Alan Lasnover, MD - Questions for his Brachytherapist
Dr, Lasnover is a retired physician who was diagnosed with prostate cancer. You may read his story at Alan Lasnover, MD. On his way to diagnosis he wrote down questions that he wanted answered by a Brachytherapist to assist him in his decision making process. Here is his own et of questions.
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ALAN L. LASNOVER, M.D.
QUESTIONS FOR MY BRACHYTHERAPIST
1. Where and from whom did you learn this procedure?
2. How many insertions did you perform in training?
3. When did you do your first seeding in practice?
4. How many seedings have you done since?
5. What major changes have you made in your techniques?
6. How many seedings did you perform in the past 12 months?
7. What type of anesthesia/analgesia do you employ?
a. If you employ local, how often is patient movement a problem?
b. If you employ local, how often do you have to put patients to sleep?
c. If you employ local, is a standby anesthesiologist present or available?
8. What modality do you employ for pre-implant planning?
9. Is your planning performed intra-operatively?
10. Do you use Prostascint fusion in your planning? Why or why not?
11. Do you use single seeds or stranded seeds? What is your rationale?
12. Do you implant needles individually or collectively? What is your rationale?
13. How do you minimize edema?
14. What is your D(90) objective? What are your usual results? Published?
15. What are your V(100) V(150) and V(200) objectives? What are your usual results? Published?
16. What are your D(30)) urethral and D(5)) rectal wall objectives? What are your usual results? Published?
17. What is your intended depth of peri-prostatic radiation posteriorly? How is this achieved? What are your usual results?
18. What is your intended depth of peri-prostatic radiation bilaterally and posterolaterally? How is this achieved? What are your usual results?
19. Do you add radiation when the prostate gland is small? Your thoughts?
20. What is your overall incidence of post-seeding urinary incontinence? At six months? Published
21. What are your established targets of cure for patients like me?
22. What are your rates of cure at three years? Five years? Ten years? Published? How is "cure" defined?
23. What is your overall incidence of post-seeding proctitis symptomatology? At six months? Published?
24. What is your incidence of post-seeding impotence at one year? Published?
25. Most published studies of brachytherapy for patients like me yield about 90% long-term cure rates? Why do you think they are not better?
26. Is post-seeding cystoscopy performed? Your rationale?
27. Are all your services covered by Medicare?
28. Are you ACR-Certified? Any Subspecialty or other certification?
29. Why do you think you are the most qualified individual to render my care?
30. Can you elaborate on any additional questions that I have neglected to ask?
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Erectile Dysfunction
Brachytherapy / Seed Implants
Hormonal Ablation Treatment
Radiation External - All Kinds
Surgical Removal - All Kinds
Watchful Waiting
Other Conventional Treatments
