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December 2, 2019

Dr. Mistry and Donna Lee Discuss HIFU (High Intensity Focused Ultrasound), a Non-Invasive Prostate Cancer Treatment Option

Speaker 1: 

Welcome back to the Armor Men’s Health Hour with Dr. Mistry and Donna Lee.

Dr. Mistry: 

Welcome back to the Armor Men’s Health Hour. I’m Dr. Mistry, your host here with my co-host Donna Lee.

Donna Lee: 

Hi, welcome back. Thank you for coming back.

Dr. Mistry: 

And a big thanks to Mark McManis, our patient, who talked about his experience with high intensity focused ultrasound.

Donna Lee: 

And one of the sweetest guys ever created.

Dr. Mistry: 

He really is a super guy.

Donna Lee: 

He’s so nice. Most of our patients are nice, but you know, we have our favorites and he’s one of them.

Dr. Mistry: 

Yes. And you’ve known him for a while.

Donna Lee: 

I’ve known him for a really long time.

: 

That really helps.

Donna Lee: 

And he’s adorable, and he gives great hugs.

: 

You know, taking care of our friends and my friends is something that sometimes they find weird, but I wouldn’t have it any other way. If it’s a friend of mine that needs a vasectomy or has a kidney stone or has a family member with cancer. I almost always insist that I take care of them myself because–except for my own vasectomy, I didn’t do that myself.

Donna Lee: 

Oh you didn’t?

Dr. Mistry: 

People ask me all the time.

: 

But yeah, that would have made a better story.

Dr. Mistry: 

No, I don’t think so.

Donna Lee: 

I know we sent a friend to you and you did as pellets.

Dr. Mistry: 

That’s right. Testosterone pellets are a big part of what we do and I think that we should maybe talk about that, maybe if there’s a break, and the next segment. I think we should talk about pellet therapy for testosterone.

Donna Lee: 

Oh for sure. I know I’ve got a couple of questions.

Dr. Mistry: 

You know, for those of you that only caught part of Mark or don’t know what HIFU is, a high intensity focused ultrasound is a form of treatment for prostate cancer that you may not be given a lot of information on. Not a lot of urologists do it. I would estimate that there’s probably only about 40 centers in the United States in which HIFU for prostate cancer is offered. But this is a specific treatment that’s especially suited for those that have localized prostate cancer that’s just like in one particular area of the prostate. It’s great for guys who are trying to avoid the complications of more invasive surgery like impotence and incontinence. A wonderful option for you to hear about and if you want to hear about it, you can get a free consultation with us. Donna, if you were diagnosed with prostate cancer, how do you get on the phone with me?

Donna Lee: 

You can call us at 512-238-0762. We do, you do the consult at no charge, which is really nice of you. We have a ton of patients on your schedule every week now and they’re calling in from all over the country, right?

Dr. Mistry: 

That’s right. And we’re getting people from all over the country to get HIFU done in our center.

Donna Lee: 

You can also send an email to armormenshealth@gmail.com or check out the website. There’s a website inquiry page for armormenshealth.com.

Dr. Mistry: 

If you do look for that second opinion for prostate cancer and are interested in getting information on high intensity focused ultrasound for prostate cancer, then what we will do is we will work to get your records together and then we will kind of, I’ll take a look at them and then when we’re talking on the telephone, I can talk you through whether or not you’re a candidate for HIFU, what it might cost you in terms of what your insurance may or may not pay for and of course what you can expect in terms of recovery and treatment efficacy, and for us we’ve had just an amazing HIFU program develop over the last year, but we have patients like we said, that come from all over the country.

Donna Lee: 

And I think what’s most impressive is the lack of side effects like Mark said. He did so well.

Dr. Mistry: 

He did great, he did great, you know.

Donna Lee: 

Most patients do so well, so quickly.

Dr. Mistry: 

Yeah, I think comparatively to other forms of treatment, a lot of people would pick radiation therapy for their prostate cancer because they’re kind of afraid of the impotence kind of side effect that they can that can accompany surgery or the incontinence side effect. And if you have the right kind of cancer and we think that you’re an appropriate candidate, you don’t burn any bridges, you still can have surgery or radiation if you need that in the future. But if we can kind of kill what you have and leave the rest of the prostate in place, then you might benefit from, you know, a higher level of care for your prostate cancer.

Donna Lee: 

For the people just tuning in, why don’t, can you explain quickly in layman terms HIFU, because I always tell you it sounds like an ultrasound, like you’re going to get an ultrasound of your arm or something, but you’re actually taking care of the prostate cancer on the spot.

Dr. Mistry: 

That’s right. So, ultrasound really just refers to sound waves and we can change how intense those sound waves are in a variety of different ways to make them for medical treatment. So one common way that people kind of heard about sound waves are the use of sound waves to do an ultrasound to image image of body part. We also have heard about using ultrasound to break apart stones that might be sitting inside the kidney or the urinary tract. And so–

: 

Which you do.

Dr. Mistry: 

–that’s right, we also do that. And if you make the wave even more intense, you can heat up tissue and kill tissue. And if you can do it under a guidance because you can actually see the tissue at the same time, you can direct those energy waves right at a particular area and then just kill just a portion of the prostate. Now we only do HIFU for prostate cancer, but you can envision a time in which you could use the same technology for liver or kidney or other solid organ type tumors. And you know, we really look forward to that. There are some centers that use high ultrasound waves to kill fibroids or benign tumors of the uterus. And so the applications of the technology are just going to become broader and broader and broader.

Donna Lee: 

It’s amazing that there’s no, almost no side effects. It’s just incredible.

Dr. Mistry: 

Well, I’ve done it in a focal way. You can really expect a really good outcome, and if we can do it in a way that spares the nerves that control your erections or spare the sphincter that controls your continence, you can usually have this done in less than two hours, as an outpatient procedure, with you know, relatively fewer complications than virtually any other treatment. Now, not all patients are candidates. If you have a really severe cancer and you’re really young and I tell you that you need your prostate out because of, you know, from a robotic surgery, then I think that you should at least hear the argument out before you decide against it. But we’ve had patients that come to us from other places that simply don’t want to have surgery or simply don’t want to have radiation. And you know, we do our best. We offer them a treatment that perhaps may not be as good as a radical removal of the prostate, but those patients are just, they want to balance the effectiveness of treatment along, you know, with side effects. And that’s what we’re here to do is to give you that best information and help you make the best decision.

Donna Lee: 

Now, I get, I see all the inquiries that come in. Can you explain what a Gleason score is and where it should be in relation to whether or not a HIFU candidate is a good one?

Dr. Mistry: 

That’s a great question. So a Gleason score refers to microscopically how aggressive those cells look. The higher the Gleason score, the more aggressive they look and the more likely they are to metastasize or to be invasive into other structures. So generally speaking, the lower the Gleason score, the better. The Gleason score range is from 6 to 10, generally. 6 is kind of the lowest, 7 is intermediate and 8, 9 and 10, those three numbers are considered about the same. So HIFU is ideal for patients with a lower Gleason score in the 6 or 7 range. It’s ideal for those patients that don’t have as much cancer, maybe only one or two spots, not all 12 spots that we check out. And it’s ideal for patients that are trying to maintain some level of function. So if you wanna maintain your erections or you want to make sure that you don’t begin leaking, then HIFU is a great option for patients with low volume, low aggressive disease. That being said, we treat patients with higher grade disease all the time–again, because people have chosen to pursue a treatment that has fewer side effects for them.

Donna Lee: 

Gotcha. Wow, that’s a lot.

Dr. Mistry: 

That is a lot of treatments.

Donna Lee: 

How many treatments do you have in your pocket for prostate cancer?

Dr. Mistry: 

Well, right now we have about 25 HIFUs coming up in the next three months. For a variety of reasons, those patients don’t all get done immediately. They have some number, they have to have preparation beforehand and some other tests. And some patients that are coming from afar, they want to do it kind of later in the year, and the holidays are coming up. So we’re going to have a very busy January and February for high intensity focused ultrasound for prostate cancer. And also we want to make sure that we take advantage of all the other features in our practice. So we want to help, you know, make sure that they’re hormonally intact. We want to make sure that they are under the care of a nutritionist for supplements and the appropriate diet. We want to make sure that they’re hitting weight targets so that the treatment for prostate cancer, you know, is effective, but also they leave that experience healthier and more likely to have a body able to fight off new cancers that develop, strong immune system, you know, strong constitution. And I think that’s a really important part of maximizing the treatment for prostate cancer.

Donna Lee: 

You poor guys and your prostates. Y’all go through so much.

Dr. Mistry: 

Well you ladies have a few parts that get problematic too.

Donna Lee: 

Oh, that’s true. And we can treat that too, probably.

Dr. Mistry: 

That’s right. That’s right. Now this is different from BPH. We had a wonderful event to “Make America Pee Again” to talk about advanced treatments for enlarged prostate. And certainly we would love to hear from you if you have enlarged prostate symptoms that you feel like could be better treated. We would love to take a whack at it and you would just need to call our office. And how do people get ahold of us?

Donna Lee: 

512-238-0762 is our number. And from that event we had, we did free testosterone and PSA screenings and we had a lot of people have results that they were surprised by.

Dr. Mistry: 

That’s right. Almost 12% of patients had abnormal results that they didn’t know about.

Donna Lee: 

That was kind of scary. So get your stuff done, guys. Come out, come on in or at least reach out to your provider. Our website is armormenshealth.com. Our number again is 512-238-0762. If you have any questions, you can send them to armormenshealth@gmail.com that’s armormenshealth@gmail.com We have four locations, one in Round Rock, North Austin, South Austin, and Dripping Springs. That was a really good segment, Dr. Mistry.

Dr. Mistry: 

Awesome, we’ll be right back after these messages.

: 

The Armor Men’s Health Hour will be right back. If you have questions for Dr. Mistry, email him at armormenshealth@gmail.com.

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