Armor Men's Health Show

EP 598: Patient Testimonial - Chris Leaks the Best-Kept Secrets in Prostate Cancer Treatment: PAE + HIFU!

• Dr. Sandeep Mistry and Donna Lee

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In this episode, Dr. Mistry and Donna Lee are joined by friend, family member, and star patient Chris Wren. An abnormal PSA test (and his daughter-in-law, Donna Lee) brought Chris to NAU Urology Specialists, where he was diagnosed and successfully treated for prostate cancer. Today, Chris describes his experience with two little-known and hard-to-find procedures that effectively treat prostate cancer with minimal side effects--prostate artery embolization (PAE) and high-intensity focused ultrasound (HIFU). Listen as Chris shares what he learned on his prostate cancer journey and gives our listeners advice about caring for men's health issues as they age. 

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.

We enjoy hearing from you! Email us at armormenshealth@gmail.com and we’ll answer your question in an upcoming episode.

Phone: (512) 238-0762

Email: Armormenshealth@gmail.com

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Speaker 1:

Welcome to the armor men's health show with Dr. Mystery and Donna Lee.

Speaker 2:

Hello and welcome to the armor men's health show. I am Dr. Mystery, your host board certified urologist men's health expert, all around great guy.<laugh> joined by my co-host Donna Lee.

Speaker 3:

That's right. Welcome to the show, everybody. The armor men's health show used to be the hour, but now it's

Speaker 2:

The show. It's really a great honor for me to be able to do the show with you every week. Donna, you're amazing. You have such a commitment to the practice that we've grown since 2007 and, and is the sponsor of this show. Mm-hmm<affirmative> that practices AAU urology specialist. Why don't you tell people about our practice?

Speaker 3:

First of all, you're stuck with me. And second of all, you can reach out to us by phone(512) 238-0762. Our practice was founded 2007 by Dr. Mystery, 15 wonderful magical years ago. We're in round rock, north Austin, south Austin, and dripping Springs, Texas are shiny new websites, armor men's health.com.

Speaker 2:

We have patients that visit us from all over the country. They both visit us as patients. They visit us via the, the website and try to ask us questions. Mm-hmm<affirmative> we love it. We love such a great outpouring of support. They love the show. I've had men cry in the office talking about how nobody would want to talk about their funny looking penis or their buried penis or their erectile dysfunction or their delayed or all these things that like, kind of really speak to them so deeply, but they just can't speak to anybody like that, right?

Speaker 3:

Well, no, they

Speaker 2:

Have you. And then, and even like their sexual proclivities, they don't know that they can share with anybody. So we love being able to be that resource for you and really like a holistic approach to men's health mm-hmm

Speaker 3:

<affirmative> that's right. And we have a very, very special guest in my life today.

Speaker 2:

He really represents the kind of person that we like to take care of. Mm-hmm<affirmative> which is the pain in the patient.<laugh>

Speaker 4:

It is,

Speaker 2:

It is, you know, like a lot of doctors, they like, you know, you're the boss, right? Right. We've heard, we've heard doctors say that I'm the captain of the ship. Right. They walk in there with their shiny white coat and say, you have this, this and this, you need this done. And they walk out and the guy gets scheduled for surgery and it sounds like that's gonna be wonderful. And then sometimes you get that guy

Speaker 4:

<laugh>

Speaker 2:

That just doesn't do a thing that you want him to do. And you gotta really do your little, your little, you know, calisthenics to get him happy, Chris Randen thank you for joining us today.<laugh>

Speaker 4:

Thank you, Dr. History.

Speaker 2:

<laugh> so Chris, you have a lot of very personal connections with our practice we're friends personally. And then of course, as a patient of ours, you first came to us because you had some abnormal lab tests. Is that right?

Speaker 4:

Yes, I did.

Speaker 2:

So you went to your primary care doctor and you had a PSA test that was abnormal.

Speaker 4:

Yeah. My primary care doctor, um, was I was with him for about 20 years and we started to monitor my PSA's way back, probably in the early two thousands, because I had some ups and downs with it and it just kind of settled out.

Speaker 2:

And so the number was high and UN undeniably, somebody suggested you see a urologist and some urologist suggested you get a biopsy, but you were kind of reticent to proceed with that. Is that right?

Speaker 4:

I, when I saw my doctor the last night was before he retired, he, uh, he was looking at my PSAs and they were up around seven or something. And he called me back after I visited him one day and he said, Hey, I just don't like this. And I I'd like to recommend some urologist to you. And I said, well, who, who are they? Cuz I didn't have a urologist at the time. So he gave me three urologists and I sort of hemmed and hawed around about it. And then lo behold, I mentioned this to Donna at a party we were at. And I said, you know, I, I need a urologist. She, I got one for you.

Speaker 2:

I got one for you.

Speaker 3:

I'd like to interject. I am his daughter-in-law.

Speaker 2:

And I would like to interject that you guys talk about weird things at parties.

Speaker 4:

<laugh>

Speaker 3:

So family parties

Speaker 4:

At that, it wasn't a deep<laugh>.

Speaker 2:

So if I had to just kind of inquire as to kind of, uh, some, some just kind of insight from my patients, like when you're given information that you have abnormal lab tests and you need to see a urologist, what kind of thoughts go through your head?

Speaker 4:

Not really too much. I, I guess I'm, I don't get too excited about it. I monitor my health for a long, long time just because it happened that way.

Speaker 2:

And I think that's a lot of patients, you know, as our population's getting older and older, I think people, a lot of people are taking better care of themselves. They expect more out of themselves.

Speaker 4:

Yeah. A little backstory in that. Uh, I used to work for Dow chemical and um, some many, many years ago, but as you reach, you reached a certain level of management within Dow and then you had to have your annual physicals and um, stress tests and so forth. And, uh, that really began, I don't even know if PSAs were, were common at that time, back in the seventies and eighties, but anyway, long story short, uh, that sort of sent me on a track to take care of myself for, for the rest of my life.

Speaker 2:

So, so fast forwarding, we ultimately diagnosed you with prostate cancer after doing a prostate biopsy. And then when you had that prostate cancer diagnosis, what kinds of things went through your head? What were you afraid of? You know, what, what, what was some of your thinking process?

Speaker 4:

Uh, I wasn't entirely surprised, you know, um, I think I was a little bit emotional about it in the beginning. And then, you know, I felt like, Hey, we're gonna get on the track with this. We're gonna do something about it. I was resolved to do something about it. And um, I think the first step of course was to do a biopsy as you suggested.

Speaker 2:

So, so, so we did that biopsy and you were given a diagnosis and I think a lot of men kind of respond to that information differently. I've seen people completely ignore it and they don't care. I've seen people break down completely emotionally. It just kind, I think a lot of times people bring baggage about what a cancer diagnosis means to them kind of into that meeting.

Speaker 4:

Uh, yeah, I, it was kind of funny. I, I wasn't really that upset about it. Um, well for one thing that the greater the cancer was low and, um, it was isolated. I think that was the case at the time. And um, I just sort of let's press on, I I'm kind of built that way. I just say, well, gotta do something about this and let's whatever we're gonna do. Let's, let's,

Speaker 3:

That's a good lesson for our listeners.

Speaker 2:

And so we talked about different treatment options. We talked about radiation surgery. Ultimately we talked about high intensity focused ultrasound, which we, we use ultrasound technology that goes through the rectum to, to take care, uh, of the prostate. And that's ultimately what we went through. But, you know, the, the, the, the kind of calculus that was going on in your head was you're, you're so functional. You love to travel, you wanna retain your sexual function, which I think that, you know, maybe as people get over the age of 70, their urologists may not think that that's as important to them, but, but, you know, as I always say, my favorite patient is the 80 year old, that's trying to have sex, right. Dr.

Speaker 3:

Mr. Loves giving an 80 year old,

Speaker 2:

A hard on given 80 year old's hardons. And so, and so, and so for me, understanding, uh, what the ultimate goals of the patient are, are so important and also not leaking and, and, and trying to balance, you know, side effects and treatment efficacy.

Speaker 4:

Well, you know, I didn't really have, uh, much of any symptoms. Um, urination was an issue only in to the extent that, um, at urgency at times, uh, drilled world. Um, but as far as, you know, I didn't have any other issues. It was like I've got cancer, but I, I don't have any,

Speaker 2:

Any symptoms. And, and that is, that is the truth for most patients with prostate cancer. In fact, if you have symptoms, then that's kind of a really, really, really bad sign. Mm-hmm<affirmative> so most patients prostate, you waited too long. So most patients with prostate cancer are not gonna have symptoms. Um, you know, following the recommendations of your doctor. I think the only thing that I would've wanted is maybe an earlier referral when your PSA was a little bit over four, but that's just because I like to catch people as early as possible. Right. And then really communicating with your urologist and your doctor, like, what are your treatment outcomes, if it is it, is it to live as long as possible, or is it to maximize your quality of life? And, and do you feel that doctors are kind of getting better about understanding these things?

Speaker 4:

I think it depends on the doctors. I was gonna say, which doctor are you? Um, I, I'm just thinking about, I have a cardiologist, um, um, I have a primary doctor and they are younger. Mm-hmm,<affirmative> younger doctors. Um, there are times when I feel like they're not available, you know, when I'd like to see them, I, I was sort of, uh, spoiled with my, my primary doctor of 20 years. He had a small practice. You could call him at a drop of that and get to see him, but I feel that way about you guys. I mean, I can, I can call him and say, I've got a problem and it's just taken care of.

Speaker 3:

So it's cuz you know, somebody who works

Speaker 2:

There. Yes. No. And it's because we're a small practice who loves everyone. Right?

Speaker 4:

That's true. Yeah. There's that? Yeah. So, um, I, I just think I've got a lot of attention from people in the practice. Um, everybody it's it's um, I I'm very happy.

Speaker 2:

So once you were diagnosed with prostate cancer, we, uh, ultimately decided to proceed with high intensity focused ultrasound treatment for your prostate cancer. Is that

Speaker 4:

Right? Uh, yes. We had gone through three biopsies over the course of what? Uh, like three years.

Speaker 2:

Yeah. So it wasn't an immediate

Speaker 4:

Thing. It wasn't an immediate thing. And um, my PSAs, uh, started to climb and they got up to at one point they got up as high as 12 and kind of rocked back down to 10

Speaker 2:

And the cancer diagnosis got a little worse

Speaker 4:

Too. And the cancer diagnosis jumped up a, a little

Speaker 3:

Bit and I heard that biopsies are super fun.

Speaker 4:

Oh, I, I tell you they're, they're a lot of fun actually. Um, I told Dr. Mystery. I said, Hey, you know what? I really do not wanna do a biopsy in the office. And um, I certainly didn't want to do a cystoscope in the office having had that experience before. So, uh, anyway, we worked that out and went to the hospital and did that pretty cool thing. Were you,

Speaker 2:

You do an MRI guidance biopsy, which was really cool.

Speaker 4:

Right, right.

Speaker 2:

And, and, and how, how old were you at your ultimately when we treated you

Speaker 4:

78,

Speaker 2:

So 78 and super functional. You wanna main your ability to travel your ability to kind of take as much as you can from life. And so we decided that a, a more minimally invasive approach, like high intensity focused ultrasound may work. Right. But your prostate was too big. We need to have a prostate. That's a little smaller for it to work. And then you were already having some urinary symptoms. So right. Uniquely amongst our patients, you chose to do something called prostate artery embolization to shrink your prostate. Yes. Uh, may maybe tell me, like, if you had to describe it to the, the listeners, how would you describe what prostate artery embolization is?

Speaker 4:

It's actually a fairly easy procedure of you've ever had a catheter catheterization for heart. This is the opposite. You're trying to stay alive with catheterization in your heart. Uh, that procedure versus this one is you're trying to cut off the blood supply or some portion of blood supply to your prostate intervention is radiologist performs a procedure. They go in through your, your growing area up, up to your prostate pro prostate

Speaker 2:

Prostate. It's good enough.

Speaker 4:

<laugh> yeah, I know frustrate. I was frustrated at time.

Speaker 2:

You were frustrated at the time

Speaker 4:

On the table and, um, I was partially under it. Um, it lasted about an hour and 10 minutes. I didn't feel a thing. And, um,

Speaker 2:

That's what she said

Speaker 4:

It was, and it was very successful. I walked out the office. That's awesome. My prostate ended up shrinking by half.

Speaker 2:

It's amazing. And so, and so in order to be a candidate for this high intensity focused ultrasound, we need to shrink the prostate. And so one of the options that we have is to rotor, roter it out, called the TURP<laugh> we can use the, we can use the water jet called Aqua ablation. And then, uh, again, uniquely, because many urologists don't offer prostate artery ization because it's not done by urologists. So I don't make the money. Right, right. So I have to, we partner with advantage IR, we sent you to them, they accomplished what we needed, which was to reduce the size of your prostate. Now what happened to your urinary issues used to have urgency and some dribbling. It

Speaker 4:

Just virtually went away as, uh, I guess I could go back and say, I was, I had a 20 year old bladder now.

Speaker 2:

That's good.<laugh>

Speaker 4:

Hey,

Speaker 2:

Wait

Speaker 4:

A minute. But no, I, I think it, uh, it was very successful.

Speaker 2:

That's wonderful. A lot of patients tell me that their erections are better afterwards. Did you notice anything improving on your erections?

Speaker 3:

I'm gonna put earmuffs on my ears since were related.

Speaker 4:

I think it was even better after H food. Yeah. But I would say that, um, I don't have any trouble getting erection.

Speaker 2:

Well, that's

Speaker 3:

Good. Now there's a testimony on, I'm gonna, we're gonna single that audio out and just put that on the commmercial smart on his face.

Speaker 2:

We're gonna put

Speaker 3:

Hist get any trouble getting an

Speaker 2:

He's

Speaker 4:

My favorite on the other side of that, you know that, uh, I'm 79 years old, almost 80 and, um, um, sustaining erection. You need a little help sometimes. And so

Speaker 3:

We got you, we got this one over here.<laugh>

Speaker 2:

As we say, I love nothing more than giving an 80 year old an erection<laugh>.

Speaker 4:

But, but as far as the procedures concerned, it was one of the easiest things they've ever done.

Speaker 2:

So, uh, for those of you out there that haven't enlarged prostate are worried about going through a surgery that you may a catheter for, or you've heard horror stories, and you wanna learn more about prostate artery embolization, please reach out to us. We have a wonderful webinar that we've done on it. We have, uh, a great partner and advantage IR that we can, we can send you to that's

Speaker 3:

Right. We do monthly webinars. And if you want a copy of the webinar, just email me at armor men's health.com.

Speaker 2:

Yeah. And then, uh, afterwards after the prostate shrunk, we did that high intensity focused ultrasound. That's where we used ultrasound energy just to target where the cancer was. Why don't you, uh, describe what that process was like?

Speaker 4:

Okay. Um, actually, um, a very short duration, um, went into hospital, um, was put, put under anesthesia. Um, I think it took what you could. I, I don't know, doctor, it

Speaker 2:

Took, it took, took less than an hour and a half to do it less.

Speaker 4:

Yeah. Less than an hour and a half.

Speaker 2:

And then you woke up and you had a catheter.

Speaker 4:

I had to, um, wear the catheter for, um, a week. Um, the good news on that was I had home healthcare. So I had a nurse come, um, every day to check me out, make sure everything is right. And I wouldn't have any problems with the catheter. And, um, at the end of seven days, took the catheter out and, um, I urinated immediately.

Speaker 2:

Thank goodness.

Speaker 4:

And thank goodness. And, uh, did have, did have some passage of blood, some small clots. So, and over the course of time had, you know, blood was being or urinary, um, through urination.

Speaker 2:

Yeah. Because blood in your semen after that kind of procedure is not uncommon, a little bit of blood in the urine and you had long after week, or you can ask up to six weeks to

Speaker 4:

12 weeks. It was probably a month. Yeah.

Speaker 2:

It can let it

Speaker 4:

A while. It just gradually just sort of dissipated.

Speaker 2:

It goes to different color stages. Yeah. Mm-hmm<affirmative>. And so you had a, you had an excellent outcome from two procedures that many of our listeners, you know, not just in the Austin area, but all across the nation, aren't gonna hear about prostate artery. Embolization is probably only offered maybe in 10 or 15 markets in the United States and Haifu, there's only 20 machines in the entire country. So if, if, if you don't live near one or you haven't been told of one or your urologist doesn't do it, you're never gonna hear about these things. Right.

Speaker 4:

Right.

Speaker 2:

And so, um, you know, if, if you, uh, were to go back and think about the things that men can be afraid of, uh, when it comes to, uh, accessing their urologic health, do you have any kind of advice to them about, uh, about what they should be doing and thinking about or what kind of things they should look for in a doctor?

Speaker 4:

Well, I think the first thing they should be doing is, um, monitoring their PSAs. Um, the, the digital rectal exam is sort of, kind of fall out of favor. I think.

Speaker 2:

Yeah. We call it the urologist handshake,

Speaker 4:

Either urologist, handshake,

Speaker 2:

Just so you know that I care about

Speaker 4:

You. Uh, and I believe you also call that, uh, that thing that they digitally do is the beast,

Speaker 2:

The beast, the beast

Speaker 4:

You call the beast.

Speaker 2:

Wow. I don't call it the beast. How

Speaker 4:

Much I calling you the beast?<laugh> it's

Speaker 2:

Everybody. The beast is here. If you pay extra, you get two fingers.

Speaker 4:

Hey, no, I, I think, I think location, I think monitoring it, um, early detection is extremely important and, um, it's the old deal is I don't want to hear anything but good news. Well, you have to hear bad news.

Speaker 2:

Sometimes there's gonna be some bad news. Huh? Yeah.

Speaker 4:

Mm-hmm<affirmative> and, and bad news. If you don't know there's anything wrong with you, uh, you're not gonna treat it or you're not gonna seek help. So first of all, you need to find, you need to stay in tune with your body and you need to get annual results typically on PSAs. And from that, then you can consult with your great urologist.

Speaker 2:

Well, uh, there are a few, uh, people that I, uh, want to be when I, uh, grow up and you're one of them, Chris. Oh, you know, my dad used to work for, uh, Dow chemical. So I feel even in even a strong connection, really, he sure did. He sure did. Wow. And I can't thank you enough for joining us and sharing your experience. It just kind of illustrates, uh, both the connection we love to have with our patients, but more importantly, the kind of cutting edge technology and the openmindedness of our patients that we just really appreciate. So thank you so much for joining us. Thank you for joining us. You Donna, how do people get ahold of us? How do people become our patients? And that's right. I share that same experience.

Speaker 3:

Oh, to have this warm, loving experience. If you can also have call us at(512) 238-0762, you can also ask for me and you can visit our website, armor men's health.com. Check out our podcasts, wherever you listen to free podcasts. They're all amazing. And award-winning and thank you both so much.

Speaker 1:

Thank you. The armor men's health show is brought to you by NAAU 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.