Obtaining a second opinion on your pathology report is no different than getting a second doctors opinion, it is a must for all of us. Suspicion for malignancy left anterior base-to-apex transition zone; - T2 = 3/5 (Recommended by my oncologist, Dr. Mark Scholz.) Many thanks for that. * Gleason Score: 3+3 (2 of 6 specimens) It was easy. Is there such a thing as having a team that isnt equipped with the best equipment nor the most experienced radiologists? Radiation oncologist of same group of doctors says to do IMRT (using Rapid ARC program) as precautionary treatment, regardless of PSA scores. If its a common cancer with a well-established standard of care, they can offer insight into clinical trials or novel treatments that may be better than the standard. U.S. News & World Report ranked the institute #7in the country. Similarly, among those who received definitive treatment, second opinions were not associated with receiving surgery. I now have my list whittled down to 3. I had a very bad experience with an incompetent nurse that did a catheter change. Our singular focus on treating cancer, and only cancer, means we have the expertise to confirm a diagnosis or treatment plan and offer options that may not have been considered. Utilize your primary care physicians as an un-biased resource to help you get second opinions from a range of specialists. * Adjacent organ invasion: None. - Prostatic adenocarcinoma, Gleason score 3+4=7 (grade group 2, pattern 4: 10%) involving 2 of 2 cores (medial core: 0.5 mm, 4%; lateral core: 1.5 mm, 10%), 1 mm to the blue inked tissue edge (the closer) There is hope. Masks are required inside all of our care facilities. 2/13 PSA 5.2/fPSA 12.5% taken AFTER DRE (negative DRE) (lab #1) I was confident I was making the right decision. They did another 3T-MPMRI (Siemens machine) and it showed a faint area, near the margin, and very close to the down stream sphincter of prostate. __________________________________________________________________________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. Read Also: Long Term Side Effects Of Brachytherapy For Prostate Cancer. I followed up with the original pathologist to compare and he was more forthcoming. Unfortunately, the 12/20/20 PSA reading was higher and that led to an MRI on 2/2/21 when two lesions were discovered. MM, Much to my dismay my 4th targeted biopsy Oct 12 revealed 5% G4 (upgraded from Grade Group 1 to 2 (Gleason 3+4 intermediate/favorable). The purpose of starting this discussion is to gather peoples thoughts and opinions and actual experiences with Prostate Focal Laser Ablation. 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. * Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project Ask your doctor for a copy of your complete medical record. My long-term prognosis appears to be good with minimal side effects. Maybe lycopene and pomegranate have helped. They also determined there was extrapostatic extension because there was some fat in the sample that involved the cancer. The main purpose of the prostate is to produce semen, a milky fluid that sperm swims in. (TZ) One suspicious area - lesion size: 2cm x 1.4 cm I then had the PHI test which showed PSA 8.70 and overall PHI 125.9. Benign Processes: The survey asked the men if they had opted for a second opinion from a urologist following their diagnosis of prostate cancer, and the reasons for the second opinion. DRE is always normal. But, ultimately decided on whole gland treatment using Proton Beam Radiation.So. And collaborating with Johns Hopkins Medicine means we can provide you with second opinions, streamlined and guided access to clinical trials, and a proven track record of excellence in care. I have requested a second pathologist's opinion from Johns Hopkins based on feedback from this forum. 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. Thank you, After more than three years on active surveillance, I've pretty much decided to have focal brachytherapy for my prostate cancer. Allow yourself the time to seek multiple opinions. Their opinions are widely held to be definitive. 3+4, 4+3, 4+3, 4+5 (1st read)Both docs are recommending surgery.PSMA CT Scan report:"BONES/BONE MARROW: There are sclerotic changes in the right pubic bone adjacent to the symphysis pubis and to lesser extent in the left pubic bone. I opted to waive the biopsy, wait 1 year and test again. Lesions are all small or very small. I have developed an "abscess" on my prostate. 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. My diagnosis is T2c, Gleason 7 (3+4). 2021 Sep 24;11(9):e044033. )I contacted Dr Busch (still in Chattanooga at the time) and he called me directly to talk me off the ledge. Recently diagnosed a Gleason 3 + 3. I've been on AS for two years after my initial TRUS biopsy showed 3 cores 3+3 (10% volume) on Right side, and 2 cores 3+3 on Left side. And should I treat prostatitis before FLA? I am an airline pilot with exposure to radiation, jet fuels/fumes, etc. 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. Secondary Gleason grade: 4 No extraprostatic extension. * He said probably not candidate for watchful waiting because of tumor volume shown and seen on MRI. 2018 May;115:133-138. doi: 10.1016/j.urology.2018.01.048. 1. Include Your Primary Care Physician as Member of Your Treatment Team. So, I made an appointment at Emory Proton Center (Atlanta, GA) and got their opinion. Medical record collection from doctors and hospitals. You may also complete an online appointment request form and we'll respond to schedule an appointment. You May Like: Best Treatment For Intermediate Prostate Cancer. Seek Perspective from a Range of Specialists. This suggests that for some men, second opinions offer a way to pursue the treatment they already planned on, rather than to explore other treatment options, according to study authors Dr. Archana Radhakrishnan, of Johns Hopkins University in Baltimore, and her colleagues. Spent the night in hospital with very little pain after the first couple of hrs. You feel healthy, you arent in pain, you Primary Gleason grade: 3 Generally, the symptoms can stabilize over time. I have actually had a second opinion a while back from Dr. Bush. The total number of cores with carcinoma is 3 * Seminal vesicle invasion: None. This may include imaging, blood tests, prior treatment, and pathology reports. This doctor or team of doctors will review the following: The doctor then communicate their opinion regarding treatment to both the patient and the primary physician. It worked great (with negative pathology of the tissue) and fixed a lot of nasty symptoms and risks. Either the patient or the primary physician can initiate the process of getting a second opinion. * PIRADS v2 Score: 3 However, there are also many more options for treatment and these options are more complicated than in the past. It is still important to do your own research. Below is the link with instructions and the authorization form for you to use with your doctor. Dont Miss: Can Prostate Problems Cause Burning Urination, Why Prostate Cancer Survivor John Shearron Thinks Its Important To Do Your Research | PCRI, Prostate Cancer Pathology in 2021 | Jonathan Epstein, MD | PCRI 2021 Conference, Johns Hopkins Prostate Cancer Second Opinion, treat rare and complex conditions through breakthrough fetal procedures, Function Of The Prostate Gland And Seminal Vesicles, Best Treatment For Intermediate Prostate Cancer, How Old Can You Be To Get Prostate Cancer, New Treatments For Stage 4 Prostate Cancer, Prostate Radiation Treatment Side Effects, Can Prostate Problems Cause Burning Urination, Prostate Cancer Spread To Skull Prognosis, Life Expectancy Stage 4 Prostate Cancer No Treatment, Diagnostic Procedures For Prostate Cancer. Compared with other men, African-American men and men with a family history of the disease are at higher risk of developing prostate cancer. * Seminal vesicle invasion: None. of tumor in the rectal prostatic angles. Lymph nodes: There is no suspicious lymphadenopathy in the pelvis. Ask us questions on this webpage. I worked out every day. First of all we would like to emphasize that the health of our employees, our patients and their relatives is our first priority. Centro Diagnostico Italiano , Milan, Italy, Manfred Dietel, M.D.Institute of Pathology Charit, Humboldt University of Medicine, Berlin, Germany, Jonathan I. Epstein, M.D.The Johns Hopkins Medical Institutions, Baltimore, MD, Robert J. Kurman, M.D.The Johns Hopkins Medical Institutions, Baltimore, MD, Elizabeth Montgomery, M.D.The Johns Hopkins Medical Institutions, Baltimore, MD, Manuel Sobrinho-Simes, M.D.University of Porto, Porto, Portugal, Ronald S. Weinstein, M.D.University of Arizona, Tuscon, AZ, Franco VisinoniMilestone Medical Technologies, Bergamo, Italy, Also Check: How Old Can You Be To Get Prostate Cancer. The urologist offered surgery and radiation as options on 3/10 when we met. However, a new study by researchers at the Johns Hopkins University has found that second opinions did not change treatment choice or the persons perception of the quality of care they receive, at least among low-risk men. So off I went to see a community urologist who performed a needle biopsy in his office. It would be more convenient to use Mayo but I want the best practitioner regardless. Required fields are marked *, PHONE 310-827-7707 The James Buchanan Brady Urological Institute, Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov. An official website of the United States government. Everything seems to be on track to remove the cancer and be cured! In other words, the cancer is still contained within the prostate. Does this also include HIFU, Cryoablation? Similarly, among those who received definitive treatment, second opinions were not associated with receiving surgery. * Adjacent organ invasion: None. It is very rare (<3% of all prostrate cancers) and potentially very lethal (one study showed that 59% of men in the study with Gleason scores of 5 had died within 3 years and it had metastasized in 13% of the remaining men). TRANSPERINEAL MRI GUIDED BIOPSY RESULTS During the next 4 weeks I meet with the recommended Radiologist, and the two local surgeons. This teamwork ensures the best possible patient outcomes. I'm currently in the process of getting an appointment set up with a Dr. Wang at UCLA. I have searched the country for intervential radiologist that perform FLA on the prostate. Here are the details: Are considering a treatment that involves significant risks, such as surgery. Following his residency in anatomic pathology at The Johns Hopkins Hospital in Baltimore, Maryland, and a fellowship in oncologic pathology at Memorial Sloan Kettering Cancer Center in New York., he then joined the staff at The Johns Hopkins Hospital and has been there his entire career. Most reputable HMOs can, however, deliver state of the art treatment for most cancers. Netto points to prostate cancer as an example: If your diagnosis changes from a higher grade to a lower grade cancer, it could mean having the option to avoid radical treatment.Seeking second opinions is becoming standard practice, and it is mandatory at Johns Hopkins. A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. I met with the radiologist 3/17 and he leans toward an IMRT radiation regimen of 5 or 20 sessions TBD combined with ADT (6-month shot but maybe 4 months was enough). Overall PIRADS Score: 5/5 The all-inclusive cost for a virtual second opinion for patients in the U.S. is $1,850. Dr. Epstein has 744 publications in peer-reviewed literature and has authored 50 book chapters with a H-factor of 118. My first PSA was 8.03. Knowing your stage and information specific to that stage makes you more medically sophisticated and enables you to navigate through the potential biases of surgeons and radiation therapists. Are you sure you want to block this member? We will then prepare a written recommendation regarding your treatment plans or options. 4. Just had my appointment today and they are pleased with the results, so far. Other: There is trace ascites in the mesosigmoid. We have a surgery date set up for the end of July at Johns Hopkins (our second opinion team).His stats:63yo, non smoker, 167lbs, Vegetarian/Vegan diet no other known health issuesWalks dogs for a living and cares for our small farmPSA 3.3 (Jumped from 1.6 in a year)Biopsy Scores 3+5, 4+3. And 2 cores from left apex of 3+3=6 with 10% involvement. If these do not work, your symptoms could progress and become chronic. Us Too Prostate is a great club and many of you have helped me a lot already. Noted that some don't even include on report and should be looked as something to note but not obsess about. * Gleason Score: 3+3, Slide 1 (vs. Sloan's 3+4) Federal government websites often end in .gov or .mil. There are also many reasons why you may want to seek another opinion during the course of your cancer care. Some specialize in reading only slides that come from a specific organ while others are generalists who read many different pathology slides from many different organ systems. There is no extraprostatic extension. He said that it will improve in the future due to future improvements in the treatments. When facing an intricate disease like prostate cancer, the above scenario is far too simple to have a promising outcome. Specimens Submitted: When you review your pathology report and are going to be making important decisions, like treatment decisions, which will be based on the information from the pathology report. I'm turning 58 in one week. However, many insurance and health care companies do pay for such opinions and acknowledge the importance of second opinions. Then about a month later I started 28 fractions of Proton Radiation.It was painless. Masks are required inside all of our care facilities. They want him to start radiation 25 sessions and chemo pills of Casodex 50 mg 28 pills. About this time, I started reading this forum and my ignorance starts going away. 5. Seminal vesicles are normal. ---------------------------------------------------- Clipboard, Search History, and several other advanced features are temporarily unavailable. What are you doing about it? Request an Appointment 410-955-6100 Pingback: PROSTATE PROS Episode 6: Breakthroughs in Radiation PROSTATE ONCOLOGY SPECIALISTS, Pingback: Like Man, Im Tired (Of Waiting): The How-to Guide for Men with Prostate Cancer PROSTATE ONCOLOGY SPECIALISTS, Your email address will not be published. 5/10 PSA 4.2/fPSA 9% taken at MSKCC (lab #3) Cancer ABCs recommends: Johns Hopkins Hospital in Baltimore, Maryland, specifically Dr. Jonathan Epstein. DIAGNOSIS: * Location: Left, anterior, base to apex, transition zone Obtaining a second opinion in Pathology can in a small percent of cases lead to a complete change in diagnosis in a wide range of conditions including non-cancerous growths, inflammatory disorders, infections, and cancer. Youve just been diagnosed with prostate cancer. The survey asked the men if they had opted for a second opinion from a urologist following their diagnosis of prostate cancer, and the reasons for the second opinion. Advances in our understanding of breast cancer have opened up new treatment options or clinical trial opportunities, including targeted drug therapies and tissue-conserving procedures proven to greatly reduce pain and nausea. This fluid causes the prostate to swell and cause a number of bladder-related symptoms. The percentage of tissue with carcinoma is 70% Getting a second opinion on a diagnosis can reverse a diagnosis or alter the treatment plan. __________________________________________________________________________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. A doctor at MSK can collaborate with another doctor to offer support and help ensure the best outcomes. After extensive discussion of his management options with his local urologist, primary care physician, and radiation oncologist, he also sought a second opinion at the Johns Hopkins Prostate Cancer Multidisciplinary Clinic at Sibley Memorial Hospital.The patient expressed an overwhelming desire to avoid surgery and any other invasive treatments. The Stanford Medicine Online Second Opinion program offers you easy access to our world-class doctors. We are vaccinating all eligible patients. Reason was large volume of cancer (even though most of mine was Gleason 6), presence of Gleason 7 in biopsy and the rapidly increasing PSA. Please enable it to take advantage of the complete set of features! Last year, Epsteins lab reviewed the pathology reports of 30,000 cases in which patients requested second opinions.Netto says patients should be proactive in requesting that doctors take another look.A second opinion can reverse the diagnosis in up to 5 percent of cases for some types of cancers, he says, like those of the breast and pancreas.Diagnosis Errors by the Numbers. I also changed my diet to plant based food, started juicing, and started taking supplements (think Turmeric, Green Tea, etc.). lesion. decision on a single medical opinion or the first appointment you get, you may Most people believe that pathology reports are always correct, accurate and that what the report says is carved in stone. A second opinion can accomplish a number of things. They did another 3T-MPMRI (Siemens machine) and it showed a faint area, near the margin, and very close to the down stream sphincter of prostate. An acute bacterial infection can cause a burning sensation. Second opinion Biopsy came after FLA G-9. We can help with your case. Total Gleason score: 6 And by FAA Aeromedical Ruling, I'd need a few post procedure reports before being cleared to fly again.) 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. In adjusted models, obtaining a second opinion was not associated with receipt of definitive treatment . doi: 10.1002/cncr.30412. The PSA Doubling Time parallels my Urologist Doubling Time (I keep changing Uro until I find one who makes sense)! Dr. Nour is 100% sure that nothing has spread. It is OK to not understand all the terminology. Different institutions have different levels of experience when it comes to analyzing prostate biopsy samples and interpreting imaging results. * Perineural Invasion detected The only prescriptions I take are for GERD (Protonix), cholesterol (Atvorstatin), and allopurinol for an episode of gout that I got while doing physical rehab for a bad tibia break (I shattered my tibia plateau 2/2020 and have pretty much recovered). Second opinions offer different things in different circumstances, Dr. Matasar says. After all, it seems like good idea to deal with your cancer sooner rather than later. Primary Gleason grade: 3 However, older men 75 years were the least likely to report obtaining a second opinion due to dissatisfaction with their initial urologist. A new study by researchers at the Johns Hopkins University has found that second opinions did not change treatment choice among men diagnosed with low-risk prostate cancer. Benign prostatic tissue poorly defined margins and intermediate to low T2. Prostate cancer is a malignant (cancerous) tumor of the prostate, a gland found only in men. He spent an hour on the phone reassuring me that I didn't need to rush into anything, and they he'd love to scan me 6-8 weeks after my TRUS Biopsyhave to let the trauma and all the blood leave the prostate for a good image. I had no idea there were second opinions and I didn't have a clue about Genomic testing, or even genetic testing. But you have to do both. Surabhi Dangi-Garimella, PhD. I am also doing a vegan diet with additional complementary substances. Seminal vesicles are normal. Surgical Delay and Pathological Outcomes for Clinically Localized High-Risk Prostate Cancer. Who Should Request a Second Opinion? Hope to hear from a bunch of people. We can help with your case. At the Breast Cancer Program at the Johns Hopkins Kimmel Cancer Center in Baltimore, MD, a second opinion requires only that you or your doctor send us your pathology slides, key medical records and signed paperwork requesting the opinion. TZ zone more beneficial, but fairly large compared to whole gland and proximity to capsule edge would likely mean treatment would be suggested. Patients are often under the mistaken notion that they have to pick between their oncologist and MSK, but thats often not the case, Dr. Matasar explains. Now, though, encouraging animal data and preliminary studies in human patients are making some doctors feel optimistic. Masks are required inside all of our care facilities. And just this week, 1 YEAR post treatment, it is .46. I was diagnosed with a 3T MP MRI and a 3T MP MRI guided 4 core biopsy. 2nd opinionBone Scan:"Mild increased activity is seen in the right symphysis corresponding to the abnormalities on the prior PET/CT examination. I was never under the misconception that I'd never have to do something, but I was going to wait until I needed to do something. However, it also is possible to seek a pathology second opinion on your own, and it does not require an in-person office visit. 180 days after treatment PSA was .50. I have selected Focal Laser Ablation as my future (soon) treatment. Further, among men with low risk disease, we did not observe a significant association between second opinions and receipt of definitive treatment or surgery. With world-renowned expertise, multidisciplinary specialists and the latest data, we partner with you to make informed decisions about managing your prostate cancer. 2011 Feb;29(1):3-9. doi: 10.1007/s00345-010-0602-y. An accurate diagnosis is essential to ensure the most effective treatment. I worked out every day and it wasn't until the last week did I feel a bit fatiguedand experience a bit of urgency and hesitation having to peeflowmax fixed that right up!90 days after treatment my PSA came in at .56. 1. Over 80,000 specimen cases are seen at Johns Hopkins each year. We experienced information overload and decision/analysis paralysis. Another DRE that results in identifying that my prostate is enlarged, but cant find and nodules. For a second opinion on the results of your prostate biopsy, there is no place better to get one than from the well known prostate pathologist, Dr. Jonathan Epstein at Johns Hopkins. More medical freakouts. - Benign prostatic tissue )I contacted Dr Busch (still in Chattanooga at the time) and he called me directly to talk me off the ledge. 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. Although a large proportion of men with localized prostate cancer obtained a second opinion, the reasons for doing so were not associated with treatment choice or perceived quality of cancer care. Covid turned the 1 year into 16 months and PSA tested at 7.44 in August 2020, followed by another referral back to the urologist. Be sure to confirm your diagnosis at a center of excellence. Forty percent of the men obtained a second opinion from urologists, most often because they wanted more information about their cancer or wanted to be seen by the best doctor . This urologist can get you in for surgery next week. Prostate, left medial base: I was on active surveillance after a FLA procedure done in 2018. Good Morning Brothers- My only concerned was heavy metal poisoning and didn't know how long AS would be beneficial since I was starting at a young age. I would feel much more comfortable, if the numbers stay the same, being involved in a recognized Active Surveillance Program. Remember if you ship them include the following information: You May Like: Blood In Urine After Prostate Biopsy. Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, The Sidney Kimmel Comprehensive Cancer Center. For these reasons, it is a good idea for HMO members to get a second opinion and make sure they are informed about clinical trials or other promising new treatments. Discover what's to love about Charm City for yourself. That is literally the first time I heard that term other than seeing it in my pathology report. Pathology reports are the opinion and interpretation of the individual pathologist viewing the tissue samples. JAMA Netw Open. If you have received a diagnosis or recommendation for treatment and want another opinion, our service can help you make a more informed decision. Cancer. Benign fibromuscular stroma; no prostatic glands are identified By taking the extra time to seek a second opinion, you have a better chance at finding the most up-to-date approach and an experienced doctor. We prioritized treatment as AS, FLA/TULSA (if a lesion ever presented itself), and Proton Beam Radiation. 2/23 PSA 4.7/fPSA 12% taken for 4K score (lab #2) With that alone, I would likely be a candidate for continued Active Surveillance. All views would be appreciated. Generally, the symptoms can stabilize over time. My PSA went up from 3.5 post FLA (It was 7.2 pre-procedure) to 6.7 in 2021, so I went to another radiologist to do an MRI guided biopsy of the suspected area that was near the prior ablation zone. Tumor Quantifications: 4, Dr. Jonathan Epstein explains the benefits of getting a pathology second opinion. If you choose to be treated at Johns Hopkins, you may be able to begin treatment immediately. We provide second opinions on the full range of gynecologic cancers: Ovarian Uterine Cervical Vulvar Vaginal Fallopian tube Placental tumors Some peritoneal cancers I tried to send the samples out for genetic testing to Prolaris and Decipher, but there was an ordering error and they never went thru. The percentage of Gleason grade 4 and/or 5 is 5 % Can it be salvaged or are the risks of cancer too high? A second review of Pathology more frequently also brings changes to the cancer grade or stage, which can affect prognosis as well as therapy. Does every biopsy provide a Gleason Score? If anyone has used him, please let me know what your experience was like. Consultation with your nurse care manager. He schedules appointments with a Radiologist and two local surgeons. G. Prostate, lesion #1, core biopsy: Read books and realize as soon as they are published, they are outdated. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. I was disappointed that only TRUS was being used, but I did find out that this was for screening only and IF you pass screeningthey use MRI guided biopsy for post-ablation follow up. If these do not work, your symptoms could progress and become chronic. 10. Am I wrong? Little is known about men with localized prostate cancer who seek second opinions, the reasons why, and the association with treatment and quality of care. Therefore, the value of these second opinions remains unknown. The Radiation Oncologist said he would be comfortable waiting a little more, but he wasn't confident that I'd grow a target lesion, nor would I be able to wait years before having to do "something." Jonathan Epstein, MD received his doctorate from Boston University. -------------------------------------------------------- IMPRESSION: Treatment decisions for prostate cancer should not be rushed due to a mistaken belief that immediate treatment is required. We are vaccinating all eligible patients. Prostate Cancer Pathology in 2021 | Jonathan Epstein, MD | PCRI 2021 Conference, Why Prostate Cancer Survivor John Shearron Thinks Its Important To Do Your Research | PCRI, John Hopkins Prostate Cancer Second Opinion, a higher risk of developing uterine cancer, surgery may not always be necessary for all breast cancer patients, The cancer vanished in every single participant, Long Term Side Effects Of Brachytherapy For Prostate Cancer, treat rare and complex conditions through breakthrough fetal procedures, Prostate Cancer External Beam Radiation Side Effects, Can Enlarged Prostate Cause Blood Clots In Urine, Life Expectancy Stage 4 Prostate Cancer No Treatment, Prostate Cancer Spread To Skull Prognosis, Diagnostic Procedures For Prostate Cancer. 9. It is OK to be overwhelmed with info. He wants me to begin the ADT around 5/1. It will be interesting to see, I think. MRI RE-READ #1 (well known radiologist, but free advice over phone, but no written report): Over kill and redundancy I know, but it's my money, my prerogative. Other Features: In other words, can I have a team here in Wisconsin yet travel elsewhere to get my MRI? Some men will have a very enlarged prostate, whereas others will have a mild enlargement. A second opinion is part of the education process that is critical for many cancer patients. 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.