1.Rebecca L. Siegel, Kimberly D. Miller, and Ahmedin Jemal, Cancer Statistics, 2019 CA Cancer J Clin. HHS Vulnerability Disclosure, Help So, I made an appointment at Emory Proton Center (Atlanta, GA) and got their opinion. I am also doing a vegan diet with additional complementary substances. FYI-We are also considering the trial at Princess Margaret Hospital in Toronto. MRI RE-READ #1 (well known radiologist, but free advice over phone, but no written report): About 80 percent of prostate cancers are diagnosed at a localized stage, which means that the cancer hasn't spread outside of the prostate. Dr. Dan Sperling - New York. According to the study, one in every 600 diagnoses showed mistakes.This study only addressed major changes in diagnoses, such as a diagnosis of cancer being reversed to no cancer, says Johns Hopkins pathologist George Netto, M.D. 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. 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. Unfortunately, monetary incentives create biases that can work against patients best interests. Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. I've had what I would consider a fluctuating PSA since first tested in November 2018. radiation, active surveillance, surgery, hormone therapy, 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. Identified an approximate 2 cm lesion of mostly Gleason 7 (3+4) with only 20% being 4, contained in prostate. I will say, the people I dealt with at Johns Hopkins were extremely nice and professional. It worked great (with negative pathology of the tissue) and fixed a lot of nasty symptoms and risks. Following the advice of all on here, I need a team of doctors to manage my care. 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. has now confirmed this assumption through a careful retrospective analysis of data from > 450 men whose records could be identified in the SEARCH database, all of whom received surgical treatment for Gleason 8 to 10 prostate cancer. The Radiation Oncologist knew of Dr Busch (by now in Alpharetta, GA) and spoke highly of him. Also these lesions did not abut or touch the wall of the prostate. 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. doi: 10.1001/jamanetworkopen.2020.28320. There were several areas of interest - but nothing in seminal vesicles, lymph, or bones. Thanks to all of you for sharing! At this point Im still ignorant about what I ought to be doing (MRI guided biopsy is what I should have gotten). Brief MRI history. Following application of the relevant exclusion criteria, 2365 respondents remained in the analytical cohort. The lesion also shows focal increased permeability. 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. JHs just said it was minimal less than 5%. Its in your best interest to ask for another look at a cancer diagnosisIf youve recently been diagnosed with cancer, its wise to ask for a second opinion on your pathology specimen.Johns Hopkins researchers with the Urological Pathology Consult Division, led by Jonathan Epstein, M.D., first reported on biopsy errors a decade ago, when they found a margin of error in prostate cancer diagnoses large enough to give them pause. 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. I followed up with the original pathologist to compare and he was more forthcoming. Reinterpretation of imaging scans and lab tests. Most people believe that pathology reports are always correct, accurate and that what the report says is carved in stone. This championship swimmer sought a second opinion at Johns Hopkins. 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. Utilize your primary care physicians as an un-biased resource to help you get second opinions from a range of specialists. 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. 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 . We prioritized treatment as AS, FLA/TULSA (if a lesion ever presented itself), and Proton Beam Radiation. Brachytherapy Experience with Dr. Albert Chang at UCLA? FLA DONE AT FIRST BIOPSY G- 7. In other words, the cancer is still contained within the prostate. In 2006 my PSA was .6. Slightly Good Morning Brothers- Natural history of progression after PSA elevation following radical Call us with any questions: 410-955-2405, ext. In those cases, patients are tremendously grateful for having received the advice and encouragement to get a second opinion, Dr. Matasar adds. I assume it is not free. If they have an enlarged colon, their physician can perform a TURP procedure. Pathology reports are subjective. My prior Prolaris study (2018) before the FLA was very low risk. Nov 7, 2016. Hello everyone. Treatment Advice: Sloans radiation oncologist says radiation treatment will likely be the same whichever pathologist report prevails, but may add hormone therapy for about 2 months. Ask us questions on this webpage. not hear all the viable treatment options or receive the most up to date Studies show the clinical and financial benefits of obtaining a pathology second opinion. The ADT has daunting side-effects but he said offers some improved chances of eradication, any long-term downsides that I should consider? He recommended waiting and watching at that time due to the lower PSA reading. Got the fiducials placed, the Space-OAR gel placed, mold made, and had the pre-treatment MRI and CT Scan. * Extracapsular extension: Possible involvement of the anterior I applaud Dr Scholz for his dedication and explanation of such a complex cancer, that has not had his common sense help available for men with prostate cancer. Read Also: Long Term Side Effects Of Brachytherapy For Prostate Cancer. BJU Int. * Both Sloan and Johns Hopkins admit that large discrepancies are unusual, yet both stand by their opinions. PI-RADS v2 score: 5. and I have already proven to myself that my body is good at cell mutation, so I wanted to be careful.At the 3 year mark (6 months after last MRI), my PSA spiked to > 6. I fear limiting myself to an inferior treatment because the people I talk to have hammers, therefore everything must be a nail. I have completed an exhaustive research effort on Prostate Cancer and PCa treatments. This has raised some questions on all the scans so far. Prostate, left lateral apex: Some men may have an enlarged prostate but not notice it. 5. I choose surgery over radiation because you can do surgery and then radiation, but it is almost impossible to do it the other way around. Pathology reports are the opinion and interpretation of the individual pathologist viewing the tissue samples. Get a Second Opinion: Johns Hopkins Kimmel Cancer Center However, older men 75 years were the least likely to report obtaining a second opinion due to dissatisfaction with their initial urologist. In other words, can I have a team here in Wisconsin yet travel elsewhere to get my MRI? Research was mixed on PINS, but in those days, many doctors saw them as likely to develop into cancer. Only one core was diagnosed with a small amount of 3+3 (it was one of the three targeted cores). Of course, my old school Urologist recommended surgeryHe, of course, knew the best robotic surgeons around.Anyway. I have posted here before, now with an update. So, Radiation Oncologist prescribed Cialis 5mg, daily. Everything seems to be on track to remove the cancer and be cured! Please don't hesitate to make any observations or ask questions. One core had 5%, one 20%, and one 40%. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. When you review your pathology report and are going to be making important decisions, like treatment decisions, which will be based on the information from the pathology report. 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! LESION 1 Benign Processes: Radhakrishnan A, Grande D, Mitra N, Bekelman J, Stillson C, Pollack CE. Your current doctor will frequently suggest a second opinion, if only to confirm the recommended course of action. Associated fees may be incurred up to $1,800 in a minority of more complicated cases requiring special studies. Also Check: Prostate Cancer Stage 7 Treatment. However, he also said it's treatable even at a 2cm size and the transition zone is a favorable spot. 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. 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. (Recommended by my oncologist, Dr. Mark Scholz.) In some situations, insurers will even insist on a second opinion. 2. Eager to hear what everyone thinks or has anything they see in the report I wouldn't have thought of. * Gleason Score: 3+3 (2 of 6 specimens) (TZ) One suspicious area - lesion size: 2cm x 1.4 cm It can be caused by many factors, including infection and inflammation. 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.
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