Phone: 512-238-0762

Fax: 512-341-7370

September 19, 2020

“Suspicious” Prostate?: Dr. Mistry Explains What Your Prostate Biopsy Results Mean

Speaker 1: 

Welcome to the Armour men’s health hour with dr. Mystery and Donna Lee. Hello,

Speaker 2: 

Welcome to the armaments health hour. I’m dr. Mystery, your host, your exuberant hosts, maybe a little too loud in the microphone. Here’s always joined by my cohost, my practice manager and partner in crime here, Donald,

Speaker 3: 

And one of your best friends. There you go. That’s right. Hello, happy day, everybody

Speaker 2: 

Date everybody. This is a men’s health show. I’m a board certified urologist and very proud to be providing this show and all this information to the listeners of KLBJ news radio and the world and the world,

Speaker 3: 

Mr. Worldwide, we’re in a few different continents countries. There are listeners overseas learning about the junk from Austin, Texas.

Speaker 2: 

The yum Yum’s in niggling this last week in the clinic. Uh , we had a , a wonderful patient who came to us from another doctor after hearing the show. And he said that, you know , one of your shows, it was real. It was real. It was real. He said that , uh , we , we taught them how to use his Viagara better. We gave him more confidence on what to expect about his prostate issues. And then he said , uh , and I told my financial planner that I need $6,500 put aside for penile and large .

Speaker 3: 

Okay .

Speaker 2: 

I think giving people the price was the best because now they have like a goal in their mind. Well, if I don’t have any McDonald’s for the next year ,

Speaker 3: 

No Starbucks carry the two.

Speaker 2: 

I can have a bigger, I can have a bigger phallus by Christmas.

Speaker 3: 

That’s awesome. That was dr . Dellinger who was talking about yours and yeah . Fillers

Speaker 2: 

That’s right. And the fillers that we offer as a partnership between our practice and his , um, for , for men with , um , uh, who are looking for some , um , genital enhancement . Yeah.

Speaker 3: 

Yeah. We had an, I also took a patient call during the week of the same thing. It must’ve been a really popular segment that day because he was called and he said, yeah, listen to the radio. And I want to know how to make my penis bigger. Right thing, right time, you know,

Speaker 2: 

Our urology practice was founded in 2007, right here in Austin, Texas, the heart of central Texas. And we have offices now all throughout the area and are open to seeing patients and open for business right now.

Speaker 3: 

That’s right. Coronavirus watch .

Speaker 2: 

No, of course a virus is a very serious disease done .

Speaker 3: 

Yeah. Whatever. I’m just, just a little tired of it.

Speaker 2: 

Masks wash your hands.

Speaker 3: 

We’re wearing our masks. That’s true. But I am ready for, to not be wearing my mask. He’s getting old, but we are in round rock, North Austin, South Austin, and dripping Springs wearing our maps .

Speaker 2: 

That’s right. We are available by televisits we’re available in person visits. Uh , we see patients of all your iLogic type issues, both men and women, whether they be kidney stones and fertility , low testosterone , uh , prostate issues, prostate cancer. And I feel one of the most , uh , holistic and cutting edge practices that you’re going to find.

Speaker 3: 

Yup . We also edit on a new provider, so she’s joining us soon . And I think that , um, she was super impressed with that holistic discussion we had with ,

Speaker 2: 

I think making sure that we can provide you care to the best of our ability and scientifically available. We had a patient this week who came to see us for fertility issues. And although we gave them the medicines to improve their sperm count, what really changed his life was the fact that we found a gluten sensitivity. It made his energy better. He lost 20 pounds and his sperm counts are through the roof. Really? That’s a great story. That’s right. And then we had another, another case of a patient who’s had a worsening hemoglobin, a one C level, which means that they’re, pre-diabetic, it’s been going on and on for quite some time they were being threatened with medication. And then after meeting with our nutritionist, they were put on a diet plan program. And along with testosterone and along with the diet nutrition plan and along with treating of the high blood pressure, they lost weight. And they’re no longer pre-diabetic.

Speaker 3: 

No, it feels great. I bet. That’s awesome. What a great holistic approach

Speaker 2: 

Do your questions really feed this show and keep us going. Uh , just like your presence in our office makes me happy to get up in the morning and makes Don a proud to be part of such a great practice. So we’d love to see you as a patient. And I’d love to hear your questions. We have a bunch. Yeah. Donna, give us a question.

Speaker 3: 

This particular person was driving around on a Saturday and he caught our show. He said it was very good timing. In his case, he had a recent pro um , prostate biopsy done one area, low grade cancer. Then two were considered suspicious. And for additional evaluation, I saw a blood and now what looks like tissue over the two weeks, but nothing significant. I had one ejaculations and also saw the redness or dark Brown in the semen . My question is, is it healthy for the prostate to get as much residual blood out as soon as possible?

Speaker 2: 

Well, first of all, very importantly, ejaculation is healthy. Right? So keep it up. Yeah , there was, there was a study that once showed that the more that , that the number of a Hewlett’s correlated with a lower risk of prostate cancer, right. My husband keeps reminding me that’s right. I mean, all you’re doing is , is damaging his chances of living without prostate cancer by, you know what I’m saying? I mean, you only have anyway. So , uh, the , the point is that ejaculations after a prostate biopsy , uh, will lead to some blood in the ejaculate and certainly getting it out is probably in your best interest . I guess how I would advise you is that if the color of the blood is bright red, so it looks like it’s actively bleeding that I might give the prostate a little bit of a rest, but if it’s darker red or brownish, then certainly, you know, cleaning the tube is going to be in your best interest. There’s no damage to your partner , uh , or risk to your partner from having that little bit of , um , a bloodstain , uh , staining of the , uh , of the semen after a biopsy , uh , having some blood in the urine and even maybe what may seem like tissue passages is not necessarily abnormal, but if you can’t pee or if you’re a couple of weeks out and the bleeding seems to be getting worse or you’re having urgency and frequency or any other problems, and you need to get in to get a urine culture, to make sure that you don’t have a urinary tract infection that’s causing worsening. So things should be getting better every day, not getting worse. And so if things are getting worse and I’d say that for almost any surgery, if things, if you’re in pain, you’re in more pain, more pain day after day, that’s probably a sign of something bad. If it’s less and less, you should be improving. Um, uh, after, you know, most procedures that we would do for example, on a daily basis. Now getting to the other part of that question, and we don’t have any information about this, this man, we don’t know how old he is or what his symptoms are, what his PSA was, but it sounds like he had a , uh, multi-core biopsy of his prostate with one positively identified as cancer and two suspicious for cancer. This is a real dilemma for many patients to decide what to do. What do you do if you’re given a diagnosis and told that this is a very slow growing disease, that is not dangerous. And this is where psychology sometimes overcomes biology. That is the, what is the psychology of living with cancer. And if this is the kind of thing that’s keeping you up at night and you’re having lots of trouble dealing with it, even if they tell you it’s not life threatening your doctor, you may want to hear an opinion for treatment. One of the best treatments that we offer that exact scenario is high intensity focused ultrasound. It’s a focal therapy. We just treat where the cancer is really lead the rest of the prostate alone. Very little side effects, if any, well, I mean, there’s, we’ve had exceptional success. Our program here in Austin is one of the busiest in the entire country of patients that come from all over the country to get the HIFU procedure in our practice. Um, it is one that we can do in a way that preserves your, your potency and your continence so that longterm side effects can be minimized. And it doesn’t take any other future kinds of treatment off the table. First, you got to decide if it’s worth treating. If you’re older, if you’re not in great health, then they may be reasons to not treat. They also worry sometimes that large prostates or certain types of prostate cancer may be under sampled in a disease like that. So we almost always try to get an MRI of the prostate to make sure there’s no big lesion that was under sampled during the course of that biopsy. And if you’ve already had a biopsy and your insurance wouldn’t pay for an MRI beforehand, it will pay for one. Now once you have a diagnosis of cancer and we usually wait about three months, let the prostate cool-down after the biopsy, and then go ahead and do an MRI of the prostate gland. And so that will tell us if maybe you were under sampled a , you have two additional areas that are abnormal or suspicious, but not diagnostic of cancer. And I tell what I, how I explain that to patients is that , uh, we diagnose prostate cancer based upon what the cells look like under the microscope architecturally. And so if there’s not a enough abnormality to get to the threshold of cancer, then it’s called suspicious. But if you rebiopsy a guy who’s suspicious more than half the time you find cancer, you’d find more that architecture. So in my mind, when I see suspicious, but not diagnostic for, you know, I, you know, I , I kind of assume that, you know, 50% of the time I’m going to find cancer if I biopsy them, that state area. So that gives me an idea of what , what they’re in for. If you’re young, if you’re 45 years old and you have prostate cancer, you know, you may want to consider treatment , uh , because even a slow growing disease is going to have many, many, many years. Uh, one of the tools that we use is the Memorial Sloan Kettering, prostate nomogram. If you are interested, we’ll put it on our , um, our Facebook site, the , uh , the link to the , uh, this, this, this nomogram you put in the information about your cancer, about your age, about your PSA, and what gets spit out is what is your risk that this disease is likely to progress with or without treatment. And that’s very valuable. Huh ? Interesting. Well, what a great question. That was a great question. That Donna, how people send us questions and how do they get ahold of us if they want to make an appointment

Speaker 3: 

During the week at (512) 238-0762, you can send us your amazing questions that we’ll answer anonymously, and I will respond to every one of them to let you know when we’re going to discuss your question . So you can listen in or receive a free podcast link. It’s armor men’s health@gmail.com. Again, that’s Armour men’s health@gmail.com. Our website is Armour men’s health.com, where you can feel like I always say dr . Mr . Smiley handsome face. So you can get a , um , uh , I dunno , I meet , meet and greet by website, and then you’ll want to make an appointment. And then you can call us (512) 238-0762. And we really appreciate y’all listening

Speaker 2: 

Armour men’s health hour. We’ll be right back. If you have questions for dr. Mystery, email him at Armour men’s health, edgy, gmail.com.

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