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Treatment options and help with how get a third opinion from Mayo
Looking for feedback. My husband was diagnosed with prostate cancer and has since had an MRI, and Psma pet. Both showed one small spot on the bone. Doctors wanted a biopsy of that spot. The biopsy was negative. We have one Doctor wanting to do surgery and one doctor saying he doesn’t believe the biopsy and recommends hormone therapy and radiation. Anyone have something similar occur?
Also, I do not have a Mayo clinic in my area. Has anyone been able to get a second or third opinion from them virtually? I’m not sure how to go about that. I’m not opposed to traveling. I think Jacksonville is the closest to me if anyone has doctor recommendations there.
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It is really hard to get a biopsy from Bone, That explains why the doctor said he doesn’t trust it.
I don’t see you mentioning them doing a biopsy of the prostate. Did they biopsy the prostate? and what was the Gleason score and the number of cores with cancer? If they didn’t do a biopsy, how did they find that he has cancer?
If they don’t want to do a biopsy of the prostate, they can get a PE test, which Will tell whether or not cancer is there and he needs a biopsy.
Are you only working with a urologist? They are surgeons so their answer to prostate cancer is surgery.
If there is cancer on a bone they can easily zap it with SBRT radiation normally. Has that been discussed?
Yes, sorry. I skipped that part. There’s was a biopsy of the prostate and 5 or 6 were positive for cancer. 2 were Gleason 8, 2 were 7, and 1 or 2 were 6.
We have seen 2 urologist both urologic oncologist with very differing opinions.
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1 ReactionWhat is SBRT? One of the urologist is recommending mri gated radiation. It’s an 1 1/2 away. Or we can do regular radiation close to home. He explained the difference. Im a little nervous because its seems to be new technology. Has anyone done this?
@bb33
First sorry for your husband's diagnosis of prostate cancer.
You can get second opinions and third opinions. Normally what they do is get your medical information from the medical facility you are being treated at. Then can go over the tests and give you a diagnosis and opinions on treatments. They may need additional tests like my second opinion wanted.
I was diagnosed at Mayo Jacksonville but wanted second opinion from UFHPTI. They handled the medical records transfer and did the diagnosis second opinion I requested. They agreed with Mayo's diagnosis but as I mentioned wanted another test called PSMA and I had that done. Mayo had already done the MRI with contrast, MRI/Fusion biopsies, bone scan, and Decipher test.
The monitors on MCC can provide links to Mayo to see if will do second opinion. I know many have second opinions done at Mayo, Cleveland Clinic, John Hopkins, etc. But you can also call.
After I got my second opinion from UFHPTI I would have gone with Mayo Jacksonville they only provide Photon radiation not Proton. My Mayo PCP and I believed what was best for me was to have the proton radiation treatments based on research that it can possible offer less radiation damage to surrounding organs and tissues as the radiation does not continue out through body like photon does.
Mayo Jacksonvile is building a new cancer center that will have proton radiation. It opens in 2026. However they have an excellent Radiology/Oncology department along with very experience urlogist.
The MRI guided is more accurate and affects nearby tissue less. If you’re just doing a bone, it may not matter if you’re doing a vertebrae then it could help to have the tightest radiation.
If any of the biopsy cores are Gleason 8 then you are a Gleason 8.
Proton radiation is also a possibility.
SBRT radiation has fewer sessions then IMRT or EBRT. Cyberknife SBRT is probably what they offered you however. It is what my brother had and he’s been fine. I had it on my spine and it worked well.
Thank you. He would need radiation on the prostate also if he doesn’t do surgery. Or is it an option to do surgery and still radiate the spot on the bone?
Thank you. Do you have a recommendation for a doctor at Mayo to try to get an opinion from?
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1 ReactionDoing surgery, followed by SBRT radiation to a spot would not be unusual.
If he just decides on radiation, they can hit the bone spot too depending on the type of radiation they are using.
@bb33
You would not be able to directly pick a doctor for a second opinion.
You would need to go to Mayo web site and look up second opinions.
My PCP referred me to a urologist who after the test referred me to R/O. If you are not a patient of Mayo, you would need to contact them about second opinions.
If a monitor is monitoring this maybe you could provide the web site links on second opinions at Mayo Jacksonville. bb33, I will go on the web site and see what I can find out too.
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I found this on Mayo web site. It refers to a previous discussion on same topic by the MCC Director. I copied and posted it below. Hope that helps.
Colleen Young, Connect Director | @colleenyoung | Dec 27, 2021
Getting a second opinion can give you peace of mind. This blog post offers further reasons why it can be a good idea:
- Advice on Second Opinions https://connect.mayoclinic.org/champions/advice-on-second-opinions/
If you would like to seek a second opinion at Mayo Clinic, you can either self-refer or ask your oncologist to submit a referral. I think most of your questions about how to self refer are answered here in this set of Frequently Asked Questions https://www.mayoclinic.org/appointments/faq
To self refer, you can get started here: http://mayocl.in/1mtmR63
Let me know if you have questions that weren't answered with all the information I just posted. Happy to elaborate.
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