Remembering Pat Washburn

Remembering Pat Washburn

by | Jan 27, 2026 | Cancer Caregivers, Men's Breast Cancer

AnCan Suffers a Significant Loss

Remembering Pat Washburn

 

Most AnCan’rs have never participated in our Advanced Cancer Care Partners Support Group. While relieved that you’re not counted in this group, you are missing a gem. The group is chock-full of compassion and practical suggestions. One of the reasons for that was our remarkable Co-moderator, Pat Washburn, GRHS.

Pat absolutely radiated love and compassion while being none too short of gumption. That’s a polite Britishism for “piss and vinegar,” defined as ‘shrewd or spirited initiative and resourcefulness. ‘ After her dear husband, Marlyn, died in 2017, 5 months after being diagnosed with breast cancer, Pat made it her mission in life to make the world aware of Male Breast Cancer.

She took Marlyn’s car, had it decorated with his photo and Male BCa awareness icons, then took to the road. North, south, east, and west she travelled – every year. People stopped her at gas stations and restaurants; she made the local newspapers and TV stations everywhere. And always it was the same message. “Men get breast cancer, too!”

The world was her oyster, and Pat took the campaign to Europe on several occasions, including Spain and Scandinavia. Her travels were not just about awareness – she visited ‘her men’ and their care partners wherever she went. She also went out of her way to meet the AnCan’rs she’d met through our Group, most recently Alexa and Brian, on her way to Houston. See who else you can recognize below…

By and large, Pat paid for all her advocacy on her own dime. A couple of the male breast cancer organizations with whom she was affiliated did not treat her well. AnCan first met Pat when she reluctantly co-moderated our now-defunct Male Breast Cancer Support Group, disembowelled by one of those groups. Reluctant because Pat thought she’d be intruding on the men, BUT they loved her. At the time of her passing, AnCan was working with Pat and Bill Harris to reinstate the group – we still hope to in Pat’s memory (anyone interested, please reach out to me at rd@ancan.org).

 

 

Except when travelling or attending one of her Grandies’ or Great Grandies’ school or sporting events, Pat was always present to support Her Majesty, The Queen of DeNile – our Care Partner Lead Moderator, Susan Lahaie. So when she failed to show at a meeting on Aug 18, we reached out. Pat had been hospitalized after fainting on her face, diagnosed with multiple pulmonary embolisms; she looked like the Lone Ranger. During her hospital stay, those clots travelled to her brain, and Pat suffered a second, fatal stroke last week, elected hospice, and died on October 2nd.

All of us at AnCan are deeply saddened and wish her entire family much comfort. Pat’s entire family doesn’t do it justice. She was truly a matriarch with 35-40 Grandies and Great-grandies. In time, Pat’s memory will always be a warm, embracing memory to all who knew her.
Pat Washburn’s obituary can be found here.

Below is the Virtual Celebration of Life for Pat Washburn, held on November 2nd, 2025

 

Low/Intermediate PCa Video Chat, January 12, 2026

Low/Intermediate PCa Video Chat, January 12, 2026

by | Jan 14, 2026 | Cancer Caregivers, Cancer Resources, Low/Intermediate Prostate Cancer, Recorded Groups

Low/Intermediate PCa Video Chat, January 12, 2026

Low/Intermediate PCa Video Chat, January 12, 2026

AnCan is grateful to the following sponsors for making this recording possible: Novartis, Johnson and Johnson, Telix, Blue Earth Diagnostics, and Foundation Medicine.

WELCOME all to our newly recorded Low/Intermediate Prostate Cancer Group. To receive notice when new recordings are posted, either follow us on this YouTube Channel or sign up to our Blog via https://ancan.org/contact-us/ – check New Blog box.

Join our other free and drop in groups:
AnCan respectfully notes that it does not accept sponsored promotion. Any drugs, protocols or devices recommended in our discussions are based solely on anecdotal peer experience or clinical evidence.
AnCan cannot and does not provide medical advice. We encourage you to discuss anything you hear in our sessions with your own medical team.
AnCan reminds all Participants that Adverse Events experienced from prescribed drugs or protocols should be reported to the pharmaceutical manufacturer or the FDA Adverse Event Reporting System (FAERS). To do so call 1-800-332-1066 or download interactive FDA Form 3500 https://www.fda.gov/media/76299/download
AnCan’s Prostate Cancer Forum is back (https://ancan.org/forums). If you’d like to comment on anything you see in our Recordings or read in our Reminders, just sign up and go right ahead. You can also click on the Forum icon at the top right of the webpage.
All AnCan’s groups are free and drop-in … join us in person sometime!

Editor’s Pick: Using DECIPHER genomic testing to assess cancer agressiveness. (bj)

Topics Discussed
Cancer discovery following an aquablation procedure for an enlarged prostate; post-procedure PSA and MRI testing to monitor remaining cancer; comparing transrectal and transperineal biopsy safety and access; importance of consulting genitourinary oncologists at major centers; using specialists like Dr. Epstein for pathology second opinions; weighing active surveillance against the risk of cancer progression; discussion of MR LINAC, proton, and photon radiation technologies; using PSMA PET scans to detect potential lymph node involvement; selecting high-volume urban medical centers over smaller clinics; using DECIPHER genomic testing to assess cancer agressiveness.

Chat

Stuart sent a chat · 8:01 PM
Dr. Ming Zhou – Mt Sinai Health System  Email: Ming.zhou@mountsinai.org      Telephone: (212)241-8881

Stuart sent a chat · 8:02 PM
Dr. Jonathan Epstein – https://advanceduropathology.com/  Tel:516-760-2037    jepstein@imppllc.com

Steve in Malaysia sent a chat · 8:39 PM
What is an AI MRI?

Steve in Malaysia sent a chat · 8:42 PM
ok 👍

AnCan – rick sent a chat · 8:48 PM
Proton vs Photon  https://ascopubs.org/doi/abs/10.1200/JCO.23.01604?md5=efb3c3159aa147415d4f2ded3334efa3&cid=DM16707&bid=358786211

Gil Solomon sent a chat · 8:52 PM
Have to sign off for dinner.

Steve in Malaysia sent a chat · 8:57 PM
I need to finish packing for trip from Penang to California shortly so would appreciate some quick questions.

AnCan – rick sent a chat · 9:07 PM
Check our AnCan video with Dr. Scholz  on Prostate Snatchers. https://ancan.org/the-prostate-snatchers-still-lurking/

Steve sent a chat · 9:14 PM
Carter

AnCan – rick sent a chat · 9:25 PM
Steve – CHEK2 may in fact make you more sensitive to RT. Check with Dr. Kivel

Steve sent a chat · 9:28 PM
Thanks Rick!

David in Portland, OR sent a chat · 9:39 PM
“Most mutations in DNA repair genes such as BRCA1/2, PALB2, CHEK2, and RAD50/51 mutations do not increase radiation-induced cancers or radiation toxicity. BRCA1/2, PALB2, CHEK2, and RAD50/51 mutations should not affect radiation therapy decisions.” Source: https://www.redjournal.org/article/S0360-3016(19)33530-8/fulltext I also communicated with Joanne Wiedhaas last year directly about this topic, and she confirmed the above quote from the International Journal of Radiation Oncology.

Govinda – India sent a chat · 9:41 PM
Daily dosage of  Viagra was 5 mg daily. Of course this varies from person to person.

Steve in Malaysia sent a chat · 9:42 PM
I’m going to sign off… thanks guys

David in Portland, OR sent a chat · 9:42 PM
5 milligrams/day of tadalafil/Cialis gives me significant heartburn. Anybody else have this problem? Any fixes other than stopping the Cialis?

AnCan – rick sent a chat · 9:51 PM
Interesting David….    the general opinion is that HRR mutations make you more sensitive to RT toxicity. I think there’s a fair amount of literature.

Stuart sent a chat · 9:56 PM
Dr James Hu – Weill Cornell

Stuart sent a chat · 9:56 PM
Dr Nagar – MSKCC

Stuart sent a chat · 9:57 PM
or Michael J. Zelefsky, MD – NYU Langone

Steve sent a chat · 10:17 PM
Thanks David!

Low/Intermediate PCa Video Chat, December 22, 2025

Low/Intermediate PCa Video Chat, December 22, 2025

by | Jan 7, 2026 | Cancer Caregivers, Cancer Resources, Low/Intermediate Prostate Cancer, Recorded Groups

Low/Intermediate PCa Video Chat, December 22, 2025

Low/Intermediate PCa Video Chat, December 22, 2025

AnCan is grateful to the following sponsors for making this recording possible: Bayer, Novartis, Johnson and Johnson, Myriad Genetics, Telix, Blue Earth Diagnostics, and Foundation Medicine.

WELCOME all to our newly recorded Low/Intermediate Prostate Cancer Group. To receive notice when new recordings are posted, either follow us on this YouTube Channel or sign up to our Blog via https://ancan.org/contact-us/ – check New Blog box.

Join our other free and drop in groups:
AnCan respectfully notes that it does not accept sponsored promotion. Any drugs, protocols or devices recommended in our discussions are based solely on anecdotal peer experience or clinical evidence.
AnCan cannot and does not provide medical advice. We encourage you to discuss anything you hear in our sessions with your own medical team.
AnCan reminds all Participants that Adverse Events experienced from prescribed drugs or protocols should be reported to the pharmaceutical manufacturer or the FDA Adverse Event Reporting System (FAERS). To do so call 1-800-332-1066 or download interactive FDA Form 3500 https://www.fda.gov/media/76299/download
AnCan’s Prostate Cancer Forum is back (https://ancan.org/forums). If you’d like to comment on anything you see in our Recordings or read in our Reminders, just sign up and go right ahead. You can also click on the Forum icon at the top right of the webpage.
All AnCan’s groups are free and drop-in … join us in person sometime!

Editor’s Pick: Importance of getting your treatment at a NCCN Member Institution. (bj)

Topics Discussed
New quarterly support group for inherited mutations (e.g., BRCA, Lynch syndrome); eligibility for active surveillance despite a high-intermediate decipher score (0.57) and specific biopsy results (Gleason 3+4 with 10% grade 4); importance of obtaining a second opinion on biospy slides; importance of getting your treatment at a National Comprehensive Cancer Network (NCCN) Member Institution versus other medical institutions; nutrional and lifestyle approaches (e.g., fasting, ketogenic diets) before radiation; MRI-guided radiation (SBRT) and the experience of having fiducials and barriers implanted under local anesthesia; management of side effects like erectile dysfunction (ED) and the benefits of heavy exercise during long-term treatment; challenges faced by patients living abroad; concerns about inguinal hernia mesh repair complicating a future prostatectomy; lack of definitive ways to prevent prostate cancer; various theories regarding calcium levels.

Chat

AnCan – Stuart sent a chat · 8:02 PM
Dr. Ming Zhou Mount Sinai Health System Department of Pathology, Box 1194 Annenberg Bldg. 15th FL 1468 Madison Ave New York, NY 10029 Email: Ming.zhou@mountsinai.org Telephone: (212)241-8881

AnCan – Stuart sent a chat · 8:03 PM
Dr. Jonathan Epstein – https://advanceduropathology.com/  Tel:516-760-2037    jepstein@imppllc.com

AnCan – rick sent a chat · 8:12 PM
877 582 7011

AnCan – rick sent a chat · 8:13 PM
GoTo Technical Help

David K – Jacksonville FL sent a chat · 8:18 PM
aquablation and PAE: I’ll be asking if anyone has had an aquablation or a Prostate Artery Embolization. – david K

AnCan – rick sent a chat · 8:38 PM
We are looking at a spckof cancer here…. half a millimeter

AnCan – rick sent a chat · 8:39 PM
*speck of

Steve in Malaysia sent a chat · 8:41 PM
Does anyone have contact info for support staff of Dr Epstein as I’ve been trying to get slides to Stanford

Steve in Malaysia sent a chat · 8:41 PM
He has them now

Steve in Malaysia sent a chat · 8:43 PM
I did email him a few days ago but no answer

Frank H sent a chat · 8:43 PM
Try ask for Mary jones

Steve in Malaysia sent a chat · 8:44 PM
Thanks Frank, do you have her email?

AnCan Bill sent a chat · 8:44 PM
Steve, you can check his website: https://advanceduropathology.com/

AnCan Bill sent a chat · 8:44 PM
Frank did say he was on vacation for the holidays.

Steve in Malaysia sent a chat · 8:45 PM
My issue is more that I need to get my slides from him to Stanford soon as I’m going to US mid Jan

Frank H sent a chat · 8:47 PM
I will need to check with her myself tomorrow

Greg sent a chat · 9:04 PM
When does Medicare stop paying for Telehealth?

AnCan – rick sent a chat · 9:05 PM
Right around now, we beleive.

Greg sent a chat · 9:06 PM
For just prostate consults or across the board visits?

AnCan – rick sent a chat · 9:06 PM
Check on the internet, Greg

AnCan – rick sent a chat · 9:06 PM
Across tehe board.

AnCan – rick sent a chat · 9:16 PM
Cancer & Fasting UCSF  https://osher.ucsf.edu/patient-care/integrative-medicine-resources/cancer-and-nutrition/faq/cancer-and-fasting-calorie-restriction

AnCan – rick sent a chat · 9:17 PM
QiL fasting during chemo https://www.vumedi.com/video/esmo-2023-insights-effects-of-short-term-fasting-on-quality-of-life-as-an-add-on-option-during-chemo/?token=aea546f6-9f4e-41f5-98fd-3a2f2c6f6add&link_data=eyJiZXRfbWFpbF9pdGVtX2lkIjoyMDAwODM0MjQsImJldF9tYWlsX2FjdGlvbiI6ImJjIn0%3A1ryYHH%3A2ho3Ayar__FqeFstiJEPOgl60cTKcylOggsW5v-BNKQ&mc_cid=af2eade45f&mc_eid=838454d636

AnCan – rick sent a chat · 9:18 PM
Meta study from Kishan on ADT duration https://jamanetwork.com/journals/jamaoncology/article-abstract/2841671?guestAccessKey=d03b0908-90c8-497e-85cd-aebb43ec2a63&utm_medium=email&utm_source=postup_jn&utm_campaign=article_alert-jamaoncology&utm_content=olf-tfl_&utm_term=112025&mc_cid=0fa42784f6&mc_eid=838454d636

AnCan – rick sent a chat · 9:19 PM
Gil – also Spratt is on the metastudy.

Greg sent a chat · 9:20 PM
Which guys at Stanford?

Gil Solomon sent a chat · 9:34 PM
Thanks. I did see the ADT duration study and diminishing returns after 6 months

Gil Solomon sent a chat · 9:36 PM
Apalutamide study HEATWAVE and it is all comers regardless of cell type.

Gil Solomon sent a chat · 9:37 PM
I’m going to sign off for dinner.  Thanks all.

AnCan Bill sent a chat · 9:37 PM
Have a good night Gil

Steve in Malaysia sent a chat · 9:40 PM
Thanks for info Gil

AnCan – rick sent a chat · 9:43 PM
But we know that f you are Lumin A, apalutamide does not work.  Balance trial  https://ascopost.com/issues/october-25-2025/biomarker-driven-apalutamide-therapy-for-patients-with-recurrent-prostate-cancer/?mc_cid=17ff95d283&mc_eid=838454d636

Steve in Malaysia sent a chat · 9:47 PM
How long after last PSA read (was same time as MRI) should I get next one?

Steve in Malaysia sent a chat · 9:47 PM
That as Oct 12

Steve in Malaysia sent a chat · 9:47 PM
*was

AnCan Bill sent a chat · 9:50 PM
Steve, you’re 2 and a half months out from the last one but you don’t  have an urgent need to get PSA right now unless your doctor thinks you should.

Greg sent a chat · 9:51 PM
Will there be another email for donation?

AnCan – rick sent a chat · 9:51 PM
bfranklin@ancan.org

AnCan – rick sent a chat · 9:52 PM

Donate

Steve in Malaysia sent a chat · 9:52 PM
Thanks Bill, I’m a bit concerned as it went from 2.22 to 4.33 in 3 weeks

Steve in Malaysia sent a chat · 9:54 PM
I’ll ask Dr Sonn if needed before consult.

AnCan Bill sent a chat · 9:54 PM
When I was in your situation, I was getting it every 3 months at my doctor’s advice.

AnCan Bill sent a chat · 9:55 PM
Talk to your doc but remember, it can lead to increase anxiety.

Steve in Malaysia sent a chat · 9:55 PM
I understand re: anxiety

Steve in Malaysia sent a chat · 9:55 PM
I had an infection and was on cipro (but finished) right before last read.

AnCan Bill sent a chat · 9:58 PM
Ah, the infection could definitely be a contributer.

Steve in Malaysia sent a chat · 9:58 PM
oddly that infection was what lead to actual detection of cancer.

AnCan – rick sent a chat · 10:02 PM
Steve – the 4.33 could have a huge amount to do with the infection. I’d repeat the PSA sooner rather than later.

Steve in Malaysia sent a chat · 10:03 PM
ok, will do before I go to CA

AnCan – rick sent a chat · 10:04 PM
If it’s 2.33 what would you do, Steve?

Steve in Malaysia sent a chat · 10:05 PM
Hmmm…. not sure … I would still proceed with process I think given Epstein and Klotz recommendations.

AnCan – rick sent a chat · 10:06 PM
Stay in the moment!!!!

Steve in Malaysia sent a chat · 10:14 PM
Good luck with treatment Greg

🌿 FDA Position on Cannabis and Cannabinoids

🌿 FDA Position on Cannabis and Cannabinoids

by | Dec 19, 2025 | Blood Cancers, Brain Tumors, Cancer Caregivers, Cancer Resources, Complementary Medicine, High Risk/Recurrent/Advanced, High Risk/Recurrent/Advanced Prostate Cancer, hospice and palliative, Low/Intermediate Prostate Cancer, mCRPC, Mental Health, mHSPC, Multiple Sclerosis, Ovarian Cancer, Pancreatic Cancer, Prostate Cancer, Recent News, RMC, Thyroid Cancer, Uncategorized

🌿 FDA Position on Cannabis and Cannabinoids

(Here is my take on this article Therapeutic Use of Cannabis and Cannabinoids A Review JAMA Network, 11/26/25.  On a personal side, I use CBD to help me sleep, and with a little (5%) addition of THC, it is a great anxiety calmer – Sally Torgeson, AnCan Blood Cancer Moderator & Multiple Myeloma Coach)

Unapproved Cannabis

  • The FDA has NOT approved the cannabis plant (botanical marijuana) for any medical use or indication.
  • Because it is classified as a Schedule I controlled substance under federal law, the FDA has not found it to be safe or effective for the treatment of any disease or condition [1.1, 1.7].
  • It is currently illegal to market CBD by adding it to food or labeling it as a dietary supplement in interstate commerce [2.1, 2.5].

FDA-Approved Cannabinoid Drugs

The FDA has approved a small number of prescription drugs containing either a purified cannabis-derived compound or synthetic cannabinoids:

  • Epidiolex (Cannabidiol or CBD): The only FDA-approved drug that contains a purified substance derived directly from the cannabis plant. It is approved to treat seizures associated with Lennox-Gastaut syndrome, Dravet syndrome, and Tuberous Sclerosis Complex in patients one year of age and older [1.8, 2.1].
  • Marinol and Syndros (Dronabinol): Contain synthetic Δ9-tetrahydrocannabinol (THC). Approved for:
    • Nausea and vomiting associated with cancer chemotherapy in patients who have not responded to conventional antiemetic treatments [2.2, 2.3].
    • Anorexia associated with weight loss in patients with HIV/AIDS [2.3].
  • Cesamet (Nabilone): Contains a synthetic substance that is chemically similar to THC. Approved for chemotherapy-induced nausea and vomiting [1.1, 2.3].

Regulatory Context

  • The FDA maintains its authority to regulate products containing cannabis or cannabis-derived compounds, even those derived from hemp (cannabis with less than 0.3% THC), under the Federal Food, Drug, and Cosmetic (FD&C) Act [1.4].
  • The FDA supports the development of new drugs through proper clinical trials to ensure they meet standards for safety and effectiveness [1.1, 2.4].

FDA-Approved Cannabinoid Drugs and Their Conditions

Drug Name (Active Ingredient) Source FDA-Approved Condition(s)
Epidiolex (Cannabidiol or CBD) Purified, plant-derived CBD Seizures associated with: * Lennox-Gastaut syndrome (LGS) * Dravet syndrome (DS) * Tuberous Sclerosis Complex (TSC)
Marinol and Syndros (Dronabinol) Synthetic THC ($ \Delta9 $-tetrahydrocannabinol) * Nausea and vomiting caused by cancer chemotherapy (when other antiemetics have failed) * Anorexia (loss of appetite) associated with weight loss in patients with HIV/AIDS
Cesamet (Nabilone) Synthetic cannabinoid (similar to THC) * Nausea and vomiting caused by cancer chemotherapy (when other antiemetics have failed)

Key Takeaway

  • Epidiolex is the only drug approved that contains a substance derived directly from the Cannabis plant (CBD). It represents the strongest evidence for cannabinoid efficacy in reducing seizure frequency in certain rare forms of epilepsy [1.1, 1.2].
  • The synthetic THC compounds (Dronabinol and Nabilone) are used primarily as a last resort for severe nausea/vomiting related to chemotherapy and for appetite stimulation in AIDS patients [1.2, 2.8].

The FDA has not approved the use of the whole cannabis plant for any medical condition, stressing the importance of standardized, tested pharmaceuticals for patient safety and proven effectiveness [1.7].1

 

🏷️ Off-Label Use vs. Unapproved Use

1. Off-Label Use (Legal and Regulated)

 

This applies only to drugs that the FDA has already approved.

  • What it is: Using an FDA-approved drug (like Epidiolex, Marinol, or Cesamet) for a condition, dose, or patient population that is not specifically listed on the drug’s official label.   
  • Legality: It is legal for a licensed physician to prescribe an approved drug for an off-label use if they believe it is medically appropriate for their patient.
  • FDA Position: The FDA does not regulate the practice of medicine; however, the manufacturer cannot market or promote the drug for the off-label use. The safety and efficacy for the off-label use have not been verified by the FDA’s rigorous testing process.

Example: A doctor prescribing Marinol (Dronabinol), which is approved for nausea from chemotherapy, to a patient for chronic pain. The drug is approved, but the condition (chronic pain) is not on the label.

2. Unapproved Use (Non-FDA Approved Products)

This applies to the cannabis plant itself and most CBD/cannabinoid products on the market.

  • What it is: Using the whole cannabis plant (botanical marijuana) or non-FDA-approved cannabis-derived products (like most CBD oils, edibles, or topicals) for any medical purpose.
  • Legality:
    • Federal: The whole plant is a Schedule I controlled substance and is not federally approved for any medical use.   
    • State: Use may be legal under state medical or recreational cannabis laws, but this does not change its status as an unapproved drug under federal FDA law.
  • FDA Position: The FDA considers these products unapproved drugs and/or illegally marketed products (especially when CBD is added to food or marketed as a dietary supplement), as they have not been tested for safety, effectiveness, or quality assurance.   

Example: A patient using a CBD tincture (which is not Epidiolex) to treat anxiety, or using THC flower to help with multiple sclerosis symptoms.

To correspond with Sally, please send an email to info@ancan.org, and we’ll be sure to send along.

Low/Intermediate PCa Video Chat, January 12, 2026

Low/Intermediate PCa Video Chat, December 8, 2025

by | Dec 12, 2025 | Cancer Caregivers, Cancer Resources, Low/Intermediate Prostate Cancer, Recorded Groups

Low/Intermediate PCa Video Chat, December 8, 2025

Low/Intermediate PCa Video Chat, December 8, 2025

AnCan is grateful to the following sponsors for making this recording possible: Bayer, Novartis, Johnson and Johnson, Myriad Genetics, Telix, Blue Earth Diagnostics, and Foundation Medicine.

WELCOME all to our newly recorded Low/Intermediate Prostate Cancer Group. To receive notice when new recordings are posted, either follow us on this YouTube Channel or sign up to our Blog via https://ancan.org/contact-us/ – check New Blog box.

Join our other free and drop in groups:
AnCan respectfully notes that it does not accept sponsored promotion. Any drugs, protocols or devices recommended in our discussions are based solely on anecdotal peer experience or clinical evidence.
AnCan cannot and does not provide medical advice. We encourage you to discuss anything you hear in our sessions with your own medical team.
AnCan reminds all Participants that Adverse Events experienced from prescribed drugs or protocols should be reported to the pharmaceutical manufacturer or the FDA Adverse Event Reporting System (FAERS). To do so call 1-800-332-1066 or download interactive FDA Form 3500 https://www.fda.gov/media/76299/download
AnCan’s Prostate Cancer Forum is back (https://ancan.org/forums). If you’d like to comment on anything you see in our Recordings or read in our Reminders, just sign up and go right ahead. You can also click on the Forum icon at the top right of the webpage.
All AnCan’s groups are free and drop-in … join us in person sometime!

Editor’s Pick: Focal therapy sounds great but has higher risk of recurrence. (bj)

Topics Discussed
Importance of getting a second opinion on your biopsy slides by a specialist; don’t rush into a treatment without getting all the information; focal therapy sounds great but has higher risk of recurrence; active surveillance is a viable treatment option—it depends on your risk factors; cryotherapy vs HIFU—effectiveness vs side-effects; fears about erectile dysfunction (ED) and incontinence make focal therapy make it easy to jump on the focal therapy bandwagon; heart disease and hormone therapy (ADT) interactions; balancing open-heart surgery and managing prostate cancer (PCa); symptom management concerns cause me to lean toward IMRT (Intensity-Modulated Radiation Therapy) vs SBRT (Stereotactic Body Radiation Therapy); concerns about ADT side effects.

Chat

AnCan – Stuart sent a chat · 7:56 PM
Dr. Ming Zhou Mount Sinai Health System Department of Pathology, Box 1194 Annenberg Bldg. 15th FL 1468 Madison Ave New York, NY 10029 Email: Ming.zhou@mountsinai.org Telephone: (212)241-8881

AnCan – Stuart sent a chat · 7:56 PM
Dr. Jonathan Epstein – https://advanceduropathology.com/  Tel:516-760-2037    jepstein@imppllc.com

AnCan Bill  sent a chat · 8:17 PM
If you are new, feel free to share your email address here and we will ensure you get our reminders.

AnCan Bill  sent a chat · 8:32 PM
Steve, we were getting a lot of mic noise from you.  We muted you.

Larry (Veteran, Alaskan) sent a chat · 8:33 PM
Do not overlook the potential value of getting a consult from a Medical Oncologist as opposed to Surgical or Radiological.

Martin  Uthe sent a chat · 8:35 PM
Stuart, What is your email? Thank you.

Martin  Uthe sent a chat · 8:36 PM
Larry, Thank you. M

AnCan – rick sent a chat · 8:36 PM
stuart@ancan.org

AnCan – rick sent a chat · 8:40 PM
I would disagrree with Larry at this time. With just a mm or two of 4+3 that we are checking with a 2nd opinion, most Genitourinary medical oncologists would not see you. You will not be able to get an appointment with Maha Hussein or David VanderWeele.   Just seeing a general med onc will only confuse you.

Martin  Uthe sent a chat · 8:41 PM
I am already confused!

Tom O NJ sent a chat · 8:44 PM
Martin confusion is why this group exist… keep coming keep doing research. I am new also and struggling w/ decision making.

Martin  Uthe sent a chat · 8:45 PM
Thank you, Tom.

AnCan Bill  sent a chat · 8:47 PM
Thanks Tom. We are here to help as best we can.

AnCan – Boykin sent a chat · 9:02 PM
Active Surveillance https://ancan.org/event/active-surveillance-prostate-cancer-2/2025-12-10/

Steve sent a chat · 9:10 PM
I was wondering if I should push for a Decipher test now?

Steve sent a chat · 9:11 PM
I tried to get one but its a bit hard from a foriegn country without a US Dr.

AnCan – rick sent a chat · 9:12 PM
Speak with Epstein first and also ask him.  May help but I don’t know enough about Decipher. Dr. John does.

AnCan – rick sent a chat · 9:13 PM
We’re awae that it’s hard to get Decipher outside the country.

Steve sent a chat · 9:13 PM
ok 👍

Steve sent a chat · 9:13 PM
Yes I had Invitae genetic test … all negative.

Steve sent a chat · 9:14 PM
12 genes tested

AnCan – rick sent a chat · 9:14 PM
From Dr. John …. Steve: since there is some ambiguity, why not, if Epstein agrees

AnCan – rick sent a chat · 9:15 PM
Invitae is a germline test – very different to Decipher.

Steve sent a chat · 9:16 PM
Yep understand re: germline … I might have used wrong terminology

Steve sent a chat · 9:16 PM
Thanks Rick

Steve sent a chat · 9:17 PM
Any thoughts on state of the air radiation treatments if I end up there?

AnCan Bill  sent a chat · 9:18 PM
bfranklin@ancan.org

Steve sent a chat · 9:19 PM
My connection dropped so not sure if I missed any texts

Steve sent a chat · 9:19 PM
re: Radiation.

AnCan – rick sent a chat · 9:20 PM
My bad…. didn’t realize the mic was on.

AnCan–John A sent a chat · 9:21 PM
Steve: likely SBRT

Steve sent a chat · 9:21 PM
ok, does that imply MRI Guided?

AnCan–John A sent a chat · 9:23 PM
Steve: probably at a state of the art center.    Maybe CT

Steve sent a chat · 9:23 PM
CT?

AnCan–John A sent a chat · 9:23 PM
Computerized Axial Tomography

Steve sent a chat · 9:24 PM
Got ya, thanks 🙂

Steve sent a chat · 9:25 PM
SBRT with Real-Time Tracking (CyberKnife)?

AnCan–John A sent a chat · 9:26 PM
that’s an example yes

Steve sent a chat · 9:26 PM
MRI-Guided SBRT (MR-Linac: ViewRay MRIdian or Elekta Unity)

AnCan Bill  sent a chat · 9:27 PM
Dr. Sanoj Punnen

Steve sent a chat · 9:27 PM
I will also check with my oncologist who I am seeing for Pet scan in a few hours

AnCan Bill  sent a chat · 9:30 PM
https://sylvester-doctors.umiamihealth.org/

AnCan – rick sent a chat · 9:32 PM
https://sylvester-doctors.umiamihealth.org/

Steve sent a chat · 9:32 PM
I’m considering adding Dr. Kishan at UCLA to my trip.

Steve sent a chat · 9:36 PM
Did you have side effects?

Steve sent a chat · 9:37 PM
I like the idea he is on west coast as its already about 20-25 hrs flight time to get to CA 🙂

AnCan – rick sent a chat · 9:45 PM
dr.john@ancan.org

AnCan – rick sent a chat · 9:46 PM
https://www.uwmedicine.org/bios/effie-andrikopoulou

Steve sent a chat · 9:50 PM
Who was the Dr at UCSF who I should talk to re: Active Surveillance?

AnCan – rick sent a chat · 9:53 PM
UCSF – Peter Carrroll is the expert but winding down. Matt Cooperberg is one. If you can’t get to him, Sam Washington.

Steve sent a chat · 9:54 PM
Thanks Rick 👍

Steve sent a chat · 9:55 PM
Did you have the name and contact of the guy in Malaysia (I think it was you who mentioned him).

AnCan – rick sent a chat · 9:57 PM
Read this metastudy …. https://jamanetwork.com/journals/jamaoncology/article-abstract/2841671?guestAccessKey=d03b0908-90c8-497e-85cd-aebb43ec2a63&utm_medium=email&utm_source=postup_jn&utm_campaign=article_alert-jamaoncology&utm_content=olf-tfl_&utm_term=112025&mc_cid=0fa42784f6&mc_eid=838454d636

Steve sent a chat · 10:01 PM
Thanks so much for all the help guys.  Makes my path alot more focused on best next steps.  Much appreciated 🙏

Steve sent a chat · 10:05 PM
My connection dropped again… back on now

AnCan Bill  sent a chat · 10:05 PM
We are glad you found us. Please keep coming to the group.

Steve sent a chat · 10:06 PM
You guys give us alot more confidence dealing with PC

Steve sent a chat · 10:10 PM
Rick/Stuart do you guys mind sharing your email?

AnCan Bill  sent a chat · 10:11 PM
rd@ancan.org and stuart@ancan.org

AnCan – Stuart sent a chat · 10:11 PM
https://www.uclahealth.org/providers/amar-kishan

AnCan – Stuart sent a chat · 10:12 PM
MR-Linac

Paul N. sent a chat · 10:14 PM
Ask Keeshan about the Prostox test

AnCan Bill  sent a chat · 10:20 PM

Special Presentation: What if You Could Predict the Risk of Radiation Effects – Prostox and Beyond

Carl S. sent a chat · 10:21 PM
Thanks guys, see you next time.

Manuel sent a chat · 10:21 PM
Thanks for a great session!

Steve sent a chat · 10:22 PM
Thanks Guys 🙂