Prostate Cancer Recurrence | Eugene Kwon, MD | DIY Combat Manual for Beating Prostate Cancer: Part 2

Dr. Eugene Kwon of the Mayo Clinic in Rochester, Minnesota is a physician who defies categorization. While he is considered a urologist, his skills go far beyond surgery and into imaging to immunology. Here, he presents his "DIY Combat Manual For Beating Prostate Cancer" with a special emphasis on imaging for prostate cancer.

0:00 Staging Your Disease as Local, Focal, Zonal, or Diffuse
0:51 Local Recurrence of Prostate Cancer
9:37 Focal Recurrence - Oligometastatic Disease 1-5 metastatic lesions
19:14 "Zonal Recurrence" - Large Cluster of Prostate Cancer in One Part of the Body
21:18 The Logic Behind "Deluxe Treatment"
25:45 Three Categories of Treatments Against Advanced Prostate Cancer
27:55 Deluxe Treatments: A Case Study

Who we are:

The Prostate Cancer Research Institute (PCRI) is a 501(c)(3) not-for-profit organization that is dedicated to helping you research your treatment options. We understand that you have many questions, and we can help you find the answers that are specific to your case. All of our resources are designed by a multidisciplinary team of advocates and expert physicians, for patients. We believe that by educating yourself about the disease, you will have more productive interactions with your medical professionals and receive better individualized care. Feel free to explore our website or call our free helpline at 1 [phone] with any questions that you have. Our Federal Tax ID # is 95-4617875 and qualifies for maximum charitable gift deductions by individual donors.

The information on the Prostate Cancer Research Institute's YouTube channel is provided with the understanding that the Institute is not engaged in rendering medical advice or recommendation. Opinions stated within this video belongs solely to the speaker and does not represent PCRI. The information provided in these videos should not replace consultations with qualified health care professionals to meet your individual medical needs.

#prostatecancer #EugeneKwonMD #MarkMoyadMD

[crankyneanderthal]

I was diagnosed with stage 4 in august 2022. Original PSA was 38. Gleason 4+5. 12 cores out of 13 cancerous. Mets to distant lymph nodes. I had RARP within 3 weeks of diagnosis. Oncologist put me on permanent hormone therapy (Zoladex). I told my oncologist that I wanted to hit this cancer with a sledge hammer so he agreed to put me on aggressive treatment plan. I completed chemo (taxotere 6 x) in Jan 2023 and just completed 25 sessions of targetted radiation therapy on my cancerous lymph nodes. Latest PSA 6 weeks after radiation is <0.03 (undetectable). Shine a light and those around you will soak up the warmth. Never give up hope. Adapt and Survive!!

[tomswoverland]

I have been fortunate to have Dr Kwon treating my stage 4 prostate cancer. After about a year and a half I have had 2 scans that are clear. Thanks Mayo and Dr Kwon.😀

[tgburger]

Dr. Kwon is my spirit animal. He inspired me to fly to UCLA for. PSMA Gallium 68 scan. Four spots were found. I’m scheduled for SBRT at PSA 0.85. I hope for a cure.

[ikramullahshad]

Super....treating patients at all stages of prostate cancer on war footings and never giving up....rather winning every time...Bravo....

[thomasbowman]

Dr. Kwon has my total respect. He has been like a great friend, and always gives me the best information to deal with my medical issues.

[ag-omnr]

Dr Kwon is brilliant ! I look forward to the day when his techniques are standard procedures !

[dougprokopec]

I greatly appreciate Dr. Kwon's Video, Part 2. Thank you.

[martinsmith]

Thankyou dr kwon you video has given me strength to Carry on fighting with a psa of 174 after 6cycles of taxatere chemo and now scheduled for a scan

[jsroesler]

At 21:24 Dr. Kwon talks about the logic behind what he calls "deluxe treatment". ***The goal should be to attain a curative, vs. palliative, outcome.*** This is **really significant** because many physicians (such as mine) are really focused on palliative therapy only, even for low volume disease!

"Up until recently, the focus of treating recurrent prostate cancer was palliation - let the cancer get bad, treat it with something, let it get bad {again}, treat it with something, etc. Use different agents until you lose control and then the patient dies." (i.e., sequential/palliative therapy).

"I like this kind of situation where you see the disease and then you go very aggressive in terms of managing the disease to the point you hope you can knock it out. We usually use a mixture of approaches and treatments to try to force that outcome. I call this curative therapy strategy."

[timoherron]

I am a 67 year old male and I was diagnosed in March of 2022 with a MRI and biopsy that resulted in 11 of 12 cores positive mostly Gleason 6 and 7 but one Gleason 8 (4+4) and one Gleason 9 (4+5) both high percentage of core 80 percent. Had the whole body bone and pelvis scan which showed no metastasis, but I kept pressing for a PSMA Pet Scan which one year ago wasn’t easy to get but my urologist thankfully agreed to ask Medicare and it was approved. The PSMA came back negative so no signs of spread on PSMA Pet Scan. My PSA never went above 10, I believe 9.5 was the highest it ever got so a slight positive I would think, but I do have high Gleason score disease. June 1st of 2022 I started Orgorvyx and had definitive Proton therapy for nine weeks (including the Seminal Vesicle and lymph nodes) then started Abiraterone mid September 2022. So I think I am one of the earliest patients to get a PSMA Pet Scan and I am now one year of ADT with Orgorvyx in June and September will be one year Abiraterone. I know the protocols have not been worked out yet for people with High Risk Disease and a clear PSMA Pet Scan.
My thoughts are that I would like to discuss the possibility of stopping the ADT early. My Radiologist has said 1 to 2 years of ADT is sufficient, my oncologist has said 2 years. I consider myself lucky to be getting good care and some of the latest treatments available. I promised myself I would give everything I got to cure the cancer but would not risk ruining my health with the ADT treatments as quality of life is very important to me. I am definitely following the advise about exercise, exercise, exercise and don’t want to do long lasting damage my body for a cure. I now have low grade anemia and osteopenia from the treatment. So my PSA has been undetectable and I also have Natera ( Signatera) Genetic Residual disease testing done every 3 months which also comes back negative for any signs of disease. I feel that I am reaching the point where the cumulative effects of the ADT are becoming a big risk to my long term health and I am considering stopping the ADT at the end of August which will give me 15 months on Orgorvyx and 12 months on Abiraterone. I am presenting my case for a review and to open a discussion on shared decision making as I am struggling with my choices on whether to stop the ADT and need all the information I can get to make my decision. Thank you so much for your consideration.
I would like to have my situation presented as a question in a future video if possible.

[norbertosantos]

Thanks not just for giving treatment but for giving hope.
Really tank you

[andrewsmith-jfou]

Dr Kwon, thank you very much for these videos and your expertise. My father (age 65 then) had what was then called type 4 prostate cancer in 1975 (thought to be there for about 4 years before showing symptoms, which was a fall in the garden from pressure on spine from mets in spine) and was put on stilboestrol 1mg per day post a large initial hospital injection series with same. He lived until March 1991 though doctors said he would never walk again because of secondaries in his spine and would only live six months. The stilboestral caused a heart attack 5 years into treatment but he was treated for this and got over it and drove up to 1 year before death. He would have driven to the end but me and mother said no, no its ok we will drive lol. I am his son now 70 years old and no cancer but always watching. Thanks again Andrew.

[hansjohnson]

Thanks for these videos. Your information allowed me to advocate for an aggressive approach in treating my recurrent cancer (which the doctor agreed to, but was not in his original plan).

[stevenpeterson]

I really found both these videos valuable but I do have one criticism. This is the continued position that radioligand therapy (Lutetium and Actinium) and PSMA PET are new technologies being developed in the United States. As a colleague and friend, who is also a urologist and prostate cancer researcher, has stressed to me from the point of my diagnosis in 2018 we are 7-20+ years behind various countries on PET imaging modalities for prostate cancer and radioligand therapy. It is time that these methodologies start being presented earlier to patients and if that can not be done here because of regulatory issues than there needs to be a lobby to get patients to countries where these methodologies can be applied. Along with this we should lobby insurers and CMS to pay for overseas treatment and imaging.

[andrewjones]

I have 2 recurrence of Prostate Cancer. First time was in the prostate bed. 2nd time is in a soft tissue area in the pelvis confirmed by a biopsy. I had a Radical Prostatectomy and radiation before. Now I’m have radiation again along with the hormonal therapy Orgovyx. Been dealing with this On/off again for 13 years. Yet the journey continues

[colemant]

Thank You for this information... I am in this re-current phase. Appreciate your works.

[thomasreffle]

Having prostatectomy in a few weeks in the NE, if that doesn't take care of everything I will travel across this country to see Dr. Kwon, who wouldn't want some one guiding them to fight this scurge from a total War footing. I'm very impressed by his approach.

[Cedrus]

Do you use/recommend lifestyle or nutritional changes for patients? I had 23 IMRT sessions with 2 follow up HDR Brachy boosts while on 3 months of ADT. My present PSA is 0.130 which is all good and well...but I immediately transtioned to a whole food plant-based lifestyle. Why should/would I feed prostate cancer when I could starve it? No more animal meat, no dairy, no poultry or fish. Our medical practice is all ''reactive" and gives little or no thought to preventive measures

[michaelyarmas]

Thank you for your work, and for giving me hope.

[jc]

Our doc said PET won’t show anything because PSA isn’t at .2 yet PSA has doubled every 90 days since radical prostatectomy. They are suggesting radiation yet how do they know where to radiate?