Can I send biopsy sample to Dr. Epstein in Johns hopkins?

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qjenxu
Regular Member


Date Joined Sep 2009
Total Posts : 187
   Posted Today 12:53 PM (GMT -6)   
Many people say you need a second opinion to look at biopsy sample. and I heard Dr. Epstein in Johns hopkins is really good. Can I ask our urologist send parrifin blocks to Dr. Epstein in Johns hopkins? Should we cantact Dr. Epstein first? what is the procedure to do so?

Thanks in advance!

Jennifer
husband 55 years old
PSA July 2009 5.5
Diagnosis confirmed Sep 21, 2009
12 Needle Biopsy = 6 clear , 6 postive
<2%, 10%, 25%
Gleason Score (3+3) 6 in all positive cores
X-ray waiting for the result


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted Today 1:30 PM (GMT -6)   
I would contact JHU and ask them for assistance on getting Dr. Epstein's assistance. They will work with your insurance carrier and get approvals and then contact your urologist or pathologist to get the slides...

When I had mine done it was taken care by my oncologist. You might ask your urologist if he can help as well...

Tony
 Age 47 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Gleason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 11, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


qjenxu
Regular Member


Date Joined Sep 2009
Total Posts : 187
   Posted Today 1:46 PM (GMT -6)   
many thanks for TC-LasVegas!
husband 55 years old
PSA July 2009 5.5
Diagnosis confirmed Sep 21, 2009
12 Needle Biopsy = 6 clear , 6 postive
<2%, 10%, 25%
Gleason Score (3+3) 6 in all positive cores
X-ray waiting for the result


TeddyG
Regular Member


Date Joined Apr 2009
Total Posts : 133
   Posted Today 6:27 PM (GMT -6)   
I did it with Epstein. Call Hopkins and the folks in the pathology department there will tell you exactly what to do. They are very experienced in second opinions.

Background:
Age 55, two teens, very fit cyclist (avg 2000+ miles per year) and weight, diet, etc. consistent with good habits. Stressful job as attorney; very supporting wife who is helping me through every stage of this war.
Stats:
2006 PSA - 1.5
2007 PSA - 2.3
2008 PSA - 5.3 (18 mos.)
2009 Jan. 20 - Biopsy 12 samples
        Feb 3 Dx 2/12 samples positive, low volume  (5% and 7-10%)
Gleason 3+4, later downgraded by second opinion at Johns-Hopkins to 3+3, but "it's still PCa" as my Doc said.
Laproscopic surgery April 9,  University of KY Medical Center, Lexington, 3 days in hospital, catheter removal April 21.
Pathology: clear margins, no cancer in prostate: told that this is very rare and Doc has only seen it in 3 out of over 1400 cases; I rearched the concept of "vanishing cancer" and found a tumor classification of tP0 and asked Doc if it applied to me. He said that it was unlikely because if a pathologist had done a much more detailed analysis of the tissue, he would likely find more foci somewhere, and biopsy found "needle in the haystack as opposed to the tip of the iceberg"; Nevertheless, it is a blessing;
Regardless of the science, my family says "miracle."
Now working w/ post-surgery issues....
 


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted Today 7:08 PM (GMT -6)   
Teddy,
Do you have the number you called?

Tony
 Age 47 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Gleason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 11, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


BooMan
Regular Member


Date Joined Oct 2006
Total Posts : 27
   Posted 9/25/2009 8:51 AM (GMT -6)   

Jennifer,

This link will get you information about how to send slides to Johns Hopkins for a second opinion.  http://pathology.jhu.edu/department/services/consults/urologic.cfm Their phone numbers are also listed and the staff is very helpful.  I have in the past requested that Dr. Epstein review my slides and sometimes another Dr. will do it.  I have also used Bostwick Laboratories.  Dr. David Bostwick is also a recognized expert in reading slides from prostate biopsies.  Even if another doctor reviews the slides, I have been assured that Dr. Bostwick then reviews their work.  They also provide, in my opinion, the most comprehensive and easy to understand report of their findings.  The link to their page regarding consultations is  https://www.bostwicklaboratories.com/HOME/services/consultations.aspx Their staff is exceptionally helpful and phone numbers are available on other pages of their web site.  I'm going for another biopsy soon and although my urologist's practice has a laboratory, I will be sending the slides to Bostwick for a second opinion.  Good luck.

Boo


qjenxu
Regular Member


Date Joined Sep 2009
Total Posts : 187
   Posted 9/25/2009 9:28 AM (GMT -6)   
thanks! called Johns Hopkins Medical Laboratories this morning

got address and fee information.

asked my husband make the inquire to his urology office to send slide to Johns Hopkins. (thought I couldn't do this for him because the privacy policy)

Hope he makes his move soon.

Jennifer
husband 55 years old
PSA July 2009 5.5
Diagnosis confirmed Sep 21, 2009
12 Needle Biopsy = 5 clear , 6 postive
<2%, 10%, 25%
Gleason Score (3+3) 6 in all positive cores
X-ray for chest and blood work waiting for the result


TeddyG
Regular Member


Date Joined Apr 2009
Total Posts : 133
   Posted 9/25/2009 10:23 PM (GMT -6)   
Tell him: "Do it!" I did get some comfort when Dr. Epstein down graded me from 3+4 to 3+3 as it took some urgency out of my fears. But it was, as my home Doc said, "still cancer." your hubby will have to sign a release form for his doc. They know what to do too. You can call the doc and I'll bet that his staff will give you the form to take for signature. these folks do it all the time.
best wishes,
Ted
Background:
Age 55, two teens, very fit cyclist (avg 2000+ miles per year) and weight, diet, etc. consistent with good habits. Stressful job as attorney; very supporting wife who is helping me through every stage of this war.
Stats:
2006 PSA - 1.5
2007 PSA - 2.3
2008 PSA - 5.3 (18 mos.)
2009 Jan. 20 - Biopsy 12 samples
        Feb 3 Dx 2/12 samples positive, low volume  (5% and 7-10%)
Gleason 3+4, later downgraded by second opinion at Johns-Hopkins to 3+3, but "it's still PCa" as my Doc said.
Laproscopic surgery April 9,  University of KY Medical Center, Lexington, 3 days in hospital, catheter removal April 21.
Pathology: clear margins, no cancer in prostate: told that this is very rare and Doc has only seen it in 3 out of over 1400 cases; I rearched the concept of "vanishing cancer" and found a tumor classification of tP0 and asked Doc if it applied to me. He said that it was unlikely because if a pathologist had done a much more detailed analysis of the tissue, he would likely find more foci somewhere, and biopsy found "needle in the haystack as opposed to the tip of the iceberg"; Nevertheless, it is a blessing;
Regardless of the science, my family says "miracle."
Now working w/ post-surgery issues....
 

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