Would you like email updates of new search results? 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. The side effects of the cut, radiate, hormone regime are unacceptable to me. This puts PCPs in a unique position to impact the treatment decisionif they only refer to urologists and not to radiation oncologists or medical oncologistssurgery is a likely treatment outcome. Who should I contact at Johns Hopkins to get a second opinion on a biopsy? Netto points to prostate cancer as an example: If your diagnosis changes from a higher grade to a lower grade cancer, it could mean having the option to avoid radical treatment.Seeking second opinions is becoming standard practice, and it is mandatory at Johns Hopkins. Hillen MA, Medendorp NM, Daams JG, Smets EMA. * Should still go for a Johns Hopkins second opinion on the pathology or is that overkill since the first one was done at MSKCC? Overall, obtaining second opinions was not associated with definitive treatment or perceived quality of cancer care. 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. Below is the link with instructions and the authorization form for you to use with your doctor. For men with prostate cancer and who live in the United States, there are some highly regarded pathology labs from which you can obtain your second opinion. This is why the prostate is important to the body. My long-term prognosis appears to be good with minimal side effects. Another type of prostate issue is chronic prostatitis, or chronic pelvic pain syndrome. Im immediately referred to Urologist. 1. A blocked urethra can also damage the kidneys. I have completed an exhaustive research effort on Prostate Cancer and PCa treatments. 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. 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. Slightly Secondary Gleason grade: 4 Seeking second opinions is becoming standard practice, and it is mandatory at Johns Hopkins. My question is regarding the results of an MRI guided biopsy into a distinct tumor vs. subsequent Oncotype Dx Results. Rectal cancer.A small trial that saw 18 rectal cancer patients taking the same drug, dostarlimab, appears to have produced an astonishing result: The cancer vanished in every single participant. 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. Prostatic Adenocarcinoma 7. Thanks! Ozzieville (Michael), Hello All and thanks for being here~This is my first post.My husband was diagnosed with PC (adenocarcinoma with Extensive Intraductal Carcinoma Present) a few weeks ago. 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. Estimated prostate volume of 35 cc with an estimated PSA density of 0.11 ng/mL/cc. Now the oncologist wants to perform a PSMA Pet Scan. Dr stated that after seeing my muscles on the inside during operation he would have predicted this. Unlike pathology labs in most hospitals, Jonathan Epstein's lab at Johns Hopkins has pathologists who specialize in reading prostate tissue samples. 3. It is OK to not understand all the terminology. I had the slides reviewed at Johns Hopkins and 1 of the HG PIN cores was changed to suspicious for adenocarcinoma while another HG PIN core was changed to benign. Prior to the results, the oncologist said that the literature shows that a 3+4=7 with less than 5% pattern 4 behaves just like a 3+3=6 and basically is an indolent tumor. It starts many years ago. Patient-Driven Second Opinions in Oncology: A Systematic Review. Its gone.I have been advised to have a Axumin Pet scan as follow up as the first pathology report indicated perineural invasion present as well as probable introductal carcinoma. Without your support, I could easily have subjected myself to random biopsies that are risky, don't do a good job of finding lesions, and can mess up the clarity of the prostate for an MRI. He adds that second opinions also can provide insight into topics like clinical genetics and family risk or issues related to complementary or integrative medicine approaches to manage symptoms. I wish the VA would be more informative about this disease they owe it to our veterans. I have posted here before, now with an update. 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. Heres What You Need to Know, Prostate Cancer Spotlights in 2020: A Year in Review, Find out about PSMA PET Imaging on Prostate Pros Podcast. About this time, I started reading this forum and my ignorance starts going away. My questions are: I was referred to a urologist and tested again in April at 4.40. Benign prostatic tissue 5. 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. You May Like: Sbrt Radiation Therapy Prostate Cancer. Oncologist. Some docs say clean up the prostatitis while others tell me to avoid overuse of Cipro as it loses its effectiveness over time. Advances in our understanding of breast cancer have opened up new treatment options or clinical trial opportunities, including targeted drug therapies and tissue-conserving procedures proven to greatly reduce pain and nausea. In unadjusted analyses, younger men , men with college-level education , and privately insured men and Medicare ) were more likely to obtain second opinions . 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. The results were ambiguous. In some situations, insurers will even insist on a second opinion. However, that information will still be included in details such as numbers of replies. Overall, nearly 80% of men received definitive treatment 76.5% of men who obtained a second opinion from a urologist received definitive treatment compared to 81.6% who did not . The Stanford Medicine Online Second Opinion program offers you easy access to our world-class doctors. The all-inclusive cost for a virtual second opinion for patients in the U.S. is $1,850. Reasons for obtaining a second opinion from urologists. doi: 10.1001/jamanetworkopen.2020.28320. BJU Int. Got my physical and normal DRE with new Dr. No issues identified. Thank you! 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. Medical record collection from doctors and hospitals. Doctors are skilled at pitching the treatment they specialize in. I had been carefully watching as my PSA increased to 3.2 from 3.9 in summer 2010. And, even working in a fairly technical field myself, I was amazed at the technology and precision of that Proton Machine. Compared to younger men, men 70-74 years old and men 75 years were less likely to obtain a second opinion whereas men with college graduate level education or beyond were more likely compared to men with less than high school level education. 6 cancers that are the toughest to diagnose are prostate, bladder, head and neck, soft tissue, skin and lymph system. A newly published paper by Fischer et al. MRI obtained outsideon 04/16/2021. If you have received a diagnosis or recommendation for treatment and want another opinion, our service can help you make a more informed decision. 7. Prostate, left medial apex: G. Prostate, lesion #1, core biopsy: Second opinions from urologists for prostate cancer: who gets them, why, and their link to treatment . While I have three lesions, they are small and, without 3T mp MRI, might not have been discovered. 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. Low post-void residual volume is Dr. Erick Walser at University of Texas Medical Center. Last year, Epstein's lab reviewed the pathology reports of 30,000 cases in which patients requested second opinions. Also, a second opinion provides the opportunity to get information from someone other than the physician who will be directing treatment, which is usually the main source of information for most patients. 2/13 PSA 5.2/fPSA 12.5% taken AFTER DRE (negative DRE) (lab #1) Extracapsular extension: The prostatic capsule is preserved. Bethesda, MD 20894, Web Policies Second Opinions (Adults) For stem cell transplant, please call 1-773-702-1994. I would feel much more comfortable, if the numbers stay the same, being involved in a recognized Active Surveillance Program. When I was diagnosed I really thought that I will live only 2 years. 1st opinion"PYL PSMA PET/CT scan demonstrating foci of moderate to intense uptake in the prostate gland consistent with known prostatic cancer. 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. This has only low-level nonspecific activity with SUV max of 2.05 and may be due to degenerative changes at the symphysis pubis." The urologist offered surgery and radiation as options on 3/10 when we met. 3. Benign Processes: Through the AHN Cancer Institute, you benefit from personalized treatment in your community, close to home, from your dedicated care team. This has raised some questions on all the scans so far. Does 3+4 at some point typically evolve into 4+3 and also serve as a trigger point for moving from AS to treatment? Check Biopsy and Imaging Results for Accuracy. Peripheral Zone: The peripheral zone is of normal homogeneous prolonged T2 and there are no suspicious focal areas of -------------------------------------------------------- 3. I am doing one in 6 weeks, regardless. Consultation with your nurse care manager. Surgical Delay and Pathological Outcomes for Clinically Localized High-Risk Prostate Cancer. Second opinions offer different things in different circumstances, Dr. Matasar says. Us Too Prostate is a great club and many of you have helped me a lot already. When I inquired with the oncologist that I had selected for my therapy before receiving the second opinion whether I would be a candidate for Active Surveillance considering the downgrading, she said 'no' due to the intraductal component. No extraprostatic extension. Prostate, left anterior MRI lesion: Six weeks later I have the biopsy in his office and a week later I get the results. * Seminal vesicle invasion: None. What are your opinions of what that is, and where to get it? 5: Prostate, left medial apex We surveyed men who were diagnosed with localized prostate cancer in the greater Philadelphia area from 2012 to 2014. You May Like: Prostate Cancer External Beam Radiation Side Effects. I suggest for all that hear, "you have cancer" that you seek more opinions! Diffusely decreased They may defer to the recommendation of the specialist, or refer you to a doctor with limited prostate cancer experience. (The pathology report from Cedars-Sinai kept my diagnosis at 3+4, but a second opinion at Johns Hopkins upgraded me to 4+3.) Especially opinions other than those of the first Urologist you see. I met with the radiologist 3/17 and he leans toward an IMRT radiation regimen of 5 or 20 sessions TBD combined with ADT (6-month shot but maybe 4 months was enough). In those cases, patients are tremendously grateful for having received the advice and encouragement to get a second opinion, Dr. Matasar adds. Sometimes, you may find out about treatment options you didnt know were available. I would really love to hear from you. "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 .