Mayo Clinic Dr to guide conversation on treatment options

Hi, I had a Gleason 3+4 result. My biopsy was done in small town Wyoming. I wanted a second opinion on treatment options. I contacted the Mayo Clinic in Phoenix. I had a Zoom appointment. It was easy to setup up and my wife was able to join me. We got the information and options. Once I decided to use the Mayo Clinic, I completed 90% of my prep work online. Likewise, my follow-up appointments have been on Zoom. I’m grateful to the Mayo Clinic for its technology; it saved me time and expenses.
Good luck with your iniquity.

Question regarding Gleason 3+3....Have had 2 annual biopsies with Only 1 of 16 total cores showing active cancer of Gleason 3+3. Went to a regional National Cancer Institute Designated University Medical Center for treatment options. When I visited with a RO regarding Proton Beam therapy, his response was he and the Urology Dept were not comfortable with that treatment modality with my Gleason 3+3 diagnosis, most recent PSA of 7.0, and Decipher score of .12. Should I accept this recommendation or seek another Professional opinion? Current urologist wants to do surgery, and I am not interested in that option. A second Urologist I met with suggested an MRI guided biopsy, but said regional medical center he works at does not do them. Plus, he expressed difficulty in trying to biopsy a 4 mm lesion in a 70 gram prostate. Anyone know where I may be able to have an MRI fusion biopsy somewhere here in Mid-America?

Yes @dbee, as @jb2buckwater confirms, for prostate cancer it is typical to start with Urology, which includes cancer expertise.

Colleen,
I live north of Atlanta, GA and was diagnosed with Gleason 4+3=7 by Johns Hopkins as a second opinion (initial diagnosis was 3+4) in December after an MRI fusion + random biopsy. Since then I’ve done gene testing, PSMA PET scan with F18 Pylarify and have discs of MRI and PET scan. I was hoping for focal therapy but recently my urologist recommended surgery SOON which would probably be my last choice.

Does Mayo Clinic do remote consultations from Jacksonville? What time frame does it take to get an appointment and what cost? FYI I am currently insured through the ACA in GA so this will be out of network and I will need to self pay. Also of note I will turn 65 in a couple of months and be eligible for Medicare which I suspect will be better.

I’m looking for some guidance to get a well qualified second opinion. If you have an email I can send more details if needed.

@bnga, good questions. I can answer some of them.
Mayo Clinic welcomes both new and existing patients for virtual and in-person care in adherence with federal and state executive orders and guidance. Virtual care is available for out-of-state patients IF the provider you are seeing is licensed in the state where you live. So while you are insured in GA, the Mayo provider will also need to be licensed to practice in the state where you live.

Video and phone visits can be great options for appointments before, after or in place of face-to-face care. Not all appointments are permitted virtually.

Appointment coordinators will recommend a virtual visit if it best fits your individual needs. I suggest contacting an appointment coordinator. They can answer the other questions about time frame and cost. Here's the contact information and how to get started with submitting an appointment request: http://mayocl.in/1mtmR63

Thanks Colleen! I will fill out the form.

Meet with radiation oncologist and medical oncologist as well as urologist. Suggest Dr Phillips at Mayo for RO and Dr Pienta at John Hopkins for MO. Both do remote calls and cost about $500.

I'm in Atlanta as well. Active surveillance 3 years and so far so good. Gleason 3+3, PSA stable around 3.8. I got a second opinion from the Busch Center here in Atlanta. State of the art MRI, run by Joe Busch who is a radiologist and well respected. He is a major proponent of the TULSA procedure and offers it at the Center---maybe the most experienced in the country. I'm not pushing that procedure, but be aware that is his business. That being said, I got a valuable second opinion in a very timely fashion along with an additional MRI that was much better quality than Piedmont Hospital. Hope this helps.

Just had a MRI perineal fusion biopsy at Mayo Phoenix, results Gleason 4+3=7 in 6 of 23 cores, 70% Grade group 3, 3 cores Gleason 3+4=7 40% 14 cores benign. I am meeting surgeon next Tuesday and also getting PSMA PET scan Friday 2/23 and Mayo ordered Decipher test at my insistence, Just a question? seems that Mayo Rochester is considered a Center of Excellence for Prostate Cancer, especially Radiation and Nuclear Medicine, is Phoenix also a Center of Excellence? I would think that Rochester would share all of the latest procedures and treatments as well as best outcomes, with Mayo Phoenix. I live in the Phoenix area, but was wondering if I should fly to Rochester. I am 70 years old, and my Mayo Urologist is recommending surgery, which I really don't want. I am really struggling with treatment options, probably not a good candidate for AS

My situation was similar: Age 73 and 6 out of 12 biopsies 3+4. I too wanted to avoid surgery and have radiation and hormone therapy. However, based upon three doctor’s opinions, ( one in Wyoming and two at the Mayo) I chose surgery. I had an excellent experience at the Phoenix Mayo Clinic. I grateful to them for a good recovery and look forward to each day.