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Second Opinions in Prostate Cancer
This is a solicitation for second opinions related to all aspects of prostate cancer, i.e. MRI, pathology, scans, treatment pathways, ...
If there are previous discussions on this topic they could be listed in a post.
I am starting this discussion not because I have either sought or had a second opinion. However, resources for a second opinion is money in the bank.
Free form as usual but why you asked for a second opinion, what for, the difference between the original and second opinion, which opinion was chosen, and the outcome would seem relevant.
Implicitly, Mayo Clinic Connect is a source for second opinions every day.
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HugInterested in more discussions like this? Go to the Prostate Cancer Support Group.
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I had it done at Mayo Rochester by David Woodrum, Radiologist. Zero issues with side effects. I had 30% of my 45 cc prostate ablated. I had zero pain and did not even take a Tylenol. I walked 2 miles the day after and started sex again at one week. You can read my description of the procedure if you click on my profile.
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2 ReactionsHi workmanbiff, I just completed the same regimen at Sloan, although for salvage radiation ((surgery 2019).
Your husband’s biopsy is eerily similar to mine in that there was a lot of G4+3 in the gland. However, the presence of cribriform cells in one sample is concerning.
That’s an aggressive form that does not respond as readily to radiation as adeno/acinar cells.
You might ask about an HDR brachytherapy ‘boost’ (seed placement) prior to the 26 sessions.
During my stay at Sloan in Commack I met 3 men who had this done in conjunction with 5 visits of Cyberknife ( not 26 of IMRT).
Sloan is one of the best but you MUST ASK QUESTIONS!! My first RO (chief also) was an older man who did things the old fashioned way; didn’t care for his approach.
My next was a young, dynamic, tech savvy guy- Dr Andrew Barsky - who was up on all the latest research and tailored my treatment from 39 visits to 25 and 6 months Orgovyx.
You gotta do this the best way possible the FIRST time, because when radiation treatment fails it usually involves a lifetime of hormones and whack a mole SBRT treatments. Best of luck to you!
Phil
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1 ReactionThank you for your insight Phil.
We just received the Decipher test results this morning - which is 0.95 high.
Have a consult with MSK surgeon on June 16th for his surgical recommendations.
Once we hear from him we can determine the best course of action.
So appreciate your reply . . . and to know that we are not alone in this journey.
Best,
glo
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1 ReactionGlo, that Decipher IS concerning, and echoes the finding of cribriform cells, which are very aggressive.
I posted 2 links yesterday to questions about IDC (intraductal cells/cribriform go hand in hand) on the forum. One said that successful treatment usually involves surgery followed by radiation (25-39 sessions) with ADT.
I know that some would prefer to do surgery and then monitor PSA to see where it goes. That might work in a less aggressive case but IMO (not an oncologist, but a patient who ultimately needed SRT anyway with much lower risk factors) I would hit this hard and not give it a chance to spread.
Of course, surgical pathology will be the true indicator of the severity of his disease, along with lymph node examination. Just be aware that surgeons can sometimes be cocky, claiming ‘we got it all’ and no need to worry about next steps; Sloan is probably more of a collaborative effort, with one department conferring with another - but I would still seek an RO’s opinion after the surgery to see if they recommend further treatment.
RO’s see all the surgical ‘failures’ and know which factors were probably responsible for the cancer returning. Best,
Phil
I know this thread is a bit old but I'm having a hard time finding someone to give me a second opinion on my Biopsy Results.
Everywhere I look I find people saying get a second read, confirm your working with the right Gleason score. But HOW is not so easy!
You call a hospital or cancer center and ask them. It will involve the signing of various forms - consent, release, HIPPA, etc. I did this twice.
Phil
I reached out to Hopkins and they were willing to look at everything I had. I did have to get lab reports and films to them But was able to do this online
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1 ReactionI had mine done at VCU by a genitourinary cancer specialist. One of two CCC's in Va. The reason: I lost confidence in my SO due to being evasive and not providing the answers I was seeking. He obtained biopsy and all relevant data and told me my story. Ended with "I only work with stage 4 patients and frankly do not find you that interesting." At that point I busted out laughing nodding my head and told him how glad I was that he didn't find me interesting, along with the other two in the room. He gave me a 70-30% chance of never having to revisit this again. Also told me to not get a PSA test until 6 months after ADT and to come see him if my PSA jumps to 2 and they will find it and treat it. Currently my psa is undetectable on ADT. Stated my greatest risk at this point is being over treated. Interesting conversation to say the least.
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1 ReactionWhat were the charges?
I am looking to have someone look at my past MRIs and see what an "expert" thinks is happening, or not happening.
I am a Hopkin's patient so there was no charge at all. I believe- at least in Maryland, you can request a new pt appointment with a Hopkins specialist, and then request a second opinion. My insurance (Cigna but I had Blue Cross before) was accepted so there was no out of pocket expenses or even a co-payment. Again, I may have had some advantage since I was already an established Hopkin's patient.
Why not go to the Hopkins website and see if you can schedule an appointment with the urology department and see what happens
At one point, I also get another opinion from Georgetown. I scheduled online and had a video session