As Seen in the Citrus County Chronicle: Two doctors have cancer in common

Citrus County Board Certified Radiation Oncologist Dr. Jayanth Rao was featured in the Citrus County Chronicle discussing how state-of-the-art prostate cancer treatments – available close to home – helped a fellow physician get through the diagnosis. Below is the story that appeared on the front page of the paper.
By Pat Faherty

Dr. John Larsen and Dr. Jayanth Rao both know a lot about cancer.

Larsen has dealt with cancer as a survivor for more than two decades, while Rao has devoted his career to knowing the disease and helping cancer patients.

Rao is a Board Certified Radiation Oncologist at 21st Century in Beverly Hills, where Larsen has been a long-time patient. So when the two talk candidly about cancer, it is on an authoritative level but indicative of the rapport Rao has with his patients.

Larsen was first diagnosed with prostate cancer in 1994 when he was 52 and working as a full-time emergency room physician in Everett, Washington.

He had some knowledge of the disease but recalls it was not enough. He was having difficulty urinating.

“That was a problem,” he said. “When you’re the only doctor in the hospital for emergencies, you can’t go and stand in the bathroom for five minutes — that was a problem.”

It drove him to a urologist.

“When he did the digital, I knew by the look on his face that something was wrong,” said Larsen. And it was after his diagnosis he also found out his grandfather had died from prostate cancer at age 56.

Subsequent tests showed the cancer had spread, and he was not a candidate for surgery. He was put on androgen deprivation and radiation treatments for about six years.

“I was good until about 2007,” he said, “and in the meantime, I had moved here.”

He was still going back to work, but on one return trip Larsen developed so much pain in his upper back he could not talk.

“So I called Dr. Rao, I didn’t know anybody here, but he was the closest one,” Larsen said. “He checked me, did the labs and started radiation as soon as possible, which did relieve the pain.”

So he went back to work, but three years later, the pain returned and he went back to Rao. After treatment Larsen, was back at work off and on. But the cancer had spread, and he had two back surgeries

followed by 11 chemotherapy treatments and more radiation treatments, which Rao described as palliative.

Since then, Larsen has done some part-time work and outwardly appears vibrant and healthy. Last week, in response to his multiple areas of bone cancer, Rao determined Larsen would be a candidate for a liquid radioactive isotope given intravenously.

“It goes through the bloodstream and pretty much locates the cancer sites,” Rao said. “Because it was so diffused, doing this would be better. Instead of doing a patchwork, it will reach all the bony sites. It’s again palliative, but it prevents the pain, prevents fractures. You can do that only once every three months or so. And it’s only for bone cancer.”

He described what Larsen has as a very aggressive cancer.

“And not surprisingly, this cancer moved, but we kept things at bay by different medications.”

However, Rao said, there came a point in time when even those became ineffective, because a patient develops resistance, which led to the isotope treatment.

Rao also touched on the controversial issue of surgery or non-surgery for prostate cancer and the definition of “cure.”

“There is no difference between surgery and radiation in terms of longevity,” he said.

As for a cure for prostate cancer, it depends on how one defines it.

“If you say cure means gone forever and it is not going to come back, then there’s no cure,” said Rao. “But if you say 10 and 20-year survival is considered a cure, we do have 10-year survivors, 15-year survivors and 20-year survivors.”

“I don’t know why I’ve survived so long,” said Larsen, “When I first started on this, I had opinions from five or six

specialists in Seattle and they gave me approximately one to four years to live. I attribute it to good care and keeping going. I’m a person of strong faith and strong will.”

As for advice, he urges people facing cancer to check all possibilities before taking a course of action.

Rao, who has practiced here for 20 years and treats all types of cancer, also addressed the controversy over PSA testing for prostate cancer.

“We need it,” he said. “It’s cheap, it’s easily available, so why not do it? Without that, we have nothing else to go by.”

His other observation on cancer, is that people in Citrus County are quick to look to Tampa or Gainesville when presented with that diagnoses, when there are great services available here.

“There’s nothing they can do that we can’t do,” he said.
Click here to read the full story on the Citrus County Chronicle’s website.