Speaker 1: Initialize sequencing coming to you live from Houston, Texas, home
Speaker 1: to the world's largest medical center.
Speaker 2: Phrase everything.
Speaker 1: Look, this is your Health First, the most beneficial health
Speaker 1: program on radio with doctor Joe Bellotti. During the next hour,
Speaker 1: you'll learn about health, wellness and the prevention of disease.
Speaker 1: Now here's your host, doctor Joe Bellotti.
Speaker 3: Well, the good Sunday evening to everybody.
Speaker 4: Doctor Joe Gillotti, thanks for tuning in this Sunday evening.
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Speaker 4: hear it right now and act on it immediately. This
Speaker 4: is not some sort of theoretical, too difficult to digest
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Speaker 4: All right, so on the program tonight, we are going
Speaker 4: to be continuing our discussion on prostate cancer. We have
Speaker 4: on the phone a little later this evening, a true
Speaker 4: expert in prostate cancer, doctor Brian Miles, who is at
Speaker 4: Houston Methodist Hospital here in the Texas Medical Center, a
Speaker 4: pioneer and not only robotic surgery for prostate cancer, but
Speaker 4: the approach to patients with prostate cancer. And certainly with
Speaker 4: the revelation of what was disclosed about President Biden a
Speaker 4: couple of weeks ago in his prostate we're going to
Speaker 4: get an opinion or suggestion of what may have actually
Speaker 4: happened with President Biden and learn about that. The one
Speaker 4: thing I want to chat about is and this really
Speaker 4: gets into prostate cancer or any cancer where you're getting
Speaker 4: a second opinion. The New York Times had an article
Speaker 4: talking about logging on for a second or third opinion,
Speaker 4: so logging on meeting, going to Google or somewhere on
Speaker 4: the internet for a second opinion. And I have always
Speaker 4: been a big advocate of getting a second opinion. So
Speaker 4: many of the patients that I see, I am seeing
Speaker 4: them as a second, third, or even a fourth opinion.
Speaker 4: So it is important that you if you're confronted with
Speaker 4: a diagnosis, whether it's life threatening or not life threatening,
Speaker 4: that you consider getting a second opinion. But in this
Speaker 4: day and age, so many people are going online and
Speaker 4: looking for a second opinion.
Speaker 3: And the amount of Google.
Speaker 4: Searches that have to do with health and wellness is
Speaker 4: really quite predominant. And this is what we are all
Speaker 4: doing now. It is a good thing. I'm not going
Speaker 4: to say don't do it, but I would believe that
Speaker 4: there is information that you can get that is inaccurate,
Speaker 4: and so you don't want to search thinking that you're
Speaker 4: going to find information that's going to be helpful to you,
Speaker 4: but then at the end of the day end up
Speaker 4: penalizing yourself.
Speaker 2: So the.
Speaker 4: Current strategy out there is that so many people that
Speaker 4: have a particular disease, whether it's prostate cancer, whether it's
Speaker 4: multiple sclerosis, whether it is breast cancer, people are posting
Speaker 4: information about their own case, their own treatment, their own
Speaker 4: sort of follow up after surgery. And by creating this
Speaker 4: community around a certain disease, there is a benefit to this.
Speaker 4: There is the opportunity to see what other people went through,
Speaker 4: but you have to keep it in the context of
Speaker 4: your own case, your own particulars with regard to your
Speaker 4: health and wellness, and have a really healthy conversation with
Speaker 4: your physician. But when you look at the different websites
Speaker 4: that you could look at, there are basically five categories
Speaker 4: of websites that you want to look at. The first
Speaker 4: would be general interest websites, something like WebMD or even
Speaker 4: the New York Times health site. It is of value
Speaker 4: and so this is where you're going to get information
Speaker 4: about a particular disease, news and lifestyle advice, and learn
Speaker 4: from medical institutions like Mayo clinics, so that's a general interest.
Speaker 4: The second is a medical research site. So if you
Speaker 4: want to learn about what is being done or published
Speaker 4: within research, you're going to have to go to a
Speaker 4: website like PubMed, which is done which is really organized
Speaker 4: under the National Library of Medicine, but if you just
Speaker 4: type in PubMed you will find out. The other is
Speaker 4: a website called Clinicaltrials dot gov, which will track various
Speaker 4: research protocols, and you can actually type in a disease
Speaker 4: and where you live and it will narrow down something
Speaker 4: that's in your particular neighborhood. Then there are a number
Speaker 4: of patient sites, and this is really what is booming.
Speaker 4: There's the Association of Cancer Online Resources. There is something
Speaker 4: called epatients dot net, as well as a site patients
Speaker 4: like me and Trusira t r U s e r
Speaker 4: a dot com which provides a bit of a Facebook
Speaker 4: style like social connection for patients. Then you get into
Speaker 4: the disease specific sites, which would be American Heart Association,
Speaker 4: American Cancer Society, American Diabetes Association, which will sort of
Speaker 4: target a particular disease. And then lastly there are web
Speaker 4: tools that will help you learn about nutrition, disease risk, factors,
Speaker 4: certain medications that you will be on. So there's a
Speaker 4: lot there. I'm going to post this article on the
Speaker 4: Facebook page which is at doctor Joe Galotti.
Speaker 3: But it's interesting. So again, we.
Speaker 4: Don't want you to not search online. I believe you
Speaker 4: have to be a good consumer and open to all
Speaker 4: of this information and trying to sort of out. All right,
Speaker 4: we're going to take a quick break right now. You
Speaker 4: tuned into your health First. Every Sunday between seven and
Speaker 4: eight pm, visit doctor Joegalotti dot com for more information
Speaker 4: about me, our team and our Livid Disease practice. Doctor
Speaker 4: Brian Miles talking about prostate cancer coming up in just
Speaker 4: a minute before all right, Well, as I've been saying
Speaker 4: this evening, we have a true expert and need I
Speaker 4: say a legend in the world of urology is a
Speaker 4: very modest gentleman, doctor Brian Miles, who his credentials are
Speaker 4: impeccable where he is the vice chair of Urology at
Speaker 4: Euston Methodist Hospital, He's a professor of urology, he's the
Speaker 4: director of Robotic Surgery at Houston Methodist Hospital and truly
Speaker 4: an individual that in the field of medicine when you
Speaker 4: talk about prostate cancer. Doctor Brian Miles's name comes up,
Speaker 4: So Dodtor Miles. So great to have you on the
Speaker 4: program this evening.
Speaker 2: Jill, thank you so much for including me, and this
Speaker 2: is a wonderful opportunity to talk about something that is
Speaker 2: foremost in many men's minds in this time.
Speaker 4: Yes, for sure, and certainly with the revelation of President
Speaker 4: Biden and his diagnosis, it's raised questions but also some
Speaker 4: confusion as to what I should do, and we will
Speaker 4: certainly get to that. So you know, the basic issue
Speaker 4: is every man over fifty, let's say, know what their
Speaker 4: PSA is, prostate specific antigen. And even this has become
Speaker 4: a little controversial. So what is your explanation everybody tonight
Speaker 4: about PSA?
Speaker 3: Who should get it?
Speaker 4: And how much weight do we put on it if
Speaker 4: it is indeed elevated?
Speaker 2: Well, PSA is an important screening tool. There's no other
Speaker 2: wonderful blood test like this for any other cancer, breast
Speaker 2: cancer or colon cancer. Could find a blood test like this,
Speaker 2: it would be a huge help. But PSA just gives
Speaker 2: us an idea that someone might be at increased risk
Speaker 2: right now. The guidelines say you should start at age fifty,
Speaker 2: and they tend to say stop at age seventy five.
Speaker 2: If you have a family history of prostate cancer or
Speaker 2: you're African American, I believe you need to start getting
Speaker 2: tested at age forty because your risk is substantially higher.
Speaker 2: I would also add it, I my Joe, that PSA
Speaker 2: is a screening tool. If someone has an elevated PSA,
Speaker 2: I don't rush to biopsy. In the old days, we would.
Speaker 2: What I do now is another specialized test. There are
Speaker 2: many varieties, but the one I use is called a
Speaker 2: four K test that looks at all aspects of PSA
Speaker 2: and one of the proteins of the Cali crime family.
Speaker 2: That PSA is a part of that family. That helps
Speaker 2: us predict whether someone has a true risk of cancer.
Speaker 2: Right if someone has a mildly elevated PSA, Joe, chance
Speaker 2: of having cancer is twenty eight to thirty percent, you know,
Speaker 2: I mean between four and nine. But I'm biasing one
Speaker 2: hundred men to find those. If I do a four
Speaker 2: K test, I only have to do I only have
Speaker 2: to buy the sixty men to find the same number
Speaker 2: the same thirty. It's a very helpful test.
Speaker 4: So I would say over the past ten years or so,
Speaker 4: or maybe fifteen years. Organizations like the American Cancer Society
Speaker 4: have come out somewhat to the chagrin of experts like you,
Speaker 4: that maybe we don't need to check PSA. Too many
Speaker 4: biopsies are being done. What do you say to that today,
Speaker 4: with the knowledge that you all.
Speaker 2: Have, that's wrong. That's wrong. We found when the US
Speaker 2: Prevented the Task Force came out with their recommendations, like
Speaker 2: the American Cancer Society, five years later, we found that
Speaker 2: the increase in people presenting with metastatic disease like President
Speaker 2: Biden shot almost straight up as you would predict. Five
Speaker 2: years is about the time it takes from inception of
Speaker 2: a disease that's fairly aggressive to metastatic disease, so that
Speaker 2: they're wrong. And you know, it's hard for many of
Speaker 2: us to admit, perhaps we were wrong, but this was wrong. Unfortunately,
Speaker 2: it is still in the mindset of some primary care doctors.
Speaker 2: But I think that with President Biden, we should all
Speaker 2: wake up.
Speaker 4: Yeah, yeah, And I would say you're right that sometimes
Speaker 4: when these these new rules come down or suggestions, it
Speaker 4: becomes the word of the land, and it is more
Speaker 4: difficult and more problematic to unravel that thinking you almost
Speaker 4: have an entire generation of physicians trained that PSA really
Speaker 4: isn't that important and they're not getting it done.
Speaker 2: I couldn't agree more. Couldn't agree more.
Speaker 4: Yeah, Now, with regard to risk factors for prostate cancer,
Speaker 4: you mentioned African American and that certainly is significant. But
Speaker 4: what are some of the other risk factors, be it
Speaker 4: obesity or diabetes, smoking, alcohol, things like that.
Speaker 2: Well, it's certainly family history is the next big one
Speaker 2: after AfOR race being African American, But obesity, for instance,
Speaker 2: there's really not an increase in prostate cancer disease so
Speaker 2: much as there is an increased risk of being more
Speaker 2: aggressive disease. Meaning if you're diabetic it doesn't or obese
Speaker 2: it doesn't mean you have a higher risk of getting it,
Speaker 2: but if you do get it, there's a higher risk
Speaker 2: that it's a much more aggressive cancer. Diet Diet is always,
Speaker 2: as you know, everything in life eventually comes down to
Speaker 2: diet because diet is what can we as individuals do
Speaker 2: to modify our risk. And unfortunately there's no real good
Speaker 2: data on this. I will tell you that in this country,
Speaker 2: people spend over one trillion dollars on nutraceuticals meaning vitamins
Speaker 2: and very substances to help modify their risk of cancer,
Speaker 2: prostate cancer being very high on that list, and yet
Speaker 2: none of them have really been studied well enough to
Speaker 2: show what the true benefit is. So there's nothing you
Speaker 2: can really do there. Keep your weight good, be active,
Speaker 2: keep your immune system good, so even if you get
Speaker 2: prostate cancer, it'll be easily managed.
Speaker 4: Right, right, And that's so general for everything, cardiovascular disease,
Speaker 4: liver disease, lung diseases.
Speaker 3: Got it.
Speaker 4: You want to have a healthy diet, stay active, and
Speaker 4: keep your weight down. Now, symptoms of prostate cancer, because
Speaker 4: a lot of people will say, well, gee, my PSA
Speaker 4: may be elevated, but I feel fine. What are the
Speaker 4: symptoms that may be very mild and nonspecific, and what
Speaker 4: are the absolute red flags to say you need to
Speaker 4: get in see an expert like yourself with regard to
Speaker 4: their prostate health.
Speaker 2: None.
Speaker 3: Okay, that's that's very easy.
Speaker 2: Because when we ask questions, we always ask questions like
Speaker 2: are you getting up too often at night? Is your
Speaker 2: stream week? Are you having urgency? These are signs of
Speaker 2: benign growth of the prostate, but any they are not
Speaker 2: signs of someone having increased risk of prostate cancer. Fact
Speaker 2: the matter is that, as in most cancers that you
Speaker 2: know of, Joe, if you get symptoms that are directly
Speaker 2: related to that cancer, it is most likely already.
Speaker 4: Spread, right right, Yeah, exactly. So again it gets back
Speaker 4: to early intervention and really awareness. Would you would you
Speaker 4: say that when you look at prostate and if you
Speaker 4: just want to compare it to breast cancer, which certainly
Speaker 4: everybody is aware of, it's on everyone's mind, do you
Speaker 4: find that the general awareness of men and prostate cancer
Speaker 4: is lacking?
Speaker 2: Oh? Absolutely, Men. Breast cancer, by the way, and prostate
Speaker 2: cancer a fairly similar. Breast cancer tends me a little more,
Speaker 2: a little more aggressive, but also found a little later.
Speaker 2: It doesn't have blood tests, it doesn't have that PSA test.
Speaker 2: But men are still historically fairly stoic and at some
Speaker 2: level whims I don't want to go to the doctor,
Speaker 2: They don't want to go to the doctor that I have,
Speaker 2: and they certainly don't want me examining their prostate rect right.
Speaker 2: But women are much more proactive. I think this comes
Speaker 2: from motherhood and all of those things. Perhaps where you're
Speaker 2: taking care of the family, a caregiver, and the family's
Speaker 2: mom and breast cancer and women coordinate better they you know,
Speaker 2: the breast cancer walks are so important. You won't find
Speaker 2: much of that. And men it's it's but women tend
Speaker 2: to take care of their husbands. Nine times out of
Speaker 2: the ten. A guy coming in to see me, if
Speaker 2: he doesn't have an elevated PSA already, is because his
Speaker 2: wife wants me to examine it.
Speaker 3: Yeah, excited, you know, speaking of the examination.
Speaker 4: And you know, we've gotten so much more technology and
Speaker 4: scanning and fancy blood works. Is the digital rectal exam
Speaker 4: a dead item or should we still be Should we
Speaker 4: still be doing these on our man and encouraging primary
Speaker 4: care physicians to do a rectal exam to say, on
Speaker 4: that digital exam, you may find a prostate cancer.
Speaker 3: What do you think?
Speaker 2: Well, you know, this becomes generational. I'm a bit older,
Speaker 2: So I was raised with a digital rectal exam. PSA
Speaker 2: came out just after I finished residency, and so we
Speaker 2: only found prostate cancer through the digital rectal exam, right,
Speaker 2: And so that's what would lead to a biopsy. But
Speaker 2: back then, fifty percent of the de men already had
Speaker 2: advanced disease beyond the prostate So thank god with PSA
Speaker 2: that's changed dramatically, and so I still recommended yours little
Speaker 2: rectal exam. But is it critical. No, if you have
Speaker 2: an equivocal PSA, I think it's very important. But if
Speaker 2: you've got to do one test, do the PSA not
Speaker 2: directly right?
Speaker 3: Exactly? All right, We're going to take a quick break.
Speaker 4: We're talking with doctor Brian Miles, a world renowned urologist
Speaker 4: and prostate cancer expert, on your Health First this Sunday
Speaker 4: evening on.
Speaker 3: Doctor Joe Galotti.
Speaker 4: Don't forget doctor Jogalotti dot com is our website. Stay
Speaker 4: tuned more prostrate discussion in a moment. Welcome back everybody,
Speaker 4: doctor Joe Glotti, thanks for tuning in on this glorious
Speaker 4: Sunday evening to your Health First. We hear every Sunday
Speaker 4: between seven and eight pm bringing you.
Speaker 3: The best in health and wellness.
Speaker 4: We want to raise your health IQ, make you better
Speaker 4: consumers of healthcare, making sure that you have all of
Speaker 4: the facts you need to stay healthy, to stay on
Speaker 4: top of your health and all of the important topics
Speaker 4: such as prostate cancer, which sometimes is just in a
Speaker 4: black box that we just don't want to talk about things.
Speaker 4: But tonight on the program, we have been chatting with
Speaker 4: doctor Brian Miles, a true expert in prostate cancer here
Speaker 4: in Houston, Texas at Houston Methodist Hospital where he is
Speaker 4: the Professor of Urology and the director of the Division
Speaker 4: of Robotic Surgery. And it's so great to have him
Speaker 4: on the program tonight explaining to us what we need
Speaker 4: to know about prostate cancer. So take me through a
Speaker 4: sixty year old gentleman that has on routine screening PSA
Speaker 4: is elevated, and maybe over the last five years the
Speaker 4: PSA was sort of in the normal range and this
Speaker 4: year it jumped up a little bit and either the
Speaker 4: primary care or the guy's wife said, wait a second,
Speaker 4: we have to get this worked up. They come and
Speaker 4: see you or some other eurologic expert, and what is
Speaker 4: the plan of care. How do you approach a patient
Speaker 4: like this?
Speaker 2: Well, as I said said earlier, besides doing a digital
Speaker 2: rec exam, I also do the four K tests and
Speaker 2: advanced test that is looking at total PSA, free PSA,
Speaker 2: complex PSA and HK two that protein within the calikrin
Speaker 2: family that PSA is a part of. That tells me
Speaker 2: whether this person really has an increased risk of prostate cancer,
Speaker 2: or whether it's just related to the genetics of his
Speaker 2: family and his age. As we get older, the PSA
Speaker 2: tends to go up within families. There are PSA patterns.
Speaker 2: I can think of a family I once that with
Speaker 2: six brothers, and they all as each brother got to
Speaker 2: age sixty, their PSA got to ten of a big number.
Speaker 2: None of them ever had positive cancer. So there is
Speaker 2: a familial trend to some of these things, and you
Speaker 2: have to fit that into the pattern of what you're
Speaker 2: doing with the patient. But a sixty year old I'm
Speaker 2: going to get a four K test of it shows
Speaker 2: an intermediate elevated risk, I'll get an MRI of the prostrate.
Speaker 2: If it's elevated risk, they're going to get a biopsy.
Speaker 2: Whether the MRI is positive or not. If the four
Speaker 2: K test says intermediate risk for aggressive disease or disease,
Speaker 2: it should be treated. The MRI is negative, I'll watch
Speaker 2: them for intermediate group. So you know, you don't want
Speaker 2: to be you don't want to be doing what the
Speaker 2: American Cancer Society said, we were always doing, over diagnosing,
Speaker 2: over biopsing, this sort of thing. You want to do
Speaker 2: it with some thought process that has value for the
Speaker 2: patient without putting them in harm's way by scaring them
Speaker 2: because they have a really low grade disease, or by
Speaker 2: a scaring them the all negative bio scenes. But are
Speaker 2: still wonder to be harboring cancer.
Speaker 4: There right right now, you have been one of the pioneers. Gosh,
Speaker 4: it's probably been twenty plus years with robotic surgery on
Speaker 4: the prostate. And what is the current state of affair
Speaker 4: with regard to prostate surgery? Because I would think that
Speaker 4: men are petrified of having that prostate cut out. They
Speaker 4: may have trouble with impotence and urinary incontinence, and they
Speaker 4: would almost well, I can't speak for them. They would
Speaker 4: almost say, forget about it, this is not for me.
Speaker 4: I'll take chemo, I'll take radiation. Where are we at
Speaker 4: with state of the art prostate cancer technology?
Speaker 2: Well, I would say that with appropriate informed consent, which
Speaker 2: form consent means you expose the patient to risk. What's
Speaker 2: the potential for risk, So risk knowledge and then risk
Speaker 2: acceptance and whether you get Chemotherapy has no role in
Speaker 2: prostate cancer till very late. So your choices are doing radiation,
Speaker 2: having me remove the prostrate or having me treat the
Speaker 2: prostrate with what are called a BLATI of therapies like
Speaker 2: high intensity focused ultra scenography or cryosurgery. Right, those localized
Speaker 2: treatments all have risk impotence, incontinence, and problems with the
Speaker 2: rectum or bladder depending on the treatment options. And the
Speaker 2: fact of the matter is that they are generally minor
Speaker 2: minimal if you will accept for impotence. Impotence is the
Speaker 2: one thing where you know, at least the third of
Speaker 2: men will in general depending on age, but in general
Speaker 2: we'll have problems getting back to normal rectile capacity. We're
Speaker 2: still studying that. I have. I've created what's called a
Speaker 2: survivorship clinic for my patients, trying to find ways to
Speaker 2: get their erections back if they were sexually potent and
Speaker 2: and interested remain interested in being intimate with their partner, Okay,
Speaker 2: And so there's a lot going on there because that
Speaker 2: is that is the key. I don't want to cure
Speaker 2: cancer and yet create another disease us, and so we
Speaker 2: have to focus on that.
Speaker 4: Yeah, So with removal of the prostate, the rates of
Speaker 4: cure are very good, would you say that?
Speaker 2: Yeah? I mean, you know, they're not one hundred percent
Speaker 2: whether you're radiated or remove it. But the thing I
Speaker 2: always catch it early and treat the primary disease. The
Speaker 2: chance of death from prostate cancer is very unusual.
Speaker 4: So now that segues into the recent news a week
Speaker 4: or so ago with President Biden, this revelation out of
Speaker 4: nowhere that he has prostate cancer, let alone it is
Speaker 4: advanced to his bones apparently. So there's all kinds of
Speaker 4: speculation and we are not here to create some political
Speaker 4: chaos and be controversial. But what do you think went
Speaker 4: on there from a professional standpoint.
Speaker 2: Well, it is really hard to explain that It's easy
Speaker 2: to judge, but you have to be careful having not
Speaker 2: been there and what you were allowed to do or
Speaker 2: not allowed to do. Possibly the person who's taking care
Speaker 2: of the president. The primary care doc was a firm
Speaker 2: believer that when you're older, you don't need to get
Speaker 2: a PSA. I am, as you know, different than that.
Speaker 2: I wrote a paper quite a few years ago, still
Speaker 2: have to get a published because people didn't want to
Speaker 2: buy it. That age is an independent predictor of getting
Speaker 2: high risk disease. You're over the age of seventy five,
Speaker 2: your chance of having high risk cancer is fifty percent
Speaker 2: as opposed to twenty or twenty five percent. And so
Speaker 2: that was not well received because I do PSAs based
Speaker 2: on the patient's robustness and their willingness to do that. Again,
Speaker 2: getting older, I've noticed that the years pile up, but
Speaker 2: I don't get old and you don't. And so anyhow,
Speaker 2: somebody missed the ball and didn't do a PSA on
Speaker 2: this man, because I can tell you he is his
Speaker 2: PSA is very high, over fifty, over fifty at least
Speaker 2: I would expect. And you know, it's unfortunate because he
Speaker 2: will die of this disease or his treatment, his treatment
Speaker 2: with hormone therapy and all will further impact his cognition.
Speaker 3: Right, And so your.
Speaker 4: Generalized theory is that going back ten years, his PSA
Speaker 4: may have been creeping up until it got to a
Speaker 4: critical point of the amount of disease in the pro
Speaker 4: state where it sort of broke loose.
Speaker 3: Correct, correct, Yeah.
Speaker 4: So is there is there, and you know it's you
Speaker 4: hate to hear that somebody like this, especially somebody as
Speaker 4: so much under the microscope as any president or dignitary
Speaker 4: or famous person that that right in a sense, right
Speaker 4: before us, this took place. But is there a lesson
Speaker 4: for everybody tuning in tonight to have them recalibrate how
Speaker 4: they are looking at prostate cancer for themselves or a
Speaker 4: parent or another loved one.
Speaker 2: Yes, I think they should. That this would hopefully enlighten
Speaker 2: your average mail out there that you know it's this
Speaker 2: is something that can sneak up on you and suddenly
Speaker 2: you're eighty and you're feeling like you're sixty and some
Speaker 2: and you never got your PSA checked because you know,
Speaker 2: the government task force said I don't have to do that,
Speaker 2: and you suddenly have metastatic disease and your life as
Speaker 2: you knew it it's not the same anymore. So it's
Speaker 2: it's something that men should take cautiously, should be aware of,
Speaker 2: but don't be afraid of getting a PSA and going
Speaker 2: to an expert, because elevated PSA doesn't mean someone's going
Speaker 2: to put needles in your prostate. It means they're going
Speaker 2: to look at it a little more closely and see
Speaker 2: what your risk are. What can we do do other
Speaker 2: studies like MRIs or PET scans and help reassure you
Speaker 2: that your life is still yours.
Speaker 4: Right and certainly you want that expert care. And so
Speaker 4: here in Texas and certainly in Houston, you and your
Speaker 4: colleagues are definitely the go to people. But if somebody
Speaker 4: is living in Colorado or New England somewhere, is it
Speaker 4: in a sense adequate enough to go to a general urologist.
Speaker 3: Should they look.
Speaker 4: Up somebody that specializes in prostate cancer? How do you
Speaker 4: give direction?
Speaker 2: Well, my sense of that is that a board certified
Speaker 2: urologist is well trained to deal with this and move
Speaker 2: forward with it. If a man has prostate cancer, always,
Speaker 2: of course seek a second opinion. If someone does that
Speaker 2: with me, it doesn't that's not an insult to me.
Speaker 2: That's a rational thing that people should do, and it's
Speaker 2: when But when you're dealing with an abnormal LAMB value,
Speaker 2: what you want to do is go to a urologist.
Speaker 2: Have the mixam in you. You know, the community urologists
Speaker 2: who refer to me are terrific surgeons are terrific docs, right,
Speaker 2: And I would have no problem at all with anyone
Speaker 2: who has an elevated PSA going to the nourish urology
Speaker 2: and talking with them about this.
Speaker 4: All right, Well, Brian Miles from Houston Method Hospital, you
Speaker 4: know years ago, Brian, when I first started getting on
Speaker 4: the radio, they had said, you know what you for
Speaker 4: me this show. We don't have guests on the program.
Speaker 4: We have experts, and you certainly and you certainly fit
Speaker 4: that bill, Doctor Brian Miles, Houston Methodist Hospital expert Urologists,
Speaker 4: thanks so much for it. It's always great and we
Speaker 4: do need to get together and cook up some pizza together.
Speaker 2: And I am counting on that, Doctor Galotti.
Speaker 4: All right, Brian, thank you so much. All right, final
Speaker 4: segment of this week's Your Hell First is coming up
Speaker 4: in just a moment, thanks to doctor Bryan Miles.
Speaker 3: Don't forget.
Speaker 4: Doctor Joeglotti dot com is our website, center for our newsletter,
Speaker 4: everything that we do, our team, it's all there on
Speaker 4: doctor Joe Galotti dot com. We'll be right back. Final
Speaker 4: segment of Your Health First on this Sunday evening, Doctor
Speaker 4: Joe Galotti. Don't forget go to doctor Joe Galotti dot com.
Speaker 4: Doctor Joe Galotti dot com. Now you may be sitting
Speaker 4: there saying, well, how does this guy spell his name?
Speaker 4: G A l A t I Doctor Joe Galotti. No spaces,
Speaker 4: no periods, just doctor Joe Galotti dot com. Me I
Speaker 4: don't pay by mills.
Speaker 1: What do I think got growth?
Speaker 2: All? Right?
Speaker 4: Final segment here, I hope you're having a good Sunday
Speaker 4: night and getting planned for the weekend. You know, for
Speaker 4: so many years, what I've been doing is we've always
Speaker 4: used Sunday night as the time to plan the week out.
Speaker 4: What are we eating, what are our activities? Looking at
Speaker 4: a calendar and planning it would be around not only
Speaker 4: what we were doing, but what about eating. It's always very,
Speaker 4: very important that you have that plan for you, your family,
Speaker 4: your kids, and those that you care most about. In
Speaker 4: the final segment here, I found an article which was
Speaker 4: in the New York Times column in their health section
Speaker 4: in their fizz ed area, and I would say, if
Speaker 4: you are interested in health and wellness, this is a
Speaker 4: very nice column by Gretchen Reynolds, and it has to
Speaker 4: do with exercise and depression. Now, the slight twist here
Speaker 4: is this is a study that I don't think has
Speaker 4: really ever been done to this level. Now, there have
Speaker 4: been studies in the past that show exercise, one form
Speaker 4: or another is good for your mood, makes you a
Speaker 4: little happier, and it doesn't make you as depressed. Maybe
Speaker 4: you sleep a little better. You tend to wake up
Speaker 4: a little bit more refreshed when you exercise. I think
Speaker 4: we all know this, but this particular study got into
Speaker 4: it way deeper, and it's pretty interesting. They get into
Speaker 4: this Mendelian randomization. And what they did was they went
Speaker 4: into a database of I believe four one hundred thousand
Speaker 4: men and women, and we carry a little piece of
Speaker 4: genetic material that is encoded for whether or not you
Speaker 4: are at risk for depression, and also whether you were
Speaker 4: going to be active or more sedentary. And so what
Speaker 4: they did was they looked at the people that had
Speaker 4: the more active gene and the depression gene, and lo
Speaker 4: and behold, they found that the people that were less
Speaker 4: depressed exercised more and vice versa. Now, there's still a
Speaker 4: lot of questions that one would have when you look
Speaker 4: at something to this grand scale. And what they found
Speaker 4: is that about fifteen minutes a day is enough to
Speaker 4: reduce the chance of developing depression. Now, if you had
Speaker 4: less taxing exercise, let's say say housework, walking fast, you
Speaker 4: needed about an hour to cut down and make a
Speaker 4: dent in the depression. So for those that now, again
Speaker 4: you're not going to go to the laboratory tomorrow and say, hey,
Speaker 4: test me, test my genes for depression, or test my
Speaker 4: genes if I should be more active or not. The
Speaker 4: bottom line is, somehow we all need to carve out
Speaker 4: time a little every day for some vigorous exercise. And
Speaker 4: there's so many ways to do that. Ride a bike,
Speaker 4: get a stationary bike, go running, get on a treadmill,
Speaker 4: do some workouts, play basketball, play a little tennis, play
Speaker 4: a little handball. There's so many things.
Speaker 3: That we all could do.
Speaker 4: And realize that it may have a definite impact on
Speaker 4: your depression. Now, the reason I brought this up and
Speaker 4: the reason that caught my eye, so many of my
Speaker 4: patients say or report that they are depressed. They just
Speaker 4: are not happy. They feel like they have the weight
Speaker 4: of the world on their shoulders, the glass is half empty,
Speaker 4: and I do not understand why I do talk with them. Now,
Speaker 4: I am not a psychiatrist, but I believe I need
Speaker 4: to take a few minutes and talk with my patients
Speaker 4: and try to understand what's going on, because if they're depressed,
Speaker 4: it's going to interfere with what I have to do
Speaker 4: with them. If they're depressed, they're not going to eat well.
Speaker 4: If they're depressed, they're probably not going to exercise. If
Speaker 4: they're depressed, they're less likely.
Speaker 3: To follow up.
Speaker 4: And and so I do take tremendous interest in this.
Speaker 4: But so many people out there, many of you listening tonight,
Speaker 4: just feel that their life is just not right.
Speaker 3: They wish they were happier.
Speaker 4: And that's a that's a that's a tough nut to solve.
Speaker 4: But can we fix some of this with exercise and
Speaker 4: and getting down to the to the basics. I just
Speaker 4: don't know. So I think what you need to do
Speaker 4: is you have to be mindful with regard to not
Speaker 4: only what you're eating. And as I said at the
Speaker 4: very beginning of the program tonight, we have to get
Speaker 4: to a point where we are listening to our bodies.
Speaker 4: Are you getting these signals? Are you appreciating that little
Speaker 4: bit of abdominal pain or that pain in your leg,
Speaker 4: that pain in your neck, that pain in your side,
Speaker 4: the shortness of breath, a wheezing that you may be getting.
Speaker 4: And again, you don't want to become a hypochondrias, but
Speaker 4: you need to listen to what's going on. All right,
Speaker 4: we're gonna close out for tonight I'm gonna pick a
Speaker 4: song that should make you a little happy as we
Speaker 4: as we go out of here tonight.
Speaker 3: I'm doctor Joglotti.
Speaker 4: Don't forget dot go to doctor joglotti dot com. We'll
Speaker 4: see you next Sunday night. Have a great week. Truly,
Speaker 4: I do mean that. Stay well now