MRI-S by Dr. Wheeler in Sarasota, FL instead of standard biopsy?

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Arnie
Regular Member


Date Joined Aug 2009
Total Posts : 370
   Posted 3/18/2011 1:55 PM (GMT -7)   
Hey all........I have a newly diagnosed associate of my wife's who is asking me a lot of questions regarding his prostate cancer (surprise, surprise, eh?). Well actually the guys' wife is asking-anyway, I told her in detail what a biopsy would entail. She wrote me back and mentioned the MRI-S procedure by this DR. Wheeler at the Diagnositc Center for Disease in Sarasota, FL---------I have my doubts, but was wondering if anybody knows anything about the MD and/or the procedure. When she called them, they advertised it as the only one in the world. So, naturally, I came here :-) -------my guess is her husband is terrified of the description he received about a biopsy (not my description, I downplayed mine as no big deal)--------but once somebody told her there was a risk of spreading the cancer via biopsy, off she went in search of an alternative.  http://www.mrisusa.com/
 
Appreciate any info or insights-Arnie in DE

Post Edited (Arnie) : 3/18/2011 2:34:44 PM (GMT-6)


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 3760
   Posted 3/18/2011 3:30 PM (GMT -7)   
Arnie,
Dr Wheeler is well known in the area of PC and has more knowledge than your average urologist (he is a urologist). He has some thoughts on supplements and delayed treatment that are out of the mainstream and has developed and pushes his supplement, PEANUTS. I've read a number of his articles and he seems to be well above average in diagonostics.
MRIS is a fairly standard scan that a lot of instutitions use; UCSF pioneered this and many patients travel to San Francisco to have it done.
UCLA and other institutions also have it. When getting an MRIS be sure it is with a Telsa 3 and not a standard Telsa 1.5 MRI as the difference is night and day.
A T3 MRIS can identify small tumors and precisely identify their size and location and if they have penetrated the margin or involve the seminal vessicles. this is very important in determinining which treatment will work best. It is not very good a identifying anterior or transitional zone tumors. It is usually used in staging someone who has already been Dxed with PC or on patients that have had multiple negative biopsies with a rising psa. It cannot by itself identify cancer, only confirm what a biopsy has already shown or identify suspicious areas to biopsy. The disadvantage is that you cannot do a targeted biopsy at the time of the scan as you can with a color doppler.
If the MRIS identifies a suspicious area then he will have to be biopsied, no way of getting around this. If it comes up clear it does not mean that he doesn't have PC, only that it is probably small enough not to be seen or cause any harm.
I would have no problem going to Dr Wheeler for diagonostics and recommendations as long as a 2nd opinion from another well known doctor was given prior to any treament decision.
The MRIS itself is a very good scan, but having had one and also a color doppler I much perfer the color doppler; I think it identifies more, is less expensive and a biopsy can be directed precisely to the suspicious spot in real time. Dattoil in Sarasota has a color doppler and would be a good place to visit for a 2nd opinion.
Hope this helps
JohnT
65 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, no side affects and psa .1 at 1.5 years.

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 7715
   Posted 3/18/2011 3:47 PM (GMT -7)   
Ron Wheeler told me something that will always ring in my head ~ He is the best **** urologist there is. Said it to me and my wife while we were working the InfoLink booth at the AUA conference in San Francisco with Mike Scott and David Bostwick.

I was always wondering who was the best and now I know. If you buddy is planning to use him, it's 25 grand and a trip to Bermuda. The procedure ~ HIFU...

btw, The MRIS devise is the Tesla 3.

Tony
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

Post Edited (TC-LasVegas) : 3/18/2011 4:14:48 PM (GMT-6)


cooper360
Regular Member


Date Joined Jul 2010
Total Posts : 161
   Posted 3/18/2011 4:18 PM (GMT -7)   
It can be lonely when you think out of the box!!! It seems no one understands you and thinks you should just do the status quo.....Don't bring up anything that goes against the grain. When you post on here with an idea just a little off center,some of the guys try and scare you tell you not to trust Dr's that are pioneers in their field, even some of the wives act like your trying to kill your husband by doing something other than the norm........ [JohnT, Zufus and a small handful of others are exempt]....small rant sorry people LOL!!!!!Cooper

Arnie
Regular Member


Date Joined Aug 2009
Total Posts : 370
   Posted 3/18/2011 9:48 PM (GMT -7)   
John, Tony, Cooper..thanks for the replies. I think this woman is doing all the due diligence and came across Wheeler's website. I couldn't tell her yea nor nay, because i didn't know. They live here in Delaware, so it'll be a trip if they want to pull the trigger on this. I will pass on the the info from you guys and let her (and him) plug it into their decision making.
 
Thanks again, Arnie

Postop
Regular Member


Date Joined Feb 2010
Total Posts : 379
   Posted 3/19/2011 10:33 AM (GMT -7)   
Just to stir the pot, slightly, on this thread. The internet is not the best source of information on a medical condition, be it websites promoting someone's practice, or opinions posted in threads here.

The best thing about this website is that it is self policing. Post an opinion, and a contrary opinion will be up in a few hours. This is a good thing. No one is trying to scare anyone else--we are just trying to keep each other honest.

MRI is an imaging method, to take a picture of the anatomy of part of the body. It hasn't been used too much because prostate cancer doesn't look very different from normal prostate tissue on the image. The stronger the magnet strength, the higher is the resolution of the image. 3 tesla MRI machines are a little bit better than 1.5 resolution scans. The limitation of any imaging, MRI or doppler, is that it doesn't tell you for sure what you are seeing--the only way to be certain that it is cancer, and how bad it is (Gleason score) is to get a piece of tissue and look at it under the microscope. The images don't substitute for that. Even for body parts where MRI is really useful (like the brain), a biopsy is usually required before starting treatment.

Tony's comments are on the money. There are a lot of people who want to make money by doing things to your urinary system. Buyer beware. No one has the secret answer to prostate cancer, no one person is the best. The best treatment is not the one that is most special with the best advertising or most chatter on the internet, it is the one with the best evidence backing it. Secret supplements, magic scans, special treatments only available outside the country, may not be backed by good evidence. It's totally understandable and OK that individuals are fans of these treatments, but responding to their posts by asking them to provide the evidence behind their opinions is appropriate and is not spreading fear. It's just saying "Show me" or "Prove it." To echo a post I did a few weeks ago, the scientific method can be summarized as "Show me!"

fulltlt
Regular Member


Date Joined Nov 2010
Total Posts : 190
   Posted 3/19/2011 11:10 AM (GMT -7)   
I actually talked to Dr. Wheeler over the phone shortly after my dx. He said he was going to give me a prescription for Casodex without ever having seen me in person. I gave him the name of my pharmacy and their phone number. He was supposedly going to call it in. I researched into it a little more and found out that he was wanting to do HIFU in Bermuda or the Bahamas or something like that. The prescription never showed up at my pharmacy. I gave up on the HIFU idea after realizing that insurance would most likely not cover it. I didn't want to dump $25,000 cash down for something as unknown as that. My experience.
age 57 2/2010
PSA Feb 8.2
biopsy 2/2010 - 2 of 8 left & 2 of 8 right positive, Gleason 3+4=7
attended support group - advised to get a second opinion
second opinion on pathology from Johns Hopkins 4+4=8
PSA 15 4/2010
5 weeks IMRT 4/2010-6/2010 at Copley Hospital in Aurora, IL
91 palladium 103 seeds 7/2010 at Chicago Prostate Center, Westmont, IL
PSA Oct 3.97, Dec 2.78, 3/9/11 2.42

cooper360
Regular Member


Date Joined Jul 2010
Total Posts : 161
   Posted 3/19/2011 1:43 PM (GMT -7)   
Postop said........"No one is trying to scare anyone else--we are just trying to keep each other honest."

That was not my experience when I first posted!!!!! Husband had a CDU by  the pioneer of CDU, a well respected Dr that has been dealing with Pca himself for many years and when I posted he didn't biopsy my husband because he didn't see anything ,only one person [JohnT] said trust what this Dr said and because of many hours of research on my part  we did. The rest of the Docs [LOL] on here freaked.............  shocked  
 
Consider the pot stirred................Cooper wink

Postop
Regular Member


Date Joined Feb 2010
Total Posts : 379
   Posted 3/19/2011 2:33 PM (GMT -7)   
So, what's wrong with having to do extensive research before you make a treatment decision?  What's wrong with having a variety of opinions, including ones that you may ultimately decide to reject, when you ask a question here? 

Arnie
Regular Member


Date Joined Aug 2009
Total Posts : 370
   Posted 3/19/2011 2:56 PM (GMT -7)   

Let me loop around to the beginning again------was originally looking for any info on this procedure as a viable option-or not. I had my friend's situation wrong here: he is not newly diagnosed as I had posted. he had blood in his rine, went for an exam, and his PSA came back at 14. Was given a 10-day course of antibiotics and it lowered it to 13. This guy's wife was asking about free PSA, etc., which I tried to answer for her. But she found Wheeler's site and asked me about it as an alternative to a biopsy, because somebody told them about the alleged risk of cancer spread, however small the odds. So, since they live in Delaware, I was trying to find out if it was worth a trip, but I didn't have enough info to give them. John's comprehensive post gave me enough to take back to her.

Arnie in DE

 


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 3760
   Posted 3/19/2011 4:07 PM (GMT -7)   
Arnie,
Please tell your friend that with a psa of 14 and no reaction to a course of antibiotics a biopsy is warrented. I also think that there are closer places to get an MRIS, if needed, like Hopkins.
JT
65 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, no side affects and psa .1 at 1.5 years.

Arnie
Regular Member


Date Joined Aug 2009
Total Posts : 370
   Posted 3/19/2011 4:18 PM (GMT -7)   

Hey John........that was my initial email back to her after she forwarded the situation; that with the PSA not going down in response to the course of AB, that a biopsy was warranted. She had stated that Wheeler's was "the only one in the world", an absolute which threw up a red flag initially. That's why I threw it out to the forum here. I since can see from your answer and others that the MRI-S with Tesla 3 is in fact available at more places around the country. Thanks again for your input. I cut and pasted your entire first post and sent it to her in an email so that she could digest it..........I'll see what she says and report back.

Arnie in DE

 

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