Here’s the second part of Dr. Kwon’s video. Like the first video, it’s very informative (perhaps even more so, at least for me).
Even though I had seen similar statistics before, one of the kickers for me is that only 33% of recurrent cancer is found in the prostate bed (local); 45% will be metastatic; and 22% will be both local and metastatic. As Dr. Kwon rightly points out, knowing where the cancer is located will guide your treatment decisions, and that’s why I have been so reluctant to blindly step into salvage radiation therapy without having first identified the location of the cancer. Why risk the possible toxic side effects of radiation if you’re not radiating in the correct location?
In my previous post, I mentioned that Dr. Kwon was a pioneer in dealing with oligometastatic prostate cancer. At the beginning, many in the profession dismissed his work out of hand (I’ll admit I was skeptical, too), but it seems that over the last 10 years, his work has gained the respect of others and is supported by further research.
In any case, this video is 31 minutes long and I encourage you to watch it.
Dan's Journey through Prostate Cancer 
Wow, that was quite a watch. Thanks Dan, I feel I learnt more in the last hour watching those two videos than I’ve learnt over the seven years (so far) of my journey.
The bad news is I’ve just had a psma scan following my second recurrence post RP/SRT. My first failure was 3 years after RP. I had SRT when my psa reached 0.1
SRT gave me undetectable for a year but my psa eventually crept back up to 0.25 two years after the failure. I do feel very lucky that living in the UK my PSMA scan was free and delivered rapidly.
I’ve been following your journey closely, you are making good decisions. With hindsight I wish I had held out longer and had PSMA before choosing my treatment pathway but PSMA didn’t seem to be on the table then…
I get my results on the 22nd, I wonder what kind of Xmas present I’m going to get.
Thanks again, I feel much more informed having watched, but it was kind of uncomfortable!
Adrian
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HI Adrian,
Thanks for sharing your story, and sorry to hear that the SRT came up short. I’m glad to hear that you have easier access to PSMA PETs than us here in the US. As this technology becomes the standard of care, I think it will get easier.
I wish you all the best with your results. Please keep me posted.
Dan
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Hi Dan, I got my psma result back. Nothing to see, probably predictable. My latest PSA yesterday came back at 0.26 so steady for around 8 months.
I spoke to my Onco this morning and she said I’ll carry on with three monthly psa tests and repeat scans so I feel well looked after.
Some relief this morning for sure, but the journey continues!
Have the best Xmas you can
Adrian
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Wow. Dr. Kwon breaks the information down, but still so complicated. I’m glad you went for the PET scan. I hope they can deliver the results tomorrow as expected so you can move forward with a care plan.
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Thanks. Yeah, it’s definitely not an easy topic or disease.
I have no idea what I may be able to see on my patient portal tomorrow, so it wouldn’t surprise me if I can’t make heads nor tails of it.
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Well worth watching and repeat watching. Treating patients blind, which is what currently happens in many cases based solely on a PSA rise and CT and bone scans only – without knowing where the cancer is -seems blatantly illogical. The difference between a dead tumour and a live tumour I’ve never heard of but the use of PET tracers is so clearly superior to current standards of practice. The benefits of identifying cancer locations early, seven years early, and the impact this can have on treatment options and cure rates is impressive. He raises an important question – why with all the recent new advances is there no improvements in survival rates? Sometimes a maverick is needed to shake the orthodoxy. I always remember the case of Dr Barry Marshall, the Australian who won a Nobel Prize for medicine for his role in shattering the orthodoxy around stomach ulcers. Dr Kwon could be a future candidate based on his many years in the field and his unorthodox approach.
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