Bonus Episode: Ignoring Your Body's "Check Engine" Lights? Dr. Mistry Answers Listener Questions on Elevated PSA, Prostate Cancer, and the Importance of Men's Heathcare
March 22, 2024Dr. Sandeep Mistry and Donna Lee
Armor Men's Health Show
Bonus Episode: Ignoring Your Body's "Check Engine" Lights? Dr. Mistry Answers Listener Questions on Elevated PSA, Prostate Cancer, and the Importance of Men's Heathcare
In this segment, Dr. Mistry answers a listener's questions about men's health education and his ongoing struggle with elevated PSA levels. Unfortunately, many urology patients dismiss the seriousness of prostate cancer and avoid diagnostic testing that may reveal its presence. Others undergo test after test to determine the precise nature of their cancer and pursue aggressive, often unnecessary treatments. Dr. Mistry reminds listeners that more than 40,000 people die every year from prostate cancer–a sobering statistic that underscores the adage, “Knowledge is power.” Tune in to learn what your body’s “check engine” lights (like an elevated PSA) may be telling you about your health and when it’s time to visit the “body shop.” At NAU Urology Specialists, our holistic approach emphasizes routine maintenance and preventative care that can lengthen your health span (the number of years you remain relatively free of disease and/or health complications that impact your well-being) and even your life span (the number of years you live). Call or visit us online to schedule your consultation today!
Voted top Men's Health Podcast, Sex Therapy Podcast, and Prostate Cancer Podcast by FeedSpot
Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.
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Speaker 1:
<silence>
Speaker 2:
Welcome to the Armor Men's Health Show with Dr. Mystery and Donna Lee.
Speaker 3:
Oh , welcome back to the Armor Men's Health Show. This is Dr. Mystery , your host, board certified urologist. I am joined by my co-host, Donna Lee.
Speaker 4:
Hi everybody. Welcome to the show.
Speaker 3:
Donna is our business manager. She's our business development manager. She helps recruit new doctors and , uh, new , uh, uh, mid-level physicians. Uh, she helps , uh, keep the morale up by remembering people's birthdays and anniversaries. <laugh> , unfortunately, that means that her birthdays and anniversaries are al always forgotten they got
Speaker 4:
Forgotten. <laugh> . That's okay. That's okay. I didn't, I only cried a little bit that day. That's
Speaker 3:
Okay. Her last seven years have been like 10 minutes
Speaker 4:
Underwater.
Speaker 3:
Underwater <laugh>. Uh , this show is brought to you by NAU Urology specialist. That is the group that , uh, I started in 2007 , uh, to provide a holistic , uh, uh, different kind of approach to your urologic care. Mm-Hmm. <affirmative> . We are very proud of the type of medicine that we provide here. Donna. Uh , how do people become our patient? And where are we?
Speaker 4:
We are everywhere in central Texas, round Rock, north Austin. South Austin, dripping Springs, and you can become our patient by calling 5 1 2 2 3 8 0 7 6 2. Check out our website, armor men's health.com. Submit your questions there, please, and we'll answer them anonymously. Just for you, what did you say in the beginning? Um, this is the most time that patients will have with a urologist.
Speaker 3:
This is the time that many people , this is the most time that many people will ever spend with a urologist speaking about these, these , these issues.
Speaker 4:
That's right. So why not do it for free? Yes, absolutely. That's right. And you can check out our podcast wherever you listen to podcasts. Uh , we have another awesome question, Dr . Mystery . You ready? Let's do it. This one started off, I thought it was like a sales presentation. 'cause we get a lot of emails in our email system that says, would you like a new cleaning company? Or would you like your bushes trimmed? Which I , you know , that's always fun . Hey , hey , that's dirty. This one started off and I was like, oh, no, sir. Delete. But then I realized it was an actual question. So he starts off with, do you do quote corporate presentations where you present via Zoom? I work for a financial services company, and we have had doctors present on breast cancer, but we've never had one on prostate cancer. So that's a whole other side discussion. But here's the questions. I'm working through my own journey. Elevated PSA three lesions at PI dash RADS four . I assume you know what that means. Yes. Okay. And want to increase awareness of men's health and the importance of proactive checkups. That's number one. Number two is, is a biopsy needed to determine if you have cancer. I was curious about the ONC bio BIOT test , XODX, pca, three tests , et cetera. And then he asked about our podcast. He's just curious. The results can be so much more worse after one year I came across your show doing research and love your approach to the topics.
Speaker 3:
Well, that's a, that's a great point. So the first thing is whether or not, if you're out there and you're part of an organization almost anywhere and would love to , uh, have us do some type of presentation on men's health, we would love to do it. So , uh, please feel free to reach out. Uh, topics that people , uh, often want presentations on are , uh, prostate cancer screening, like this patient or this listener , uh, mentioned. Mm-Hmm. <affirmative> . But low testosterone approaches to men's health, weight loss solutions, as well as enlarged prostate type of issues are certainly things that a lot of men don't often get information on. And if you're the employer , uh, having healthy workers is always a really good thing. Mm . And
Speaker 4:
Certainly so
Speaker 3:
They stick around. Yeah. Testosterone and weight loss are certainly things that keep people at their desk, you know, for longer and , uh, for , uh, in , in , in healthier ways. So the next part is some of the things that this, this, this listener mentioned. So he has an elevated psa Mm-Hmm . <affirmative> , which means that he had a blood test done that showed that a certain protein that's made by the prostate was elevated. Mm-Hmm. <affirmative> . And some 40 years ago, a urologist and his lab discovered that this protein, when it's above four mm-Hmm . <affirmative> , that your chances of having prostate cancer were higher. And depending on which side of the fence you're on, it either touched off a firestorm of improved care for prostate cancer. Mm-Hmm. <affirmative> , or it led to a wild goose chase in which lots of people were being overdiagnosed with a, a very disease that wasn't gonna hurt many people. Mm-Hmm. <affirmative> , and I would say the jury is probably, in some people's minds a little out on this, but prostate cancer related deaths that are directly attributed to prostate cancer are on the decline. Treatments are improved. And this way of thinking about prostate cancer, that it doesn't kill anybody is wrong. Right. It kills 40,000 people, you know, men in the United States every year. And so, and, and the , and and more importantly, a lot of men, even though not dead, live with metastatic prostate cancer and have to be on medicines that make them feel poorly. I mean, finding something early always makes more sense to me than finding something late. Right.
Speaker 4:
What does metastatic
Speaker 3:
Mean? Metastatic means that it's spread outside of the prostate to other parts of the body. Okay. And that's going to cause, you know, that that's what's gonna ultimately lead to death. Okay . And so what what I find is that getting the actual data is scary to some doctors and some patients . So, you know, if, if your check engine light was on in your car Mm-Hmm. <affirmative> . But you were scared that it was the sign of a really bad transmission problem. Mm-Hmm. <affirmative> . But you knew it was probably just that your gas cap wasn't tightened. Right. Do you just say, well, it's probably just the gas cap, let's just keep driving <laugh> .
Speaker 4:
That's what I do.
Speaker 3:
Yeah. And that's what watching an elevated PSA is like your check engine lights on. Mm-Hmm. <affirmative> and this patient had another test. He had an MRI that showed three areas that were abnormal and highly suspicious of having cancer. So a 70% chance of having cancer. But he's still driving and he wants another test or another light or some other sign that says that he may have prostate cancer.
Speaker 4:
Oh, so you're telling him to go to the body shop or
Speaker 3:
The auto he needs , he needs to have a biopsy. Yeah. So getting to his third question is, does he need a biopsy? Mm-Hmm. <affirmative> . Well, yes. You have three areas of the prostate by MRI and if your urologist, you know, has, has morals and an emotion, then he will be able to provide you a navigated MRI , uh, fused biopsy. That's the latest and greatest that we can offer today. Mm-Hmm. <affirmative> , we can take that MRI image and we can fuse it with a real time ultrasound in our practice. We don't charge you extra. The big guys in town charge you $800 extra for your biopsy. Wow. Just to be able to use that machine. We don't do that because it doesn't make any sense because
Speaker 4:
We're terrible at making money. That's , but giving to the people
Speaker 3:
That , that is correct. <laugh> , you know, but, but it , it doesn't even jive in my mind that we would charge you for a better diagnosis. Mm-Hmm . I mean , your doctor should be able to provide you the best. They should have the equipment to provide you the best services they possibly can.
Speaker 4:
For sure.
Speaker 3:
And so that's what we do. So then , uh, the , the listener rattled off a number of other tests that can be done to better assess your risk for having prostate cancer. He mentioned several tests. Mm-Hmm. <affirmative> . And if you go to a well-trained urologist, they're also gonna have, you know, a buffet of tests that they kind of prefer. Mm-Hmm. <affirmative> these tests are best suited for people who, in my mind have already had a negative biopsy. Okay . So let's say your PSA's high, your biopsy is negative, you come back five years later and the PSA's high, and you're like, man, yeah . I , I really don't wanna go through that biopsy again. Uh, I'd really like to, you know, find additional data to tell me whether or not I needed it. Mm-Hmm. <affirmative> that's when these additional adjunct tests, you know, have a little bit more value. Okay. But if you have an abnormal MRI , you could have prostate cancer. Now, with that information in mind, do you want to know? That's the question. Mm-Hmm. <affirmative> , if you don't really, if, if you know that most people have a non-life threatening prostate cancer, or you have multiple myeloma and your life expectancy is only seven years anyway. Or you have bad cardiac disease or you, you , you know , you're on oxygen in a wheelchair. But this is not the vast majority of people. Mm-Hmm. <affirmative> , most of us are aging better than our grandparents did. Right. We are, we are, have a higher life expectancy. We are healthier later. And these are good things. So prostate cancer saying that it's not lethal, it could cer certainly take away from your quality of life. Mm-Hmm . If diagnosed late. And so I'm an engineer from my background, and so I'm also a urologist, but I'm an engineer, you know, from education. Mm-Hmm. <affirmative> . And I think that having the data and being able to make a decision based on the data makes a lot of sense. But you've heard of a biopsy, Donna, why , why do you think people wouldn't want a biopsy?
Speaker 4:
Um, what I've heard from patients is that they're incredibly anxious and scared about it might be painful or can you do it in the office? And some people prefer the surgical facility. Those are the things I hear. So I think they're just nervous. It's
Speaker 3:
Good . And many, and many urologists do it in the operating room. Mm-Hmm. <affirmative> . But they do it when they own the operating room.
Speaker 4:
Oh.
Speaker 3:
Because the efficiency of doing it in the operating room is, is , is very low. So a procedure that takes us, you know, let's say eight or 10 minutes here in the office as a urologist, you could spend one hour or an hour and 15 minutes waiting for the turnover time and waiting for the hospital. Mm-Hmm . <affirmative> . And for the patient, it's a lot more expensive to do it in the hospital as well.
Speaker 4:
A biopsy sounds like you're taking a knife or something scrapy and painful and like putting it in their booty hole . So maybe you can relieve the myth of how painful it's,
Speaker 3:
I'm, I'm afraid I cannot do that. Oh, yes . It , it , it is in fact putting something in the booty hole. Well ,
Speaker 4:
I knew that. Or ,
Speaker 3:
Or surely we can also, we can also, but the needle can either go through the skin underneath your scrotum or it can go through the rectum. We do it trans rectally. Uh, we have , uh, partners in town that do it. The the other , the other way that we can recommend you to do Mm-Hmm. <affirmative> . But it hurts the same.
Speaker 4:
But is there no, like painkiller involved? We
Speaker 3:
Give Valium. Okay . If you're particularly sensitive, we can give you an IV sed sedative here in the office. Oh . And if you're incredibly scared, then we'll just take you to the operating room.
Speaker 4:
That's fine. Gotcha. Okay. So you have
Speaker 3:
Options because it's , it's , it's what you want. Mm-Hmm. <affirmative> , you know, even if we think that most people should be able to tolerate something here in the office, that doesn't mean that we're the expert on everybody right now. Uh , I do probably around three or 400 biopsies a year. Mm-Hmm. <affirmative> . Uh , and , uh, I would say that, you know, 99.9% are done here in the office. Mm-Hmm. <affirmative> . And , uh, you know, we get the data and we get the information, and then we make decisions on what's going on. Nice. And , you know, 10 minutes of your life and we move along. Donna, great question. Tell us how , uh, people get a hold of us. If you
Speaker 4:
Would like your booty, hold scrape. Uh , call us at five one two <laugh> 2 3 8 0 7 6 2. And if you would like a biopsy, our website is armor men's health.com. You can check out our podcast wherever you pod for free.
Speaker 2:
The Armor Men's Health Show is brought to you by NAU Urology Specialist. For questions or to schedule an appointment, please call 5 1 2 2 3 8 0 7 6 2 or online at armor men's health.com.