Phone: 512-238-0762

Fax: 512-341-7370

December 29, 2019

Goodbye, Rectum Coils! Hello, Prostate Rainbow! Dr. Mistry Discusses Prostate Cancer Screening and When To Start Getting Examined

Speaker 1: 0:00
The Armor Men’s Health Hour is brought to you by Urology Specialists. For questions during the week. Call us at (512) 238-0762 or visit our website at armormenshealth.com. The Armor Men’s Health Hour is a show dedicated to providing information on a variety of medical topics, some of which may include sensitive subject material about penises. All cases discussed have been done with the permission of the people involved and their penises.

Speaker 2: 0:35
Welcome to the Armor Men’s Health Hour with Dr. Mistry and Donna Lee.

Dr. Mistry: 0:42
Hello and welcome to the Armor Men’s Health Hour. I’m Dr. Mistry, your host here with my certifiably cohost…

Donna Lee: 0:48
Certifiably?

Dr. Mistry: 0:50
Donna Lee.

Donna Lee: 0:50
I am a board certified cohost, thank you.

Dr. Mistry: 0:54
Welcome to our show. The Armor Men’s Health Hour is a show about men’s health predominantly, but also health issues that affect men, even if they affect women and men both. I am a board certified urologist and a self-declared expert in men’s health. I have a practice that I started here in Austin. It’s called NAU Urology Specialists. We are the second biggest urology group in town.

Donna Lee: 1:16
That’s right. You know why?

Dr. Mistry: 1:17
Because we try harder?

Donna Lee: 1:18
Because the other two giant groups merged.

Dr. Mistry: 1:21
They are a big group. They’re a big group now.

Donna Lee: 1:23
And now we’re the second largest, so there.

Dr. Mistry: 1:24
Well that’s good. I mean there’s a Nordstrom’s, and then there’s other places.

Donna Lee: 1:27
Right? So we’re not the Nordstrom’s of urology?

Dr. Mistry: 1:28
We are the Nordstrom’s.

Donna Lee: 1:30
Oh, ok. Phew.

Dr. Mistry: 1:30
We’re the small boutique place that takes care of you and caters to you.

Donna Lee: 1:34
The other place is Amazon I guess.

Dr. Mistry: 1:35
Except because of government rate setting, we all have to charge the same.

Donna Lee: 1:39
Well that’s true.

Dr. Mistry: 1:39
Well welcome to our show today. We have a wonderful show packed for you today and we just really enjoy interacting with our listeners. We have a practice that’s all throughout the city. We have 3 urologists, 3 mid-level PA and nurse practitioner providers. We have an in-house nutritionist and in-house, pelvic floor physical therapist, in-house sleep apnea counseling, and really, a…

Donna Lee: 1:59
And an in-house practice manager.

Dr. Mistry: 2:02
That’s right.

Donna Lee: 2:04
Don’t forget about me!

Dr. Mistry: 2:04
I wonder where she is? And really a focus on taking care of the whole individual. And we love talking about what that approach is. We talk about a lot of urologic topics on this show, but we also love to have guests on that are usually the preeminent physicians in this town in their area, whether it be orthopedics or gastroenterology or general surgery. And so you’re gonna hear a lot of those. We’d love for you to catch us on our podcast. You can find our podcast anywhere you find your podcasts. Look for the Armor Men’s Health Hour, and you’ll see, you know, an ever growing burgeoning list of summaries, but all of our episodes are on there.

Donna Lee: 2:39
And you can see our lovely, shiny faces on the podcasts–and our banana. We have a banana with a stethoscope because our marketing people are very clever. It’s very cute. So we want to keep your banana healthy. Tune in to the men’s banana hour.

Dr. Mistry: 2:51
And welcome to our last Sunday show.

Donna Lee: 2:53
That’s right. We’re moving.

Dr. Mistry: 2:54
We are moving to Saturdays.

Donna Lee: 2:56
We’ve been promoted, I feel like.

Dr. Mistry: 2:57
Yes, maybe.

Donna Lee: 2:58
Maybe.

Dr. Mistry: 2:58
We’re gonna to clean it up a little bit.

Donna Lee: 3:00
You keep saying that, but we’ll just by ear muffs with our logo on the side for all the children that are in the cars.

Dr. Mistry: 3:04
The end of the year is an interesting time to be a doctor. It’s so busy with everybody trying to get both things done because their deductibles are met, but also because they have time. Maybe work is slower, maybe you know, the kids are out so they don’t have to worry about picking them up and taking them to sports.

Donna Lee: 3:22
They want to get away from their families.

Dr. Mistry: 3:24
But you know, there’s one huge downside of being busy when you’re a urologist specifically at the end of the year, and that’s, you have to tell people sometimes that they have cancer right at Christmas time.

Donna Lee: 3:36
Oh, I don’t like that part.

Dr. Mistry: 3:38
I think that I’m going to next year, I’m just going to ban all appointments…

Donna Lee: 3:42
In December.

Dr. Mistry: 3:42
…before Christmas because this year, of all years, was probably one of the most heartbreaking years that I’ve had having to tell people in their 40’s and 50’s that they were diagnosed with prostate cancer. At the same time, trying to give them hope about what to expect and how our treatments are so great and how I’m going to take care of them and they’re going to be just fine, but they don’t really hear anything after you give them that C-word.

Donna Lee: 4:05
It’s scary.

Dr. Mistry: 4:06
It’s scary. It’s scary. And so, you know, what I thought I would do was kind of talk to our listeners today about what are some of the treatments that are offered for prostate cancer, when to start looking at it and maybe maybe encouraging those of you that can to make sure you get screened at the beginning of the year so that if you are diagnosed, we have ample time to talk to you about different treatment options and make sure that you’re treated well. The, generally the guidelines for when people…need to start getting screened for prostate cancer are beginning at age 50 but if you are African American or you have a family history, you should be at 45. But there are exceptions. This week I diagnosed a 48 year old with a pretty significant prostate cancer whose father died of prostate cancer. So I’m telling him to have his son starting to get screened at 35 or 40. This is a disease that takes many, many years to grow. And you also have to use different criterion to decide when to do a biopsy or when to do an MRI or when to better evaluate that patient.

Donna Lee: 5:04
With that patient though, is it ridiculous to start the children at 20, 25 or there is just no reason to do that? I know it’s a dumb question. I’m just wondering.

Dr. Mistry: 5:12
There’s, so there’s trying to be really proactive and then just putting the fear of God into a 25 year old kid who is still trying to figure out how to pay his car insurance, you know? And so, I think there’s a balance. There are some people that can take that and say, “Okay, well I’m just trying to be proactive with my health.” And then there are others that are just so worried about a potential illness, maybe they’ll even run from the medical profession because they don’t want to face reality.

Donna Lee: 5:39
What’s the earliest age you’ve ever diagnosed prostate cancer?

Dr. Mistry: 5:42
We’ve diagnosed a 29 year old. We’ve diagnosed and operate on a 29 year old.

Donna Lee: 5:46
When he had family history?

Dr. Mistry: 5:46
He had a family history and probably some genetic component that predisposed him to several different kinds of cancer in fact. And so the most common form of screening in the past has been the PSA test. It’s blood test that looks for a particular protein that’s made by your prostate. If elevated, puts you at an increased risk for having it. The PSA itself isn’t a dangerous entity. It’s not like cholesterol where we actively try to work to reduce your PSA. And your PSA that’s right for you are the one that’s appropriate for you changes with age. But we have additional screening tests that we didn’t use to have. We have additional blood tests, we have certain kinds of urine tests and we have one of the most powerful additions to the prostate cancer armamentarium and that’s the MRI of the prostate. The MRI of the prostate is something that can find large lesions. If there is a lesion in the prostate, there’s about an 80% chance that you might find it on MRI. And so this is a great test, especially for those people that have had a negative biopsy in the past but are still at high risk, or people who maybe have a normal PSA. About 17% of patients will have a normal PSA but still have prostate cancer. And so, insurances pay for the MRI variably. If you have Medicare or government insurance, the MRI will be covered. If you don’t, then, the cash pay price of an MRI in this town is between $520 and $780. So, don’t let the cost of it potentially scare you away. That’s not money that comes to us. These are just our radiologic partners around town that will do it, and they’ll do it for me and do it for anybody. They’ll do for other urologists, do it for your primary care doctor, for anybody. It’s really up to you to decide that you want to be serviced by that particular exam and to know and research your own, on your own, if that’s right for you.

Donna Lee: 7:34
Gotcha. Wow. That’s a lot of information.

Dr. Mistry: 7:36
Yeah. I mean it’s a new era. It’s a new era for finding things early and that’s where we want to be. Right. And proactive.

Donna Lee: 7:42
Right, and what, 10 years ago, there’s probably what, just a few of those options and now there’s a handful of options.

Dr. Mistry: 7:48
Oh yeah. If 10 years ago, if you needed an MRI of your prostate, they put a coil inside your rectum called an endorectal coil. How many people do you think sign up for that one?

Donna Lee: 7:58
Right? Just that weird guy that hangs out at the sex store.

Dr. Mistry: 8:01
Only if you were told, I guess, you know, you’re not gonna just beg for that one. Can you please…

Donna Lee: 8:06
You don’t want the word coil and the word rectum together.

Dr. Mistry: 8:06
Can you please give me that one.

Donna Lee: 8:12
Can I have the rectum coil, please?

Dr. Mistry: 8:12
If you are found at risk to be potentially at a higher risk, we’ll have what’s called a mutual or consensual discussion on what the risks and benefits are. I think a lot of men, because of how media hass portrayed prostate cancer, are really lackadaisical about, about going through this discussion. And if you’re found at risk and you don’t want to get biopsied, then that’s your choice. But make sure that you’re informed, not by the internet or by your friends, but by a meaningful, thoughtful physician who can treat these conditions. And so I think that if you have a high PSA or an abnormal MRI, but you’re scared about having a biopsy or you’re scared about potential treatments or potential side effects of treatment, make an appointment with us. Even on the phone we can talk, and talk about, you know, what are your options for getting diagnosed. It’s a slow and deliberate process. It’s not, you come in and it’s a whirlwind and next thing you know, your prostate is taken out. There’s a lot of different options for treatment and I think we ran out of time today on talking about all the treatment options, but really I’d like to talk a little bit about the importance of being proactive in your own health, especially when it comes to prostate cancer. And we have so much experience here we’d love to take care of you.

Donna Lee: 9:31
Maybe we should change the word “cancer” to something less benign. No pun intended.

Dr. Mistry: 9:36
Prostate rainbow?

Donna Lee: 9:37
Prostate issue, or prostate experience.

Dr. Mistry: 9:42
I don’t think so.

Donna Lee: 9:43
Oh all right.

Dr. Mistry: 9:44
It’s not Disney.

Donna Lee: 9:44
Just trying to make it better.

Dr. Mistry: 9:46
You know, it’s funny, I think that some cancers they do that. Like when people are diagnosed with bladder cancer a lot of times to not scare the patient, urologists may use to like, “Oh a non-aggressive tumor.” And then then I see them five years later and I say, “Oh you have bladder cancer.” They go, “Well that’s weird. I was told I had a non aggressive tumor five years ago.” I’d be like, “Yeah, thank you for that.” Now you’re completely off schedule, and now things are worse than they should have been.

Donna Lee: 10:16
That’s the trouble, it’s a problem.

Dr. Mistry: 10:16
So, I guess I try to be a straight shooter.

Donna Lee: 10:18
Well, that’s true. Okay. Well there’s bad. So, we’re going to do our non-aggressive commercials now, so people had to get ahold of us at (512) 238-0762. We have a non-aggressive staff that will answer the phone and we are located in Austin and Round Rock, North Austin, South Austin, and non-aggressive Dripping Springs. So, it looks like we’ll be right back after these messages.

Speaker 3: 10:41
The Armor Men’s Heatlh Hour. We’ll be right back. If you have questions for Dr. Mistry, email him at armormenshealth@gmail.com.

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