On the Frontier of Medicine's Cutting Edge

[lovinthehd]

So now he's going on a medical adventure like he's going to Mount Sinai Disneyland?

And your self-admission of 'we have our issues' is actually proof that you came in here to stir the pot with him?

No, where did you get all that from?

 

[lovinthehd]

I thought I'd unsubscribed, trying again.

 

[ryanosaur]

A few months ago it became apparent that my Prostate Cancer treated by proton beam five years or so ago, had returned.
It was confirmed by MRI and Pet Scan.

A month or so ago, I had mapping by needle biopsy under general anesthesia. Only one was positive but close to the urethra and its valves. Gleason score is now 9.

So after considering the options with experts I have elected to have a cryoablation procedure. This is a cutting edge interventional radiology approach done in an interventional MRI suite. I did not know there were such units to be honest. They are very new and none in Europe yet.

Unlike an X-ray/CT unit an MRI can not be switched off. The magnet's electromagnetic coil is cooled as close as possible to absolute zero, with liquid Helium. So the coil once energized, has a continuous flow of electricity without adding more energy. The magnetic field is incredibly intense. So anything brought into the room must be not magnetic and incapable of having current induced in it from the intense magnetic field. So totally novel instrumentation has to be used. The interventional radiologist has to have a precise and continuous view of the operative field on the MRI monitor screen.

The procedure which will take three to four hours under general anesthesia, will involve insertion of the delivery device into the lesion, and liquid argon inert gas inserted into the lesion. This will be cooled as close as possible to 0 degrees Kelvin (-273C).

As this is happening the urethra will be warmed with liquid Helium to protect the urethral valves.

So, time will tell how all this works out. I return four days later for studies, and hopefully catheter removal. I will stay in a hotel the night before and the night after the procedure. I enter St. Mary's Hospital Rochester MN on Friday morning at 7:00 AM.

Don't be surprised if my responses are tardy for a while.

Wow. Blessings of health and wellness!

 

[Alex2507]

Mark, don't be offended. We're not all cut from the same cloth and I would use the term 'trailer park' but that would be unfair to folks in trailer parks.

Your efforts here and the close association of a few others have had a somewhat edifying effect on at least me. But you can't expect to reach everyone, try as you may.

We're all gonna get to find out if we have your level of composure when our worst news ever comes. Don't be offended by loose words of lesser men.

 

[Eppie]

Hope all goes well for you Mark. You're willingness to share such personal matters is appreciated. I have learned a lot about the medical profession from your posts.

 

[Verdinut]

I hope all goes well for you Mark. Positive thoughts are for you.

 

[TLS Guy]

Thank you all for your kind words.

The episode reminds me of a colleague who was a bit of a character. Great guy. Anyhow, before the days when people got access to their records, I was called to see one of his patients, in the ER. Under social history, he had naughtily stated: - "This woman's divorced and I know why". So did I after the encounter.

 

[TLS Guy]

I am glad to report that all went well yesterday. it was a long procedure. Dr. Woodrum thought he saw another lesion in the prostate. He sampled it and sent it for frozen section. (Frozen sections allow a pathologist to get an initial result in an hour or less). This turned out to be another malignant lesion, so both were dealt with via cryotherapy with liquid argon cooled as close as possible to 0 Kelvin. I asked Dr. Woodrum why wamed Helium was used to protect the urethra. I should have known the answer. It is the only gas that does not expand when heated, making it the ideal liquified gas for this purpose.

I had a little discomfort yesterday, and today it is minimal to none. The biggest issue is the urinary catheter which is more of a nuisance than anything else. I return Tuesday for testing and catheter removal.

Intensive follow up studies are scheduled for three months.

All things considered, I feeling pretty good, and thinkful I live in an age where such technical miracles are possible.

 

[ski2xblack]

Whew! Can't properly express how glad I am that the procedure went well, including finding and eliminating the prostate lesion. Amazing tech, with precision that makes targeted radiation methods seem crude.

Have a speedy recovery, Doc.

 

[TLS Guy]

I am glad to report I am back to normal. I was at Mayo this morning. They put water in my bladder, and I voided it. Ultrasound showed no residual in the bladder. I am home and doing fine, and have no incontinence, which was Dr. Woodrum's biggest concern.

Full studies in three months.

I consider myself very fortunate, especially that Mayo Clinic is only 75 miles south of here.

 

[panteragstk]

I am glad to report I am back to normal. I was at Mayo this morning. They put water in my bladder, and I voided it. Ultrasound showed no residual in the bladder. I am home and doing fine, and have no incontinence, which was Dr. Woodrum's biggest concern.

Full studies in three months.

I consider myself very fortunate, especially that Mayo Clinic is only 75 miles south of here.

That's great to hear.

 

[TLS Guy]

I had my three month review yesterday. MRI showed that at least two thirds of the prostate gland has been destroyed by the cryo bubble. PET scan showed no mets and my PSA is zero. PSA to be checked every three months and repeat studies in a year. What really amazes me is how minimal a disturbance this whole procedure caused me.

One interesting facet of this saga, is that I had a para neoplastic syndrome in the months prior to this intervention. This is a curious skin lesion most often over the knuckles of the hands, called granuloma annulare. I developed it some months ago over the knuckles of my right hand.

This is what it looks like.

It is very itchy.

By the evening of the cryoablation the lesions had stopped itching and now are resolved. So early on I was pretty certain the cancer had been eradicated.