Does Mayo's have first class prostate onocoligists, I just seem to hear about Dr Kwon in urology.
Mayo's Drs : Does Mayo's have first... - Advanced Prostate...
Mayo's Drs
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Joecarver
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Not in my opinion. Kwon made himself famous among patients through PCRI and youtube videos, but he's not a prostate oncologist, mainly a researcher. If you're in Minnesota, U of Minnesota has Charles Ryan who is also the new CEO of the Prostate Cancer Foundation. Emmanuel Antonarakis joined their faculty last year.
I meant are their others dealing with prostate cancer patients.
I'm sure there are. Mayo had a great MO who left a few years ago. No one yet at that level. Are you constrained to Mayo?
No wouldn't be, but. Having been there 10yrs ago, can't imagine the prostate cancer wouldn't be first class, however all I hear about is the urologist Dr Kwon
That's because he promotes to patients. Among top MOs, few would know his name other than as a researcher.
OK are their top prostate MOS at Mayo's .
I said, not in my opinion
Kohli?
Manesh Kohli?
I believe he is at Huntsman now.
Yes, I saw him once at Moffitt in Oct 2019. He was their newly arrived PCa expert. However, in a few months he was gone. I had already decided not to use Moffitt. What's your opinion of him, if you have one?
Excellent!
Unfortunately I find myself on the cusp of metastatic prostate cancer after a RP and salvage radiation. I know this a subjective question but would you tell us what you believe to be the best hospitals in the country with prostate oncologists.
Any of the NCCN or NCI-accredited hospitals. There are top doctors all over the US. Where are you located?
I live in the southern U.S. but am very fortunate to be able go anywhere in the country to find the best doctors. Thank you so much for responding so quickly to me.
In New Orleans, there's Oliver Sartor at Tulane. In Texas, Eleni Efstathiou is at Houston Methodist, or any of several at MD Anderson. In North Carolina, there's Andrew Armstrong or Daniel George at Duke... many more. All of the top doctors know one another and keep up with what the others are working on, so any one of them would be fine.
Very gracious. Many thanks.
NYC Dr. Michael Morris MSKcc........ great doctor......
Good Luck. Good Health and Good Humor.
j-o-h-n Sunday 01/30/2022 3:39 PM EST
Tall any top Oncologist in Florida in your opinion?
Only Zhang at Moffitt comes to mind, but I'm sure there are some good ones at Sylvester in Miami too.
Hello, I have heard Dr. Eugene Kwon talk several times at PCRI conferences in Los Angeles. I have also listened to him on several occasions on this forum. IMHO he is one of the best. Very knowledgeable and his explanations and visuals are top rate.
Didn't mean to deride the qualifications of Dr Kwon was, curious about the onocoligists in the prostate cancer treatment program
It's closer to me than MD Anderson,
See my post later in this response as well but I have been to many hospitals all over the US from coast to coast north to south and in between. I mantain care at three hospitals in different parts of the country, as I reside in different states.
I have Dr visits and receive test, shots, and other care at two which are local to my homes but travel to MAYO MN for meeting scans and care from Kwon who directs my care. The others hospitals are happy working with that relationship.
This has been especially helpful during Covid.
I also really like the whole environment at Mayo/ Rochester/Minnesota. I live in Southeast as well.
Us too. We started 250 miles away, now 1500. Locals pretty much work with him. Except a urologist from Duke decided bill only needed PSA yearly. Kwon says 3-4 mo…. Found different doc..
My two cents. I think you are in Illinois ?Chicago Land is a gold mine in terms of good MO's and maybe not the long drive you would have to Mayo.
Again my two cents and personal feelings along with knowledge of patients who went to Mayo is that in our lifetime Mayo became a "NAME" we began to associate with the best in care. I don't know if that is really true. Especially the last couple decades.
At Mayo, some are world class; some aren't. Besides, Most prostate therapy at Mayo is "team" driven, multi-discipline. Doctor wise, You could do a whole lot worse than the Mayo cancer center. It is one of the best.
Specifically, Kwan is really a research nuke med doc so I assume this is your focus at this time. Ryan is also a research doc specializing in PC, but from an internal med and onco by training perspective.
Both are very, very research/academically/publication "current". Emmanuel Antonarakis (also mentioned) is another heavyweight out of Hopkins.(now at Minn) focused on "translational" approaches to PC. Interesting doc...Hematology, Oncology, and Transplantation.
These 3 docs "run" departments or centers. They are not true clinicians. How much time they spend directly with patients is something you need to find out.
Good luck.
I have spent extensive time with Kwon and find him to be an outstanding Urologist who specializes in Radiotherapy. I have also worked with Karnes and Park. Karnes is a Urologist/ Surgeon. Park is an RO. The Mayo works as a team. Title doesn't matter if you have experience. Kwon is known throughout the world to urologists and oncologist alike. I'll admit he is a self promoter but imho people don't come to see him from around the world because he's on you tube. (no disrespect intended Tall Allen). I cannot speak to Charles Ryan, but heard good things, however specifically, I have my own experience inside the U of Minnesota and cannot in good conscience, recommend being treated at their facility. A consult yes. Treatment - no way.
Do you think the big name prostate consultants at u of m benefit the M Health and Fairview system at large?
A great question but one I'm not qualified to answer. I guess when I hear/ read about leading cancer centers, the U of M doesn't come up. I know the Mayo does, UCLA, Cleveland Clinic etc. But really take these comments with a grain of salt. I'm no expert in facilities, just my own experience. I'm not trying to be mysterious. I just know what I experienced and will never go back. I won't call out any specific Physicians. Just not in my nature. I can say Charles Ryan was not involved in my care. There are buffoons and incompetents in every profession. I can recommend Kwon
We did not have a great experience with my Dad's prostate cancer treatment at the Mayo in Arizona. A few errors were made. Diagnosis was extremely late. (He'd been a patient there for 30 years and was also a physician.)
My feeling was that they were great with surgery when he broke his femur in a fall. He was a very tricky surgery candidate with atrial fib and heart failure. But we had some problems otherwise.
Rather astonishingly, when we were forced to go to a closer hospital (he had aspiration pneumonia that was tanking him quickly and thus required an ambulance ride), we got better care and better palliative treatment for his cancer. He was on hospice at that point. An alert discharge nurse at the Banner Desert Hospital asked whether he'd had palliative radiation treatment and we said no. Mayo hadn't offered it. He had cancer in abdominal lymph nodes and in his sacrum and iliac crest.
It took some doing but we got him in for the radiation treatment while managing to keep him in at-home hospice care. The radiation oncologist, Dr. Yerko Berghero, had trained at MD Anderson and was just top-notch. The treatment was more than a palliative, we feel. We're pretty sure it bought my Dad around 6 more months, which he wanted.
Sorry but I just had to: NancyWorld: I joined this group when my Dad was suffering with APCa. He passed away in August 2018, but I still feel a kinship with people here.
It is never too late to honor our fallen heroes. I am very sorry that your dear Dad passed from this world to a wonderful one in August 2018. He like many others here were fortunate to have a daughter who loved and still loves and cherishes him. You undoubtedly cared for him during his last days fighting the beast. He will always be with you in mind and in spirit and will live forever as your loving guardian. God Bless you.
j-o-h-n Sunday 01/30/2022 3:56 PM EST
You can look up specialties by filtering for medical oncologist and prostate cancer. And location. mayoclinic.org/appointments...
When we lived in Minnesota we used Mayo for second opinions. We were always disappointed in the way they herded patients around and the cattle calls even for labwork.
Dr. Kwon was/is a rockstar and a gifted, enthusiastic speaker whom we liked. We didn't get very far with him as he wanted his scan done and at first my insurance said no. We went elsewhere for a better scan.
Our encounters with two urologists at Mayo were sad which I have written about here previously. Our most recent visit there with an arrogant orthopedic surgeon was a total disappointment and waste of our time.
The surroundings at Mayo are impressive. They make you feel like you are in good hands which is comforting until you leave.
We have been seeing Dr. Kwon at Mayo in Rochester for the past year and 1/2. We are very pleased with our care.! He works closely with Dr. Vladimir Hugec, an MO at Minneapolis Onchology Center. At diagnosis, my husband was given 6 months to live. Dr. Kwon was our second opinion. Now, after some aggressive treatment, his last two scans show NED and his PSA is undetectable.
Hi What was the diagnosis if you do not mind my asking? What treatment was followed? My husband has not quite managed to get to NED but I do not believe that his treatment was aggressive enough at the beginning.
My hubby was diagnosed in Nov. 2020 with Metastatic Stage IV prostate cancer Gleason 9. It was discovered because he broke his back moving our dock. Turns out there was a metastatic tumor on his spine. When then saw Dr. Kwon for the second opinion. He started with Cyberknife radiation to remove the tumor on his spine, Firmagon for ADT, 6 rounds of chemo, 5 treatments of proton radiation to the prostate. Right now just continuing the ADT, getting a PET scan and labs every three months.
So glad Dr. Hujec is still on the team. He directed Bills chemo in 2015. Been non detectable, NED 5.5 years, no cancer meds 4 years. Hang in there
I must ask...what do you mean by 1st class? and how do others here define what is 1st class? Studies showing better results under such Docs? Where would we find those stats? Must 50% of practice be with PCa patients? 25%??
Just asking.
No takers on my question!!
In the insurance world, doctors are literally ranked by how well they follow recommended clinical outcomes based on physician best practices that result in successful treatments/ cures. These outcomes are based on billions of medical claims.
The best practices are determined by system built algorithms created by and approved by physicians and are universally accepted in the practice.
There are outside organizations as well who audit, such as NCQS certification under HEDIS which help ensure quality of care.
Of coarse therein lies the problem. People are often referred to "Better" or "1st class"physicians when their treatment is failing so those physicians are sometimes ranked unfairly because they see the more complex cases and often times too late.
Insurance algorithms account for this though.
Personally, 1st class to me is how long and how well I live with this terminal illness.
I understand your perspetive, but I don't think it would help me find a "1st class" Doc.....it sounds like a retrospective analysis.
It's not my perspective. It is the industry standard and of course it's retrospective. You cannot know the quality of a physician without knowing what his past outcomes are.
Not easy to know past outcomes. and what would the standard be? 100% "cures"?
No you would never see something like that. There are of course multiple variables that go into the algorithms.
So let's say someone with PCA is also obese and being treated for a heart condition and diabetes. He has a heart attack and dies. Clearly the MO is not going to be held accountable for that. These are risks that are built in. Also age is recognized as a limiting factor. These processes that are in place now replaced the age old actuarial process. I worked with actuaries when I was in life insurance and was amazed at their precision.
As to 100% cure rate, you and I both know that isn't possible beyond the doctors 1st day at work. The overall national mortality rate of all causes eliminates the possibility.
As a prospective patient, you would likely see one of two things. When searching for providers in your network, you might see a star rating. It's more rare now than it used to be because it's so fricken offensive to a doctor.
More commonly, the providers with the most successful outcomes will be listed first. And surprisingly, it's not about the money. The ones who order the fewest tests do not go to the front of the line. The ones who order unnecessary ones don't either.
Word of mouth is also a great way to determine if you are seeing the right surgeon, MO, etc. Ask the nurses. They know who provides the best care. They won't bad mouth the doctor you're seeing but if you ask them where to go for a second opinion, they will share their thoughts.
What should all be concerned about blanket statements on the quality of care given at any facility or by any particular physician. Those that have personal and direct experience with one or the other or both are qualified to share their experience. It's up to you (me too) to weigh the validity of the response.
I have experienced first class treatment only at Dr Luke’s clinic in Omaha. Amazing and blew everyone else away.
1. It's not clear to me that being a researcher makes one a better or worse Doc.
Though, being a researcher means his mind is always thinking beyond standard of care. Something maybe you don't get from a doc whose attention is owned by insurance company treatment guidelines, which make it unpleasant to even push near the boundaries of SOC.
2. He is clearly a superior communicator. Good communication always improves results. If anyone wants to dispute this, I will discuss it separately.
Kwon is one of the best communicators in this field.
3. In his YouTubes he is always warning that Docs are pressed for time and can't always give your case the attention it needs.
Obviously he is speaking from personal experience.
4. He is one of the few docs at a medical center of excellence who is able is willing and able to practice medicine outside the box.
If your treatment is not going well, or SOC just isn't doing it for you. That is so so so important.
5. Trust no one, not even Mayo. That is the only way you can get results.
He doesn't think much of BAT, does he?
I am unaware of his opinion.
But I don't think an institution like Mayo would permit him to even think about it until there was much more research on it.
If you want BAT, I think you need to find it at small specialty clinics.
Bipolar Androgen Therapy!! I've discussed this with Kwon and he's not a fan. Apparently the research is not super robust.
Exactly. He needs to be a bit conservative at such an institution.
But no harm to try it for a cycle or two. See if it works on you.
It's low risk, high reward if you try it that way.
For some people it's very effective. For some not. They are still learning who it works for and who not.
I did as well and he went a bit further to say the studies he has seen are lacking proper controls. Too many drop outs if I recall correctly and I may not be. Also discussed with Hugec who is a MO in the twin cities and he said more or less the same thing. But of course there are people here on the forum who can speak to its efficacy. I can't.
I don't think it is a matter of trust....trust in what way?
A “team approach” can be a leveling mechanism to the lowest common denominator which is called SOC. Nothing wrong with that at all, for very many. However, for those like me and some others here, we are looking for adjuncts to possibly enhance results and minimize adverse effects where there is some knowledge but not complete knowledge. Where risks and benefits must be carefully considered. This requires an educated patient and a very knowledgeable MO (and often an RO etc.) to navigate and properly monitor the journey. Just as cesces is describing. It is NOT practicing by guidelines alone or by committee, but considers all available evidence (and the quality of that evidence as TA so often points out). There is much unknown that we will discover in RCTs of the future. In the meantime there is this one life to live fully. Great good fortune to you.
I started at University of Minnesota cancer center with a study, chemo, hormone therapy. Cancer returned and they wanted to nuke my abdomen. I found Euge Kwon and he told me he was going to throw a nuclear bomb on a dandelion. Did C-11 scan, lesions all over my body, radiation would have done no good. Together with V Hugec at MN oncology they brought me back from certain death. Euge is not a standard of care guy. He says standard of care gets you hospice. 10 years later, after Gleason 9, I have undetectable PSA. Ya the meds suck but I get to see my grandkids. Besides being a great doc Euge is one of the smartest people I have ever met. Also a fabulous person, great sense of humor, great listener, really caring guy. IMHO you can do no better than Euge.
Totally agree
Bashing the oncology department at Mayo has no place in this forum. Expressing a personal vendetta against a medical officer at Mayo makes one question another's sincerity while posting in this group.
I MADE APPOINTMENT AT SLOAN NY DR MORRIS AS PER TALL ALLEN RECOMMENDATION... DR KWON SEEMS VERY KNOWLEDGEABLE VERY AGGRESSIVE IN HIS APROACH..
I'll chime in here even though echoing the facts brought in by others. Dr. Kwon is the main guy at Mayo for metastatic PC and recurrence. He is a scientist/ researcher, yes, but as a clinician he sees a lot of patients and works with a team of wonderful NP and PA who, among other jobs, carry a lot of the admin burden. As a urologist, not oncologist himself, he's believer in medical Oncology sending patients to a few MO, especially Hugec of MN Oncology in St. Paul, and Park in Rochester for Rad Onc. I disagree about self promotion, although he does have a missionary zeal about imaging and projects the message effectively through PCRI. There's some worked up controversy on this site about types of scans. Mayo in MN now has therapeutic PSMA scanning which I'll experience this coming week. My experience with Kwon over the last four years (both with me as patient, and my dad who's appointments I sit in on) tells me he cares a lot about his patients, going the extra miles. Kind of funny, his first appointments are at 0645 each clinic day well before the staff's start time, so he comes out the "A"door to get the first patients of the day.
I so agree… love those early appointments too… helpscuscgetvon our 1500 mile drive home, earlier..
I go to Mayo Phoenix and I am very happy with their care of my advanced prostate cancer. I see Dr. Singh (MO) and Dr. Humphries (urology oncologist) and very much know what they are doing.
Seems like not many here know there is more than one Mayo Clinic. I, too, go to the one in PHX. I like the team approach, but you always have to be the team leader.
I started at MD Anderson, they had decided I was a lost case, ADT for life they said, 5 to 10 years life expectancy. Said no sense looking for where it was in my body because it was in my bones and everywhere. However a MO there told me to go to MAYO if PC was in my Lymph nodes. Said I'd live 2 to 3 years longer if went to MAYO. I went to MAYO Kwon, we found PC in pelvic lymph nodes only. I had whole pelvic plus two years ADT. Currently off ADT for 6 months PSA at 0.029 currently 5 years from diagnosis. Monitoring PSA at this point and only on ADT for 2 years 4 months over past five years?
All I can say, is my husband would not be alive today if it wasn’t for Kwon. Stage 4. Found in lymph at surgery. C choline pet scan, when his PSA didn’t go below 3 after surg showed seeding in the lymph in chest. 2 years aggressive protocol, similiar to PEACE1 study and he has been non detectable, no evidence of disease 5 years, no cancer meds 4 years. Yearly pet scan of which I’m thinking a PSMA ( has been c11 choline since 2015), We aren’t concerned about the title behind his name. Something tells me he knows a little bit about prostate onocology.
I’ve been with Dr. Kwon for 7 yrs. And have nothing but respect for the man and his approaches to and individual not SOC. He relies on a team approach, which I think is great. He’s very up to date on new trials and therapies coming down the line. He has a ways made me feel comfortable with my treatment plan, and brings in other specialist when needed. He seems to recognize and know his strengths and weaknesses.
Depending on what you are looking for in and Oncologist.
It is hard to believe anyone that has had Dr. Kwon for a physician would think any of these negative comments could be true. He gives a lot of himself to his patients, questions unnecessary treatments and motives, and doesn't give up. Extremely grateful to him, after a 1st diagnosis of <1 year and a second one of radiation that might be <30% effective, now undetectable and going to scans every 3 months. Have had numerous types of scans and grateful to the one that found in the lungs and got chemo instead of radiation. It is hard to get in to see him, he is most certainly overworked. Hard to see people be critical of him as have seen nothing but kindness and going the extra mile... most certainly not a narcissistic man, quite humble and always looking at what might be possible.
Well said! I couldn't agree more.
He said this in a speech many years ago: " I want to make it very clear that the objective is not to create a livelihood, the objective is not to sell drugs or to do procedures, the objective is singularly to fix prostate cancer for the individual that walks into the room."
We have not seen Dr. Kwon yet, but have an appointment with him in a few months. My loved one has failed multiple treatments, and I emailed Dr. Kwon. I heard back from him right away, and I am impressed with his response and caring attitude. I will update after we see him. Hopefully Mayo is as good as their reputation.
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