Dr. Todd Morgan

earlier seem to do better, but also patients with lower PSAs may have a slower doubling time and they may actually just be lower risk patients. And that makes it a little more challenging as always to tease out cause and effect. But guidelines, we feel very, very confident in that 0.5 threshold. We want to give salvage treatment. We want to initiate it before PSA 0.5.

And look, if you have that patient who's got a high risk disease and their PSA is 0.1 and you know it's going up and they've healed up and all that, There's no reason to delay. And in fact, the patient is going to be better off if we don't delay. And so one thing that we just fall short of as urologists is getting those patients to radiation oncology quickly.

And look, if you have that patient who's got a high risk disease and their PSA is 0.1 and you know it's going up and they've healed up and all that, There's no reason to delay. And in fact, the patient is going to be better off if we don't delay. And so one thing that we just fall short of as urologists is getting those patients to radiation oncology quickly.

And look, if you have that patient who's got a high risk disease and their PSA is 0.1 and you know it's going up and they've healed up and all that, There's no reason to delay. And in fact, the patient is going to be better off if we don't delay. And so one thing that we just fall short of as urologists is getting those patients to radiation oncology quickly.

And it really does make a big difference.

And it really does make a big difference.

And it really does make a big difference.

So I I've done maybe about 10 of these. Have you done some?

So I I've done maybe about 10 of these. Have you done some?

So I I've done maybe about 10 of these. Have you done some?

Yeah. There was about a three-year period where I was doing them. I mean, it's doable. There's some challenging ones. I mean, like Mayo and Jeff Carnes have published their experience. They have a vast experience with this. And so I talked to Jeff and learned from them. I also talked to Dan Lin at UW a number of times back when I was doing these because he also had a lot of experience with these.

Yeah. There was about a three-year period where I was doing them. I mean, it's doable. There's some challenging ones. I mean, like Mayo and Jeff Carnes have published their experience. They have a vast experience with this. And so I talked to Jeff and learned from them. I also talked to Dan Lin at UW a number of times back when I was doing these because he also had a lot of experience with these.

Yeah. There was about a three-year period where I was doing them. I mean, it's doable. There's some challenging ones. I mean, like Mayo and Jeff Carnes have published their experience. They have a vast experience with this. And so I talked to Jeff and learned from them. I also talked to Dan Lin at UW a number of times back when I was doing these because he also had a lot of experience with these.

And they're doable. Pretty, like, you know, you learn a lot. It's super interesting. At the time, we were mostly basing our information from patients who went elsewhere for, say, choline PET or maybe a little, like, Axmin 2 back when that was being used.

And they're doable. Pretty, like, you know, you learn a lot. It's super interesting. At the time, we were mostly basing our information from patients who went elsewhere for, say, choline PET or maybe a little, like, Axmin 2 back when that was being used.

And they're doable. Pretty, like, you know, you learn a lot. It's super interesting. At the time, we were mostly basing our information from patients who went elsewhere for, say, choline PET or maybe a little, like, Axmin 2 back when that was being used.

And, you know, you'd go and you'd do a full dissection, and of course you'd find that node that was positive and about seven other positive nodes. And sometimes the PSA went down to zero, and most of the time it didn't. And sometimes it was a really difficult case.

And, you know, you'd go and you'd do a full dissection, and of course you'd find that node that was positive and about seven other positive nodes. And sometimes the PSA went down to zero, and most of the time it didn't. And sometimes it was a really difficult case.

And, you know, you'd go and you'd do a full dissection, and of course you'd find that node that was positive and about seven other positive nodes. And sometimes the PSA went down to zero, and most of the time it didn't. And sometimes it was a really difficult case.

I mean, I've only tackled one that's very memorable of when the node was in that kind of perirectal fat and just trying to, you know, so we've learned based on PET imaging that maybe about 10% of lymph node metastases go that direction. Different nodal chain and like finding that little pea-sized thing in there was unpleasant. We got it out, but we're like, by the grace of God, we got it out.