Marek Jantos

Bringing relief to people who suffer from chronic pain has been the focus of my clinical and research work for almost three decades. Initially I worked with cancer patients undergoing chemotherapy, radiotherapy and bone marrow transplants. In 1994 I was invited by the Director of the Sexual Medicine Centre of the Canberra Hospital to assist with the study and management of complex chronic pelvic pain conditions. These were pain disorders that primarily affected the urinary and reproductive systems and gave rise to genital pain associated with intimate sexual activity. For over twenty years I have directed my focus to a range of female chronic pelvic pain syndromes collaborating in the development of protocols for the management of vulvodynia, painful bladder syndrome/interstitial cystitis and other less known urogenital pain conditions. This has been professionally rewarding and resulted in significant improvement in the quality of life of thousands of patients who pursued therapy in my clinics based in the capital cities of Sydney, Melbourne, Brisbane, Adelaide and Perth. Many of the clients have shared their case studies in the hope that other sufferers would benefit from them. Working at the forefront of new and evolving therapies, being willing to think outside the bounds of convention, while maintaining a commitment to evidence-based practice, has posed some unique challenges. Through it all my commitment has been, and will be, to advance the understanding of these complex conditions and to gain greater insight into the underlying mechanisms of pain, to enhance the wellbeing of my clients and all who suffer from chronic pelvic and urogenital pain.

“There is, there has been, there will always be a certain group of people whom inspiration visits. Its made up of all those who’ve consciously chosen their calling and do their job with love… Their work becomes one continuous adventure as long as they manage to keep discovering new challenges in it. Difficulties and setbacks never quell their curiosity.”

Wisława Szymborska
Polish Poet, Nobel Prize Laurette

Philosophy of Therapy

My approach to the management of chronic urogenital pain evolved over many years of practice. My philosophical perspective is best described as wholistic. I consider the balance between the physical, emotional, social and spiritual domains as vital to facilitating healing and recovery from pain and functional brokenness. Following years of work in tertiary institutions, undertaking my own studies, teaching, researching and supervising post-graduate students, I sought to apply the current state of knowledge and experiential learning to the clinical mangement of chronic urogenital pain syndromes such as vulvodynia and bladder pain/interstitial cystitis. I entered private practice in 1997 and established a network of clinics in Australia and overseas. With the use of conservative, but not necessarily conventional therapies, we made notable progress in the management of these disabling pain conditions which affect a disproportionate and ever-growing number of women. On account of chronic urogenital pain I have seen countless intimate relationships disrupted, marriages unconsummated and broken, and plans to establish a family halted. The pervasive nature of chronic pelvic pain can have a very debilitating impact on individuals and couples. It is professionally satisfying to guide patients to an understanding of the potential causes and mechanisms of pain and to assist them with selecting therapy that may bring relief from their suffering and despair.

“One of the most difficult tasks… in reconsidering our treatment of painful urogenital disorders involves the “unlearning” of long-held beliefs rather than the acquisition of new knowledge. Many of the assumptions we have carried with us for years… have contributed to the iatrogenic propagation of pelvic pain syndromes.”
“I tell my patients with chronic urogenital pain and pelvic pain that I have two equally important obligations to them. On the one hand, I must make sure that they get all the treatments they need, but on the other hand, I must often expend just as much effort to make sure they are not subjected to treatments they do not need.”

(Daniel Brookoff, 2009)

Integrated Mapping and Assessment Protocol – iMap

“Innovation distinguishes between a leader and a follower.”

Steve Jobs, Co-Founder Apple

Individuals affected by urogenital pain often suffer in silence. When circumstances cause them to seek professional help it is not uncommon for their pain and symptoms to be questioned and met with disbelief. When investigations and test results return negative, and to the untrained eye there is no pathology to explain the pain, it is often implied, if not openly stated, that their pain is not real but imagined, that it is feigned, or a sign of malingering and avoidance. From my earliest publications in 1997 onwards, contrary to popular opinion, I found no evidence that these conditions had a psychological basis to them. So many of the views held by professionals were based on erroneous assumptions and Freudian myths that continue to permeate perceptions of pelvic and urogenital pain. Though my views were unpopular and controversial, the psychophysiological profiles of patients, including electromyographic studies of pelvic muscles, demonstrated that dysfunctional, overactive muscle states were associated with chronic urogenital pain conditions, including vulvodynia and bladder pain. In recent years, following on from numerous retrospective studies, my associates and I developed an evidence-based Integrated Mapping and Assessment Protocol (iMAP). This new and innovative approach to the appraisal and management of chronic urogenital pain is not an alternative to traditional medical assessment and interventions, but one that complements, broadens and guides the conventional medical approach. The iMAP identifies peripheral mechanisms of pain and highlights the role of muscles as generators of pain. I strongly believe that the majority of non-neoplastic chronic pain conditions arise from dysfunctional neuromuscular states, fascial restrictions, ischemic states and end-organ symptoms. In a recent editorial and various earlier publications I continue to stress the importance of understanding the role of muscles and fascial restrictions in the management of chronic pain. The iMAP provides a clear evidence-based rationale for the utilisation of myofascially-orientated therapies. Pragmatically, I also acknowledge that the severity of pain is mitigated by individual perceptions, personality traits and emotional states, and that these are important factors that also need to be addressed in therapy. The iMAP and therapeutic modalities used in my practice place lesser emphasis on pharmaceutical and surgical interventions. Their importance is recognised, but in the context of third and fourth level interventions, either in conjunction with, or when conservative treatments have failed. Whatever combination of therapies may be used the sufferer must not be stigmatised by notions that their pain is psychogenic in its origin, stems from faulty beliefs, constitutes avoidance behaviour, somatization or sexual dysfunction. Such views are counter-productive and without scientific basis. Psychological changes observed in individuals arise on account of chronic pain and are secondary to the physical and emotional suffering endured but are never the cause of the symptoms.

Credentials

I received my PhD through the School of Medicine at The University of Adelaide in South Australia (this was a research degree, not a qualification in medicine as I'm not a medical practitioner). I obtained my Master's Degree from Andrew's University in Michigan and my Bachelor's degree from Flinders University in South Australia. However, the most important source of ongoing learning is from my patients, of whom there have been several thousand, and to them I remain indebted. As an academic, clinician and facilitator of learning I have been an active member of various professional associations and community organisations. My professional interests span across several areas of health and emphasise the importance of lifestyle and personal behaviour. In 1997 I founded the Behavioural Medicine Institute of Australia, based in Adelaide South Australia and under its auspices convened various conferences and training workshops in Australia and overseas. These conferences not only focused on the psychophysiology of pain, but in August of 2000 also included an inaugural meeting focusing on the management of vulvodynia. In 2005 I convened the first national conference examining the relationship between spirituality and health. This multidisciplinary conference, attended by over 500 scholars and clinicians, led to the publication of a supplement on spirituality and health in the Medical Journal of Australia. My personal contribution to the spirituality and health meetings, journals and textbooks specifically focuses on the impact of prayer and mediation on health and wellbeing. I always enjoy sharing and contributing to the study of mind-body medicine and a better understanding of personal wellbeing. With a greater and ever evolving appreciation of mechanisms involved in chronic pelvic and urogenital pain, I’m motivated to share my insights through professional journals and textbooks, conference presentations and workshops. I am involved with the editorial board of the Journal of Lower Tract Genital Diseases and contribute as section editor for Chronic Pelvic Pain for the Journal of Pelviperineology. In recent years I have been a regular visitor to the beautiful land of China sharing with thousands of specialists our assessment and management protocols for chronic pelvic and urogenital pain. I also treasure my relationship with the Medical University of Lublin in Poland where I have been granted an honorary position and recently presented an inaugural lecture. For a more detailed listing of academic and professional activities please see my personal curriculum vitae.

Marek Jantos, Medical University of Lublin 2015

Collegial Opinions

To my many colleagues, associates and fellow clinicians, as well as academics and administrators who share the passion of serving women and men affected by chronic pain I am grateful and indebted. I humbly accept their kind words in relation to my work.

Dr. Marek Jantos is one of the world’s pre-eminent clinicians and researchers on topics related to pelvic pain. He is a master clinician with more experience in this area than anyone that I am familiar with. His approach is professional, but warm and compassionate, and is guided by his successes with hundreds (if not thousands) of patients. Dr. Jantos is universally respected and esteemed by his colleagues around the world. I can think of no other clinician to whom I would be more confident in making a referral.

Dr. Richard Gevirtz, Ph.D., BCIAC Distinguished Professor CSPP@ Alliant International University San Diego, California, USA

The Spirituality and Health conferences have emerged in Australia as a direct result of Dr Marek Jantos vision. He has a capacity to bring people together with a common goal to develop an idea into a reality. His ongoing passion for the area of spirituality and health is recognised and respected by his colleagues and has seen the conference become a permanent fixture on the Australian calendar.

Dr. Ann Harrington RN, DNE, B.Ed, M.Ng, PhD, FCN, FRCNA Flinders University

The title of Dr in the above statements refers to my academic doctoral degree (Ph.D) and is not a reference to medical qualifications.

Personal Interests

When my work is done I enjoy spending time with my six grandchildren, my two beautiful daughters, their partners and my wife. They fill my life with joy and happiness. I love the outdoors and tending my pets, large and small. I enjoy travelling and exploring new places, meeting new people and experiencing international cuisine. Most of all I finding meaning in sharing the blessings of life with those in need, be it in Australia or abroad. As I reflect on the brevity of life, and its many challenges, I review the past and focus on moving forward. In the quiet moments, as well as the turbulent times, I sense the guidance of a higher power and personally pray for strength and wisdom. I firmly believe that each one of us individually, and together collaboratively, must strive for greater understanding, seek higher goals and better outcomes in our professional and personal pursuits.