined the staff at The Johns Hopkins Hospital and has been there his entire career. Urologists are trained as surgeons, radiation oncologists administer radiation, and medical oncologists provide cognitive oversight and general management of the cancer. 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. Dont Miss: Screening For Prostate Cancer Icd 10. My local urologist didnt want to schedule one because it he said it wouldnt change my treatment options, radiation or 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. During your visit, our specialists will review your medical records, diagnostic tests and other information provided by you or your current physician. 5/10 PSA 4.2/fPSA 9% taken at MSKCC (lab #3) One core had 5%, one 20%, and one 40%. My other option for treatment is either LDR or HDR brachytherapy. I also changed my diet to plant based food, started juicing, and started taking supplements (think Turmeric, Green Tea, etc.). These results, if validated in other studies, justify additional investigation on how second opinions can contribute to increasing the value of cancer care, the authors concluded. FAX 310-574-4002 Biopsy in 12/27/11 showed 3/14 cores, Gleason 6 with PSA of 4.5. He never sought treatment for the injury. Benign prostatic tissue John, I was diagnosed on 11 December, 2013. If a targeted biopsy is planned, this lesion can be sampled at the same time. With no travel needed and no red tape, its easy to get a second opinion, all from the comfort of your home. An accurate diagnosis is essential to ensure the most effective treatment. 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. Peripheral Zone: The peripheral zone is of normal homogeneous prolonged T2 and there are no suspicious focal areas of This condition causes pain in the lower back and groin area, and may cause urinary retention. The prostates function is to create some of the fluid that insulates sperm cells found in semen. So, Radiation Oncologist prescribed Cialis 5mg, daily. It starts many years ago. BJU Int. Second opinions offer different things in different circumstances, Dr. Matasar says. Why Did Nurse Jackie Kill Herself,
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So my question for you is have you ever heard of PRECISE and if so what should I make of it? 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. Unfortunately, monetary incentives create biases that can work against patients best interests. Dr. Erick Walser at University of Texas Medical Center. Following application of the relevant exclusion criteria, 2365 respondents remained in the analytical cohort. My diagnosis is T2c, Gleason 7 (3+4). 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. Any input on this would really be appreciated. First MRI done in June 2016 by Scottsdale Medical Imaging - nothing found. In the mean time my PSA was movingno longer static, but never back up to 6. Fear, confusion and uncertainty set in. 5. Patient preferences and urologist recommendations among local-stage prostate cancer patients who present for initial consultation and second opinions. She put me in the hospital. They told me to expect a spike in my PSA sometime in the future, and they told me that studies are showing that a slow, steady decline in PSA is often indicative of superior results (whatever that means. Keep in mind that not all PCPs are knowledgeable about prostate cancer or know the skill levels of all the specialists in the field. I had my first of those 2 PSA tests last week and it dropped to 4.77. Reasons for obtaining a second opinion from urologists. Dr. Epstein has 744 publications in peer-reviewed literature and has authored 50 book chapters with a H-factor of 118. 9: Prostate, left anterior MRI lesion I have had a second opinion from Johns Hopkins that confirmed the initial pathology of gleason 3+4. Got the fiducials placed, the Space-OAR gel placed, mold made, and had the pre-treatment MRI and CT Scan. Keeping a timeline and organized medical records is important because it can contribute to your treatment plan. Similarly, among those who received definitive treatment, second opinions were not associated with receiving surgery. 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. Consultation with your nurse care manager. H. Prostate, lesion #2, core biopsy: I was referred to a urologist and tested again in April at 4.40. During the next 4 weeks I meet with the recommended Radiologist, and the two local surgeons. Nor did I have any idea that the 1 core had 20% involvement and <5% pattern 4 involvement. Asking for your comments: Unable to load your collection due to an error, Unable to load your delegates due to an error. I am an airline pilot with exposure to radiation, jet fuels/fumes, etc. - 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) It's really that simple! My prior Prolaris study (2018) before the FLA was very low risk. restricted diffusion. In adjusted models, obtaining a second opinion was not associated with receipt of definitive treatment . Greatest dimension 2cm. Ask us questions on this webpage. Axial T1-weighted images of the pelvis show no bony or bulky nodal disease. 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. decision on a single medical opinion or the first appointment you get, you may Men who sought second opinions because they were dissatisfied with their initial urologist were less likely to receive definitive treatment (odds ratio, 0.49; 95% confidence interval, 0.32-0.73), and men who wanted more information about treatment were less likely to report excellent quality of cancer care (odds ratio, 0.70; 95% confidence interval, 0.49-0.99) compared with men who did not receive a second opinion. Studies show the clinical and financial benefits of obtaining a pathology second opinion. My goals are to control PCa, to minimize side effects, and to keep options open in the future. My profession for forty years was health actuary consultant, so I have a pretty fair understanding of health data, outcomes, and risks. Get a Urology Second Opinion | Johns Hopkins Brady - Hopkins Medicine HMO members may also be discouraged from trying expensive treatments that have only a small chance of success, even if that chance is real. IMPRESSION: However, he also said it's treatable even at a 2cm size and the transition zone is a favorable spot. Thank you for your understanding and cooperation. A doctor may prescribe surgery or perform an endoscopic procedure. If they have an enlarged colon, their physician can perform a TURP procedure. Two from one lesion were positive as was one of the two from the other. I'm going to reach out to UCLA to see what they can do. 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! 8600 Rockville Pike 4/16 3T MRI performed (reports/re-reads below) The symptoms of acute bacterial prostatitis are similar to those of CPPS. Treatment decisions for prostate cancer should not be rushed due to a mistaken belief that immediate treatment is required. Right mid anterior transition zone (PIRADS 2). 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. 180 days after treatment PSA was .50. It is OK to be scared. Jonathan Epstein, MD received his doctorate from Boston University. I didn't study for the test and it's possible some morning activities might have affected my test score :) Second round of Radiation Therapy - t - Advanced Prostate I made the appointments. By choosing the first doctor you speak with to be your treating physician, you may be putting your health in the hands of someone who lacks the expertise to accurately and safely treat your prostate cancer. To learn your stage of prostate cancer, take the staging quiz on keytopc.com. Intensity: min 148 / Max 459 But was able to walk right into the JH Urology clinic for immediate treatment (flushing of bladder cleared everything up). 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 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. 10. Treatment must be chosen based on stage and your 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. PSA that brought me to this was 7.1. Our gynecologic pathology team can also help determine if the tumor is localized or has metastasized from another region of the body. Hopkins states that the one positive core (10% G6) was visualized by the MRI, so I am hoping that this increases our chances of making it through the screening process. This is often the case when the primary physician advises an expensive treatment. Dr. Dan Sperling - New York. FLA DONE AT FIRST BIOPSY G- 7. 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. We are vaccinating all eligible patients. About 60% of prostate cancers occur in people older than 65. Following his residency in anatomic pathology at The Johns Hopkins Hospital in Baltimore, Maryland, and a fellowship in oncologic pathology at Memorial Sloan Kettering Cancer Center in New York., he then joined the staff at The Johns Hopkins Hospital and has been there his entire career. Urologists are trained as surgeons, radiation oncologists administer radiation, and medical oncologists provide cognitive oversight and general management of the cancer. 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. Dont Miss: Screening For Prostate Cancer Icd 10. My local urologist didnt want to schedule one because it he said it wouldnt change my treatment options, radiation or 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. During your visit, our specialists will review your medical records, diagnostic tests and other information provided by you or your current physician. 5/10 PSA 4.2/fPSA 9% taken at MSKCC (lab #3) One core had 5%, one 20%, and one 40%. My other option for treatment is either LDR or HDR brachytherapy. I also changed my diet to plant based food, started juicing, and started taking supplements (think Turmeric, Green Tea, etc.). These results, if validated in other studies, justify additional investigation on how second opinions can contribute to increasing the value of cancer care, the authors concluded. FAX 310-574-4002 Biopsy in 12/27/11 showed 3/14 cores, Gleason 6 with PSA of 4.5. He never sought treatment for the injury. Benign prostatic tissue John, I was diagnosed on 11 December, 2013. If a targeted biopsy is planned, this lesion can be sampled at the same time. With no travel needed and no red tape, its easy to get a second opinion, all from the comfort of your home. An accurate diagnosis is essential to ensure the most effective treatment. 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. Peripheral Zone: The peripheral zone is of normal homogeneous prolonged T2 and there are no suspicious focal areas of This condition causes pain in the lower back and groin area, and may cause urinary retention. The prostates function is to create some of the fluid that insulates sperm cells found in semen. So, Radiation Oncologist prescribed Cialis 5mg, daily. It starts many years ago. BJU Int. Second opinions offer different things in different circumstances, Dr. Matasar says.
Why Did Nurse Jackie Kill Herself,
How Much Does Pepsi Pay Messi,
Articles J