The Coach Dr. Barken the PCa Ref.~advice found on P2P~webcasts~etc.

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zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 1/29/2011 4:04 PM (GMT -6)   
I contacted Dr. Barken way back in 2002 as one of my web advisors and info guys. Not part of my 8 opinions I got, those were face to face with various doctors of many types. Anyway Dr. Barken has been consistent in his advice to PCa over all the years and his wisdom seems to match up with and is pretty consistent with peers like Dr. Strum, Scholz, Lam et al others. He has various ways to get in touch with him, retired, but works as the PC-Ref for coaching and some advising on P2P.  www.pcref.org  I think is his website still.
 
His mantra behind the doctors oath,  is refreshing in statements like less intervention and more on surveilence and assessments. I will quote some of the items at P2P for people herein so you get an idea of his philosophies in treating a patient. Now this was a reply to a specific patient whom is post primary treatments, so not to be taken out of context and not to be held at only face value, without a seeing the full context, so don't shoot down the underlying statements. This patient was treated with radiations 10 years ago and dealing with BCR (low psa values) and what to do and this is some of the reply:
 
My overall approach would be as follows:  “Minimum Intervention and Maximum
Surveillance.”

Since all treatments end up being about the same in regards to their
efficacy, I would recommend you use the less aggressive treatment in order
to minimize side effects and preserve quality of life.  Maximum surveillance
means maximum testing in order to validate that you do not have more
aggressive disease than was anticipated.  The tests will provide bench marks
for further follow up.

The standard approach is to leave the patient alone when you have such a
slow rise of PSA.  Nobody knows what the cut off level of PSA is that should
trigger treatment.  Regardless of that unknown number, if you are concerned
about a certain level, think first and double check what else is going on
before you jump to a treatment.  You cannot rely only on the PSA level to
determine that treatment is mandatory.   I believe that the PSA should
really be an immediate trigger to further testing, not treatment.

So what needs to be done now is to define the current status of the disease
by trying to find out how aggressive the prostate cancer is right now and
where the location of the cancer is right now.

The list of tests to be considered when you sit down with your treating
physician is:

1.        The aggressiveness of the disease:
a.       Tumor markers in the blood
b.      Tumor markers from biopsy materials if available.
c.       Considering past information about the aggressiveness of the
disease if available.

d.      Please see the Coaching Check list from PCREF (write to
info@pcref.org for a copy or go to www.pcref.org)
e.      Consider PCA3
2.       Imaging tests:
 a.      Color Doppler Ultrasound and possible more advanced techniques
using Contrast Material  or Elastography.
b.      S MRI or better yet , Multiparametric MRI ( available at
UC San
Francisco
)
c.       Consider Body scans by MRI if there is evidence from the marker
tests that the low PSA is misleading.
Dr. Barken can be contacted at the website and still offers patients some coaching advice for some sort of donation basis or reasonable fee, you would have to check it out. Back in the early days I got one on the house for my own questions, in 2002.  He is answering some of the questions on P2P website a freebie for certain patient situations, hopeful for their requested answers to be looked at....everyone else watches for free in effect.  I am not affiliated nor compensated believe me.  It is good the docs are getting envolved in P2P, to answer questions on us types....for 'F-R-E-E'.  That I can easily afford.
 
He also is an advisor to the PaactNewsletters, so is Dattoli, Mark Moyad, Tucker, Myers, Onik, Labrie, Bahn, Berger, Lee, Ragde, Trump, Wheeler, Baladalment, Ablin, Arterbery and some others.  www.paactusa.org  for newsletters, which makes it worthy to read. fyi

 

 


 

Post Edited (zufus) : 1/29/2011 2:15:59 PM (GMT-7)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 1/29/2011 4:12 PM (GMT -6)   
good information
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

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 1/29/2011 4:22 PM (GMT -6)   
Thanks Purg- notice no polls (lol). I liked talking to him and his approach with patients, does not make one feel stupid and inadequate but more at ease and calming, reasonable and usually understandable for all lay persons. I don't mind putting in a good word for deeds well done. You know me I will put in a bad word too on occasions.
Dx-2002 total urinary blockage, bPsa 46.6 12/12 biopsies all loaded 75-95% vol.; Gleasons scores 7,8,9's (2-sets), gland size 35, ct and bone scans look clear- ADT3 5 months prior to radiations neutron/photon 2-machines, cont'd. ADT3, quit after 2 yrs. switched to DES 1-mg, off 1+ yr., controlled well, resumed, used intermittently, resumed useage
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