Phone: 512-238-0762

Fax: 512-341-7370

September 12, 2020

If It Walks Like a Duck and it Quacks Like a Duck, It Might Be Testis Cancer

Speaker 1: 

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

Dr. Mistry: 

Hello and welcome to the Armor Men’s Health Hour. I’m Dr. Mistry, your host, here with my cohost, the great Donna Lee.

Donna Lee: 

That’s right. Hello everybody.

Dr. Mistry: 

I’m a board certified urologist. This is a men’s health show. We are brought to you by our urology practice–NAU Urology Specialists, based right here in Austin.

Donna Lee: 

That’s right. You founded this place in Round Rock, Texas. And now where are we? We’re all over the place.

Dr. Mistry: 

We’re all over the place. We’ve been very honored to be able to provide urologic care, what I think is comprehensive holistic urologic care, to thousands and tens of thousands of patients here across Austin the last 13 years. I think we really bring something different to the medical field, and that’s what I think is a whole body approach to how we treat your urology and urologic conditions, whether it be cancer or stones or chronic pain. We have a nutritionist on staff, pelvic floor physical therapy. We have four physicians, four physician assistant and nurse practitioners, and luckily a growing in patient number and practitioner every day.

Donna Lee: 

Oh boy, are we. We also have sex therapy.

Dr. Mistry: 

That’s right.

Donna Lee: 

Don’t forget that important link.

Dr. Mistry: 

That’s right. And we also have you the seventh funniest mom in America.

Donna Lee: 

… in America. That’s right. Speaking of funny, I have a cute little story. My mom, you know, my mom’s in Thailand and she’s been there for a while . She’s probably going to stay there for a while because of Covid. She’s 82 years old, and guess what she asked me the other day?

Dr. Mistry: 

What’s that?

Donna Lee: 

She called me and she said, “Donna, Donna what is this the tickey tok?” So I had to explain what Tik Tok is. You know, I love my Tik Tok.

Dr. Mistry: 

It’s the Chinese overlords overseeing it.

Donna Lee: 

That’s right. She said , “Donna, why is the Tickey Tok bad ? Why is the Tickey Tok bad?” And I said, “Well, it’s supposed to be this Chinese issue. And the Chinese people getting our information, but it’s magical and glorious . And I love it.” And you know, she gets all of her social media confused. So she said, ” Donna, be safe. Don’t be on the QuickBook and get killed.” And I said, “Mom, that’s the Facebook story you saw where somebody was stocked and killed.” And so now she’s equating Tik Tok to QuickBooks and death.

Dr. Mistry: 

That is a pretty funny mom story.

Donna Lee: 

It is pretty cute. Bless her heart, 82 years old, trying to figure out what Tik Tok is in another country.

Dr. Mistry: 

Well, we love your questions, love your addition and all of your input into our, into our show and into our practice. We are all around town and we are seeing patients currently in a Covid-safe manner, I think. We keep the waiting room fairly empty, we get you right in your room. All the rooms are cleaned down with bleach inappropriate places between every patient. And we have space for you on our telemedicine schedule, as well as our in-person schedule. So if you have a urologic or health issue that you want to see us address, please come on in. A lot of patients are looking to improve their immune system, immune their basic health through testosterone and hormone health. And these are exactly the kinds of things that we specialize in. And if you have an emergency, a urological emergency, there is no reason to sit out, you know , of the healthcare system. We’re here to help take care of you. Donna Lee, how do people get ahold of us? How do they make an appointment? They can call us during the week at (512) 238-0762. That’s our number during the week. You know, Donna Lee, this week, I was reminded of a topic that we don’t really talk about a lot on the show, mainly because our demographic tends to be older men and women that are listening to the show. But it reminded me of a couple of the good things about our practice, you know , some of the mistakes that we’ve made in the past and an important topic, and that topic is testis cancer. Testis cancer affects several, you know , tens of thousands of people. I think the incidence is about one in 2000 men a year in the United States. It generally affects men when they’re much younger and when they’re older. So like, you know, under 25 and over the age of 65. There are multiple different types of testis cancer, and it usually presents with an enlarged mass in the testicle.

Donna Lee: 

And pain or no pain?

Dr. Mistry: 

Not usually pain. About 10% of the time, there’ll be pain, but 90% of the time, there won’t be pain.

Donna Lee: 

Really? 90% of the time there’s not pain?

Dr. Mistry: 

That’s right . So usually a painful testicle is an infection. A painful testicle is an infection. And so maybe seven years ago , I came across a patient who had really bad testicular pain, and his testicle swoll and they just looked , it was an infection every time. And he was in his mid forties. And so we would give him antibiotics and you get better. And then you come back four months later and give him antibiotics and got better. We did some things with his diet and gave him probiotics so he wouldn’t get infections so commonly. He was a little young to have prostate problems because prostate problems are associated with testicular infections. He had not had a vasectomy because sometimes in rare occasions, vasectomies can be associated with recurrent episodes of epididymitis. And, you know, then one day he came in and exactly presented us the exact same way. It was the exact same duck walking the exact same way.

Donna Lee: 

Quacking the same way?

Dr. Mistry: 

Quacking the same way. He had an enlarged testicle that was very painful and tender, gave him antibiotics. Expected him to go away because that’s what happened the other 10 times he had the same problem. He came back to us three weeks later, testicle a little better, a little less tender, but still swollen. Sent him for an ultrasound. Ultrasound said it was an infection. Sometimes takes a little longer to get these things better. And so then he came back another time, still swollen, just a little better. And at that time we decided, I decided that sometimes the testicle can be so infected it has to come out, and at that point he left us to go to another doctor. He wanted a second opinion. That doctor took his testicle out, and it ended up being cancer–unexpectedly in a man in his mid forties. So really a reminder of how, even though you can take care of something over and over again, something like testis cancer can really come up and surprise you. Now how this story ends is that he continued to have problems with his other testicle, continue to have prostate problems. And lo and behold , now three or four years later , he’s come back to us because he knows that we’re going to take excellent care of him, even though in his last episode , perhaps we were a little slow on the diagnostic uptake. I feel confident that we would have caught it, nonetheless, because we were ready to take his testicle out anyway , because it wasn’t healing. But…

Donna Lee: 

Well now, how’s his prostate?

Dr. Mistry: 

But we’re going to fix that. He’s a young man. So he, you know, he has got, he’s got prostate issues. And so we talked today about Urolift, we talked about prostate artery embolization. We talked about a number of things, including the use of Axonics neuromodulation to help with refractory urgency and frequency syndromes.

Donna Lee: 

Tell people about that. That was fascinating. We had a patient on talking about that. It’s put on the little backside, a little tiny incision, and there’s like a little computer that’s put your butt.

Dr. Mistry: 

That’s right. So it’s specifically for men and women with urgency, frequency, urge incontinence. It works also for people with fecal incontinence. So if you’re having a strong urge to poop and then you can’t control it and you lose a little bit of poop, it’s another, another use for it. There’s been, you know, some people that have used it in an off label way for premature ejaculation and for chronic pelvic pain. We use it often in patients with interstitial cystitis, and if you have a weak bladder, it’s a way to calm your bladder down. So the ways that we usually treat overactive bladder urgency and frequency syndrome include medicines like Oxybutynin or Myrbetriq, or Vesicare–these are some names you may have heard. But they have side effects: dry mouth, some can cause high blood pressure or some can cause constipation. And then we have a treatment that’s semi surgical, which is to implant Botox into the bladder wall. That’s also for urgency and frequency. That bladder wall injection was good. We can do it in the office. We can do the operating room. It’s covered by insurances, but it can sometimes make a weakened bladder a little weaker. And then, so what Axonics is, is it uses a small electrical impulse to act kind of like a pacemaker for the bladder is what I say. It kinda calms the bladder down. The battery that they’re putting that little computer, it’s actually the battery.

Donna Lee: 

The computer in the butt?

Dr. Mistry: 

That’s right. We use a product made by a company called Axonics. There’s another product made by a company called Medtronic called the InterStim. We’ve used both with varying levels of success. I think that because we choose our patients so well, we have a very high level of success in reducing urgency and frequency without medication. So if you’re out there with , you know, the quintessential patient’s going to be one that has lots of back problems or mobility problems, lots of urgency, and is wetting themselves because they can’t get to the bathroom fast enough. Maybe even had multiple prostate surgeries or prostate medications, or women who are wearing pads because they can’t get to the bathroom fast enough. Now we don’t want to use medicines in older patients because they can cause side effects. So this type of neuromodulator therapy is something that’s an excellent option for some patients. And we’ve had a lot of success with it. We’ll test you for it in the office and put it in the operating room and it’s covered by insurance.

Donna Lee: 

Sounds so futuristic.

Dr. Mistry: 

Isn’t it?

Donna Lee: 

So fancy.

Dr. Mistry: 

We’re just turning into cyborgs.

Donna Lee: 

Just robots doing some business. Next time we do the Botox procedure, can we accidentally put some in my face?

Dr. Mistry: 

Accidentally?

Donna Lee: 

Oops, there’s a little leftover!

Dr. Mistry: 

This stuff’s in the bladder with me. You start peeing out of your eyes.

Donna Lee: 

That would be a strange side effect. Eww. Well, that’s fascinating.

Dr. Mistry: 

I could be the seventh funniest mom in America .

Donna Lee: 

I’ll give it to you, for today only.

Dr. Mistry: 

Donna Lee, how do people send us questions and how do people get a hold of us?

Donna Lee: 

You can call us during the week and talk all about your Botox and Tickey Tok if you’d like at (512) 238-0762. Our website is armormenshealth.com. It’ll take you to our main website. You can also leave your questions there or send us your questions directly to armormenshealth@gmail.com. I get every one of those, I respond. You can also check out our podcasts wherever you listen to podcasts, they’re free. They’re magical. And they’re amazing. So check us out on any platform where you have your podcast listening. Thanks so much, Dr. Mistry.

Dr. Mistry: 

Thank you.

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Dr. Mistry wants to hear from you! Email questions to armormenshealth ed gmail.com. We’ll be right back with the Armour men’s health hour .

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