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A Must Watch for All High Risk Guys

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Posted 6/25/2015 11:49 PM (GMT 0)
Just re-posting Cicero2k's post of Dr. Eugene Kwon's talk at the 2014 PCRI conference which re-inforces the need for Multi-Modal therapy for high risk guys. Many of the best cancer centers take a similar approach including MD Anderson where I get treated.

https://www.youtube.com/watch?v=NkqizmvqJPo
Posted 6/26/2015 12:20 PM (GMT 0)
WOW. Great to have him in your corner. So down to earth and simple and practical in his explanation. So many strong take-aways, but mostly his drive to improve a patients' life. Some great case studies and confirms that the "wait and see what happens" school of thought is not for me. I have always been convinced that the multi-modal treatment for intermediate and high risk disease is superior to the sequential approach and glad that my docs started with the multi-modal approach.

I would like to know more of the starting point for many of these men than just the dx PSA. What were the initial G scores of the metastatic 0 PSA recurrences? Can a G7 eventually evolve into PCa that does not emit PSA? We know this can happen with G9 and 10.

From a practical standpoint, when should a high risk person as myself have the scans? Our current approach is that so long as my PSA is undetectable, we will not do anything. Sounds like to me, if it starts rising the first thing to do would be the scans. The message from Dr. Kwon that resonates with me is to first find it, then decide how to treat it. As he said..."gotta get imaging".

Thanks for the re-post and I am sorry I missed it the first time.
Posted 6/26/2015 4:51 PM (GMT 0)
Good stuff!

I too was surprised about the implication that everyone needs to get scanned. I was treated at UCSF and I consult with Scholz and both said a scan would show nothing in my case. (PSA about 0.1 when I started SRT.)
Posted 6/26/2015 5:23 PM (GMT 0)
The best for detection is MRI .It sees the whole prostate even the part that is hidden. It is not invasive and they say with in years it may be used In place of Dre exams. Out of Berkeley California at the big urological meeting they reccomend every man gets screened but not every man needs a biopsey. I don't see over treating a man who is 80 + but because how invasive and sneeky PC is if you are under 70 why wouldn't you do everthing in your power to protect your live.
Posted 6/26/2015 6:23 PM (GMT 0)
Hi,

I stopped getting the DRE exam for two reasons. First and foremost, I undergo a 3T mp-MRI every year, and my urologist feels that the DRE is the least sensitive of all the exams (including the PSA test). Second, after I underwent the TURP which led to the diagnosis of cancer, the surgeon I consulted afterwards found my prostate to be firm on one side after a DRE  and sent me to be examined with an MRI. I searched the internet for a possible effect the TURP might have on the prostate and, sure enough, I found that a previous surgery would compromise the prostate in any DRE exam.

Posted 6/26/2015 6:57 PM (GMT 0)
Thanks Hawaii and Cicero for posting this ... I'm sending a copy to my local oncologist, so that he understands what exactly we're doing (he's been supportive, but skeptical). Maybe it will help other brothers ...

Really strengthens my resolve to keep on the path ...

Ray
Posted 6/26/2015 11:55 PM (GMT 0)
I have to say that's the positive stuff I like to see.
Never give up hope.
Now how do i sign this guy up to be part of my team?

Good stuff. Thanks for posting guys!
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