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A Plea for Help from Dr. Ronald E. Wheeler to “Drain the Swamp”
Presently, I am at odds with the “Powers that Be” in the State of Florida! A witch hunt of sorts that started as a personal vendetta has gained some momentum while an undereducated attorney for the State of Florida plies his trade in an attempt to make a name for himself. Doctors in my profession (like any profession) become jealous of others or let their Ego get in the way and do not want your humble servant to succeed. So let’s accept the fact, there are exceptions to every rule so it is not surprising that not all men with prostate concerns should be biopsied despite its lofty position as a “Standard of care”. People who should not be biopsied are men with heart valves or stents, knee or hip replacements, blood disorders like Atrial Fibrillation as there are concerns for clotting issues despite the best opinion from another thought leader. Jehovah Witnesses as a religious group cannot accept blood products so we should exclude them as well! To be sure, if there is an exception to any rule, all the populace should be aware and take advantage of prevailing thought allowed to others once the appropriate precautions and total discussion is given. Every individual in all 50 States can avoid a biopsy whenever they choose regardless of reason for doing so. After all, we all deserve to guide our own best interests! The State’s expert in Urology did not know about “needle tracking’ associated with spreading of cancer cells at the time of the biopsy. Our attorney who is pumped on the topic believes I am overstating the issue and trying to scare people into avoiding a biopsy. I have evidence from the Journal of Urology (our professional gospel … if you will) which he has apparently mastered and tossed to the side line as not credible or relevant. All patients must understand the risk of biopsies commonly spreading prostate cancer cells. This is nothing to be afraid of if you agree the procedure needs to be done. As Urologists we do not commonly biopsy a Kidney as we have concern for “needle tracking” … imagine that! If a biopsy is to be embraced, one must also accept various degrees of bleeding from every orifice below the waist (for upwards of 6-8 weeks), endure the pain, understand a biopsy has an 8% chance of causing a patient to be hospitalized from sepsis (referencing Johns Hopkins) with a small but significant chance that an individual can die from septic shock. Similarly, any patient should have the right to refuse such an invasion if their preference is to choose an alternative. After all, we all embrace the right of every patient to choose what is best for him or her. By the way, the same issues are in play with breast cancer concerns from biopsies spreading cancer cells to the Sentinel node in women. So what can we do as an alternative to a biopsy?
First and foremost, we have outstanding imaging which most doctors who deal with prostate disease fail to realize or prefer to ignore rather than embrace. Some say it is for financial gain or self-preservation of our purpose to use an ancient art while eschewing modern and more effective diagnostic means. If the truth be known, biopsies will never go away but will be avoided by the better educated. I wonder if the American Civil Liberties Union (ACLU) would think about biopsies for the under educated only. Taking its place in the hierarchy of diagnostic thought is a 3.0 Tesla Multi-parametric MRI (3.0T MP-MRI) scan of the prostate and pelvis … with and without contrast. The cost is much less than a biopsy, much more accurate and without pain, bleeding or trauma. Some doctors refuse to embrace what is now being recognized as a force to be reckoned with in imaging. I was the Principal Investigator with an IRB sanctioned study with General Electric from 2006 to 2010. What I learned has been incredible!
Instead of getting credit from the “Powers that Be” as an innovator of a great diagnostic tool, I get no credit and told this is not part of the “Standard of Care”. Why isn’t imaging part of the “Standard of Care” you may ask! After all, MRI has been around for the past 30 plus years and most certainly a part of the “Standard of Care”. So let’s compare … Guessing where prostate cancer may be hiding with a typical 12 core biopsy that can miss cancers when present up to 50% of the time or shall we play another game of “pin the tail on the donkey” or throw darts multiple times in the dark to find a cancer regardless of the pain inflicted. I have a famous case from the VA where the doctor in question did more than 50 needle punctures over 5 years (on one unwitting patient) while watching the PSA climb from 8.5 to more than 18. The doctor in question asked me if I wouldn’t mind assisting with my research technology as he had lost his confidence to find a cancer. In effect, hundreds if not thousands of patients everyday are at added risk when imaging is not a priority with a rising PSA in the face of a negative biopsy. I put the patient on an anti-androgen using my privilege to use an FDA medication in an “off label” protocol to reduce the PSA and thereby suppress the disease. For the record, I have used this medication with impunity over the past 20 years. I told the doctor in question, I would be pleased to do what I could to solve the conundrum. After all, a high PSA or a PSA continuing to rise was reason enough to suspect prostate cancer. A lesion or area of interest was discovered on the left side of the prostate consistent with a cancer. This was confirmed by a competent Radiologist. Asked if he wanted to perform a biopsy the area, he politely said no and asked me to prove to him that a cancer was present and that my research was relevant. I obliged and found a cancer associated with a Gleason Score of 7 (3+4). I was thanked and he was amazed. More importantly, the patient could now be treated with hopes it was not too late to cure him. Now why wouldn’t our attorney friend with the State of Florida try to reason with doctors while allowing my skill set to be taught to the most academically enthusiastic and driven Urologists? The State of Florida is thinking it is far easier to get rid of one maverick doctor than to enforce or encourage a better brand of medicine through imaging with a benefit for all. The residents of the State of Florida and throughout this great land of ours deserve the best and will never put up with this kind of chicanery. Once the dust has settled, a 3.0T MP-MRI scan has a 98-100% Positive Predictive Value according to the NIH (in a Journal publication from 2011) while a biopsy done without imaging has a 50-60% chance of finding a cancer in the most liberal of analyses.
So what will it be? More of the same or changing healthcare for the better by helping me fight the bureaucracy. As stated earlier, even United Healthcare provider agrees a biopsy or a 3.0T MP-MRI are equally diagnostic. Together we can win this fight but I need your help! Those who see value in what I preach are urged to assist my legal expenses to defeat the enemy camp as we take the 1st Amendment (Free Speech), patient choice and Second Opinions to a more honorable court that will not be controlled by the whim of our mighty State’s attorney who has venom to spare. We need to take this fight all the way to the US Supreme Court if that is what must be done to achieve success. I know we must “drain the swamp” otherwise known as the Department of Health and replace the Board of Medicine ridding ourselves of unfaithful and biased servants as we move further into the 21st Century.
To make matters worse, your humble servant is a world leader in HIFU (High Intensity Focused Ultrasound) as an ablative invention for prostate disease. The FDA approved HIFU in late 2015 to ablate prostate tissue without a designation to treat cancer. Therefore, no biopsies are necessary to treat a diseased prostate with HIFU or acoustic energy. Isn’t this an incredible irony! I am being challenged by the “Powers that be” and who choose to rule rather than govern regarding a treatment of prostate disease that does not require a biopsy. How can that be?
This is our great State of Florida where the pulse of competition wants to dictate to us all no matter whether or not it makes sense. Cooler heads need to prevail in my case and will prevail as we deal with the lesser knowing in the battles that loom. Remember, there are doctors who do not have my skill set and would love me to be erased from the landscape! I will not quit or move from my support for all patients and their right to direct their own healthcare (assuming their ability to understand). It is my privilege to stand for what is right and to defeat those who choose to alter a progressive course to better disease recognition and treatment. May God bless and please do not hesitate to contact the DOH and Board of Medicine to voice your concerns. Even better, contact your local governmental representatives. They need to know about this miscarriage of justice. I am your voice and welcome your contributions to “drain the swamp”. The best is yet to come for participants at the DOH or the Board of Medicine who are relieved of their duties relevant to a privilege they never clearly understood. My promise to all patients who see me is to do all I can (within my power) to assist them with a cure.
Checks should be written to me personally while identifying the legal fund in the subject line. I am thanking you for any and all contributions whether large or small as we have a mountain to climb together. This is a fight we have to win! This case is all about patient’s rights!
Ronald E. Wheeler, M.D., Legal Fund, 1819 Main Street, Suite 401, Sarasota, Florida 34236
Sincerely and thank you for your generosity! May God Bless you!
The following is an example of some to the extraordinary work I have performed:
|Prostate Cancer Cures while using the “Wheeler Methodology” – 10/27/2016|
|Initials||Age@HIFU||DOB :: Date of RX.||PSA Prior to HIFU RX.||PSA Post Treatment||Gleason Score||PIRADS Score|
|KL||56||9/24/1959::1/08/2015||17.76 (Avodart Hx.)||◄0.1||4+5=9||5/5|
|DJ||66||2/28/47::10/25/2013||33.9||◄0.1||Biopsy Denied||5/5 ECE|