Anyone have experiences with Dr. Quevedo at Mayo: Align with Kwon?

Have you seen Dr. Kwon’s Talks at PCRI. He does have an impressive set of ideas. He is a urologist while Doctor Heath is a highly recognized Oncologist for prostate cancer treatment. You have a really good set of doctors you can talk to for ideas about treatment. Then it’s up to you to make a decision. I would ask Dr. Heath to manage my treatment if it were me.

I attend online advanced prostate cancer meetings every week at Ancan.org. I know that Rick, who runs the meetings has found that Dr. Kwon has not moved quickly enough with treatment with more than one person that has come to his meetings. He also knows Dr. Heath. You could attend a meeting and ask about the ideal doctors to see and doctor Kwon.

You would be a target for triple therapy if you’ve got multiple metastasis in your body. Pluvicto is now seen as a treatment you can get before chemotherapy and it may help you. I’ve seen cases where multiple metastasis just disappeared from the PET scan after Pluvicto. Something to discuss with your doctor. If you have five or fewer metastasis, they could probably just zap them with SBRT radiation. Ask your doctor.

I had Dr. Kwon back in 2017 after surgery, BCR and failure of SRT.

At the time, from my perspective I felt he was ahead in his thinking. While much of mainstream clinical practice were wedded to monotherapy, sequential and progressive, each destined to fail, then death, he was more of combine treatments, bring them forward in the disease and "overwhelm" it. It was the for4erunner of today's doublet and triplet therapy.

That's the layman's version...

Mayo also had the C11 Choline scan, which was useful in locating recurrence, thus informing the treatment decisions. The PSMA PETs were in clinical trials, difficult to get into and definitely not generally available for serial imaging to assess treatment.

That being said, I had the triplet therapy done here in Kansas City by my medical team and would go back to Mayo for C11 Choline scans and updates.

At this point, I don't see a need to go back to Mayo. Everything I need is here in Kansas City, PSMA scans, I have a medical team who are active listeners and support shared decision making.

You ask, share my experience.

I felt he used his PA to do more of the consults than he did. His PA was very capable, so, technically, nothing wrong. In one of my trips up there, he spent a few minutes initially, turned me over to his PA and left. As my wife and I walked out, he was out in the lobby making small talk with the nursing staff. Again, nothing "wrong" but didn't meet my expectations of a doctor-patient consult.

On another consult, when I mentioned the genitalia shrinkage from the ADT, he laughed, made a comment about "taking me back to my pre-pubescent days..." Again, he was not wrong, but his patient-doctor bedside style rubbed me the wrong way.

Some other things I didn't like:

During one of the consults, he opened up by saying there was nothing wrong with my labs. Since I had the Mayo App, I could see my results and knew that several were out of tolerance and felt he should have mentioned those and any concerns or not he had.

The radiologist disagreed with his assessment of the C11 Choline scan but during his consult with me, he never mentioned it until I raised it. In felt it was important to discuss as it impacted the radiation treatment plan.

and finally, when I said I would do the WPLN radiation treatment here in Kansas City rather than spend five weeks at Mayo, he more or less disparaged my medical team here saying more or less only Mayo could do it to "standard." The Mayo radiologist was fine having it done by my radiologist here in KC and the two of them talked about the treatment plan, number, margins, boosts...

Study of one as they say, my experience.

Kevin

Is this about DR Kwon or DR Quevedo? My doctor now passes me off on to his PA now. I basically see him annually. I like the PA and she does a good job answering my questions. The problem is she doesn't know all the answers to my questions. The doctor I have now is very palliative in his treatments. I will be going on my third round of wait for PSA to rise to some where between 6-10 then radiation and meds. Then take a year break and do it all over again. NOT FUN. I am hoping to find a doctor who will listen to my concerns and be more aggressive upfront so that maybe my breaks in treatment are more than a year +. Thanks for sharing. Good luck in your journey. James

I have had aggressive prostate cancer since 2015. I originally had Dr Igor Franks and was transferred to Dr Kwon who I feel gets the more “persistent “ cancer cases. I feel that Dr Kwon has treated my cancer aggressively- he has never used a wait and see approach. I have had my prostate removed, have had radiation treatment 5 times, am on hormone therapy, had chemo and Pluvicto. Currently there is no sign of cancer. I have a Choline 11 scan and PSMA scan. These alternate every 3 month. I was told that each scan is better at finding cancer in different ways so alternating is the best way to go (for me). I have no problems with Dr Kwon’s bedside manner. He typically starts his day at 6:30 or 7:00 am and is usually the last person to leave as his patient load is so high. I always see his PA first and then Dr Kwon. At first he spent lots of time with me but now I spend more time with PA. Not a problem as I’m sure he has other patients that need him more than me right now. His PA will spend all the time with me answering questions and will let Dr Kwon know of any concerns that she can’t answer.

James

It was my experience with Dr. Kwon.

I have learned over my journey that is is not necessarily that the individual is not a qualified doctor, they have their training, education, license and board certifications...it is their "bedside manner" that may not be a fit for us.

I have "fired" some extremely capable urologists and oncologists from my team over the years. Why, not because they weren't experts, because they weren't active listeners, didn't want to share in decision making.

Dr. Kwon's PA was very good. Dr. Kwon himself is very good and his aggressive approach to treatment I believe saved my life and generally people on this forum and others say he did the same for them when their local teams were mired in standard of care treatments.

In my case, my medical team here has what I want, aggressive approach, active listeners and share in decision making...

I have all his YouTube videos bookmarked and share those with others where it may be pertinent to their clinical data and decision making.

Kevin

My Medicare advantage plan is with Kaiser. People complain about how Kaiser doesn’t do this or doesn’t do that, But my experience with prostate cancer treatment is very different.

Early in my PC treatment I was assigned the only GU oncologist at Kaiser. She trained at UCSF and really knows her stuff. She meets with me every quarter, By video conference. I can email her and she will answer any question I have, within hours, and when I meet her on video, it’s really productive.
She even set me up for a second opinion with one of the other Kaiser oncologists and he was really up on what was going on. I’m sure anybody using him was really pleased with their treatment. I do, however know that other people have been very disappointed with some of the Kaiser oncologists. I have always been proactive with my oncologist and because of her knowledge, she agrees with almost everything I’ve asked for. Even though we are in the same city, I’ve never met her in person.

Does anyone have experience with Dr. Fernando Quevedo? What thoughts do you have? Do his philosophies seem more palliative and traditional or progressive and align with the triple treatment philosophy? Were you happy with your care and treatments?

Does this guy not have any patients? I cannot find anything about the guy positive or negative. I am not sure if I should ask for someone else of just go with the doctor that Mayo assigned me. Ugh

Hi @jbnewby1313, I merged your 2 discussions into one discussion. I’m sure you’ve already seen this info about Dr. Quevedo, Medical Oncology at Mayo Clinic’s Comprehensive Cancer Center in Rochester MN
https://www.mayoclinic.org/biographies/quevedo-j-fernando-m-d/bio-20053928
You will be in good hands with the team at Mayo Clinic. And I do mean team. The “multispecialty, integrated, collaborative team” (MICT) approach offered by Mayo Clinic serves as a model adopted by several great institutions across the US and around the world.

It is likely upon reviewing your records that Dr. Quevedo was matched to your initial needs assessment. He will be your quarterback, so to speak. However, Dr. Quevedo does not work in isolation. With you at the center, the team will discuss your preferences and philosophy to match the optimal treatment recommendations suited to best evidence, your clinical status and your wishes.

You have obviously done a lot of research and are asking great questions that you will serve you well at your appointment in March. Are you leaning to a specific philosophy or approach? Have you already received a diagnosis or treatment plan elsewhere and are going for a second opinion?

Thank you for your detailed response. Yes, I have done quite a lot of research and feel very strongly about the information and research coming out of the Prostrate Cancer Research Institute (PCRI) and the Mayo Clinic. Without sharing too much, my PSA has gone up .1 every month. My current doctor wants to wait until it gets to 10 (!!) before doing anything, so yes, I am seeking a second opinion. I am grateful to hear that Dr. Quevedo was matched to me based on my initial needs. As a coach and athlete I appreciate the team reference.