An acute bacterial infection can cause a burning sensation. We can help with your case. Estimated prostate volume of 35 cc with an estimated PSA density of 0.11 ng/mL/cc. Patients may experience a fever or chills as a result of the infection. At Johns Hopkins, you can feel confident knowing our multidisciplinary cancer clinics combine the very best resources and specialists all within in a single location for a highly coordinated experience that delivers exceptional care while conserving time, money and energy. So my question for you is have you ever heard of PRECISE and if so what should I make of it? A newly published paper by Fischer et al. Accessibility 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. However, many insurance and health care companies do pay for such opinions and acknowledge the importance of second opinions. MRI RE-READ #2 (VERY VERY well respected radiologist): My strong preference would be to do FLA again and monitor. 2. And it is OK to have paralysis by over-analysis. AHN patients have unprecedented access to the Johns Hopkins Center for Fetal Therapy. Further, among men with low risk disease, we did not observe a significant association between second opinions and receipt of definitive treatment or surgery. In other words, the cancer is still contained within the prostate. Unfortunately, monetary incentives create biases that can work against patients best interests. With world-renowned expertise, multidisciplinary specialists and the latest data, we partner with you to make informed decisions about managing your prostate cancer. The reasons for opting for treatment: the single lesion - previously Gleason 3+4, with a small percentage of pattern 4 - has grown, and according to a biopsy performed March 25, my Gleason 3+4 is now a Gleason 4+3. While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. - Prostatic adenocarcinoma, Gleason score 3+4=7 (grade group 2, pattern 4: 5%) involving 1 of 2 cores (lateral core: 4 mm, 35%), 0.1 mm to the blue inked tissue edge All views would be appreciated. Keywords: As I said, I am 58, so I would really like to preserve my quality of life for as long as possible, but the genomics report has me concerned. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. The researchers also found that patients who obtained second opinions because they wanted more information, were seeking the best doctor, or had been encouraged to do so by family or friends were more likely to undergo surgery. Tumor Quantifications: 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. Y'all are in my prayers! Grade Group: 1 1. Its in your best interest to ask for another look at a cancer diagnosisIf youve recently been diagnosed with cancer, its wise to ask for a second opinion on your pathology specimen.Johns Hopkins researchers with the Urological Pathology Consult Division, led by Jonathan Epstein, M.D., first reported on biopsy errors a decade ago, when they found a margin of error in prostate cancer diagnoses large enough to give them pause. Radhakrishnan A, Grande D, Mitra N, Bekelman J, Stillson C, Pollack CE. Best practices dictate that you obtain a second confirmatory pathology evaluation. P60 MD006900/MD/NIMHD NIH HHS/United States, T32 HL007180/HL/NHLBI NIH HHS/United States, K07 CA151910/CA/NCI NIH HHS/United States, P30 CA016520/CA/NCI NIH HHS/United States, K07 CA163616/CA/NCI NIH HHS/United States. Had my PSA remained static I'd have remained on AS and had I grown a Target Lesion I'd have sought focal treatment.This science is emerging and only getting better. Enter the last name, specialty or keyword for your search below. You know - urinary incontence, erectile dsyfunction, and exhaustion (hormones) are not my cup of tea. In order to give treatment for each patient with utmost security we would like to announce that currently there will be no visitors allowed.Please note that only one attendant per in-patients is permitted. Following application of the relevant exclusion criteria, 2365 respondents remained in the analytical cohort. I did genetic testing and there were no mutations of concern, and everyone agreed that there probably wasn't "enough meat on the bone" to get a good genomic test from the biopsy.After seeing Dr Joe Busch, he said he didn't see any target lesions (PIRADS2), nor did he think I was in any danger. He was right. MRI RE-READ #1 (well known radiologist, but free advice over phone, but no written report): Second Opinions An accurate diagnosis is essential to ensure that the correct and most effective treatment is given. But I did speak to an oncologist who wanted to order Oncotype, which I did. The other samples produced 4 more positive cancer cores for a total of 7 of 12 positives. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. I luckily found this webpage and I started reading everything I could get my hands on. Epub 2010 Oct 20. Tumor Quantifications: In some situations, insurers will even insist on a second opinion. They won't be offended, and they may even be able to recommend a specialist for you to see. 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. Masks are required inside all of our care facilities. Lesion 1: Left mid-base transition zone. Thanks to all of you for sharing! It is not uncommon that two different pathologists looking at the same slide come to a different interpretation and opinion about what is in their microscope! An acute bacterial infection can cause a burning sensation. 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. Eager to hear what everyone thinks or has anything they see in the report I wouldn't have thought of. Peripheral Zone: The peripheral zone is of normal homogeneous prolonged T2 and there are no suspicious focal areas of Bookshelf When you get a diagnosis of breast cancer from your doctor, its not uncommon to get a second opinion. All wanted to do what they do, schedule treatment which at this time is only Gleason 6 which I now know is not life threating. 1st opinion"Note is made of sclerotic changes in the right pubic bone adjacent to the symphysis pubis having only low-level activity and this is thought to be more likely due to degenerative changes rather than bony metastasis." I followed up with the original pathologist to compare and he was more forthcoming. 5/10 PSA 4.2/fPSA 9% taken at MSKCC (lab #3) That is literally the first time I heard that term other than seeing it in my pathology report. So, I made an appointment at Emory Proton Center (Atlanta, GA) and got their opinion. Thanks for Everyone's Help, LESION 2 No extraprostatic extension. Both Drs and nurses knew what they were doing and had lots of experience. Some men have minimal or no symptoms at all. Dr. Nour - Emory in Atlanta. 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. In addition to providing a better understanding of your diagnosis, a second opinion can also shed new light on treatment options and give you confidence in how to proceed with your care. Studies show the clinical and financial benefits of obtaining a pathology second opinion. Five years ago I had a TURP. the transition zone. We specialize in minimally invasive treatments for prostate cancer such as: We place a high priority on sparing the nerves and tissue around the prostate whenever possible. 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. I just turned 71 in February. 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. Whether you want expert confirmation, lack understanding or confidence in your treatment plan, have a rare or unusual type of cancer, your cancer isnt responding to current treatment its reassuring to know that you have options through a second opinion. In adjusted models, obtaining a second opinion was not associated with receipt of definitive treatment . Though, for the most part the reports seem encouraging.I am curious if anyone has had something similar. I am relatively new to this forum and trying to educate myself as to my best course of treatment. If anyone has used him, please let me know what your experience was like. I also changed my diet to plant based food, started juicing, and started taking supplements (think Turmeric, Green Tea, etc.). Another type of prostate issue is chronic prostatitis, or chronic pelvic pain syndrome. My biopsy report does not mention a GS and the second opinion from Johns Hopkins did not list a GS either. - High grade prostatic intraepithelial neoplasia (HGPIN) MRI June 2017 again at SMIL. Hillen MA, Medendorp NM, Daams JG, Smets EMA. They hesitated calling it a TARGET LESION, but scored it PIRADS 4. I can do radiation as a monotherapy. We will then prepare a written recommendation regarding your treatment plans or options. The average age at the time of prostate cancer diagnosis is about 66. Watch: Are supplements good for prostate health? 3. Numerous publications show the clinical and economic benefits of obtaining a second opinion for Pathology specimens. This championship swimmer sought a second opinion at Johns Hopkins. How important is Oncotype DX test for Gleason 7? A biopsy was performed on 2/26. The Radiation Oncologist knew of Dr Busch (by now in Alpharetta, GA) and spoke highly of him. 6: Prostate, left medial base Our regional community network integrates academic specialty cancer care at Allegheny General Hospital and West Penn Hospital and at more than 20 community cancer centers throughout the region. If I am rested, I find that I am more ready than if I am not. Getting a second opinion from Johns Hopkins, is it free or does one have to pay for it? The total number of cores with carcinoma is 3 Seeking second opinions is becoming standard practice, and it is mandatory at Johns Hopkins. I have requested a second pathologist's opinion from Johns Hopkins based on feedback from this forum. We are vaccinating all eligible patients. Hoping that after I go through this that my advice to others will be able to guide them and that they can learn from my experience, as I feel I am gaining a solid foundation from both a practical and mental standpoint. Anyone with insight into this and advice? Two 1cc tumors, gleason score 3+4 each, one in each lobe. My involvement is below maximum of 15% of core. * Size: 1.5 cm Us Too Prostate is a great club and many of you have helped me a lot already. Prostate, right medial base: See this image and copyright information in PMC. Prostate volume: 17.58 cc -------------------------------------------------------- And when I attempt to ask questions about intradcutal, I get responses about how little is known about it because it's so rare or that it is controversial or that they're not familiar with the study I'm referencing. Medical record collection from doctors and hospitals. * Adjacent organ invasion: None. This is the most common urinary tract problem in men under 50, and the third most common in men over 65. Comments appreciated, Thanks! Here are the details: Unable to load your collection due to an error, Unable to load your delegates due to an error. My diagnosis is T2c, Gleason 7 (3+4). Similarly, among those who received definitive treatment, second opinions were not associated with receiving surgery. I am doing one in 6 weeks, regardless. Radhakrishnan A, Grande D, Ross M, Mitra N, Bekelman J, Stillson C, Pollack CE. -------------------------------------------------------- A second opinion is part of the education process that is critical for many cancer patients. (The pathology report from Cedars-Sinai kept my diagnosis at 3+4, but a second opinion at Johns Hopkins upgraded me to 4+3.) I guess the PET scan will be the next step in what type of treatment options are in store.Has this occurred to anyone else? Family history of prostate cancer. Value of Second Opinion in Prostate Cancer Uncertain, Says Hopkins Study. -------------------------------------------------------- I have selected Focal Laser Ablation as my future (soon) treatment. Of course, my old school Urologist recommended surgeryHe, of course, knew the best robotic surgeons around.Anyway. Before 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. Anyway, would appreciate knowing how to contact Johns Hopkins. Dr. Dan Sperling - New York. Seminal vesicles and other margins are negative for tumor. If you are diagnosed with a urologic cancer, including but not limited to the prostate, bladder, kidney, and testicular or urinary tract, its important to consider a second opinion. Biopsy in 12/27/11 showed 3/14 cores, Gleason 6 with PSA of 4.5. What are your opinions of what that is, and where to get it? ZERO - The End of Prostate Cancer Support Community. * Asked and Dr. said he isn't overly concerned about perineural finding with the grade and it won't impact treatment options or overall prognosis. The out-of-pocket cost may be in the $300 range (insurance may not cover it), and it is a simple matter to call your urologist to forward the slides to them. Different institutions have different levels of experience when it comes to analyzing prostate biopsy samples and interpreting imaging results. Everything seems to be on track to remove the cancer and be cured! TZ zone more beneficial, but fairly large compared to whole gland and proximity to capsule edge would likely mean treatment would be suggested. Radiation oncologist of same group of doctors says to do IMRT (using Rapid ARC program) as precautionary treatment, regardless of PSA scores. Seminal vesicles are normal. I could not get a definitive answer from them on how much, how many cells, or any information. * Gleason Score: 3+3 (2 of 6 specimens) restricted diffusion. 180 days after treatment PSA was .50. 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. - Prostatic adenocarcinoma, Gleason score 3+4=7 (grade group 2, pattern 4: 5%) involving 2 of 2 cores (combined: 10.5 mm, 40%), 0.2 mm to the blue inked tissue edge 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, Read Also: Nhs Prostate Cancer Risk Calculator. I would really love to hear from you. Good Luck and God Bless everyone. Got the fiducials placed, the Space-OAR gel placed, mold made, and had the pre-treatment MRI and CT Scan. * Sloan only sent partial cores, slides 1 and 4. According to The National Institute on Aging, prostate problems are common after age 50. 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. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. Fear, confusion and uncertainty set in. In the mean time my PSA was movingno longer static, but never back up to 6. Many health insurance companies will pay for a second opinion, especially if it is for a medically necessary treatment. A doctor may prescribe surgery or perform an endoscopic procedure. If these do not work, your symptoms could progress and become chronic. Need guidance choosing from multiple treatment options. Generally, the symptoms can stabilize over time. Recently diagnosed a Gleason 3 + 3. Remember if you ship them include the following information: You May Like: Blood In Urine After Prostate Biopsy. Read books and realize as soon as they are published, they are outdated. It is best to begin by talking with the doctor who made your initial prostate cancer diagnosis. We are vaccinating all eligible patients. I recently sent my Pathology Slides to Dr. Epstein for a Second Review. There are so many different departments at Hopkins that I don't know the optimal department to contact. 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. IMPRESSION: I had a follow up 3T MRI guided biopsy on March 18 at Emory. 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. Greenfield G, Shmueli L, Harvey A, Quezada-Yamamoto H, Davidovitch N, Pliskin JS, Rawaf S, Majeed A, Hayhoe B. BMJ Open. It can: Confirm your original diagnosis and treatment plan Give you more detail about the type of breast cancer you have and stage it's in. Does that mean my Gleason Score based on my biopsy would be less than a Gleason 6? Caused me to bleed heavily. The lesion also shows focal increased permeability. We provide second opinions on the full range of gynecologic cancers: Ovarian Uterine Cervical Vulvar Vaginal Fallopian tube Placental tumors Some peritoneal cancers The biopsy took 12 cores, two from each lesion area and 8 randomly. There is no extraprostatic extension. Targeted MR/Fusion biopsy of one 4x8 mm lesion on Right side showed 3+3 in 2 of 5 cores (20% of total volume), and random Right side: 1 core 3+4 (10%, 20% on second opinion from Johns Hopkins) and 1 core 3+3 (10% volume) ; Left Side 1 core 3+3 (10%, no PCa on second opinion from Johns Hopkins). Without the genomic test I have I lesion 3+3=6 and another, 3+4=7, with less than 5% pattern 4, and an MRI that shows no ECE, no other suspicious lesions and questionable cellular EPE based upon disagreement of pathologists. I still have some urgency and frequency issues, but I am not complaining too bad. We will give that a shot and see how it turns out. As soon as pathology slides were ready, Emory sent them to Dr. Epstein at Johns Hopkins. 7 People with PN had an increased likelihood of: 6 Eating disorders Self-harm First MRI done in June 2016 by Scottsdale Medical Imaging - nothing found. 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). Get a Second Opinion Prostate Cancer Grading: Greetings gentlemen! SMIL radiologist reported nothing found. Clipboard, Search History, and several other advanced features are temporarily unavailable. 2017 Oct;22(10):1197-1211. doi: 10.1634/theoncologist.2016-0429. I'd like to talk with former patients who have gone through the procedure. A blocked urethra can also damage the kidneys. Anyway, I'm reaching out to this group to see if anyone would be willing to chat with me about their brachytherapy experience at UCLA (even to talk me out of it). :) In those cases, patients are tremendously grateful for having received the advice and encouragement to get a second opinion, Dr. Matasar adds. They hesitated calling it a TARGET LESION, but scored it PIRADS 4. Rectal cancer.A small trial that saw 18 rectal cancer patients taking the same drug, dostarlimab, appears to have produced an astonishing result: The cancer vanished in every single participant. Find a doctor at The Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center or Johns Hopkins Community Physicians. I would appreciate hearing from that 2.8% out there who have an intraductal component. I trust the second opinion Dr. Bush gave. Benign prostatic tissue I've had what I would consider a fluctuating PSA since first tested in November 2018. I fear limiting myself to an inferior treatment because the people I talk to have hammers, therefore everything must be a nail. MY THOUGHTS AND ANYTHING DOCTOR NOTED: - High grade prostatic intraepithelial neoplasia (HGPIN) A small early-stage clinical trial found that a carefully selected group of patients who responded remarkably well to chemotherapy could skip surgery altogether. Right mid anterior transition zone (PIRADS 2). FYI-We are also considering the trial at Princess Margaret Hospital in Toronto. Original Sloan Biopsy Results: Good Day Everyone. This has raised some questions on all the scans so far. They seem to think it'll do the trick.I feel great and I am glad I chose this treatment path. Just had my appointment today and they are pleased with the results, so far. During the next 4 weeks I meet with the recommended Radiologist, and the two local surgeons. 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. A enlarged prostate can also cause blockages in the urethra. The neurovascular bundles are intact. Because physicians may differ in their approach to treating breast cancer, its very important to check with a breast cancer expert to know youre receiving the best treatment for you. * Should still go for a Johns Hopkins second opinion on the pathology or is that overkill since the first one was done at MSKCC? PROSTATE PROS Episode 6: Breakthroughs in Radiation PROSTATE ONCOLOGY SPECIALISTS, Like Man, Im Tired (Of Waiting): The How-to Guide for Men with Prostate Cancer PROSTATE ONCOLOGY SPECIALISTS, Considering Prostate Cancer Clinical Trials? He wants me to begin the ADT around 5/1. There are also many reasons why you may want to seek another opinion during the course of your cancer care. You may choose to consider a second opinion if you: 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. 2017 May-Jun;30(3):298-307. doi: 10.3122/jabfm.2017.03.160359. Be sure to ask about and research the skills and experience a doctor has with treating prostate cancer. Low volume post-void residual urine is present in the bladder. I understand that patient privacy is a priority (I'm actually a privacy lawyer), but surely there are patients who would give consent and be happy to talk with a prospective patient about their experiences? 2. I want to insure that the Imaging was read correctly and nothing was overlooked or missed. But in the spirit of disclosure for those of you with BPH a TURP can complicate a future Radical Prostatectomy (or possibly Cryo) and increase the risk of side effect risks. The margin of error is 1.4 percent, which is equivalent to 30,000 cancer diagnosis mistakes annually in the U.S. Of 6,171 biopsy slides sent since late 2008 for a second review at Johns Hopkins, pathologists disagreed with the diagnosis on 86 of them. Given that some 3+4 is now evident, I can no longer say that all my PCa is all 3+3 and that I can stay on AS for an extended period. 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. How long do you have left? undefined will no longer be visible to you including posts, replies, and photos. Usually, patients obtain a second opinion after being referred to a second physician or to a special team of experts in a cancer center, called a multidisciplinary team. Slightly Explore our state-of-the-art patient care facilities in the Sheikh Zayed Tower. Brief MRI history. The TRUS biopsy is behind me, the second opinion from Johns Hopkins is behind me, and its time for next steps. Johns Hopkins second opinion - nothing found. What is NOT OK is quitting or avoiding the bad news, or handing the entire decision over to someone else.Good luck fellas! Overall, obtaining second opinions was not associated with definitive treatment or perceived quality of cancer care. Prostate, right lateral apex: I choose surgery over radiation because you can do surgery and then radiation, but it is almost impossible to do it the other way around. For these reasons and others, it is advantageous to seek more than one opinion about how your cancer can be treated. If I am rested, I find that I am more ready than if I am not. My urologist has decided we'll go ahead with the MRI due to the continued elevated PSA scores, in addition to the overall PHI score. I have been drinking out of an information fire hose. Some specialists have more expertise and more experience than others. LESION 1 I'm going to reach out to UCLA to see what they can do. This shows very high signal intensity on the diffusion-weighted HHS Vulnerability Disclosure, Help An increase of 1.1 in 3 months is not good news. The side effects of the cut, radiate, hormone regime are unacceptable to me. The study included nearly 2,400 men in the Philadelphia area recently diagnosed with localized prostate cancer. Call us with any questions: 410-955-2405, ext. 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. Other: There is trace ascites in the mesosigmoid. 5. Would you like email updates of new search results? 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). Instead, I did my homework. If you are considering undergoing a specialized treatment, such as cancer surgery, within your HMO, it is important to inquire about the number of such procedures performed each year by the HMO and the results. This condition causes pain in the lower back and groin area, and may cause urinary retention. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. Pathology reports are the opinion and interpretation of the individual pathologist viewing the tissue samples. 1st opinion. Mohamad Allaf, M.D., answers questions about prostate cancer diagnosis and treatment options and discusses robotic prostatectomy at Johns Hopkins. * PIRADS v2 Score: 3 But you have to do both. My plan is to choose quality of treatment over cost of the treatment. 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. Benign Processes: Had a little complication a day after release, excessive blood/clots in urine. These so-called grading and staging errors are more common and can affect how aggressively a patient is treated. The prostate gland is slightly enlarged secondary to transition zone hyperplasia (25cc total) It works. PSA that brought me to this was 7.1. Transurethral microwave thermotherapy : In selected patients, microwave energy helps to restructure prostate tissue and alleviate symptoms such as incontinence and voiding dysfunction, Laparoscopic prostatectomy: The prostate is removed with a miniature telescopic instrument, which allows for a quicker recovery, Robotic surgery: This breakthrough technology, which often is used for prostatectomy surgery, requires only a few small incisions. Seek Perspective from a Range of Specialists. Noted that some don't even include on report and should be looked as something to note but not obsess about. 1: Prostate, right lateral apex !I've pasted a previous update below for background.I just got my PSA results and the numbers are still trending in the right direction. Your email address will not be published. Conflicting Prostate Biopsy OpinionsWhat to Do? Call us with any questions: 410-955-2405, ext. I retired as a Dentist at the VA and saw many veterans with a wide range of outcomes as most of them became 100% service connected when diagnosed with prostate Ca due to exposure to Agent Orange if they served in Vietnam. OTHER: None. - DCE = (+) Jonathan Epstein, M.D. However, there are also many more options for treatment and these options are more complicated than in the past.