35 Burst results for "Prostate Cancer"
Darth Vader actor David Prowse dead at 85
"The actor that played Darth Vader in the Star Wars franchise has died. The rebels are alerted to our prisons on reliable came out of light speed too close to the system. He felt surprised. Advisors is clumsy and he is stupid. David Prowse audition for Darth Vader and Chewbacca deciding on Darth Because everyone remembers the villain. The voice of Darth Vader is James Earl Jones. David Price was battling prostate cancer since 2018. He was 85 years
Al Roker gives positive update after prostate cancer surgery
"Roker, who returned to the Today show this morning. Did you see him gave an update on his progress dealing with prostate cancer. The beloved NBC weatherman revealed his diagnosis earlier this month and has since had surgery Now, he said, January I'm gonna go get a blood test. Hopefully, it'll be a reading The P s a reading that The prostate specific antigen that that's below 0.5. And if that's the case that mean and then six months after that, and that means then Right now. There's no cancer evidence. Yeah, His doctor Memorial Sloan Kettering is Dr Vincent Law. Joan appeared with broker saying Al has an excellent prognosis. He's a good dude. His wife, Debra Roberts, a long time journalists also that good people. Good news to hear that.
Al Roker says he is 'relieved' his prostate cancer surgery is done and is recovering back home
"Out broker is home after having his prostate surgery he is doing well back home. Thanked all. The doctors thanked everybody for all of the care that he had. For his surgery last week, he's posted pictures of himself. In the hospital. But he says, you know, the good news is is that we caught The prostate cancer early, So you know, right now that the surgery's over, he is resting at home. Good to hear that, Um, let's talk about
Theranos, whistleblowing and speaking truth to power
"So i had graduated seven years ago from berkeley with the dual degree in molecular and cell biology and linguistics. And i had gone to a career fair here on campus had gotten an interview with the startup called thanos and at the time. There wasn't really that much information about the company but the little that was there was really impressive. Essentially what the company was doing was creating a medical device where you would be able to run your entire blood pam panel on a finger stick blood. She wouldn't have to get a big needle stuck in your harm in order to get your blood tests done so this was interesting not only because it was less painful but also it could potentially open the door to predictive diagnostics. If you had a device that allowed for more frequent and continuous diagnosis potentially you could diagnose disease before someone got sick and this was confirmed in an interview that the founder elizabeth holmes had said in the wall street journal. You know the reality within our healthcare system today. Is that when someone you care about gets really sick by the time you found out. It's too late to do anything about it. And it's heartbreaking. This was a moonshot. That i really wanted to be a part of and i really wanted to help bills and there was another reason why i think the story of elizabeth really appealed to me so there was a time that someone had said to me. Erica there are two types of people. There are those that thrive in those that. Survive in you my dear our survivor. Before i went to university. I had grown up in a one bedroom trailer with six family members. And when i told people i wanted to go to berkeley they would say well. I want to be an astronaut. So good luck. And i stuck with it and i worked hard. I managed to get in honestly. My first year was very challenging. I was the victim of a series of crimes. I was robbed at gunpoint. I was sexually assaulted. And i was sexually assaulted at third time. Spring on very severe panic attacks where it was failing my classes and dropped out school and at this moment people had said to me erica. Maybe you're not cut out for the sciences. Maybe you should reconsider doing something else. And i told myself you know what if i don't make the cut i don't make the cut but i cannot give up myself and i'm going to go for this and even if i'm not the best for it i'm going to try to make it happen and luckily i stuck with it and i got the degree and i graduated. So when i heard elizabeth holmes had dropped out of stanford at age nineteen to start this company and it was being quite successful to me. It was a signal of you know. Didn't matter what your background was. As long as you committed hard work and intelligence that was enough to make an impact on the world. And this was something for me personally that i had to believe in my life because it was one of the few anchors that i had had that. Got me through the day. So you can imagine when i thought about theranos. I really anticipated that. This would be the first and last company that i was going to work for. This was finally my opportunity to contribute to society to solve the problems that i had seen in the world but i started to note some problems so i started off as an entry level associate and the lab and we would be sitting in a lab meeting reviewing data to confirm whether the technology worked or not. And someone would say to me. Well let's get rid of the outlier and see how that affects the accuracy rate. So what constitutes outlier here. Which one is the outlier in the answer. Is you have no. You don't know right. In deleting a data point is really violating one of the things that i found so beautiful about the scientific process which it really allows the data to reveal the truth to you and as tempting as it might be in certain scenarios to place your story on the data to confirm your own narrative when you do this has really bad future consequences so this to me was almost immediately a red flag in a kind of folded into the next experience and the next red flag that i started to see within the clinical laboratory so clinical laboratory is where you actively process patient samples and so before. I would run a patient sample. I would have a sample where i knew what the concentration was. And in this case it was point to for tps psa which is an indicator of whether someone has prostate cancer or is at risk of prostate cancer. Or not. but when i'd run it in the theranos device it would come out eight point nine and then i'd run it again and it come out five point one and i'd run it again. Had come out point five which is technically in range. But what do you do in this scenario. What is the accurate answer
"prostate cancer" Discussed on Mayo Clinic Q&A
"When diagnosed with this type of cancer of course when the cancer is more advanced than we certainly taylor the the focus to actually treating the cancer so any man with a pardon all the lingo but gleason score seven or higher a great group to or higher prostate cancer and You know somebody with what i would consider. Intermediate risk parameters really should be encouraged to treat intermediate responders or higher should really be encouraged to focus on treating the prostate cancer. Especially if they have a life expectancy of more than ten to fifteen years and that's an important topic to mention is that because prostate cancer can present very advanced stages or ages. Life expectancy is a consideration to in part of the discussion because if a man is in his eighty s and has competing Medical problems sometimes even with significant prostate cancer. We may not treat that cancer because our goal is to do no harm. You mentioned the gleason grade Just for the listeners. And the view is. Can you explain a little bit what that is. Gleason grading is a pathologic grading system. That really looks at the actual cell structure of the cancer under a microscope in the look at the cell structures determine the aggressiveness of the cancer. So the gleason grading system starts from six or three three equals six to five. Plus five equals ten on the extreme advanced presentation form so They've tried to shift away from this gleason pattern to what they call a great groups. Great group one through five and simply for the fact that when men here a gleason six cancer to them they hear six out of ten and they get very concerned that the cancer is beyond five notes to them. It sounds more advanced. So we've changed the nomenclature over the years to accommodate for the fact that gleason six prostate cancer is actually a very slow growing cancer and very early detected non-aggressive other times we think for example patients should seek a second opinion. I think oftentimes when you use the basic minimum to make a diagnosis in stage patient I think that's that is all that's required for most providers. I think for patients who want more information to ensure that they are accurately staged and accurately diagnosed. I think a second opinion at center of excellence is important because there are various things we can offer such as a second opinion. Review of the pathology slides. You'd be surprised. How often pathologist will disagree looking under a microscope looking at the same exact cell and tissue and they may disagree about the the grading of the cancer so gleason grading can be somewhat subjective. And it's based on that physicians experience and opinions. So i think mayo clinic. Of course we have very experienced with Most of the day they spend looking at prostate cancer so they really become specifically interested also experts on prostate cancer so they can be better qualified to make some of those calls when when there is a kind of a a know a subjective situation the other reason why people come for second opinions to a prostate cancer specialist is also to ensure that there are no other tests that could be run that may improve the staging of the cancer so one example of staging imaging. That is really helped over the years. Mri surprised to help patients who are diagnosed with prostate cancer. Oftentimes.
"prostate cancer" Discussed on Mayo Clinic Q&A
"And that's a metric that most organization use to determine a prostate cancer aggressiveness in prostate cancer. even some of the ages still has nearly one hundred percent five year survival and that's different than the perspective of someone having pancreatic cancer brain cancer where the five year survival Not even fifteen percent time. So you know. I do counsel patients of based on that and tell them to put things in perspective. I encourage all my patients to make long-term plans still into the positive outlook because the dynamic is also the landscape of prostate cancer. Treatment is also being. it's a dynamic process. A one of the things that you mentioned. That was about the stage of diagnosis. Can you just mentioned Described trust to pack. What do you mean by the stage. So the stage of the cancer is the extent of the cancer within the prostate itself so when the cancer is localized to the prostate. We usually say that's oregon confined or stage two when it's a stage three cancer. It simply means that the cancer has gone beyond the capsule or the surface of the prostate. And so that means the Cancers tumors actually penetrated the surface of the prostate in gone beyond its out a nearby structures Outside of the prostate wall stage four prostate cancer means that the cancer has grown into a lymph node or has grown far away from the prostate distant until liver surrounding organs Bones so that would make it a stage four cancer. I see and then obviously i'm assuming depending on the stage. The treatments vary. Can you talk to us a little bit about the treatments that patients can expect when we say localized cancer were simply focused on cancer. That has not left. The prostate has not penetrated the surface of the prostate has not gone into the bones or lymph.
Al Roker to take time off work to battle prostate cancer
"Morning show. Personalities is facing a health battle Lance. Surprising US Phase West Coast Bureau, NBC weatherman L. Rooker on the Today show Friday revealed he has cancer. Turns out I have prostate cancer on ditz. Good news. Bad news. Kind of thing and good news is we caught it early. Not great news is that it's a little aggressive, So I'm going to be taking some time off to take care of this. The 66 year old wanted to
Al Roker to take time off work to battle prostate cancer
"Roker has revealed he has prostate cancer broker says he's going to take some time off work and have his prostate surgically removed next week. Broker says the cancer is somewhat aggressive, but he caught it early. Johnny Depp has been
Al Roker Reveals He Has Prostate Cancer
"Has shared some scary personal medical news. He's been diagnosed with prostate cancer. But he's taking aggressive steps to beat it
NBC News’ Al Roker announces prostate cancer diagnosis
"From the Today show has announced that he has a prostate cancer now just came through a few minutes ago. Said he had done a routine checkup. The prostate specific auntie gin levels that they check were at a very, very high level, so they did a biopsy and memory. Confirm the diagnosis. He does have prostate cancer. They did catch it early, but it is an aggressive form of prostate cancer. So hopefully he he says, I don't want anyone feeling sorry for me. I'm going to be okay. Is going to be off the today show for a little while. And
Al Roker to take time off work to battle prostate cancer
"This morning about al broker. I'll row chorus announced today that he has been diagnosed with prostate cancer and he will undergo surgery. The 66 year old broker says the surgery will take place next week at Memorial Sloan Kettering Center in Manhattan. His doctor appeared on the Today show and said brokers cancer appears to be somewhat limited or confined to the prostate, but because it's more aggressive. They decided to remove the prostate AL broker announcing today that he's been diagnosed with prostate cancer and will undergo surgery.
Digital Tools to Measure Blood Sugar & Metabolic Health with Dr Casey Means
"Well, hey everybody, welcome back to the dr. Jockers functional nutrition podcast and you guys know that one of my favorite topics to talk about is blood sugar insulin and metabolic health and we had a great interview recently with Dodge van Dyckman. We went in depth on that and this is almost like a follow-up to it because we're going to talk about really the personalized approach to really looking at your blood sugar and how it's responding to the foods that you're consuming and so my guess is dr. Casey means she is the chief medical officer at levels and she is a Stanford trained physician again, chief medical officer and co-founder of the metabolic whole company levels, and she's the associate editor of the international Journal of disease reversal and prevention and he can find more information about her at levels health.com and we're going to talk about what the best food. Are for blood sugar management for metabolic health and how that could be variable depending on how your body is responding to the foods that you consume. We're talking about personalized medicine. So dr. Casey that joining us here. Thank you so much for having me. Dr. Jockers. So happy to be here. Well, yes for sure and I've heard of several of your interviews on other podcasts and you really do a great job of explaining how important blood sugar stability is and you know, this this new technology that we have now continuous blood glucose monitoring. And so what I love to do is start with your story and you know how you went from Stamford and trained in in medicine to now kind of branching out into a functional nutrition Integrative Medicine approach. Yeah. Absolutely. So like you mentioned I trained as a medical doctor conventional medicine. I trained at Stamford did my undergrad and Med medical school there and then I went on to become a head and neck surgeon. So I was deep in the surgical birth. Hold for about five years and in my role as a head and neck surgeon, which is really treating the conditions of the like your nose and throat. So an ENT surgeon something I noticed was sort of hitting me back, you know after about five years, like wow pretty much all of the conditions that I'm treating are inflammatory in nature. They're all related in some way to chronic inflammation. So some of the things you think about are like sinus infection, which is inflammation of the sinuses and chronic ear disease, which is inflammation of the eustachian tube the tube that connects the nose to the ear you get, you know inflammation in that tube and you get past building up in the ear, you've got Hashimoto's thyroiditis, which is inflammation of the thyroid you've got things like vocal cord granulomas which are inflammatory masses of the vocal chords and then lots of head and neck cancer, of course, which we know cancer has very much relationship between inflammation. So it was really interesting to me sort of step back and say wow. This is sort of a very common theme between a lot of the conditions that I'm treating and in some way it didn't make total sense wage. That we would be treating those conditions with surgery because chronic inflammation is fundamentally a issue with how our immune system is responding to perceived or real threats in in the environment in our bodies and thoughts were more were learning about how chronic inflammation is in many ways really rooted in our everyday exposures. So what we eat the toxins were exposed to in our food air and water, you know, how much sleep we get the stress in our lives how much or how little exercise were getting our microbiome all of these things have a direct relationship to chronic inflammation. So I'm treating it with this sort of very reactionary invasive more anatomic approach with surgery, you know, there was some sort of missing missing link there and certainly surgeries are really important in beautiful art but phone no other conditions really rooted in chronic inflammation. It kind of got me thinking there might be a better way to approach us. What could we be doing what sort of really personalized dietary and lifestyle interventions really foundational help to really quell bath. Chronic immune response. Well that threat the body is sensing and potentially keep Patients Out of the operating room. You're not going to prevent all surgeries, but I certainly think there's some low-hanging fruit we can do to help minimize the severity of the disease is and hopefully never have to get have them get that really end of the line where they see me in the or going under the knife, which is a really serious serious thing. So that really got me on this journey of trying to understand the root cause of disease and that led me to functional medicine and so I actually stepped away from the operating room got training with Institute for functional medicine and really started thinking of disease a lot differently. I started seeing things much more as symptoms and diseases often being the branches on a very similar true and that tree that we that that sort of route that that connects a lot of seemingly disparate diseases often comes down to things like inflammation and even deeper Inflammation metabolic dysfunction this was talked about so beautifully on your episode recently with dr. Bed big man who is talking about metabolic dysfunction and insulin resistance, but was so interesting is that you know in our country. It's it's not that about 88% of Americans have met have signs of metabolic dysfunction that was shown in a study a couple of years ago from UNC that 88% of adult Americans have at least one biomarker of metabolic dysfunction and metabolic dysfunction and insulin resistance, which are kind of two sides of the same coin really can directly feed into inflammation. So it's all really created and what's sort of hopeful about this is that those are things that are readily modifiable with smart choices in and how we live and what we expose ourselves to so became really interested in that and and really this system the network biology movement, which is really stepping back and saying, you know, we've we've conventionally looked at diseases in in conventional medicine. As isolated silos, you've got depression. You've got obesity. You've got diabetes. You've got prostate cancer. You've got IBS and these are all things that are different and we treat them separately with totally different with medications a totally different mechanisms. But when you step back and you use sort of more advanced research techniques, like whole genome sequencing and proteomics, how can we actually see? What are the molecular links between diseases and you create a web a network a system and that's really the root of systems and network biology. And when you start doing that you see these connections and I think the future of Iraq and its really treating conditions at that level at the connections between diseases cuz when you do that you can you know, hit a lot more birds with one stone that's sort of a negative metaphor, but you know what, I mean, it's it's it's got instead of playing whack-a-mole. You're really you can have multiple various effects with with some single interventions effect that root cause physiology. So my career really moved
Working toward a new staging system for prostate cancer, and why it matters
"Doing some fascinating research. We have some new trials that we have ongoing and we're about to open some new ones. One that I'm very excited about for prostate cancer patients and those patients that have early stage prostate cancer that are considering our cyber knife program. Which we have ongoing that may need some hormonal therapy and instead of using the traditional hormones is a new hormonal agent. Now that we hope will spare men their potency in their erections in their testosterone level, and I'll be the lead investigator here for the GNU land going Enterprise. It will be open in the city as well as here on Long Island, and I hope to have that open in a few weeks. I'm very excited about that clinical trial. It's sponsored by the Dana Farber Cancer Institute. And I think will be the only center In the area That's going to be doing that, and we have some other trials as well. That will be talking about for those men with diagnosed with prostate cancer that have had a relapse of cancer using Very widely used medication called Met Foreman for diabetes, and our research has shown that There are certain receptors on the prostate cancer cells, thie insulin receptors. That, you know, has always been thought that maybe Sugar is involved in cancer growth. And if you can block the the sugar from entering into the cells, and it seems that made Foreman seems to do that. And prevent thes cancer cells from growing. This trial has been ongoing. It's up, it's up and running. And if you know of anyone that's already been treated for prostate cancer and Has had a relapse, meaning that there say is rising. Whether it be after surgery or after radiation than you can give us. Ah Ah call and be sure to Ah. You know, we have to evaluate the You know the individual, You know, it's a clinical trial. But
Designing Immunotherapies that Can Overcome Recurrence and Resistance
"For joining us. Inviting me this great opportunity in great pleasure. We're GONNA, talk about cancer immunotherapy and bio clips efforts to develop a multi mechanistic immunotherapy to overcome the ability of cancers to develop resistance and. The immune system perhaps, we can start there. What are the challenges? That immunotherapy is facing and how to tumors grow resistant and and evade the immune system. Let me start by saying that's three different questions first of all anti-cancer immunity. And Immune evasion mechanisms are. Just being discovered. And we don't know the immune system especially in the micro the tumor micro environment is much like a black box. So if we want to reset that immunity, we have to learn a lot more about what is in black bought the black box in right now, what we're doing is we're using things like adoptive cell therapy like car T.. And we're using. Checkpoint. Inhibitors and we're. Using. Antibodies and all these different things you know. Vaccine's against the civic tumor antigens. We're using these things to help initiate some sort of passive nudity in that tour micro environments, and the reason that we have to do this is because. A lot of people you know give the tumor itself malevolent characteristics I could you know inveighs nudity and what? Happens is that these are very fast growing cells there's a there's a deficiency in the beginning. Of either the self control of the immune system. That allows the cells to grow aggressively in when you put pressure on them using therapy trying cure them. the ones that aren't specifically attacked by that therapies continued to grow. And so. The the challenges on what is the therapy that can keep the tumor suppressed not recur later on and in in how you approach those kind of therapies to radically eight the tumor once and for all. You Know I. Think Dan one of the. Well known but Unhappy Facts about cancer is that Many cancers likely to reappear later in life immune. Immune system. Hod diminishes as we grow older You know it reminds me of how we knew originally that the immune system played such a huge role in cancer in that is that when we used immunosuppressive drugs or when people had immune deficiencies, they tended to get tumors also. So it's a very complex question and I think people are doing the best. They can to the best that they can to approach it. We know a lot. We know a lot more than we sued, but there's still a lot of things that we don't know. How big a problem is recurrence and resistance with regards to immunotherapy is today. So it depends upon it depends on the indication For, the most part and the reason is is when we can treat those cancers in if a patient fails standard of care most times, they have recurring tumors. So for example, in in ovarian cancer on A. Upwards around seventy percent, eighty percent of. Patients. Are Resistant to the standard of care, which is usually platinum drugs. And one of the exciting things about ovarian cancer is that. For the first time with Immuno therapies. We've been able to you know change that A. Change, the outcome for many of these patients, and so we're we're hopeful. you know other. Other therapies. For, say breast cancer and prostate cancer. Are Fairly well tolerated by patients, and if you catch the tumor with early diagnosis, there's a better outcome. So I look at it actually our technology we specifically approach this really difficult question of refractory solid tumors. In the reason we did that is because ninety percent of all cancers are solid tumors. But. In Clinical Trials Only about thirty percent of clinical trials directed toward solid tumors. And And we found that to be not only a challenge but a huge unmet market need. So. So When we think about refractory solid tumors were thinking patients that have Gone through standard of care their tumor becomes resistant to standard of care. And Once they're resistant to standard of care, the tumor may reoccur. So that's the. That's the indication in the tumor type that were addressing with our therapy.
"prostate cancer" Discussed on 710 WOR
"Two kinds of surgeries for prostate cancer open where the doctor opens with his hands in a knife or robotic, which is not really robotic. Was that gives more put in your body either way, with open or robotic surgery for prostate cancer, most likely 97% chance The man's sexual life will be damaged, often destroyed and we'll show that data when you come in. And you'll see from surgery on the prostate 80% chance the man will be leaking urine or having damage with her urinary control. We see that so often. And number five. The thing all of these are actually seldom spoken about by the surgeon. So here a man with prostate cancer, prostate issues, and they're planning to radical surgery. We may never be the same if you have radical surgery. First of all, you may not make it through. Radical surgery, which is pretty sad to die on the table or during the postoperative period to be left. Impotent, incontinent and with his shortened Penis, yes. Radical surgery on prostate cancer is the number one cause of Penis shortening in The world. And who wants that? Because he just listen to that. And With 152 100,000 prostate cancer's a year. You probably know someone who has prostate cancer. It might be. You are loved one and by passing on the information that you get better results. Most likely keeping your sexual life and your urinary life And, of course, not altering your body, not shortening your Penis, which is done by radical surgery. You may understand why so many men with prostate cancer come here and.
"prostate cancer" Discussed on The Gays Are Revolting
"Mentally. For a lot of men which is horrible. But Yeah, obviously let you get cancer of the prostate and then they have to remove it or you get radiation therapy that you have to which both have really bad side effects on your reproductive organ your. Heinous and you'll shelter. Any litmus at need a sort of anatomy a very big penis level anatomy lesson. Is it right to say that the prostate is kind of like the male what we joke about as the male g spot? We be hidden on when when we do. Yeah, it's like it's the size of a walnut I guess but it produces your same and you'll sperms the liquid that comes out when you agenda. But we're sort of living in an age now where we're finding more and more man have the chance to live an older life especially going through the AIDS and HIV epidemic in the eighties nineties a lot of older men just didn't make it whatsoever and those. Didn't make it to the age that you are at risk of getting prostate cancer is well now we're getting like a big insurgence of people being able to live with HIV and not dying from it dying from AIDS. So the getting to these ages now where it is becoming such a big. Also. None of us Dr Share. We're just think base if you want definitely A. Search and look it up, and it's very helpful to know because we didn't know of before everyone should be getting that prostate checked. You know not to drag down the class level of this. my daddy got his. Watch just come daddy daddy is like this little boy in person or is this your actual day his? Never say. Daddy. Sorry I don't know why I said that my father when I was a teenager had a he was testify prostate cancer a few times because he's he's in this demographic. He's an older white men, Ryan everything, and it was very ashamed of it one a lot of men and not comfortable having a that part of their buddy examined and it's not like a social norm for men to have that part of their buddy examined and so when they actually like posted back, they did some x rays because I checking something around that area as well and they posted back and I knew exactly what it was because came in the big lake or like the giant on Yeah and I was like this is the inside of my daddy's. nudes. Yeah and so I took an because I grab the mail ru quick and I knew my dad ashamed of and I put them up Olivia my bedroom wall. Muff like artwork I room and and then he was mad but it forced us to have a dialogue about Oh ati health and. You need to get this checked because Oh. There was this strange myth I think out of the prostate cancer because it's Of the prostate and That it somehow agay Kenza the the potentially were more risk of getting it only evidence. Watts. But it affects game differently who's gay sex obviously, very different straits. But if you get the radiation therapy, a lot of men can get erectile dysfunction. Sorry like they cannot get as high as before a lot of the time it. You can be softer and like still have sex with a vagina is like yeah. You need Kinda more punch power without yeah hunch. Powell When I came from. Full now. Like, in in saying that, it's like I guess, a lot of people would just be like all. Why don't you just bottom then instead will the problem with that is like your anus itself becomes a lot more sensitive and actually becomes pain. They can become painful to have anal sex as well. So it's Up, in Botham's. Like it's no guarantee that you'll ever get function of direction back. To have a L-. Obata. That's who have a desire to have sex as to have like. Wouldn't that be the worst owning feelings and suffered? There's nothing they're not only that like a lot of gay men that live in metropolitan areas even just meant in general that live in metropolitan areas more exposed to I guess equal healthcare where you can go see lgbt Qa plus doctor and it's fine and it's not a weird thing whereas like a lot of people that don't live in metropolitan areas, they just not getting checked because they don't want to be ridiculed by the doctor whatsoever because they are gay or the your God I cannot think of anything worse than going to like a super straight being like can you tell me about my but as a gay man like and then? Just like grimacing at your, not ever wanting to treat you probably because, yeah, you have to disclose to them that you'll gay and it's really sad a lot of people that live in sort of moral areas areas that aren't gay friendly. They don't disclose that whatsoever and they pretty much like brokerage back into the cause at which I absolutely high and that should never have to be anything that anyone has to deal with with the health professional whatsoever. Be An absolute sites means I think. Also it's it's worth the conversation that happens around the prostate as as just a body pot and not some. Thing and You know like it's a gay thing or whatever. It excludes a certain part of a community of people who do not identifies men that do actually physically have prostate and. I've seen a lot of the men's health sites and and they yuck. Yuck like they saw heavily targeted towards the luckiest laureate literally just like running up each with a surfboard and dog. entered. Could you imagine being a person that didn identifies Mayo wanting? To. Stay on top of their the health in all areas. But having to navigate at the minefield of toxic masculinity it would be awful and if we could grow up and realize a hoses about prostate is. And a body parts suggest buddy pots and we need to look after them and. Take narrowly unless you give each. Yeah unless you have Roy Doug and Maitland go. Oh My. For like two and a half minutes and then. You did. ruined. Yeah I'm sure there aren't many straight men in country. Victoria listening to our show politics of. Could you imagine going to check out this office show about the press they're appearing fruit awakening also officer I don't think countrymen are GonNa be listening literally paying for content from us. Do you imagine the what a attribute? Maybe. They paid because I thought it was like a hate show the gazer revolt like aren't they? Let me pay. Seven dollars. And He's like I'm I'm gonNA give thirty dollars. mikey's teeth in the mail..
"prostate cancer" Discussed on On Point with Tom Ashbrook | Podcasts
"This hour we're talking about prostate cancer why we don't talk about it because of issues like incontinence, impotence, men's private parts, and so forth I'm joined by Boston Globe Mark Shanahan who is out with a new podcast Mr Eighty percent, which tells the very personal story about his own prostate cancer and a warning again to listeners, we are talking a very frankly about this disease about sexual function and so on and so forth, and so this might not be suitable for younger listeners. We just want to put that warning out there. mark I want to talk a little bit about how this diagnosis it didn't just affect you affected your loved ones too. So your audio, your daughter Julia was in junior high when you were first diagnosed. So I want to hear a little bit of the two of you talking in episode one of Mr Eighty percent. I think I just took it to like. Like he actually died I would basically lose my best friend. This is my daughter Julia she's in college. Now they say like we're not your best friend like where your parents by. Having. Cancer means you get a preview of what your kid might say at your funeral. You're the funniest person I've ever met I. Think one of the most supportive and hardworking people I've ever met and. I also think you one of the most intense people I've ever met and you have a very impressive career, and so I always like looked up to that and by impressive you mean I have talked to Bj. Novak. You took me to Taylor concert. She gave me her bracelet, right? So. So that's a cut from Mr Eighty percent I'm here with Mr, with Shanahan and mark that's really touching moment. But say a little more about that because you make this, you spend a lot of time in this podcast talking about. The effect that this has on your entire family, and by the way the way your wife stepped up in heroic ways and supported you and this is a huge theme about in this story. It's true Anthony that You know you just can't anticipate something like this and and again it's the nature of this disease that you know. This was something that as my surgeon says, at some point in the podcast, you know when you're when you're treating. Prostate cancer patient, you're really treating the couple. And So Michelle had a heavy lift Michelle, your wife correct. I should say right Michelle. My Wife. And she was Extraordinary and But so it's a learning process. For she and then in terms of our children. You well, I Beckett we would like to get back into the podcast but your son as fifty s fifteen year old boy now and You know we wanted him to say, well, we're going to have to talk about our penises and that was. He he just wasn't willing to go there. So again, it's it is. You know we say in the podcast that you get the cancer but everybody's life changes and you know I I don't think that unless you go through something like this, you can really appreciate what that means but I. Certainly do i WanNa talk a little bit about Get get you to talk a little bit about the course of treatment that you opted to follow. So so walk us through first of all the options that you had to consider. When you were first diagnosed well. So we want to also say that because prostate cancer. So slow growing and because many men who are diagnosed are much older I think that people should think very very carefully before embarking on any treatment that there is something called active surveillance, which means we watch it we pay attention to it. And but but. For Myself I was young I had two kids. I had forty years may be to live and. I had a gleason score, which is a score after they give you your biopsy and take a look at what's happening they grade basically of the severity of the intensity of your cancer in mind was seven. Out of ten that's considered to be intermediate I guess you know the options for me were to watch it to have surgery. Or to a radiate my prostate and. In, the end there have been enormous advances in the treatment of prostate cancer over just thirty years. If I had gotten prostate cancer fifty years ago. I. would be rough rough rough. And not just for me every man who had a prostatectomy which is surgical procedure to remove your prostate. before nine, hundred, eighty, two, left the hospital impotent every single Guy which is just incredible to me because nineteen eighty two is not that long ago. Right, it is incredible. So you went for the surgery but I did but that wasn't the end of your ordeal surgery. It turns out we learned didn't get all the cancer. So you had to go back and sign up for pretty radical course of hormone therapy, and this is really the most excruciating part of your journey to read into here about you describe it essentially as a kind of. Chemical. Castration. Well. Indeed and I don't just describe it that way. That's in fact what it is It removes the testosterone from your body and the reason that we do that is because it's the thing that feeds the cancer prostate cancer. Grows Thanks to to Saas thrown. So if you removed from your body to cells cancer cells week in some cases they die and then when they're at their weakest blast them with radiation. The problem is that when you take a testosterone out of a man's body it is a as you say excruciating I became a different person. ahead you know the the euphemism is mood swings. I didn't have mood swings had a I had tantrums and I will say that I was on the phone this morning, the guy who listened to the first three episodes of the podcast and. He. said, he'd never talked to anybody about his course blueprint and he was arrested he actually got arrested. Because a parking garage. because. He could he he got completely out of control. So it's scary. And and you know now as I sit here. There's you know at this surgery if if the prostate cancer should return, there is no surgery there is no radiation. Those are no longer alternatives. and. The prospect of more loop ron or any kind of hormone therapy is really terrifying mark. You're honest in this podcast in and you tell a story in there and we heard from your daughter Julia just about how difficult this became when you were on this loop Ron Therapy and you tell the story of her eighth Grade Graduation and where you pretty much. Fall apart and and She loses this moment to be photographed in her right of passage. It's a it's a very, very sad story, but I'm just wondering what it was like for you to make that decision to go public with that to hear your family and friends describe. What an unbearable person you became. Well. You know. Here's the thing I really don't have a lot of. You know. Again it's a good story and I'm interested I'm interested in A. After a drinker to these are the stories that I tell and So when somebody at the globe said, you know you got an idea for a podcast I said you bet I do. But I in terms of like. How others will view me and? That sort of thing. I I really don't care. It doesn't that doesn't concern me what's really weird also is that. I didn't do the podcast right the story really yet of any. Sense of. Its crusade that I'm on at all however now that it's out there and emails that I'm getting in on the phone calls and the and the feedback, it's it really is very gratifying. To think that there are guys who were like me. But have no outlet to and no desire to they won't talk about it but they WanNa talk about me. Mark, I want to bring in Dr Mark pomerantz. He's an oncologist. He's one of your doctors through this ordeal and he joins us from the Dana Farber Cancer Institute in Boston Dr Pomeranz Welcome to on point. Thanks for joining us. Oh..
'Mr. 80 Percent,' An Intimate Portrayal Of Surviving Prostate Cancer
"We're talking about prostate cancer why we don't talk about it because of issues like incontinence, impotence, men's private parts, and so forth I'm joined by Boston Globe Mark Shanahan who is out with a new podcast Mr Eighty percent, which tells the very personal story about his own prostate cancer and a warning again to listeners, we are talking a very frankly about this disease about sexual function and so on and so forth, and so this might not be suitable for younger listeners. We just want to put that warning out there. mark I want to talk a little bit about how this diagnosis it didn't just affect you affected your loved ones too. So your audio, your daughter Julia was in junior high when you were first diagnosed. So I want to hear a little bit of the two of you talking in episode one of Mr Eighty percent. I think I just took it to like. Like he actually died I would basically lose my best friend. This is my daughter Julia she's in college. Now they say like we're not your best friend like where your parents by. Having. Cancer means you get a preview of what your kid might say at your funeral. You're the funniest person I've ever met I. Think one of the most supportive and hardworking people I've ever met and. I also think you one of the most intense people I've ever met and you have a very impressive career, and so I always like looked up to that and by impressive you mean I have talked to Bj. Novak. You took me to Taylor concert. She gave me her bracelet, right? So. So that's a cut from Mr Eighty percent I'm here with Mr, with Shanahan and mark that's really touching moment. But say a little more about that because you make this, you spend a lot of time in this podcast talking about. The effect that this has on your entire family, and by the way the way your wife stepped up in heroic ways and supported you and this is a huge theme about in this story. It's true Anthony that You know you just can't anticipate something like this and and again it's the nature of this disease that you know. This was something that as my surgeon says, at some point in the podcast, you know when you're when you're treating. Prostate cancer patient, you're really treating the couple. And So Michelle had a heavy lift Michelle, your wife correct. I should say right Michelle. My Wife. And she was Extraordinary and But so it's a learning process. For she and then in terms of our children. You well, I Beckett we would like to get back into the podcast but your son as fifty s fifteen year old boy now and You know we wanted him to say, well, we're going to have to talk about our penises and that was. He he just wasn't willing to go there. So again, it's it is. You know we say in the podcast that you get the cancer but everybody's life changes and you know I I don't think that unless you go through something like this, you can really appreciate what that means but I. Certainly do i WanNa talk a little bit about Get get you to talk a little bit about the course of treatment that you opted to follow. So so walk us through first of all the options that you had to consider. When you were first diagnosed well. So we want to also say that because prostate cancer. So slow growing and because many men who are diagnosed are much older I think that people should think very very carefully before embarking on any treatment that there is something called active surveillance, which means we watch it we pay attention to it. And but but. For Myself I was young I had two kids. I had forty years may be to live and. I had a gleason score, which is a score after they give you your biopsy and take a look at what's happening they grade basically of the severity of the intensity of your cancer in mind was seven. Out of ten that's considered to be intermediate I guess you know the options for me were to watch it to have surgery. Or to a radiate my prostate and. In, the end there have been enormous advances in the treatment of prostate cancer over just thirty years. If I had gotten prostate cancer fifty years ago. I. would be rough rough rough. And not just for me every man who had a prostatectomy which is surgical procedure to remove your prostate. before nine, hundred, eighty, two, left the hospital impotent every single Guy which is just incredible to me because nineteen eighty two is not that long ago. Right, it is incredible. So you went for the surgery but I did but that wasn't the end of your ordeal surgery. It turns out we learned didn't get all the cancer. So you had to go back and sign up for pretty radical course of hormone therapy, and this is really the most excruciating part of your journey to read into here about you describe it essentially as a kind of. Chemical. Castration. Well. Indeed and I don't just describe it that way. That's in fact what it is It removes the testosterone from your body and the reason that we do that is because it's the thing that feeds the cancer prostate cancer. Grows Thanks to to Saas thrown. So if you removed from your body to cells cancer cells week in some cases they die and then when they're at their weakest blast them with radiation. The problem is that when you take a testosterone out of a man's body it is a as you say excruciating I became a different person. ahead you know the the euphemism is mood swings. I didn't have mood swings had a I had tantrums and I will say that I was on the phone this morning, the guy who listened to the first three episodes of the podcast and. He. said, he'd never talked to anybody about his course blueprint and he was arrested he actually got arrested. Because a parking garage. because. He could he he got completely out of control. So it's scary. And and you know now as I sit here. There's you know at this surgery if if the prostate cancer should return, there is no surgery there is no radiation. Those are no longer alternatives. and. The prospect of more loop ron or any kind of hormone therapy is really terrifying
Dr. Richard A. Van Etten: Cancer
"Please welcome to the show Dr Rick van how you doing. Thank you very much Andrew and Brittany I greatly appreciate the opportunity to be able to come and talk to your talk your listeners today. Yeah. Well, thank you for taking the time out of your busy schedule to talk to us. So we're GONNA be talking about obviously cancer and how you can prevent cancer do your best to prevent it. But as I mentioned in the Intro, most likely someone knows someone who's had cancer or they've had cancer themselves even it's pretty it seems like it's touches a lot of people but can you kind of tell me how many people does cancer impact on a yearly basis? Well. Thank you for the question Andrew. The lifetime risk of getting cancer is approaching thirty eight or thirty, nine percent. So more than one in three Americans will get cancer during their lifetime. So that explains what you said that basically almost everybody is either been personally. Involved with cancer knows a close family member or a loved one that's been stricken by cancer. So some of the statistics nationwide in the United States, there's about one point seven million people diagnosed each year with cancer. And they'll be about unfortunately six hundred thousand Americans will die every year of cancer. Here in Orange County it's interesting that cancer has overtaken cart diseases, the number one killer, and as soon gonNA happen nationwide. So a very very. Prevalent disease what kind of has led to what's led to that trajectory? Why is that happening? Well, actually the the the death rate from cancer has been falling and it's been falling significantly over the past fifteen or twenty years, which is a success basically for the research that's gone into it through the National Cancer Institute and other mechanisms. But the fact that cancer is now the number one killer has actually also reflected progress in cardiovascular disease. So doing which used to be the number one killer. So we're doing a better job at preventing. Heart disease through the things that you know about treatment of the risk factors like high lipids, blood pressure, diabetes et CETERA. Right? Interesting. Okay. All right. So we got some work to do on the cancer and Kinda catch up. And, that generally, like I mentioned usually happens through education funding, which we'll talk about in a little bit What types of cancers are the most prevalent today? I know that you specialize are a believe in like blood cancers by what are the most prevalent that people run into so we can talk both about incidents, which is the new diagnosis that we have each year and prevalence, which is the number of people living with the disease at any given time. But the top four in both categories are pretty similar. So there's breast cancer which obviously predominantly affects women but also can affect men. Then there's lung cancer there's prostate cancer which obviously is a male cancer and the last one is colorectal cancer. Those are the big four. Close on their heels are diseases like skin cancer and melanoma that's particularly relevant for Orange County where we have two hundred and eight, hundred, ninety days per year rate. And after that come some blood cancers that I specialize in, which is mainly things like leukemia lymphoma and Myeloma Okay. What kind of leads to these types of cancers occurring out of those top four that you mentioned, what? What's the biggest contributor to people getting? Is it? Is it just genetics you got bad genes or something in your lifestyle or in your the world around you I guess causing it. So they're. Probably, equal contributions both from genetics and from lifestyle. Okay. When I say genetics I mean the cancer is principally in the opinion of a lot of primarily a genetic disease in the cancer cells have acquired mutations that contribute to their malignant or cancerous phenotype, their ability to grow and attack the body. Most of those mutations are acquired in other words they happened just within the cancer cell and they're not inherited. So you don't get them from your mother or your father. Now there are exceptions there are well defined cancer susceptibility syndromes the most the one that may be most familiar to your listeners is the bracket jeans Brca which segregating families particularly people, of Ashkenazi, Jewish descent that are inherited either from your mother or your father, and greatly increase your risk for developing breast cancer or ovarian cancer so that the risk for women who doesn't ever bracken gene mutation is about one about eleven percent or one in nine during your lifetime. If you inherit one of these genes, it's virtually almost everybody will get breast cancer ninety percent risk over your lifetime. So, this cancer susceptibility syndromes are very important the need. For instance when there's a new cancer diagnosis, you need to take a careful family history and in some cases be referred to a genetic counselor to determine whether testing family members is indicated. Yeah. Well, that's interesting that you bring that up because my wife actually we went through that process, and so she was found her mother had breast cancer and through that process they found out, she had the bracket gene Brac to and then and so my wife decided because they kind of give you choice like do you want to get screened? Do you not like you kind of have? Do you want to know more or or like not and stay naive to it I guess and so what I've discovered, we went through it and is interesting out of the split my wife got it and her sister didn't so the fifty, fifty there and. It. Seems like. It's I think my opinion is it's good to know because now they're just more aggressively screening her and is that typically the case when you find out about something like that, you're more your screened even more regularly than the average person should be. That's right. A change basically changes the surveillance. In it not to make it more complicated. But there are some genes like the broncos where the penetrates which means that the chance of actually getting breast cancer. If you have the have, the mutation is very high I think there it's pretty straightforward to decide whether to get screened. Right. There are other mutations that can be inherited that don't increase the risk that much increase it above the background, but it's not nearly as high and there it's more complicated to try to decide what to do about that. But. My advice to your listeners is to seek the advice of a NCI cancer center in a a qualified genetic counselor. Those are the people best qualified to help guide you through that decision making process right? Right. When you're going through like you said they ramp up the screening process if you had the genetic mutation but how does how did we get to discovering these genetic mutations I? It sounds like you kind of have somewhat of a background like you discovered or help discover this protein that was causing leukemia right and. How does that process even work? How do we make these discoveries? How do you make these? Discovery I was involved in is one of these acquired mutations not inherited, but it came about from studies done many many years ago actually nineteen sixty that showed that patients with this particular type of leukemia had an abnormal chromosome in their blood cells. And when to make a very long story short when that was tracked down, it was shown that the chromosome was actually an a Barrett. That was acquired in these cancer cells that lead to the expression of this abnormal protein. And that protein. Hasn't is an enzyme which means that it has a ability to catalyze chemical reactions. Okay and that particular reaction stimulated the growth of those blood cancer cells. So. That led a drug company, which is today is no artis to develop us a drug a small molecule inhibited the action of that protein. And that That drug which has the trade name GLIVEC revolutionized the treatment of that leukemia so that in the past everybody died of this leukemia, unless you had a bone marrow or stem cell transplant. Today everybody takes a drug likely. And most people go into remission and when they do, they have normal age adjusted life expectancy. That's example would that's Therapy likely that can do to cancer right? So does this all come from these discoveries? Does it come from just? Tons of data over decades like this one you're saying, it came from research started in the sixties and this didn't have until the early nineties. Is that right or wealth the the The structure of the protein was discovered. I'm saying Circa Nineteen, eighty-four which I got involved. The drug development efforts took place shortly thereafter I'm and the was FDA approved in two thousand one. So it's been on the market now for almost nineteen years I and there are many many other efforts in other cancers that are parallel parallel that. The thing that's happened today is because of our new technology and the genomics and the ability to determine, for instance, the genome sequence very quickly that's accelerated the progress that we can make. So what took forty years from sixty two to the drug being approved now can be done in a couple of years. Wow. Everything's happening much much faster. That's awesome. That's great news for those of US living right now.
"prostate cancer" Discussed on Clark Howard Show
"The most hated of all airline fees. . Is the fee your charge to change your ticket? ? And never more than right now during corona virus where if somebody books a ticket to travel somewhere, , they may later say, , ooh, , I really don't feel comfortable going. . And that's why. . The nation's airlines have followed the longstanding policy of South West. . With. . asterisks where you can buy a ticket now. . On. . Any US, airline , and under Their straightjacket conditions. . You don't lose the money. . If you choose not to take the flight, , you just gotTa meet all the rules jump through the right hoops and all that. . But the reality is. . Bit Airlines have only looked at what they make from change fees rather than how much business they ultimately don't get because they have changed fees in the first place. . Let me explain. . So I. . Fly a lot on south. . West Airlines. . Until this year when I'm not flying anywhere because I'm in. . Quarantine. . Because a pre existing anyway. . So I would fly typically in a year. I . would take somewhere twenty five to thirty trips a year. . Right, , now I'm taking zero. . So. . I had a trip that I talked about. . On the show last fall that change five times before I took it and I talked about how on the big three full fare airlines American united and Delta. . I would have paid a thousand dollars and change fees before I ever left the ground. . But because that was a ticket on south, , west at paid zero in change fees. . And so it's always been competitive market advantage for South West that they don't charge change fees that other airlines do. . Well now, , United Airlines. . Has announced that they are eliminating change fees. . Not Related to corona, , virus, , just eliminating change fees. . On. . All their airfares for domestic travel except. . Basic economy basic economy is the one where we hate you but we'll take your money and let you fly. . That has a long list of don'ts. . And all that with basic economy, , they have basic economy at the airlines so that their fares look lower. . Than they really are. . But anyway. . As on United. . Or going to have no change reason that this is something that upfront looks gutsy on United's part. . Because according to the fads united collects over six, , hundred, , million dollars a year that goes straight to profit. . From the change fee junk fee because the reality is. . The cost for an airline somebody changing a flight. . If any is just a couple of pennies. . There's really no cost to the airline is just a junk fee. . And so United's walking away from fifty million dollars a month. . and. What . they're not GONNA get in change fees but what they may well find. . Is that people are more likely to book a ticket. . Knowing that they can change it later without having to pay pay change fee. . Now, we'll , see over the course of this week. . If The. . Other two full fare airlines. . American Delta. . Follow United because often the three full fare airlines pretty much act like tweedle dee tweedle dum on what they do in terms of junk fees and nuisance fees and all that, , and so we'll see and this will. . Potentially. . Erode. . A huge market advantage four southwest airlines if airlines just blanket. . Eliminate pretty much all the fares that are subject to junk fees united did not do so for international flights, , but most people fly only domestic. . So it it's not as much an issue for most people but. . This is a very positive change. . And I think back. . That the junk fee for changing a flight for a long time was twenty five dollars. . And then over the years the full fare ions got more more greedy kept raising it to the ridiculous two hundred dollar point and as travel writers pointed out repeatedly. . Two hundred dollars change fee in most cases is higher than the fair bid a leisure travel or paid for their ticket in the first place. .
United scraps ticket change fees
"The most hated of all airline fees. Is the fee your charge to change your ticket? And never more than right now during corona virus where if somebody books a ticket to travel somewhere, they may later say, ooh, I really don't feel comfortable going. And that's why. The nation's airlines have followed the longstanding policy of South West. With. asterisks where you can buy a ticket now. On. Any US, airline and under Their straightjacket conditions. You don't lose the money. If you choose not to take the flight, you just gotTa meet all the rules jump through the right hoops and all that. But the reality is. Bit Airlines have only looked at what they make from change fees rather than how much business they ultimately don't get because they have changed fees in the first place. Let me explain. So I. Fly a lot on south. West Airlines. Until this year when I'm not flying anywhere because I'm in. Quarantine. Because a pre existing anyway. So I would fly typically in a year. I would take somewhere twenty five to thirty trips a year. Right, now I'm taking zero. So. I had a trip that I talked about. On the show last fall that change five times before I took it and I talked about how on the big three full fare airlines American united and Delta. I would have paid a thousand dollars and change fees before I ever left the ground. But because that was a ticket on south, west at paid zero in change fees. And so it's always been competitive market advantage for South West that they don't charge change fees that other airlines do. Well now, United Airlines. Has announced that they are eliminating change fees. Not Related to corona, virus, just eliminating change fees. On. All their airfares for domestic travel except. Basic economy basic economy is the one where we hate you but we'll take your money and let you fly. That has a long list of don'ts. And all that with basic economy, they have basic economy at the airlines so that their fares look lower. Than they really are. But anyway. As on United. Or going to have no change reason that this is something that upfront looks gutsy on United's part. Because according to the fads united collects over six, hundred, million dollars a year that goes straight to profit. From the change fee junk fee because the reality is. The cost for an airline somebody changing a flight. If any is just a couple of pennies. There's really no cost to the airline is just a junk fee. And so United's walking away from fifty million dollars a month. and. What they're not GONNA get in change fees but what they may well find. Is that people are more likely to book a ticket. Knowing that they can change it later without having to pay pay change fee. Now, we'll see over the course of this week. If The. Other two full fare airlines. American Delta. Follow United because often the three full fare airlines pretty much act like tweedle dee tweedle dum on what they do in terms of junk fees and nuisance fees and all that, and so we'll see and this will. Potentially. Erode. A huge market advantage four southwest airlines if airlines just blanket. Eliminate pretty much all the fares that are subject to junk fees united did not do so for international flights, but most people fly only domestic. So it it's not as much an issue for most people but. This is a very positive change. And I think back. That the junk fee for changing a flight for a long time was twenty five dollars. And then over the years the full fare ions got more more greedy kept raising it to the ridiculous two hundred dollar point and as travel writers pointed out repeatedly. Two hundred dollars change fee in most cases is higher than the fair bid a leisure travel or paid for their ticket in the first place.
"prostate cancer" Discussed on Clark Howard Show
"Where my cancer has not thank goodness grown at all I've never had to have any treatment I just am monitored. On. A regular set schedule. So, there's plenty of time if my cancer suddenly decided to get mean to deal with it but as part of the whole process. My doctor told me that I needed to improve my eating habits and lose weight. So since twelve years ago I've lost fifty pounds five zero pounds. And I never perceived myself as being. Fat. And I don't think anybody who knew me would consider that but they could see carrying extra weight. And I did it gradually over time With controlling how many calories consumed per day and taking the world's worst diet And gradually steadily improving. Because one of the factors with Nachos, prostate cancer, but other illnesses is carrying too much weight. And also eating nothing but the wrong things now I still eat a lot of the wrong things but you know I the right things to. And I used to be allergic to any kind of green except money. So any vegetables were green. They just weren't part of my life. really any vegetables at all put? I've made that change over time and. It's probably part of why I've been able to manage disease. Instead of having to have. An operation you know surgery or having radiation or different kinds of cancer treatments that may be required someday, but I've been able to. Make a difference almost certainly with the behavioral things I've always been an exercise maniac. But adding into at the loss of weight and improving what I eat is considered to be very important. Well. Each year in September. The. Prostate Cancer Foundation has a campaign to try to get guys to improve how they eat. But thing. Is that there's no reason you couldn't. Improve how you eat even if you're not a guy, I mean all of us. are in a position where we can probably eat a little better. Unless we're one of those vegans and the campaigns called, eat it to beat it. We have all the information for you Clark Dot Com.
Incontinence Problems at Any Age
"Welcomed addition of nutrition today's show is brought to you by a nutritional weight and wellness. My Name Is Kara Harper and I'm a licensed nutritious I also have a masters degree in holistic health, and I'm very excited to be here this morning with my co-host Melanie Beasley Melanie registered and licensed Dietitian. She's been practicing nutrition for three decades. I think in a variety of settings bono. Okay sorry. You would never know by looking at you mail, but. Both Mellon I. We've personally had our share of health challenges over the years. Some of you maybe have even heard some of our personal stories. If you've tuned in for many years, and if you also have health challenges, we understand we know what you're going through. We also understand the importance of eating real food to conquer those health challenges, so we want to welcome you and welcome all of our listeners to today's show and the topic of our show today is incontinence problems at any age, and isn't that interesting because he always thinking continents is just you know someone's getting older, but it really kinda fact. Yeah from bed-wetting that wedding from the time you're little you know up until end of life it can affect. People ran. It affects quality of life so I'm really excited that we're talking about this and putting things out on the table for people to think about good morning. Everyone, I bet some of you are thinking. What is my diet and nutrition have to do with incontinence or lack of bladder control? Control well, many of our clients have said to us I thought my problem was structural problem and only doctor could help me certainly not a Dietitian nutritionist I know by UCAR, but they fill out a lengthy wellness form to come in for us. Look at in. That's of the questions on there, so some of you may also be thinking the exact same thing, so it may be surprising to know that. A number of our clients ask us for help with incontinence, which is defined as involuntary loss of urine. But car you and I were talking about. It's more than just you know. Expand a little bit on what you were saying that you had listened to that matter. I was just listening to a doctor. She was a urologist and she was just discussing kind of the criteria for diagnosing incontinence. And you know it's the involuntary loss, but it's also the frequency that urgency you know I have to get to the. The bathroom right away. I can't wait also night. You know nighttime frequency is one of the diagnosis as well you know if people are getting up two or more times per eight, that would fall under incontinence as well. Yes, and it affects it affects sleep which we've talked about before. Definitely yeah, and because continents is such a very personal topic, it can also be rather embarrassing to a significant number of people. Many, people feel uncomfortable talking about it even to their doctor. And when we bring it up I, think they they're almost relieved to have someone to discuss that issue with For that reason, we wanna get into the topic. Get it up and out in the open as a dietician WHO's helped numerous people overcoming continents I, believe your food choices can work magic on the symptoms of incontinence, coronary artery and talk about the foods that are certainly considered bladder irritants. We will also talk about foods that helped strengthen and maintain certain key muscles that are necessary for bladder control. And incontinence it's a really common problem like we already mentioned for both men and for women, and in fact, twenty five million adults in our country suffer from incontinence, seventy five to eighty percent are women. That's probably not a surprise in reality in a one in four women over the age of eighteen will experience episodes of leaking urine, and and this is the statistic that Kinda got me. Is that half of women over sixty struggle with this, but again it can happen to under sixty as well absolutely. And Stress Urinary incontinence that that's just kind of a data separate diagnosis, but kind of a subcategory that usually shows up. You know after childbirth, and after menopause for women, and then some prostate cancer treatment can also trigger incontinence for men, yes, and getting men to talk about it in clinic. I find too, that they're. They're happy to bring it up, but you have to bring it up I because people just assume well, this is just who I am. I'm getting older. This is my portion. That I have to deal with now. Not knowing that could, there can be some help well. Have you noticed the number of TV ads for disposable incontinent products? Now? Yes, I have some people. Call them adult diapers. I don't like that I. Think it's In two thousand eighteen five billion dollars were spent on the purchase of incontinence products. The cost of these incontinence supplies can easily beat two hundred to three hundred per month. The National Association for Continents Reports that. The psychological cost of urinary incontinence can be depression. Isolation decreased self esteem and work related difficulties. Yeah I mean even the sleep piece to think about how lack of sleep. If you're getting up several times at night, you don't get that quality or length of sleep. That can affect mood that can affect work performance immune system, so it's you know it's a big issue. And why isn't continent so prevalent? Well one reason it could be from following a low fat, low calorie style of eating in addition to not eating enough protein, and often those will go together. And a lot of. We say women because I think a lot of women are. Wanting to lose weight and. They're working. They're trying to do this by going fat, free low calorie, and that automatically sort of cuts out a lot of protein in the Diet because if they're trying to avoid fat, you're. You're not getting a lot of protein so. Following a low fat, low protein diet has left some people with weak pelvic floor, muscles and thin fragile tissues in the urethra, so it's a lack of beneficial healthy fats, and then short changing the amount of protein that you're getting that could really have a direct influence on incontinence, and I always tell clients how important it is to eat. Sufficient amounts of beneficial healing fats I mean feel like we're always kind of trying to promote the healthy fats right now we are. We're trying to overcome decades of it is. It's fear fat forty to fifty
LGBTQ community celebrates Supreme Court ruling on employment nondiscrimination cases
"Gerald Bostock joined a gay recreational softball league seven years ago, signing up for the HOTLANTA, Softball League his job in the Child Welfare Services Department for Clayton County. Georgia. He was fired for quote. Conduct unbecoming of county employ. That men he didn't have health insurance. He recovered from prostate cancer, but it set in motion illegal fight that led on Monday to a landmark decision from the supreme, court, which ruled six to three that the Civil Rights Act of nineteen, sixty four protects against discrimination based not just on race and gender, but also sexual orientation. And now Gerald's name will forever appear in constitutional law textbooks. After reading Justice Neal Gorsuch as majority opinion, validating his right not to be fired, simply because he was gay Gerald reflected on the journey from the den of his home. When I lost my job, it was my dream job, so imagine having. That, you went to every day and you enjoy doing it. the habits suddenly taken away from you because you decided to join a gay recreational Softball League I lost my income I mentioned that I had lost mine insurance while I was still recovering from prostate cancer I lost friends in relationships with with many colleagues. I had to sell my home in that community. So the Germans been difficult. The court ruling grouped three related cases involving employees who said they were fired because of their sexuality or gender identity. Gerald was the only plaintiff still alive to see the outcome Amy Stevens. A funeral director who was fired, because she was transgender, died last month of kidney failure after attending oral arguments in her case. Last Fall Donald Zara. A skydiving instructor who was fired because he was gay, died in twenty, fourteen, leaving his sister and partner to advance his case. Gerald, who's fifty-six plans to return to a trial court in Georgia to fight his case after all these years of legal roadblocks, he and his partner Andy toasted with champagne last night to celebrate the ruling, which he hopes will bring a little bit of sunshine. In some dark times. He told my colleague Samantha Schmidt that more work remains to be done. He wants Congress to pass the Equality Act which would enshrine nondiscrimination protections for lgbtq people in Employment Housing Credit Education public spaces and other realms of American life. The state of Georgia has also yet to pass a hate crime law. He, says joining the gay. Softball League was one of the best decisions he ever made. The arc of the moral universe is long. But it bends toward justice.
The Atheist Experience with Matt Dillahunty & Lloyd Evans
"Telling you. Guys are no longer quarantined has got you know so. That's nice. Maybe I can go out I can go anywhere. I like in the car. Don't wish to Ruben though I can go anywhere I like in the car. Or okay. And actually it's annoying to me right now, because basically the mayor of Austin has announced like a day or so ago that. Because there's been an increase in uptick since I, started opening things up that he's probably going to extend the stay at home order, which was supposed to end on the tomorrow the fifteenth and I haven't heard yet. If the announcements been made, it may be that it gets made tomorrow. I don't know I. Get frustrated because on the rare occasions when I do have to go out like I have to get groceries or do whatever I find myself like physically bristling at all the idiots that aren't social, distancing an art, wearing masks and our. Hey, let's go down to the beach and let's go downtown. A party and I can I can understand a grant. Not, necessarily in favor of taking the risk for protest, but I mean you know Bach lives matter and we're in this constant state where it seems like somebody some African. American male is going to be killed by the cops any given week. And I think that's an important thing to address so I'm not down on the protest I. Wish people would be a little more safe and a little 'cause This cursing not gone, and we have several states who started to reopen and what we've seen is an uptick in the number of hospitalizations, and that's going to be the prime driving factor whether or not the mayor of Austin keeps it that way for for Travis County. Ration- of other people is just lacking in general in society nowadays, isn't it? I mean you would think that black lives master would just be a given. The people don't get behind it, but just lack of consideration for other people's experience Israeli. There's a lot of lot of positions that I. think should be met with well Duh and they're not. Yeah some cases they're met with. No, no, no. Don't say that say lives matter right so when we're trying to save the rainforest. You'RE GONNA. Come up and say hey. For strikes they've all forests you know. Don't do any research on prostate cancer cure all cancer we did. The black lives matter livestream my channel today and one of my guess came up with an excellent answer to lives must've from Matthew Iowa. Uh, you know what Jesus says you. If you're missing a sheep, don't you? Leave all of your chic behind and go find your lost sheep right well. Shouldn't the same logic apply when you have an entire demographic, the suffering inequality and injustice. Don't you focus on that so i? The Biblical explanation I've heard wildlife, Mahama Gosh we're GONNA have to put that in front of. In front of every Christian, who doesn't seem to understand it, but I don't know
"prostate cancer" Discussed on The Naked Scientists
"Entire clinical team including the pathologist radiologists surgeons and nurses them meet to discuss each patient and the best way to manage their case. It depends on the biopsy type because if it is transparently biopsy we take more samples so that take long to expand if it is translated told standard by up say it usually take ten days and then be discussed the case in multi disciplinary team meeting. And we see the patient and gave that assaults and stage. What do you say to the patients? Or what information can you impart to them? And what's the next step so in duracell clinic? We will have the information about the biopsy yourself better. It is a cancer or note if it is a cancer what grade of the cancer and we would have discussed what treatment option is available for patients so when we see the patient be will discuss the findings of the biopsy say advance stories a locally advanced or early prostate cancer and we discussed the treatment options with the patient. We can now worker with quite good accuracy. Where the likely prognosis meeting to see the outcome is with or without treatment. And that's what we use together with the patient to work out what to do next. The first thing to know is that there is absolutely no evidence that rushing through a diagnosis of prostate. Cancer has any impact and survival. So it doesn't really matter how long it takes. The key thing is that he's done well in general terms from the minute somebody presents to say the hospital for investigations to get Anne Marie. Scan to be seen to have a biopsy and get a diagnosis. We try to do that within two or three weeks and then we can make decisions about what to do next. Some people listening to this may be wondering why it is that we have screening programs for certain diseases. But we don't have one for this given that you've said that eighty percent of men aged eighty may well have prostate cancer which argues perhaps would be worth looking for. It's it's therefore very common condition. Why is there no screening program for prostate cancer so the problem screening in prostate cancer is not the fact that it isn't save lives because he does the problem as that he picks up a lot of disease which is treatment and that over diagnosis can also lead over treatment because of poor understanding of the natural history of disease sort of instinct treat rather than monitor and if you look at the statistics as well is very hard to justify so for example in prostate cancer terms the lifetime risk of developing prostate? Cancer is nearly ten times risk of dying of it. You have to find an awful lot of men to save a single life but problem with screening is that its tended to rely on a single test at a single point in time and the test is in good. Psa Like I said is a nice test but it's just not good enough and so a lot of our work. A lot of work of others is actually trying to do two things. Define what is the right time point to pick it up and secondly trying to get a better test to pick it up. Are you having any luck? Yes there are actually a number of tests out there which already better than the pse. The problem is that the cost more as well. We are very interested in actually binding better tests with a much more evolving way of looking at this because the way we see it is that each man's risk changes with time and how put together as what we are exploring at the moment but. I do think we have the tools to be able to better detect Kansas which are going to spread for example and actually intervene enough and would that translate into a saving? And that's exactly what the Holy Grail is. Because in the end of the day screening low early detection for cancer actually has converse side which is not picking up things that you don't want to pick up and that in itself is a goal which I think is worth doing because if you can reduce the number of people you're going to be looking for something that means you can get your resources redirected to finding the ones which are important. Most of the time we're so fixated on finding and more and more cancers that's what we WANNA do. We forget about the fact that there's a lot of people who are investigated who turn out not to have chances And that is actually a big burden for the health economy for the individual and ultimately if you do diagnose something which too early you you do. Condemn someone to be monitored for something which didn't know about. It's a little bit lake saying if we started do genetic testing birth everyone what it tells us a potential. You might get something rather than you will get something and then you're going to end up stressed body for all your life and.
"prostate cancer" Discussed on The Peter Attia Drive
"The bloodstream. So what can make the PSA rise besides just having getting older and having a larger prostate. Well if you get an infection in your prostate so think about that like you got your city. You have her sewer network and there's an earthquake all all the pipes are rat a little bit and they all are extra leaky. And that's what an infection is is not a infections in the prostate or either all or none really they're not focal so the whole prostate gets more leaky in the. PSA number can go way up the other way to think about it as if you have cancer and the the analogy would be lulled. There's there's a city block that has the pipes pipes you know the sewer systems clogged. There's more backflow into the bloodstream. And that's how I pick it up. That's not really how it happens. But that's a good way for patients to think about it. So what is a normal. PSA well a normal PSA is age adjusted so normal PSA for a forty year old is around point five two point six nanograms per aml for fifty year old normal meaning. This is the median for all the population for a fifty year old. It's one and so it kind of goes up stepwise by by decade so there are eight adjustments that we do for the PSA number now what are PSA numbers that tell you you don't have a cancer there's no. PSA number that that is one hundred percent no cancer but there is a proportional rise in cancer detection with rising PSA numbers so originally the cutoff set a PSA of four. We do you know we think about things more based on the individual scenario so if you're a younger person and if your PSA more than two point five that usually considered to be abnormal and may want you may need further work. You don't need a biopsy right away these days in my opinion but you need further workup. So depends on the age of the patient and depends on how also their prostates announce how many guys will go and when they get their PSA check. There's another thing that gets checked. Checked called the free. PSA and then a number is reported. which is the percentage free which is obviously that if their? PSA is three and they're free PSA is one the percent free free is reported thirty three percent. What does that mean? These are different ways for urologist. Try to fine tune this prostate specific antigen test to make it more a cancer specific test so again. PSA goes up when you have an every man has it's not cancer specific so so percent free. PSA was the first way that urologist began to look at what. What's the chance that A? PSA of four is coming from cancer sir versus a PS four coming from just benign overgrowth. So remember there's a lot of factors in play one would be if you had a man who's prostate volume was eighty grams that big and his. PSA was four well. That's of low ratio that's something called. PSA density how much PSA's made per gram of tissue issue. So you'd say well that guy. It's very low chance that he has a cancer that guy would also have a high percent free free. PSA So percent free PSA is another way to just look at what how much of the PSA's produced from benign cells versus cancerous cells. So if two guys have A. Psa of four and one has a free of one. He's twenty five percent free and the other guy has a free of three which is seventy five percent free. What's the different physiologically in those situations?.
"prostate cancer" Discussed on The Peter Attia Drive
"He's at at the hutch and Seattle, and he published a paper, and they look. At the germ lines of men with metastatic castrate resistance with the most end stage prostate cancer, and what they showed was that. In contrast to the general population of men that mutations in these different DNA repair, pathways or significantly enriched and individuals who had metastatic prostate cancer. So about eleven to twelve percent of men with metastatic, castrate resistant prostate cancer mutations. Particularly Brock to Braca one ATM RAD fifty one these different pathways that are involved in DNA damage repair. If you look in the tumors of men with metastatic, castrate resistant prostate cancer, it depending on where you look over one third of the tumors. The cells will have mutations in these pathways, which makes them incredibly sensitive to park in addition. So that's a huge game changer. The other thing that people now look at his kind of the total genome scorer the alterations in the genome of the individual cancer cells will that make them more sensitive to immunotherapy? Fear. Not that's more coming online. But the idea that there are things in the semantic DNA of the tumor cells, and in the germline of individuals that you can use to screen for not only, you know, prostate of breast pancreas excetera that's a huge game changer. And then as we touched on earlier, those are not just prognostic biomarkers, but their predictive of drug response, which is pretty amazing. And then I think allies test the version two point. Oh, or the beta version of it which has a lot of these built in biomarkers at predict responsive drugs that now are being tested in clinical trials with with the idea that let's test the ability to predict response, it's pretty mazing. Stop actually. So obviously, you specialize in prostate cancer the field of urologists so much bigger than that. Right. We haven't even talked about renal cancer bladder cancer, and to do so would only be to do it an injustice. You know, given that we've been talking for a little while. And I know you've got a hard stop here in about twenty minutes. I wanna talk a little bit about benign stuff. So I'll tell you personal maybe.
"prostate cancer" Discussed on The Peter Attia Drive
"Is converted via an enzyme called five after reduc days into a very similar molecule called dihydrotestosterone abbreviated DAT. Dat is actually any slightly more potent steroid and in men who fifty times more potent. Yeah. So the in men who are susceptible to baldness DHT, drives that process D H T also probably plays a role in the enlargement of the prostate is correct. Most of the five for duck days enzymes in the prostate. So yes, reducing Anderson's in the prostate by reducing effectively. Reducing DHT production reduces the size of the prostate. So a lot of guys take medication to reduce DHT either to reduce prostate volume size of something called benign prostatic, hypertrophy or to re minimize hair loss, and it's usually the exact same drug given it slightly different doses. And sometimes even come up with different names for the same drug. So proc-. Car is financed. Rated five milligrams. And I think pro-peace says the one milligram nets. Right. Okay. Now, I remember many years ago, and I don't I'm sure this has been revised one hundred times, but maybe ten years ago, maybe less, but a paper came out that said look in guys who have suppressed DAT levels when they get prostate cancer. They're more high-grade is at my remembering that correctly. And there's been definitely case reports of that. It's hard to really study that over I gotta yeah. So what is the current thinking on five algebra dictation habituation, and that relationship to prostate cancer? Well, there's was a very large randomized trial to see if you could take that medication with the idea that if you reduced the relative amount of Andhra Jensen the prostate by preventing the production of his potent androgen DAT. Could you reduce the risk of prostate cancer in those men and the answer was if you took that medicine that reduced potent Anderson? Hugh could. So there was a oatmeal study. This was in men starting out who did not have cancer. That's right. So it was called the prostate cancer prevention trial, and it was over seven years at the trial is conducted in Thompson was the PI on the trials of big study. It did reduce the chance at a man would develop prostate cancer overall, you know, reasonable amount of time. But one of the problems was that there was increased detection of more aggressive cancers in the men who are taking the finance. Right. And so then the question was, well, what is that? From is it inducing, a more high grade cancer, you know, and whether or not that's true or not as or is it selecting for it because any cancer that comes out of a low DHT environment. Well, yes. So I personally think that what you were just saying as is true. So yes, and there's case reports that people with low testosterone, or for example, people with low PSA's because PSA is only made when there's testosterone around, for example. That those individuals have more aggressive cancers. Now, this is what I've been focusing on in my lab for like the last four or five years now. And so one of the cool things we did in this collaboration with this company genome DX in this great, scientists alight of an she Oni was to look at the biology of prostate cancer, how grass if they were and compare the gresh Innis of the prostate cancer with the Anderson output of the tumor another nuanced way to normalize things a bit. Yep. And so we had this ipod uscis that the tumors that had the most amped up Anderson, signaling the most Anders output because prostate cancers and ginger tumor that they would be the most aggressive, and I say that way 'cause you know, the answer stieg's act posit the tumors with the lowest Anderton output or the are the most aggressive tumors. So it's somewhat relates to PSA, but not entire. Fairly like there's not a is on a true, you know, linear correlation. So the high Anders output tumors. They can be aggressive, but they are not as aggressive as Alterra low once's by modal distribution. And this is a good way to segue. Talking about these molecular tests because this is a commercially available test from genome DX might tell a funny story about ally. Before we go down there. Sure, I've told this story before but now we get to put a name to it..
"prostate cancer" Discussed on The Peter Attia Drive
"I'm sure have different versions. But even from a screening standpoint that they could be you'd have one tool that is so good in both yet. There is fortuitous. Yeah, they're good tools. And then so after if there's an abnormality in the P H I R four K score. Then I moved to an MRI. And then there's been good day. Can you just because I mean, we talk we geek out on this stuff because I'm super nerdy about what type of MRI to do for what thing, but for a patient listening to this Ted who's going to go to their doctor, and whose doctor is hopefully cooperative enough. What do you recommend because not all Emmys doing the trick here? Yeah. I mean on paper what you want a multi parametric prostate MRI, the most important phase the most important parameter in the multi parametric MRI is actually the diffusion weighted imaging which is the most operators dependent. So it really requires a skilled technician and escape. Killed interpreter. Radiologist to look at those DWI images, that's the most important one. So we do get patients contrast. But people showing you can get a lot of value out of just non contrast DWI based the one we use. No contrast, but it's their DWI's exceptional. I've sent you the images I think if they're Schaefer approved I'm happy. They're very good. Yeah. T one t two DWI an multiplayer MR is if you're listening to that. And if you and if your doctor refuses that I think those are the kinds of things that make me think you need another doctor because at this point and look your insurance might not cover. You may have to foot the Bill for that. And that's that's horrible. Well, wouldn't cover that? That was true. But there's recently reported a large multinational prospective clinical trial, looking at the utility of Mariah used for screening for prostate cancer. And the study was half the men got an MRI of their suspicious lesion. They got that lesion biopsy. And they increase detection of high grade cancer reduce it over. Detection of low grade prostate cancer. So it was a quote, unquote, positive study. We haven't had problems in the mid west Illinois getting 'em is approved. But that randomized trial based out of reported out of the UK that really has changed a lot about what companies are approving for Moore is for screening so rate to here. So so if somebody has an MRI if there's an Adra malady on the MRI, I'll recommend a biopsy. Now, there's a lot of data that says you shouldn't just sample the suspicious lesion that you should do the suspicious lesion plus doing a Sexton. Bob Sierra, kind of what I tell patients is right left top middle bottom that adds value. Not just in the detection of cancer. But if someone is gonna move to surgery, for example, and I don't do a biopsy in ninety year old guy. Even if they have an abnormal Marai, do it. If I think that person's gonna live a long long enough to benefit from treatment in those scenarios. I do those systematic by because I want to know exactly where the extent of the cancer and one of the problems of them arise it it doesn't. Actually, see the true boundaries are true. Borders of the tumors within the prostate, very well. So they're often especially the DWI because it's not really an anatomic. Yes. The way a t one way to images traffic. So if you take if you take the lesion on T to for example, it often under sizes the tumor by between five and ten millimeters. So pretty significant for prostate, which is generally pretty small. So so I do those to get a better roadmap..
"prostate cancer" Discussed on The Peter Attia Drive
"On every cancer. And there's one other one other oh, the CDC is the fifth body to weigh in. And we show them. Here are the recommendations from all five of these for every cancer. And I remember when that shift changed to for prostate cancer. There's no more recommendation while the recommendation is talk about it with your doctor pass the buck besides the I think the American kademi of family practitioners, and they don't recommend PSA screening still. I'm not sure why. But you know, that's a different discussion. But the bottom line is that almost all the guidelines now say it's a shared decision making process, which I think makes perfect sense. That's how I view mod modern medicine. Yeah. It does it. In theory, makes great sense. What I worry about Ted is theirs. A bunch of patients they get caught. They don't have doctors like you or me who are willing to be able to have had the luxury of the time and the ability to educate themselves to do that. Because I still see a lot of patients that show up and they're not getting screened because their doctors basically saying, well, obviously, this is quote, unquote. Controversial, you know, I sort of remember hearing that we shouldn't have been screening. So we're not gonna do it. And that's that's sort of my fear with these things. Well, I think I think shared decision making it require also. So then to me conceptually, it makes a lot of sense in reality. What does that actually mean? Well, that's the next question. That's the next unknown. Right as well house. Our shared decision making process, how does it occur? And when a patient sees you that's different than when a patient sees an average internist, let's say, and it's different. When a patient doesn't see any doctor. So, you know, the idea that there's the bus that rolls up that just does your bloodwork and send it back in the mail. That's terrible. I mean, I did that when I was a resin they pay me fifty bucks. Go man the bus and do that. That's not really doing that patient, those individual men any, you know, any they're not helping those people because you don't know their whole health history. You know, and all that. So I experienced that. And you know, I got into it with Otis Brawley about screening, and you know, he raised that point in. It's valid. I did that when I was rather than because I was told to do it..
"prostate cancer" Discussed on The Peter Attia Drive
"Forty percent of men coming in with prostate cancer metastatic at the time by two thousand it was four percent. Now, the skeptic is going to say this is such a controversial topic. So it's so good that we're. Doing this the skeptical say, well, that's just lead time bias. I mean, all you did was catch a bunch of men earlier. So you have a much bigger funnel. Right. Right. So by the way, the same controversy exists on mammography. So I can't wait to actually sit down with Ted Schafer quivalent of breast cancer at some point. Because I realized that an episode like this is probably a little bit more geared towards male listeners or probably the female listeners who have males houses or people that care about going through this. But it's interesting to watch the rise of mammography and the rise of PSA go through this parallel thing and Kohanovsky though to a slightly lesser extent that really being the big three mass employed screening while it's and it's been written about Al Peter you've written about this. So Peter Albertson is a nother Hopkins alum, he's Charon Connecticut, and he's an anti screener effectively for prostate cancer. And he wrote about this, and he showed that if you just look at incidents of metastatic prostate cancer incidence of metastatic, breast cancer. There's no change with implementation of. Mammography? There's a huge drop in the incidence of medicine prostate cancer with implementation. So why is he anti screener? Well, he just he was historically. He wrote this paper and showed that there is a huge difference. So now with screening you have increased detection, and what we've learned is unlike let's say pancreatic cancer where most of the time if if you picked it up early if you did nothing it, you would die not everybody who has prostate cancer has a lethal variation of it. And so initially we developed a biomarker to pick up all prostate cancers that was the PSA blood test. We pick them up we treated them, we reduced deaths. We also over treated people people who had a cancer that would never have been lethal in their lifetime. That's the dying with the dying from. And this is something you and I used to talk about nearly twenty years. I remember sitting in the cafeteria because you know, even though you know, you. We were still interns, and basically two knuckleheads you knew you were going to do this. And you were always head and shoulders above everybody else in terms, which when I said, I remember asking like, I don't get it. Like, why do some guys get prostate cancer? And it seems to be relatively uninteresting like, yeah, they and another guy though at it and they're dead in two years in it's his devastating pancreatic cancer. What is it about the biology of that because it strikes me as more a function of the biology than the environment? You're the host. But but I could be wrong, of course. But I remember talking about the Salahdin and really coming away scratching my head thing. I don't but clue what's going on this disease. I mean, I'm still scratching my head about it. Because that's my whole research program is all about his will what's the molecular biology, lethal prostate cancer? So we'll talk about that in a second. But to circle back to our story. So we diagnosed many men with prostate cancer, we.
"prostate cancer" Discussed on The Peter Attia Drive
"For protection when they're out and about functionally totally fine now for a fifty year old, man. I think there's a over ninety percent chance that you can recover sexual function. Yep. But with each deck member, you know, erectile dysfunction is a disease of the aging male. So for each decade that somebody gets older there's decline in sexual function. So he's been people say that they're totally potent and their seventy they'll tell you if you ask them, no miam-, not as good as I was when I was twenty. So there's that component of things in the other factor is prostate cancer. And it's not like, there's the prostate. There's five millimeters of tissue, and then there's this nerve bundle. There's the prostate. There's no capsule or lining encasing, the prostate. And then there's the neuro vascular bundle of Walsh named after Dr wolf. So you have prostate. The prostate itself has different zones or different regions prostate cancers develop in the peripheral region or perforate zone. So right at the edge of the prostate. So you have to Mer at the edge of the prostate, and then you have the nerve bundle. And so you're talking about one or two cruel trick of fate of of the cancer's not developed centrally. They don't develop centrally they develop Rivoli. So I understand why patients by listeners to say, why don't you don't you just you know, what I don't get it? Because it in many cases today, we I published on this a lot. Now. You know, there's prostate cancers that we pick up today are just bulkier. They're more aggressive and so. When you have a tumor that you know is going to be outside the prostate. You know, it's extra prosthetic it's involving the nerve bundle. A lot of the times. And so you have to remove part of it. You have to remove you know, the tissue around to try to clear your margins. And so when you do that in sixty five year old guy, and you take out half of his nerve on one side. It's unlikely that he'll be able to regain sat sexual function on his own. Now, these days I'd try to be very upfront about that. And I try to set appropriate expectations. We can we have special tools that we have in urology that will enable Amanda get don't total satisfaction sexually. So we can maneuver around out. So to speak. And these days many of the people I see have very aggressive cancers that are quote, unquote, the real deal. So we really have to be careful you our number one goal for doing cancer surgeries to get the tumor out. It's talk a little bit about prostate cancer because it's not a cancer that comes without its controversy to let's start with the biggest Connor is really one of the biggest controversies or things that would confuse the layperson because about every year, the advice changes on this thing called P S A. So what is the prostate specific antigen PSA is a protein it's made by the prostate. And it's normal function is to liquefy semen. So it's highly expressed in the process of the way, I explained the process of people the best analogy, I can come up with his if you think about it like a sewer system, you have the main sewer leaving the city, that's the urea three that's the tube that we normally urinate through. But this channel also deliver semen out. A tip of the penis off this main sewer are slightly smaller sewers had go to different neighborhoods within the neighborhood. There's a sewer that comes out of the individual house and the individual houses in this analogy are prostate epithelial cells, they make components of the semen, and the semen is used to give nutrients to the sperm while it's trying to fertilize an egg to enable the sperm to penetrate, the cervical mucus these different functions PSA is a protein that breaks down the semen and liquefies it and people think it's an important for for this whole process of fertilizing egg. So that's what it does. And if you look in the semen, the PSA numbers are hundred million per m l mean, the numbers they mount of this protein in the semen is astronomically high. So that's what it is..
"prostate cancer" Discussed on The Peter Attia Drive
"And I don't think I was I don't think could process it what it would have meant. Anyway, if I had asked, but when I was a medical school, and I was doing my PHD I asked. My parents what he died of and he died of prostate cancer. So I was at the NIH I was doing science. I had done some clinical work. I realized what people in DC not in science. But in politics were interested in their interested in cancer biology, and they are interested in prostate cancer. I saw at other people are interested in and I had this very vivid memories of my, you know, my father migrant, my grandfather, having prostate cancer and dying from it. And I decided that that's what I wanted to do. So when I came back to medical school. I knew that I wanted to be to be a prostate cancer biologist and understand the disease. I also knew that I wanted to be a surgeon. And so I didn't to be a medical oncologist. Although that appealed to me a lot, and I'm always flattered when people think of a medical colleges because those guys are smart, they're smart. But I knew I wanted to do something I love working with my hands. So for me, the I. The of being a surgeon. Scientist was just it just made sense. I loved the biology I love, but I still love the idea of not just conceptually deconstructing something and putting it back together. But actually, physically deconstructing something putting it back together. So as a perfect fit for what I wanted to do for the listener to put some things in context at the time that you and I began our residencies. I don't really think there was any debate about what the best urology program was in the United States. I think there is a good race for number two or lots of programs that would have competed to be the second best urology program in the country. But but Johns Hopkins was hands down in a league of its own. And they only take two residents per year. So if there are four hundred or five hundred medical students graduating who want to go into urology only two of them get to go to Hopkins, and you were one of them, which perhaps isn't surprising. Did you wanna go to Hopkins for reasons other than it was the best program? Was there something about the environment? There. There that drew you to it. Yeah. It was a people. It's an amazing place that I think about think about it all the time. So I interviewed there and the chair of the department. The time was is the godfather of my field. He made all the contemporary modern discoveries in prostate cancer. And it was real simple. He looked me in the eyes. And he said, I looked at your CV. I know what you have the ability to do. And I wanna help you get there so pet well selected you as much as you selected Hopkins. I guess you can say that. Yeah. You know, it was a perfect fit because as we've talked about mentorship is just so much of everything. It's everything in life. Really? If you're motivated, and you have drive, it's, you know, even if you're not motivated, you don't have drive you need a good mentor. So for me, I showed up for the interviews. I'd interviewed all over the country..
"prostate cancer" Discussed on Discovery
"I'm annoyed on and this is the truth about cancer on the bbc world service the series that investigates the most common global cancers and what's being done to tackle them i'm in port of spain the capital of trinidad and tobago in the carribean people are enjoying the food stalls and the music in this park their families all around us and you can really clearly see that some of the people are of african ancestry and others have very clearly of southasian indian ancestry and that's because their ancestors were brought here during colonial times as slaves and indentured labourers and you can really see that mixed heritage in the food busy young men of year serving doubles this is up fried indian bread with chick be curry and fiery sauce another lady over here grilling meats and serving fried plantains now trinidad and tobago has one of the world's highest rates of prostate cancer this is a cancer specific two men so i'm here to find out why that's the case and how doctors are dealing with it prostate cancer right no is the leading cancer in trinidad and tobago it's ahead of breast cancer it accounts for twenty percent of the council's prostate cancer is also the leading cause of death from cancer in trinidad cancer being the second most common cause of death in trinidad led by cardiovascular disease so what is the prostate and how does prostate cancer develop will head into a prostate examined just a moment but to run over the basics the prostate is a small gland in a man's pelvic region it sits immediately beneath the bladder behind the penis in most men the prostate gets bigger as they age but in some individuals cells in the gland develop abnormalities which make them grow out of control and become malignant this is prostate cancer.