MY THOUGHTS AND ANYTHING DOCTOR NOTED: !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. My local urologist didnt want to schedule one because it he said it wouldnt change my treatment options, radiation or surgery. Fear, confusion and uncertainty set in. He is the past president of the International Society of Urological Pathology. A report with the diagnosis will be faxed to your doctor. 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. MRI RE-READ #2 (VERY VERY well respected radiologist): I wish the VA would be more informative about this disease they owe it to our veterans. One to a 3+4=7 and the other to a 3+3=6. No extraprostatic extension. And just this week, 1 YEAR post treatment, it is .46. A blocked urethra can also damage the kidneys. Of course, my old school Urologist recommended surgeryHe, of course, knew the best robotic surgeons around.Anyway. Steve, Groucho was wrong when he said "i don't want to belong to any club that would have me as a member." According to the doctor it is around 3 mm. My girlfriend lives 2 blocks from the Emory Proton Clinic.We prayed on it and overthought the crap out of it. * Size: 1.5 cm A enlarged prostate can also cause blockages in the urethra. 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. 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. He wants me to begin the ADT around 5/1. The peripheral zone has a patchy signal pattern. We are vaccinating all eligible patients. Prostatic Adenocarcinoma - 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) I have completed an exhaustive research effort on Prostate Cancer and PCa treatments. To learn more about how to get a Neuropathology second opinion, please visit our Neuropathology Division second opinions website. This has only low-level nonspecific activity with SUV max of 2.05 and may be due to degenerative changes at the symphysis pubis." Pathology report indicated additional presence of cells at right apex, but unclear whether intraprostatic incision or extraprostatic extension. 1st opinion"Nonspecific sclerotic change of the right pubic bone with low-level radiotracer activity, favor degenerative change rather than osseous metastasis." I assume the data on gleason scoring is much more robust/reliable than genomics as it has been around longer and used more extensively. Good Morning Brothers- I now have my list whittled down to 3. Thank you for your understanding and cooperation. 1st opinion"Note is made of sclerotic changes in the right pubic bone adjacent to the symphysis pubis having only low-level activity and this is thought to be more likely due to degenerative changes rather than bony metastasis." Five years ago I had a TURP. Reasons for obtaining a second opinion from urologists. 30%/40% or higher)? 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. -------------------------------------------------------- The symptoms of acute bacterial prostatitis are similar to those of CPPS. One Johns Hopkins study showed that out of 14,000 men who had surgery and were found to have Gleason 6 cancer confined to the prostate, "zero of those 14,000 men had lymph node metastases. It was easy. Most people believe that pathology reports are always correct, accurate and that what the report says is carved in stone. 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. Patient-initiated second medical consultations-patient characteristics and motivating factors, impact on care and satisfaction: a systematic review. Dont Miss: New Treatments For Stage 4 Prostate Cancer. Prostate Cancer Grading: 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. It hasn't let me down. By basing a treatment My questions are: Second opinions are a common practice in any area of medicine that is complex and that has multiple treatment options available. So the pathologist suggested a second opinion. The total number of cores identified is 3 doi: 10.1002/cncr.30412. Tumor Quantifications: Accessibility 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. Mohamad Allaf, M.D., answers questions about prostate cancer diagnosis and treatment options and discusses robotic prostatectomy at Johns Hopkins. Further, among men with low risk disease, we did not observe a significant association between second opinions and receipt of definitive treatment or surgery. The purpose of starting this discussion is to gather peoples thoughts and opinions and actual experiences with Prostate Focal Laser Ablation. Just got my pathology results. So, I asked the Radiologist if she will schedule one for me. Lesion 2: Right mid anterior transition zone. I have been drinking out of an information fire hose. We are vaccinating all eligible patients. However, it also is possible to seek a pathology second opinion on your own, and it does not require an in-person office visit. Men often seek second opinions from urologists before they initiate treatment for their newly diagnosed prostate cancer. T2W MRI score= 5, DW MRI score= 5, DCE MRI score=positive 4.5 year journey (18 months post proton beam), 4.5 Year Update (18 month post Proton Beam). Axial T1-weighted images of the pelvis show no bony or bulky nodal disease. I am doing my own research, but I am curious as to thoughts of the best possible MRI to obtain to give me the best chance at finding something the needle biopsy didnt find. Four had 60-70%, five have between 5-10%. 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. Seems like a simple request. Of course, my old school Urologist recommended surgeryHe, of course, knew the best robotic surgeons around.Anyway. Family history of prostate cancer. Dr. Nour - Emory in Atlanta. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. Interesting differences: Surprisingly, while one in nine men will get diagnosed with prostate cancer in their lifetime1, there are very few doctors who specialize exclusively in treating prostate cancer. Clipboard, Search History, and several other advanced features are temporarily unavailable. The average age at the time of prostate cancer diagnosis is about 66. 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. Wow, I sound like a snob now! Some men may have an enlarged prostate but not notice it. 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. Any input on this would really be appreciated. Some docs say clean up the prostatitis while others tell me to avoid overuse of Cipro as it loses its effectiveness over time. You have a rare or unusual cancer. __________________________________________________________________________July 2022I've neglected to make journal entries for a couple years, so I will recap below and continue with what I have done and what I have learned.In 2018, at the age of 48, after a routine physical that showed a PSA of (4.X) and after a TRUS biopsy, I was diagnosed with PCa. 1. At this point Im still ignorant about what I ought to be doing (MRI guided biopsy is what I should have gotten). This is not true. 3. Benign prostatic tissue Because every patient is different, there are several ways to approach prostate cancer treatment. MEASUREMENTS: Thanks for Everyone's Help, But I've had trouble getting Dr. Chang's office to provide any patient referrals. After applying exclusion criteria, the final analytic cohort included 2365 respondents. PROSTATE PROS Episode 6: Breakthroughs in Radiation PROSTATE ONCOLOGY SPECIALISTS, Like Man, Im Tired (Of Waiting): The How-to Guide for Men with Prostate Cancer PROSTATE ONCOLOGY SPECIALISTS, Considering Prostate Cancer Clinical Trials? 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. This fee includes: Recommended Reading: Radiation Therapy For Prostate Cancer. 2nd opinionBone Scan:"Mild increased activity is seen in the right symphysis corresponding to the abnormalities on the prior PET/CT examination. No two cases of prostate cancer are alike and an accurate diagnosisis critical to developing the best treatment plan. Following application of the relevant exclusion criteria, 2365 respondents remained in the analytical cohort. DRE is always normal. 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 . From what I've learned from Dr. Scholz videos at PCRI, and from posts on this site it would lead me to believe the DX test is fairly common knowledge. My long-term prognosis appears to be good with minimal side effects. Associated fees may be incurred up to $1,800 in a minority of more complicated cases requiring special studies. We will then prepare a written recommendation regarding your treatment plans or options. You May Like: Prostate Radiation Treatment Side Effects. This is the most common urinary tract problem in men under 50, and the third most common in men over 65. I will say, the people I dealt with at Johns Hopkins were extremely nice and professional. In those cases, patients are tremendously grateful for having received the advice and encouragement to get a second opinion, Dr. Matasar adds. Move ahead to Dec 2020. mail@prostateoncology.com, 7 Tips for Seeking Second Opinions For Men with Prostate Cancer. Getting a second opinion from Johns Hopkins, is it free or does one have to pay for it? 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. )I contacted Dr Busch (still in Chattanooga at the time) and he called me directly to talk me off the ledge. 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. Careers. 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. Last checkup (July 2022) my PSA was .46 and it is currently at .32.I am still eating primarily a plant based diet (only lean meats/cheeses/eggs about 10% of my diet) and maintaining steady weight and I am still quite active physically.As for symptomswith 5mg Daily Cialis the occasional ED symptoms have pretty much gone away.