Tuesday, December 11, 2012

Setting the Record Straight

Following my diagnosis of recurrent cancer, a few folks have asked,"If you had it to do over, would you choose proton therapy?" My answer is an unqualified, unmitigated, "YES." My initial research indicated several available options demonstrated a high degree of success. Proton therapy and surgery appeared to be more effective when compared to brachytherapy, cryosurgery and various types of photon therapy. No less effective than the other options proton therapy stood out because of  fewer, less severe side effects. A high success rate combined with minimal side effects appealed to me then and strikes me as being equally persuasive to this day.
A few weeks ago an internet friend informed me that of the several thousand prostate cancer patients treated at UFPTI since opening in 2006, I am one of three individuals whose proton therapy proved unsuccessful. UFPTI issued a press release this November which contained the following stunning success-ratio statistic:
"Five year progression free survival rate of 99 percent in low-intermediate-risk prostate cancer patients."
If only I could locate an equally effective means of treating my recurrent cancer.
If I made a mistake along the way it was not securing a second opinion on my original biopsy as recommended by Marckini et. al. Although, before initiating treatment, UFPTI  confirmed my original Gleason score as being 7(4+3). At a much later date using the same set of slides Mayo Clinic concluded my score was actually 8(4+4).The Mayo clinician who called this to my attention speculated that had UFPTI concluded likewise my radiation may have been preceded by one or more doses of Lupron which may have prevented the recurrence.
Why the soul searching and hand wringing at this point you might wonder? Well this exercise represents my attempt to set the record straight. In so doing I hope to enable others who follow in my footsteps to make a good decision for themselves. A 2012 Christmas gift? Perhaps.

Saturday, December 1, 2012

Mainstream Oncologist #2

Dr Trewkare may not be infallible, but I suspect he is about as good as they come. Even though we had seen him only three times over a four year period, he greeted my wife and me on a first name basis as if we were old family friends. Apparently Dr Trewkare reviewed most of the medical information I had submitted prior to our appointment. We quickly reviewed the treatment plans that I had considered and rejected including brachytherapy, cryotherapy, HIFU and surgery. It seemed evident he agreed I had not overlooked the ideal option. He visibly shook his head ever so slightly at the mention of HIFU.
At this point I asked him about the advisability of the Casodex plan. "Who recommended that" he wanted to know? "An oncologist by the name of Dr Cy Fer," I answered. "I know him," he replied, "he irritates me every time I see him at one of our meetings, and now it is all the more obvious that he DOES NOT KEEP UP WITH THE LITERATURE." It was fairly apparent that this is about as bad as it gets in the medical community in general and the oncological profession in particular.
"Your PSA remains fairly low," Dr Trewkare returned to the task at hand, " and in my opinion its rate of ascent is not particularly worrisome." ( Although this observation runs counter to my perception of my predicament, it directlly parallels Dr Gud E. Nuff's judgement precisely). "We should begin to think in terms of treatment when your PSA reaches 10," he continued. "When we do treat we should consider traditional hormone therapy on an intermittant basis. Please monitor your PSA, provide me with the results, and when you return from Texas in six months come in and see me." So goes the current plan