PET Imaging | Eugene Kwon, MD | DIY Combat Manual for Beating Prostate Cancer: Part 1 | PCRI 2021

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.
To see Dr. Kwon's full talk and Q&A, and to see radiation oncologist Michael Steinberg, MD, speak on radiation therapy, visit the Day 1 video of our Prostate Cancer Patient Conference here: • 2021 Prostate Cancer P...
To watch pathologist Jonathan Epstein, MD speak on prostate pathology and medical oncologist Tonya Dorff, MD, on treatments for advanced prostate cancer- visit the Day 2 video of our Prostate Cancer Patient Conference video here: • 2021 Prostate Cancer P...
Get the full conference experience here: pcri.org/2021-conference
Donate to PCRI: pcri.org/donate
0:00 Introduction to Prostate Cancer
8:55 Basic Tenants for Attacking Prostate Cancer
11:51 The Significance of PET Imaging
18:13 Types of PET Imaging Agents for Prostate Cancer
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 KZbin 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

[@ThePCRI]

If you have questions about prostate cancer and need help from our Helpline team, you can email us here: [e-mail]

[@pistol90pete]

Dr Kwon does an outstanding job presenting his topics in layman's terms. I'm 53 and was recently diagnosed with very early CaP (small % of biopsies were Gleason 6 and 3+4). I will be consulting with Dr. Vipul Patel in Celebration FL this Wednesday. I have been doing a lot of research through PCRI and especially enjoyed Dr Kwon's talks. I will be sure to discuss PET with Dr. Patel. Thank you for your leadership in this science!

[@mperloe]

Please ask what percent will need post surgery radiation. Checkout and consider ViewRay SBRT available in Tampa, Miami and Atlanta, soon at Northside Hospital.

[@garytowne1548]

This is the best I've seen at clarifying the imaging picture. Thank you Dr Kwan.

[@grateful7839]

Great to hear a good doctor’s caring for us patients. Thank you Dr Kwan and Mayo.

[@RealRocdad]

Just had PSMA/PET, after 40% Gleason 7 and suspect metastatic seen on CT contrast.... Offered nothing so far, doc ruled out surgery & radiation already... Currently self treatment with RSO for pain & nausea, Taking FBZ 444 mg daily with Turmeric and vitamins...

[@on1accord78]

I love him immediately! So sweet to dedicate the video to patients who have died, and the joke was pretty cool!

[@stephie_rw]

So grateful my Jeff (Gallagher) is under Dr. Kwon and team’s care.

[@vegasrox]

Brilliant outstanding! 👏 Thank you for this detailed explanation of the pca journey that continues for so many.

[@lyfandeth]

Most informative and clarifying. Thank you, Doctor.

[@robertknapp6746]

Excellent Dr. Kwon thank you.

[@jeanclaudebouchara5182]

Thank you Dr Kwon

[@tomswoverland]

Diagnosed with stage 4 started with firmagon then lupron then 44 radiation treatments. Than my wife got me into Dr Kwon. Don’t know if I would be here if it wasn’t for my wife and of course Dr Kwon and his excellent team. I’m in remission and on Abiraterone now. Thanks Dr Kwon and all others involved. 😀

[@patriciageorge9648]

What procedure did Dr Kwon use to get you into remission. I really like Dr Kwon too but we haven’t used him yet. Thanks 🙏🏻

[@ga6589]

@@patriciageorge9648 My husband is a patient at Mayo-Rochester, but works with a different oncologist. He was diagnosed stage 4/Oligometastatic prostate cancer (Gleason 9, PSA 24) two years ago, and was immediately placed on Lupron injections/abiraterone, as well as 26 rounds of radiation. Within three months, his PSA was negligible

[@danielmombiedro3641]

OUTSTANDING DIY GUIDE,!,,,,THANKS EUGENE.

[@Kaburra]

Brilliant! Thank you, Doctor.

[@dickspade7045]

Thank you for this extremely valuable & life saving talk. Your explanation is easily understood & up to date. FYI, I'm 5 years out from successful Proton Beam Therapy with almost undetectable PSA,

[@model.train.railway.]

Thankyou very much.

[@davepaul8975]

Excellent presentation! Thank You Doctor Kwon

[@johnston378]

Thank you

[@Idahomie]

Thank you Dr Kwon for your candid and sometimes controversial comments.

[@ingridkoppers4540]

Excellent explanation! thank you Dr Kwon.

[@josephsweeney4245]

Dr Kwon gives a great informative video.....I have learnt a lot.....however one can only take control of one's treatment if one has the money to do so. I live in the UK and I was offered one treatment hormone treatment and EBRT because of my high gleason score. I would love to be treated at the Mayo clinic by Dr Kwon but unfortunately couldn't afford it.....I have to accept what is offered....but great informative video.

[@tedjohnson64]

Excellent presentation, I learned a lot!

[@jeremybaldic2047]

WOW! Excellent lecture!

[@williamfeldner9356]

What an excellent presentation. As a patient at Mayo Clinic I know I am getting the best treatment available. Wm A Feldner DDS

[@jeremybaldic2047]

Amazing!!!!!

[@johncoughlan9578]

Dr Eugene please may I ask if you think that a PET Scan is better as a source of diagnosis rather than taking initial prostate biopsies? Thank you Sir.

[@MyCousinGrandpa]

Thanks Dr Keon. When you mention getting PET scans are you specifically referring to the Axumen scan?

[@ThePCRI]

He discusses the four different options around 18:15. Generally, the two PSMA PET scans are the most sensitive and specific that are available, but there is a certain percentage of men, around 10%, whose cancers will not show up on PSMA PET. The most widely available PSMA scan goes by the trade name "Pylarify," and their website is pylarify.com. The Axumin scans are widely available, and the Choline scan is only available at Mayo Clinics. Dr. Kwon says that any of the four available PET scans are better than no PET scan.

[@joeotero3350]

Thank you Dr. Kwon! I very much appreciate you sharing your knowledge and your experienced based advice!! During my most recent colonoscopy there was an area discovered that warranted further investigation and a biopsy was scheduled. The results of the biopsy detected 5% cancer of one core on the left side. I then had an MRI which outlined suspect areas. My PSA count is very low and I don't believe the PSMA scan would benefit. However, I'll be calling on various experts to determine if the other scans would be of any value in better understanding my situation. I'm now scheduled for another biopsy (this time ultrasound guided) in four months and I'm dreading going though that again as the last biopsy resulted in an infection which lasted for 9 months! Having to deal with pain due to the infection for that long was horrible. Thanks again Dr. Kwon... Very much appreciate your very informative video!

[@fazilmohamad3539]

Very good news about prostate

[@mikeash7428]

Good informative talk. I've put off getting biopsies for fear of infections because of my living situation requiring me to be physically active. I wasn't aware of PET scans as a diagnostic tool. Is it wise to get a scan first and is that better than a biopsy?. I do have some bumps on my large prostate. My PSA is between 2 and 3 in past blood work.

[@maureenobrien9815]

I think so, Mike. But, boy do you get resistance when the patient has a low psa. Low psa doesn't mean you can't get mets. .my friend's just worked around it, hormone resistant, and now we're facing a real scary metastasis on a rib. One I told them had to be a met while they held to their belief that low psa = good to go. It's not always the case.

[@ahmedalbalooshi8518]

A topic well presented and not so difficult to follow the presenter. Thank you

[@williamogara6752]

This is a very good and informative lecture. PSA 1.2 IS SAFE?

[@johnblack2193]

Do your clinic do second opinion from a pet ct scan. if so what type pet ct scan do you recommend. Thanks.

[@jamespmullin21753]

Is 4 months a long time to diagnose cancer?

[@emcinc9654]

Which Mayo Clinic do you work at. I’m in Florida and without looking up I believe there is a Mayo in Jacksonville on in the Miami area.

[@ThePCRI]

He works at the Mayo Clinic in Rochester, Minnesota.

[@jamesnicholasnicholas6761]

I am 89 yrs old and was diagnosed with prostate cancer 15yrs ago. I now using a mediation name of Dodart what can be told of this medicine.

[@sandraredmond4812]

What is difference between psma pet ct vs psma pet mr?

[@keevanabramson7126]

In patients not yet diagnosed, can a Pet scan shed light on an equivocal MRI done for rising PSA levels in the 4-5 range to prevent the need for a biopsy?

[@Sanity1234]

I would be interested in the answer to this question as well.

[@lyfandeth]

Why is it that women have the Skene's gland, analagous to the male prostate, but we never hear about Skene's glands being cancerous? Aside from it only having been "discovered" and recognized only a few decades ago?

[@Energyequalsmc2]

Can you please elaborate on why PSMA scans work better for some patients and Choline scans for others?

[@ThePCRI]

Hi! Please email [e-mail] and our Helpline team, may be able to help.

[@sushantakundu6526]

Thanks Dr.Kown , it is really easy to understand . Sushanta. India

[@motorcop02]

Excellent presentation! My PSA has dropped from 17 to 4 over the last four years with no treatment of any kind. Ive not gotten an answer to what is making it drop. Thankful but curious.

[@ThePCRI]

The PSA can be elevated for a lot of reasons, most of them benign. Asymptomatic inflammation, for example, is a reason it could be a lot higher for one reading and then drop back down for the next.

[@JasonRoberts556]

Did you ever have an MRI? Great job by the way! Did you change anything?

[@ebenezergarbrah5255]

Wow Picked a lot of knowledge. Maybe Not out of the woods yet with a PSA of 0.2 stable for 1.5 years now after radiation and hormone treatment.

[@mar_il6314]

Hi! do you mean after prostatectomy? Tnx

[@ebenezergarbrah5255]

@@mar_il6314 Nope , after radiation treatment on the prostrate and three months of hormone treatment with zoladex

[@mar_il6314]

@@ebenezergarbrah5255 thank you! could you tell me please if you have some adverse effects after radiation and hormone treatment, by now?

[@marka9073]

Hi, what type of radiation did you have? (EBRT, SBRT, Brachytherapy) Any lasting side effects from radiation? (Leaking, incontinence, erectal disfuntion, other)

[@MrMediterrano]

The big question for me is whether to make the PET/CT already before the biopsy. All the doctors with whom I had contact say that first a biopsy has to be performed but I don't see why if PSMA PET/CT is much superior and comes with no risks. Also in my case, mpPRI did not show anything so therefore a random biopsy would be performed. How can a random biopsy be superior to PSMA PET/CT ??

[@pinegd1]

Biopsy is essential because it scatters tumor cells so they can survive initial therapy thereby guaranteeing long term treatment profit opportunity.

[@sandraredmond4812]

Is PET imaging dangerous ?

[@mperloe]

Why does Mayo still use choline11 PET scans?

[@Energyequalsmc2]

I am unclear as to why PSMA scans work better in some cases, and in other cases Choline scans work better.

[@JasonRoberts556]

I must ask, why get treatment BEFORE systems IF the treatment failure rate is 33%? This is what I’m having a VERY difficult time wrapping my head around.

[@randycolwell5575]

Had psa of 12.2 in 2020 prostatectomy was done psa started rising again had 38 rounds of radiation. Psa is on rise again last psa was 0.14 oncologist had me do PSMA petscan came back negative now urologist wants me to start eligard and zytiga I am so confused right now one doctor says I am good other is saying put the fire out before it gets bad. I am only 55.

[@scottjackson163]

😞

[@assetstopurchase8432]

I've had trouble urinating since 2019, but presumed it to be stress-related, initially. Then in early January 2020, I began hurting in my penis, testicles, and even rectum, so went for an ultrasound, which showed it to be only slightly enlarged. This made me even worry more that it might be malignant. A CT scan from June, 2020 showed the the left hemisphere of the prostate with tissue changes and also the left inguinal lymph node. I was also coughing and had back problems and pain in the sole of my left foot , exactly where another lymph node is, so feared it might have spread to the back, the feet, and even the lungs, and opted for a PET scan. The PET scan showed tracer uptake in my the left hemisphere of my prostate, the left inguinal node, and right axial lymph node. Could there be trace uptake in the prostate or anywhere else even though the lesion is benign? The doctor recommended an FNAC, which wasn't available over here, and I opted against the extraction of the lymph node for the biopsy. The doctors tell me not to worry because my PSA is coming in very low, but I might have managed that because I went on a strict vegan diet and a cocktail of vitamins. I'm in my mid-50s, have three children, and can make a sperm deposit into a sperm bank, should I crave for more children, but since this has really crippled my life because of trouble urinating and the pain, I want it taken out even if it isn't malignant, just to play it safe. My only problem is incontinence and inability to have sex. I know, I'd till be able to have sex if they spare my nerve. But what about incontinence, would I have that if the lesion removed isn't too large?

[@ThePCRI]

Hi! Please email [e-mail] and our Helpline team, may be able to help.

[@jnagarya519]

The patient is in control of his own health care except when the health "care" system negates that control. That begins with refusal to comply with state patient rights laws. Let's not pretend that health care professionals -- as the norm, not the exception -- don't exempt themselves from the rule of law. Being traumatized as result is the norm, and that includes retaliation for daring to assert one's rights as a patient in keeping with the actual law. There is no profit in health. The profit in health "care" is in illness; the more ill the greater the profits.

[@sepiaskyme]

Funny 😁

[@Dickie9028]

The last statement " need more experience at reading PET's " I think, this is where AI will strive in medicine. AI will have reviewed 50K images in 60 seconds.

[@lyfandeth]

Too many pathologists are unqualified. Too many radiologists read everything as stage 3 or 4 cancer, when they are not even cancer. And too many urologists are only in a hurry to do radical prostectomies, since those often work, and damn the serious collateral damage. Men who seek help have a hard time finding it.

[@Sanity1234]

My Urologist wants to do a biopsy acting like its no big deal. I know that is incorrect and have been trying to avoid it though I have an enlarged prostate and a PSA of 5. Hard to find alternatives.

[@donaldpiper9763]

@@Sanity1234 I know exactly what your talking about . I saw my primary physician in June PSA was 4.25 refer too urologist in July blood PSA was 5 , had a MRI two week’s ago,see the urologist again this Tuesday . I’am scared of what’s next . Listening to Dr. Keon’s advice make’s me feel a little better. I guess I’ll find out if I have to have a biopsy,I’ll have a perineal one in stead of anal less chances of infection .