![[Dattoli]](http://mywebpages.comcast.net/tdoherty/Dattoli.jpg)
The whole Tampa experience was top notch.If interested, please read on.
The whole Tampa experience was top notch.
If interested, please read on.
Below are all the very explicit details of my prostate cancer treatment by Dr. Michael Dattoli in Tampa, Florida using conformal 3-D external radiation combined with implantation of Pd-103 radioactive seeds into my prostate and of my recovery.
The photo was taken just 12 hours after the seeding.
With my combined treatment of conformal 3D external radiation (EBRT) and seeding (brachytherapy), I am fully confident that my odds of a cure are far better than if I had had a radical prostatectomy (RP). There is no question in my mind that Dattoli's masterful and scientific seeding of my prostate has eradicated all the cancer in the prostate itself. In the unique treatment protocol Dattoli designed for me, he aggressively placed radioactive seeds on the outside part of my prostate and used supplementary 3D-EBRT; both procedures serve to irradiate any cancer that might happen to be in the outlying tissues surrounding my prostate.
Since I still have a functioning prostate, I am still producing prostate specific antogen (PSA), but the value is low (0.7 on 6 Dec 2000) and expected to go down. Of greater significance is a low prostatic acid phosphatase (PAP) reading of 0.2 (0.0-0.8 scale). Dattoli, et. al. research [J. Brachytherapy Int. 13:1], found PAP is a much better predictor of brachytherapy failure than PSA.
Fortunately, I could afford to wait 6 months for a seeding date with Dr. Dattoli by temporarily taking a combination of Casodex and Lupron hormone blockade to essentially eliminate manufacturing testosterone which feeds the cancer; thus I temporarily stopped the growth of my cancer in its tracks.
I was diagnosed with prostate cancer (T1c; Gleason 3+3=6) via a 2/6/98 biopsy and my urologist recommended radical prostatectomy (RP) surgery as the best option. This is not unusual as it is the recommendation of most all urologists because they have devoted most of their career to RP and it is what they are most familiar with. In his defense, my urologist offered seeding as an alternative procedure; also, my general practitioner (GP) supported my seeding decision.
************************************************************* Chronology
I am 57, athletic, in excellent health; I live in Wilmington DE 12/97: PSA = 5.0 led to -->sextant biopsy 2/6/98 found
2/6/98 biopsy (prostate size = 37.6cc; both DRE & ultrasound are neg) results:
3/98: PAP=2.1 (ref=0-2.5);
12/2/98: PSA 0.6; PAP 0.4 (0-0.8); CEA 1.0 (Tampa)
*According to research of Dattoli, et. al. in J. Brachytherapy Int. 13:1 (Oct 1997), an elevated PAP level is a much better predictor of failure for a seed implant than is PSA level.
Summary: Diagnosis to Seeding
Editorial (I am not a medical doctor):
For reasons discussed herein, brachytherapy is rapidly replacing RP as the treatment of choice in the manner of a typical technological substitution process with the providers of the old technology (RP) reacting in an expected defensive manner. The reason the RP to brachytherapy technology substitution has been rather slow is because most GPs will refer their patients to a urologist, and urologists traditionally treat this disease with a time-honored, "gold standard" surgical procedure. But even "gold standard" technologies eventually outlive their usefulness and are replaced with improved technologies.
Dr. Patrick Walsh, arguably the world's leading RP practitioner, is a particularly obnoxious brachytherapy opponent. Walsh uses unscientific arguments on his web site to try to debunk brachytherapy research. His most flagrant obfuscation is when he supports RP by comparing post-operative PSA readings. If the cancer was originally confined to the prostate, a successful RP would result in an "undetectable" PSA reading as there is no prostate; whereas, successful brachytherapy would result in an detectable PSA reading as in most cases there is still a functioning prostate generating PSA.
While a radical prostatectomy was considered the treatment of choice only a few years ago, it should now be considered barbaric. There is no level of prostate cancer where RP is a better treatment than seeding/EBRT, especially if the cancer may have penetrated the wall of the prostate. In addition, there is some concern that if any cancer is in the outlying tissues of the prostate, the surgical procedure to remove the prostate may actually act to spread the disease. I would expect that by 2010, RP will only be used in very small niche markets, if at all. There appears to be no advantage to an RP.
Brachytherapy has a much more rapid recovery, a much lower (almost infinitesimal) risk of incontinence, a similar risk of impotence and leaves a functioning prostate. To me, the choice was obvious.
After a few, long, one-on-one telephone conversations with Dr. Michael Dattoli, I chose him to do my brachytherapy. Since his first seeding date was not until July, he put me on Casodex from Mar 19 to Jul 13 and monthly Lupron injections Mar 26 to Jun 15 to minimize (essentially eliminate) testosterone production and reduce the size of the prostate to improve seeding efficiency.
10/94: PSA = 4.0
6/24/99: PSA 1.1; PAP 0.9 (0-2.7); CEA 0.9 (Wilmington)
11/6/99: PSA 0.8; PAP 0.6 (0-2.7); CEA 1.0 (Wilmington)
12/6/00: PSA 0.7; PAP 0.2 (0-0.8) (Tampa) [CEA no longer needed]
- 3-D Color Flow Doppler Ultrasound detected no cancer
12/20/00: began daily 5mg/day Proscar to reduce my prostate size from
*************************************************************
For additional details see
Stages of My Seeding Experience:
Diagnosis and Decision,
External Radiation (Conformal 3D-EBRT) and Preparation for Seeding,
Brachytherapy (Implanting 82 Palladium-103 Seeds),
Post-Seeding EBRT,
Recovery Complications, Medicines and Heart Concerns,
My Doctors and
Overall Summary
Visit the SeedPods web site at http://www.prostatepointers.org/seedpods
to learn even more, and to ask your own questions.
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