Integrative Oncology

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Tony Crispino
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Date Joined Dec 2006
Total Posts : 8128
   Posted 11/19/2010 7:54 PM (GMT -6)   
At last night UsTOO meeting here in Las Vegas our guest speaker was Dr. Brian Lawenda. His credentials speak for themselves. Graduated from Temple valedictorian, residency at Harvard University, 13 years serving honorably in the Navy, and a brilliant speaker. I wonder what he might accomplish when he turns 42. Dr. Lawenda just discharged from the navy and has set up shop in Las Vegas where he and his wife have family. He has been here for just 4 months and he has spoken twice at our group, and we were packed last night for his presentation, for which he has been highly recognized for, on Integrative Oncology. He defines integrative oncology as a combination of several things:

Conventional Therapies (surgery, radiation, chemo...etc.)
Complimentary Therapies also called CAM (i.e. acupuncture, massage, meditation, etc)
Behavioral/Lifestyle Education (stress management, nutrition, physical activity, sleep, etc.)
Customization (uniquely designed approaches for each individualized patient.)

This does not sound too amazing, but he gave me a presentation that just absolutely hit the mark with every one of our members. The room was entirely attentive and engaged. I am providing Dr. Lawenda's website here:

www.integrativeoncology-essentials.com/

There is free publications on the site and Dr. Lawenda is not selling anything there. The site has a road map for any patient diagnosed with any cancer, a blog, and a point of view that will be of interest to all here. Dr. Lawenda is a bourd certified Radiation Oncologist. But he has also studied all aspects of oncology at Harvard.

Have a look at the site. It's a great one indeed...

Tony
Disease:
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:
RALP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 11/19/2010 7:57 PM (GMT -6)   
Probably important to note that Dr. Lawenda is not my doctor, but clearly is one of the best speakers we have had. I am very impressed by his efforts. I just met him a few months back when he came and spoke about differing radiation techniques. My oncologist, Nick Vogelzang, is one of the finest in prostate cancer and has met Dr. Lawenda recently as well. When I met with Dr. V. last week he was almost "giddy" about Dr. Lawenda coming to Vegas. I think it is very refreshing to meet great doctors and I beleive that this is one of them...

Tony

Post Edited (TC-LasVegas) : 11/19/2010 6:32:20 PM (GMT-7)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25394
   Posted 11/19/2010 8:44 PM (GMT -6)   
Tony,

I don't doubt his credentials, his experience, or his speaking ability. I read the entire guide in PDF, the guy is way too far out there for me. Too much emphasis on diet, and I counted at least 4 references to "Pot" as alternative therapies. Different strokes for different folks. That's all I am going to say about it. Was still an intersting read.

David
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 11/19/2010 9:32 PM (GMT -6)   
"Too much emphasis on diet"

I don't see that at all. I believe that diet is a very important part of fighting cancer and I don't think it is emphasized enough. Lawenda's discussion on it it inline with Mark Moyad, Snuffy Myers, and many others that I have seen.

I probably should have mentioned about the cannibinoids discussion but it is not an allowed topic here. I will state that what he said about it in the presentation is that he does not prescribe it and he is against smoking anything. He studied it at Harvard.

Tony

Post Edited (TC-LasVegas) : 11/19/2010 9:06:25 PM (GMT-7)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25394
   Posted 11/19/2010 9:39 PM (GMT -6)   
I got really freaked out doing some consulting work last year for a Licenced Hypnotist, guy was nutty as a fruit cake. Was convinced that cancer was in a person mind, and could be eliminated througy hypnotherapy. He was wanting to "experiment" on me for free, having cancer, but I never gave him the chance. I just did his taxes, lol.

You heard the speech, and the explanation on the "pot" topic first hand. Just reading the guide, I took it at face value and assumed the guy endorsed it. Perhaps he should put a disclaimer on that in the guide. Bothered me, obviously wouldn't bother others.

I would be interested in hearing his conventional views on prostate treatment, since he is also a radiation oncologist. Did he state a position on surgery as a primary treatment, AS, etc.

David
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 11/19/2010 10:07 PM (GMT -6)   
David he did,
And it was not what you might expect. He said that the pendulum has been swinging wildly in the last few years about how to treat prostate cancer and that more and more urologic AND radiation oncologist need to exercise restraint. He fully acknowledges the long term morbidities with radiation and feels that the radiation community is sugar coating them.

In another discussion that he and I had personally, he is seeing urologists now purchasing radiation equipment and contracting RO's to come into their shop to practice. In fact we are seeing it here in Las Vegas.

Dr. Lawenda's presentation on radiation was truly the best I have yet seen. He interned at Harvard's proton center, has worked with Cyberknife, and currently practices with image guided IMRT using Calypso beacons. He has quite a bit of insight on the subject...

Tony
Disease:
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:
RALP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25394
   Posted 11/19/2010 10:19 PM (GMT -6)   
I too, personally believe the radiation community/industry sugar coats their stats long term and side effects. Not sure anyone else here at HW Prostate Cancer has underwent major radiaton twice in their lives as I have, but both times, it was horrific. While I am disapointed that my open Surgery didn't get it all as hoped, and I was obligated to undergo SRT, I do not believe for one minute, that Radiation, either in conventional delivery or seeds would have worked at all for my numbers and situation. Some downplay, IMO, what do you do for a secondary treatment for a failed radiation approach as one's primary treatment, but I feel its an important thing to consider. What do you do if your primary treatment fails? I have seen the answer to that from the radiation side glossed over one too many times.

I know those on the other side will totally disagree, and that's ok too.

David
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 11/19/2010 10:53 PM (GMT -6)   
LOL,
Well Dr. Lawenda also said radiation is a very effective tool against prostate cancer. I believe what he said was that there is a "specific" patient criteria for radiation as a front end treatment and that salvage radiation therapy is the most effective second shot at a durable remission after post-prostatectomy rise in PSA.

I would prefer to hope anyone here, regardless of how they are treated, gets well and does great with everything. I certainly wouldn't criticize anyone anymore on what they chose because the decisions here are very personal and I am learning more and more about that aspect. If I have offended anyone in the past I would certainly apologize. It's easy to be overzealous about our own decisions.

The integrative oncology approach is a great approach because it will improve your overall health beyond the cancer. Centers that do it are Mayo Clinic, MSK, Harvard, Stanford, etc. etc. My oncologist is on board with it too. I think all of the very good PCa doctors actually are.

Tony

Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
   Posted 11/20/2010 3:58 PM (GMT -6)   
TC-LasVegas said...
At last night UsTOO meeting here in Las Vegas our guest speaker was Dr. Brian Lawenda....
 
Tony, I reviewed his web site, and I am very impressed.  Your area is fortunate to have someone offering this type of care...

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2692
   Posted 11/20/2010 4:05 PM (GMT -6)   
His website will take me weeks to digest, but I agree with Casey. The standard URO is too narrowly focused. Anything outside of surgery, and maybe a little radiation discussion is beyond his scope of knowledge (generally speaking)

I do like the broad approach.

Thanks again Tony.
Goodlife
 
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01
15 month PSA <.01

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 11/20/2010 4:39 PM (GMT -6)   
Casey,
You are so very right. Las Vegas has typically straddled the very bottom in healthcare for many years. With Nick Vogelzang coming out in 2005 and now Dr. Lawenda, we have some serious improvement in that discussion. These are a couple terrific oncologists.

Goodlife,
Dr. Lawenda started his presentation with a slide that looks like this:

The IO Encounter: Planning
#1 priority is to help my patients increase their sense of control, QoL, and hope.
- Educate on the following
1> How to improve the body's innate ability to fight/prevent cancer
2> How to Address and manage symptoms/side-effects
3> Prevent the development/exacerbation of comorbidities

The tools to be used are:
->Nutrition/diet
->Use of appropriate supplements
->Use of conventional and CAM approaches
->Increased physical activity
->Stress reduction techniques
->Connect with family and friends
->Engage your spirituality

He defines spirituality as related to but distinct from religiosity. The intent is to focus on purpose, meaning and connectedness with ones self, others, and a higher power.

Even now I am looking at the slide show again and it is a good one...

Tony

don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 11/20/2010 7:42 PM (GMT -6)   
Hi Tony,

There is a lot to digest here. I appreciate your posting this and have added to my file on PCa for futher reading.

Don
Diagnosed 04/10/08 Age 58
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
IGRT/IMRT with adjuvant HT (lupron) 2yrs
PSA:
02/08 21.5
07/08 0.82
10/08 .642
09/09 0.32
03/10 0.32
06/10 0.32
07/10 0.10

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4269
   Posted 11/20/2010 8:06 PM (GMT -6)   
I'm in total agreement with an integrated approach to fighting PC. It just makes sense to also involve diet, stress reduction and excercise along with conventional treatments to get the best results. It's a shame that more doctors don't adopt this approach.
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.

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 11/20/2010 8:43 PM (GMT -6)   
John I agree.
This should be the standard of care. A lot of centers have the tools but are not good communicators. This website will take some time to get through but this is the best oncological website I have yet seen to date. At every level of it is supporting links from very reputable sources. I have had the talks about this stuff with Vogelzang, but Brian has put together a wonderful portal here.

My predecessor, Lew Musgrove, from our UsTOO Chapter told me that Lawenda's presentations are the best he had seen in his 17 years. Considering that our chapter has had Mark Kawachi, Stephen Strum, Duke Bahn, Mark Moyad, Mike Scott, Bob Leibowitz, Nick Vogelzang ~ among many others as guest speakers that says a lot. Forget that Lew is the former CEO of UsTOO International and has participated in virtually every major prostate cancer function. He has seen a few presentations about prostate cancer.

Tony
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