Husband disgnosed stage 1: Should he wait 5 months for second opinion?

Since Active Surveillance is common at 3+4 probably not. However, what creates the wait: Insurance? NHS? The diagnosis is based on biopsy results and a second opinion can be done through telehealth since they will get the original biopsy pathology to examine directly from provider. Put up biopsy details if you want more information. The lower the Gleason 4 percent and the fewer aggressive factors noted on the biopsy the longer the wait can be.

@jim18 just my opinion. I wouldn’t wait. There is a treatment some doctors have expertise in. That is freezing the cancer in the prostate gland. My senior friend had it done. He did not want to have surgery.

@jim18 my husband wants to go to Johns Hopkins for a second opinion. The doctor referred him there.
The biopsy showed nothing in the left side. There is PNI. There was 30% 4 in two cores, and 20% in one.

I don’t think I would be too eager to wait five months for a second opinion.

Here’s another place in Maryland that’s recommended by the National Cancer Institute, maybe you can get an appointment sooner

University of Maryland
Marlene and Stewart Greenbaum
Comprehensive Cancer Center
Baltimore, Maryland

I would not wait that long for second opinion since after that you will need at least 2 mos to set up preferred treatment. Biopsy exams just 1% of the whole gland and gleason could be actually higher than what is seen. My husband was 4+3 and after 5 mos after his gland was removed it actually was 4+5 with unifocal EPE and other scary findings. However his initial gleason also showed IDC and cribriform which are very aggressive features but doctors told us there is no reason to rush *sigh. My advice is - do not wait that long.

Wishing all the best to you and your husband 🍀.

@surftohealth88 thank you. He is trying to get an earlier appointment even if it isn’t with the doctor he was referred to. I think any of the doctors at Johns Hopkins should be good. He’s also looking at University of Maryland as another poster suggested. Appreciate all the help.

Is the second opinion with another urologist? I would try to get an appointment with at least one radiologist.
Also, you could get a second opinon on the biopsy itself.

@topf his doctor sent the referral to a surgeon he had trained with. He said all of my husband’s records would be sent and they would look at the biopsy and give us a second opinion. We are hoping once he gets to Johns Hopkins he will be able to see other doctors like a radiologist. He doesn’t want surgery.

@jneylon Urologists are surgeons so tend to recommend what they know; therefore, the comment about seeing a RO. With all disease on one side, he might be a good candidate for one of the focal ablation therapies (IRE/Nanoknife, HIFU/Tulsa Pro, Cyro (freezing), or Laser). These target the cancer vs. the entire prostate like surgery (removed) or radiation (fried). Tend to have higher recurrence rates but far lower side effects. Depending on specific location of lesions some of these will be better than others. Treatments covered by classic Medicare but may not be by commercial insurance or Advantage plans.
Several posts on this site about experiences especially with Tulsa Pro and Nanoknife.

@jneylon

I have been happy with Johns Hopkins. After my MRI indicated a lesion on the left side plus other negative factors it was rated PiRads 4. I was scheduled for my biopsy with my urologist in my local hospital. They were unable to read the CD and cancelled the biopsy just days before. I called Johns Hopkins on a Friday and sent them all of my information. They triaged me and gave me an appointment for the following Monday! They expedited the biopsy which found cancer on the right side as well.

I am now waiting for my Decipher score and another PSA test to determine a treatment plan. My surgeon is Dr. Rai and my wife and I both like him. He is the principal investigator at JH for a clinical trial using transurethral aquablation, and I am hoping to get accepted into it. The second arm of the trial will be starting shortly.