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Treating Ogliometastatic Disease with Radiation


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Paul Edwards

On 13 November 2014 Snuffy Myers’s weekly video was on the subject of “Treating Ogliometastatic Prostate Cancer.

 

 

On 26 November 2014 a copy of a letter by Dr Michael Dattoli was posted on the internet to the Malecare Advanced PCa Group in which he said;

“I have recently viewed a video from a prominent Oncologist, entitled “Treating Ogliometastatic Prostate Cancer.”  I found this presenting Oncologist to be woefully mistaken about numerous issues” and gave his comments on what he believed to be “the misinformation promulgated in the video blog”.

  

This came as a surprise to those of us familiar with Snuffy Myers’s cancer journey.  Dr. Dattoli was the Radiation Oncologist who treated Snuffy Myers with aggressive radiation therapy and seed implantation and Snuffy Myers subsequently referred patients to Dr. Dattoli many times.

 

On 5 December 2014 Snuffy Myers has done a further video “Treating Ogliometastatic Disease with Radiation” to clarify his earlier video.

 

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Paul Edwards

Associate Professor Michael Hofman from Peter MacCallum Cancer Centre in Melbourne appears to agree with Snuffy Myers's point of view that you treat oligometastatic disease differently from disease which is not oligometastatic.

 

In a paper delivered last week at the Annual Scientific Meeting of the Clinical Oncologists Society of Australia he said:

 

"No imaging technique, however, can detect micrometastatic disease or predict which patients have circulating tumour cells that are destined to seed. Therefore, whilst improvement in imaging technology is a valuable advance, it can also provide false hope by introducing lead time bias and detecting disease at an earlier stage without changing outcome. This may direct patients to interventions with curative intent that are ultimately futile and cause significant morbidity. To minimise this, in addition to utilising PET/CT with the most appropriate radiotracer, a period of observation is recommended before defining patients with asymptomatic disease as oligometastatic."

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Paul Edwards

Dr Snuffy Myers in his videos mentioned above was concerned that stereotactic radiation depressed the immune system.   Recent studies have shown that any such radiation-induced immune suppression in high-risk men is temporary, and there is a long-lasting enhancement of the anti-cancer immune response.  There is an interesting post in the New Prostate Cancer Infolink about the immune-stimulatory effect of radiation. It mentions the abscopal or bystander effect whereby systemic micrometastases and tumors well outside of the radiation field can be killed off as a result of radiation.

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