Greatest dimension 2cm. Prostate, left medial base: This shows very high signal intensity on the diffusion-weighted PELVIC LYMPH NODES: No adenopathy. It can be caused by many factors, including infection and inflammation. A doctor at MSK can collaborate with another doctor to offer support and help ensure the best outcomes. My girlfriend lives 2 blocks from the Emory Proton Clinic.We prayed on it and overthought the crap out of it. Day 7 after surgery I took my last pain pill. Dr. Dan Sperling - New York. 8: Prostate, left lateral base In fact, additional biopsies revealed no additional cancer. I personally have benefitted from second opinions on my so-called cancer journey. But, after 4 drinks or if I'm tired/jet lagged I find that sleep is more appealing than sex. What have your doctors told you? Brachytherapy Experience with Dr. Albert Chang at UCLA? What is NOT OK is quitting or avoiding the bad news, or handing the entire decision over to someone else.Good luck fellas! 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. peripheral zone signal intensity on T2-weighted images. P60 MD006900/MD/NIMHD NIH HHS/United States, T32 HL007180/HL/NHLBI NIH HHS/United States, K07 CA151910/CA/NCI NIH HHS/United States, P30 CA016520/CA/NCI NIH HHS/United States, K07 CA163616/CA/NCI NIH HHS/United States. During puberty, the body produces semen in a large number of cases, including enlarged prostate. One to a 3+4=7 and the other to a 3+3=6. You have a rare or unusual cancer. Prostate cancer is the second-most diagnosed cancer in American men. I was on active surveillance after a FLA procedure done in 2018. Patients may experience a fever or chills as a result of the infection. * Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project 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. Only took Motrin and Tylenol for pain after release. I find that when I'm trapped in the cockpit not able to use the bathroom for a long time is when I experience that most. * Prostate size: 3.9 x 2.8 x 3. cm Many health insurance companies will pay for a second opinion, especially if it is for a medically necessary treatment. Surgical Delay and Pathological Outcomes for Clinically Localized High-Risk Prostate Cancer. Hoping that after I go through this that my advice to others will be able to guide them and that they can learn from my experience, as I feel I am gaining a solid foundation from both a practical and mental standpoint. Y'all are in my prayers! How could this compare using only partial slide re-reading? Can it be salvaged or are the risks of cancer too high? Whats right for you will depend on the stage of the cancer, your level of risk and your general overall health. After sending off all of our records, CD of MRI and path reports, my husband is booked for screening in December. IMPRESSION: Disclaimer. After a little experimenting I have been able to achieve a partial erection. Thanks for Everyone's Help, When I read the forums and questions on this site everyone mentions their Gleason Score from their biopsy. I have selected Focal Laser Ablation as my future (soon) treatment. The linear amount of tissue with carcinoma is 23 mm Dont Miss: New Treatments For Stage 4 Prostate Cancer. The James Buchanan Brady Urological Institute, Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov. 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. Prostate, right medial apex: You May Like: Prostate Cancer External Beam Radiation Side Effects. G. Prostate, lesion #1, core biopsy: Masks are required inside all of our care facilities. Spent the night in hospital with very little pain after the first couple of hrs. While I have three lesions, they are small and, without 3T mp MRI, might not have been discovered. My question is regarding the results of an MRI guided biopsy into a distinct tumor vs. subsequent Oncotype Dx Results. 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. !I'll try editing a previous post and see if it reads like a journal instead of creating a new thread every update.I just got my PSA results and the numbers are still trending in the right direction. It is still important to do your own research. Got the fiducials placed, the Space-OAR gel placed, mold made, and had the pre-treatment MRI and CT Scan. FAX 310-574-4002 So, I also sent this MRI result to Johns Hopkins for a second opinion. Possible additional organ confined malignant lesion in right apex * Size: 1.5 cm Unfortunately, the 12/20/20 PSA reading was higher and that led to an MRI on 2/2/21 when two lesions were discovered. 30%/40% or higher)? 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. If you choose to be treated at Johns Hopkins, you may be able to begin treatment immediately. 2015 Feb;115(2):188-97. doi: 10.1111/bju.12665. However, learning more about prostate cancer and prostate-related health issues can help optimize health. The all-inclusive cost for a virtual second opinion for patients in the U.S. is $1,850. Remember if you ship them include the following information: You May Like: Blood In Urine After Prostate Biopsy. Seems like a simple request. Best practices dictate that you obtain a second confirmatory pathology evaluation. He also said perinueral invasion, but not extracapsular extension. A PSA test at time of biopsy revealed my PSA had risen to 6.5. It is OK to not understand all the terminology. Several friends rushed towards surgery and now wish they had the information he provides before they decided to go with such care. The review process normally takes several days, after which we will send your slides and other materials are returned. 2: Prostate, right lateral base The people were great. - DWI-ADC = 4/5 - PI-RADS for this lesion = 4/5 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. Ramsey SD, Zeliadt SB, Fedorenko CR, Blough DK, Moinpour CM, Hall IJ, Smith JL, Ekwueme DU, Fairweather ME, Thompson IM, Keane TE, Penson DF. We can help with your case. 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. The symptoms of acute bacterial prostatitis are similar to those of CPPS. 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. However, he also said it's treatable even at a 2cm size and the transition zone is a favorable spot. The main purpose of the prostate is to produce semen, a milky fluid that sperm swims in. Didn't know if she had the catheter in far enough and not getting any urine through itwondered if she had inflated the balloon enough and wondering if it was the reason that I have developed an abscess. Based on this forum, Im very lucky for this outcome. You know - urinary incontence, erectile dsyfunction, and exhaustion (hormones) are not my cup of tea. Johns Hopkins second opinion - nothing found. And, even working in a fairly technical field myself, I was amazed at the technology and precision of that Proton Machine. radiation, active surveillance, surgery, hormone therapy, and more. How long do you have left? About 80 percent of prostate cancers are diagnosed at a localized stage, which means that the cancer hasnt spread outside of the prostate. Good Morning Brothers- Overall my PSA is between 4 and 10. Second Opinions (Adults) For stem cell transplant, please call 1-773-702-1994. Diffusely abnormal appearance of the prostate may reflect prostatitis, which can obscure underlying prostate cancer. Peripheral Zone: The peripheral zone is of normal homogeneous prolonged T2 and there are no suspicious focal areas of 1st opinion. And when I attempt to ask questions about intradcutal, I get responses about how little is known about it because it's so rare or that it is controversial or that they're not familiar with the study I'm referencing. 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. FYI-We are also considering the trial at Princess Margaret Hospital in Toronto. The peripheral zone has a patchy signal pattern. (TZ) One suspicious area - lesion size: 2cm x 1.4 cm 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. I did ask some questions about the study, if anyone is interested. Johns Hopkins is home to many of the world's leaders in Pathology. Benign Processes: Depending on your location, you may be able to have a telemedicine consultation. 1. Last year, Epstein's lab reviewed the pathology reports of 30,000 cases in which patients requested second opinions. An accurate diagnosis is essential to ensure the most effective treatment. As evidenced on this site, some studies indicate that GS 6 shouldn't even be classified as PCa and that it isn't aggressive. 3 months has passed, and its time for a PSA and a plan to have an MRI. I find that when I'm trapped in the cockpit not able to use the bathroom for a long time is when I experience that most. HHS Vulnerability Disclosure, Help It has been 2.5 years and the PSA has still not doubled as well. Anyway, I'm reaching out to this group to see if anyone would be willing to chat with me about their brachytherapy experience at UCLA (even to talk me out of it). I had the MRI in April 2021 and it showed a PI-RADS 4 lesion. 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. MRI obtained outsideon 04/16/2021. An acute bacterial infection can cause a burning sensation. Does every biopsy provide a Gleason Score? At a rectal exam 6/20 the urologist told me my prostate felt normal, not enlarged, nor did he feel any tumors. This teamwork ensures the best possible patient outcomes. I've tried to find out about Dr. Wong but there's very little info on him. Some men have minimal or no symptoms at all. Thanks, BigD. They want him to start radiation 25 sessions and chemo pills of Casodex 50 mg 28 pills. Interesting differences: 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 . Radiation oncologist of same group of doctors says to do IMRT (using Rapid ARC program) as precautionary treatment, regardless of PSA scores. A total of 2386 men responded to the survey (adjusted response rate, 51.1%). The Radiation Oncologist said he would be comfortable waiting a little more, but he wasn't confident that I'd grow a target lesion, nor would I be able to wait years before having to do "something." We prioritized treatment as AS, FLA/TULSA (if a lesion ever presented itself), and Proton Beam Radiation. I understand that patient privacy is a priority (I'm actually a privacy lawyer), but surely there are patients who would give consent and be happy to talk with a prospective patient about their experiences? However, older men 75 years were the least likely to report obtaining a second opinion due to dissatisfaction with their initial urologist. 6. Even for men with faster growing, more aggressive prostate cancer, taking the time to seek a second opinion should be a priority. I am meeting with a multidisciplinary team of docs on March 18 at St. Joe's in Atlanta. 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. 5. To learn your stage of prostate cancer, take the staging quiz on keytopc.com. MY THOUGHTS AND ANYTHING DOCTOR NOTED: I really just want the results of their innovative PTEN test. 2. However, many insurance and health care companies do pay for such opinions and acknowledge the importance of second opinions. Secondary Gleason grade: 3 I am relatively new to this forum and trying to educate myself as to my best course of treatment. My other option for treatment is either LDR or HDR brachytherapy. More medical freakouts. 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. 3. Dont Miss: Screening For Prostate Cancer Icd 10. The prostates function is to create some of the fluid that insulates sperm cells found in semen. Also indicated everything else was "organ confined." 8600 Rockville Pike * Perineural Invasion also detected * Gleason Score: 3+3, Slide 1 (vs. Sloan's 3+4) 2019 Jan;69(1):7-34. doi: 10.3322/caac.21551. But, after 4 drinks or if I'm tired/jet lagged I find that sleep is more appealing than sex. 7 People with PN had an increased likelihood of: 6 Eating disorders Self-harm Request an Appointment 410-955-6100 Especially opinions other than those of the first Urologist you see. 3/3 4K score 19% (high end of intermediate) We will then prepare a written recommendation regarding your treatment plans or options. I measure PSA frequently, and it is stable and slightly declining with the last score at 5.5. 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. of tumor in the rectal prostatic angles. The more often a doctor diagnoses and treats prostate cancer the more proficient they become. A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. Abstract Context: In men who develop an elevated serum prostate-specific antigen level (PSA) after having undergone a radical prostatectomy, the natural history of progression to distant metastases and death due to prostate cancer is unknown. My involvement is below maximum of 15% of core. My only concerned was heavy metal poisoning and didn't know how long AS would be beneficial since I was starting at a young age. Potentially inaccurate results can lead to selection of the wrong type of therapy. Luckily, his report co-coincided with the original QDx report. and transmitted securely. I certainly would - after all, there's a certain brotherhood bond here. You A biopsy was performed on 2/26. Overall, obtaining second opinions was not associated with changes in treatment choice or with improvements in how patients viewed their quality of cancer care. Time moves fast when dealing with cancer, but Doctors dont. My new Dr however didnt order PSA so I asked him for one. This teamwork ensures the best possible patient outcomes. I don't know if the FLA could affect the results, or if it was just done because it was not in the study parameters of the test. In circumstances where there may not be a single established standard of care, we can ensure the treatment plan integrates the most current, up-to-date data, Dr. Matasar says. By Dec 2019, my PSA reached 4.13. Second Opinion Results, Johns Hopkins biopsy reading of 2 slides sent by Sloan: