A second opinion about second opinions

The mysterious disappearance of Dr. Jonathan Epstein

By Howard Wolinsky

In late April, I hosted a program for Active Surveillance Patients International (ASPI) on second opinions on prostate cancer slides featuring Johnathan Epstein, MD, top gun among urpathologists. Epstein reviewed slides for a mind-numbing 12,000 patients a year.

I told him many support groups referred patients to him and asked him who he would recommend as a backup in case he wasn’t available.

He laughed and declined to suggest anyone in a live webinar. Too political. Too personal. It likely would put him in hot paraffin with his colleagues.

We all laughed. I suggested that Epstein share his recommendations off-camera. It didn’t happen.

Epstein went on an indefinite leave of absence in May for unexplained reasons.

A couple of weeks before the webinar, I had been talking to Mark Lichty, chairman of ASPI, about how I was concerned about who we would refer patients to should Epstein leave the scene. Then, poof.

Did I have a premonition? It wouldn’t be the first time.

I was speaking to a leading urologist at Hopkins. He said the urologists were puzzled. He said Epstein’s absence was noted at a memorial service in May for Dr. Alan Partin, former director of the Brady Urologic Institute at Hopkins and former urologist-in-chief at the Johns Hopkins School of Medicine.

Epstein’s departure remains a mystery. There are rumors about why, but I won’t share them. Eventually, the truth will be known. Dr. Epstein should know that we wish him well.

Meanwhile, where do we get our pathology second opinions?

I’ve been getting positive feedback from patients who have seen Epstein’s three proteges. The doctors still discuss their findings with patients.

For information on the Hopkins second opinion program: https://pathology.jhu.edu/patient-care/second-opinions/send

Note: Hopkins just raised the cost for a second opinion to $400 from $350.

A patient who attended the Epstein webinar wrote and asked me if I ever spoke to Epstein about a non-Hopkins backup. As I said, I didn’t.

But I can safely say Epstein approves of Dr. Ming Zhou, chairman and pathologist-in-chief at Tufts Medical Center. I suspect that if Epstein needed a second opinion for prostate cancer, he’ might go to Zhou, who trained at Hopkins, as well as his proteges.

(Ming Zhou, MD, PhD)

Epstein recommended Zhou as a stand-in speaker to an AnCan program on another occasion.

I have previously sent patients to Zhou.

One patient had four second opinions. He had gone to a world-renown medical center and had two second opinions from pathologists. Amazingly, general pathologists rendered these second opinions, not uropathologists. The conflicting results confused the patient.

So, on my advice, he sought second opinions from Epstein—and Zhou—both of whom are prostate experts. Zhou and Epstein agreed on the findings.

Here’s the contact information for

Dr. Ming Zhou, Anatomic Pathology Department of Pathology and Laboratory Medicine, Ziskind 5, Tufts Medical Center, 800 Washington Street, Box 802, Boston MA  02111

Office:  617-636-5829 Fax:  617-636-8302

He charges $250 per case.

If you have any suggestions for other uropathologists for second opinions on prostate slides, please share them in the comment box on the website, TheActiveSurveillor.com.