النص الكامل لحلقة Innovations at St. Clair Health Protecting Men During Prostate Cancer Treatment

And if you're doing fine and have no family history, maybe age 50. 00:05:24.438 --> 00:05:27.538 But my philosophy is it's a blood work test. 00:05:27.678 --> 00:05:31.638 It's not hard to get. Just get a baseline in your 40s. And based on that, 00:05:31.798 --> 00:05:35.938 we can decide, hey, is this kind of elevated? Should we watch it a little bit closer? 00:05:36.298 --> 00:05:40.798 Is it normal? Oh, don't worry about it. Get another one when you're 50. 00:05:41.018 --> 00:05:44.598 So I think there's some guidelines. There's no rules. And you really have to 00:05:44.598 --> 00:05:47.098 individualize it to each person. 00:05:47.698 --> 00:05:50.298 That's true. But there's no warning signs. Like, for instance, 00:05:50.558 --> 00:05:52.838 you know, you wouldn't feel it or you wouldn't feel like. 00:05:53.798 --> 00:06:02.278 Yeah. So, even before I was into urology and during my training, 00:06:02.698 --> 00:06:04.418 the PSA wasn't available. 00:06:04.698 --> 00:06:10.038 So, my old school professors would say, hey, before we had the PSA, 00:06:10.478 --> 00:06:13.258 men would come in and it would be already spread. 00:06:13.738 --> 00:06:19.618 Oh, it's great. So, once you develop symptoms, the problem is you're already 00:06:19.618 --> 00:06:21.838 kind of behind the eight ball with prostate cancer. 00:06:21.838 --> 00:06:27.998 That being said, if you're having blood in the urine, if you're having significant 00:06:27.998 --> 00:06:32.778 urinary symptoms, meaning that you're struggling to pee, you're having pain, 00:06:33.258 --> 00:06:36.498 those are things you should get checked out. Okay. 00:06:38.362 --> 00:06:43.542 Predominantly, PSA will predict, I make the analogy, it's kind of like that 00:06:43.542 --> 00:06:44.882 earthquake Richter scale. 00:06:46.222 --> 00:06:51.122 We are not going to feel a very low-grade little minor earthquake, 00:06:51.282 --> 00:06:53.182 but the PSA, it'll measure it. 00:06:53.742 --> 00:07:00.422 But by the time that you're feeling something, you're already the golden gate breaker. 00:07:01.582 --> 00:07:06.322 Early detection. Just go for the blood. Right, so that's an easy test. 00:07:06.562 --> 00:07:10.702 Get checked out and we'll just go on from there. Yes. 00:07:11.062 --> 00:07:17.302 Now, how does prostate cancer affect not just the patient, but also their loved ones? So, yes. 00:07:18.242 --> 00:07:23.442 The prostate cancer can affect, it's really, we try and bring in the whole family 00:07:23.442 --> 00:07:25.962 when we talk about prostate cancer. 00:07:26.102 --> 00:07:29.702 Obviously, it's a relationship between the gentleman and the doc. 00:07:30.122 --> 00:07:33.682 But prostate cancer can affect sexual function. 00:07:33.862 --> 00:07:39.202 It can affect urinary function. So it really can affect the relationship that 00:07:39.202 --> 00:07:41.082 that man has, that that couple has. 00:07:41.442 --> 00:07:48.562 And we try here at St. Clair to really work early on, if the patient wishes, 00:07:48.562 --> 00:07:53.562 with his family, with his wife, with his partner, to let them know what to expect. 00:07:53.842 --> 00:08:01.602 So I think being open and honest and confronting those potential issues is essential. 00:08:01.822 --> 00:08:04.362 I love that. It's St. Clair Health that, you know, you guys, 00:08:04.502 --> 00:08:07.522 that you're all giving communication and you're really helping, 00:08:07.522 --> 00:08:10.442 you know, the families, not just the patient, but, you know, 00:08:10.582 --> 00:08:12.042 because a lot of people don't understand. 00:08:12.102 --> 00:08:14.722 What does this mean? What does this mean in the future? 00:08:14.922 --> 00:08:17.602 You know, what kind of things do I need to do for this? 00:08:17.902 --> 00:08:23.202 So how has prostate cancer care advanced in recent years and what excites you 00:08:23.202 --> 00:08:26.782 most about the treatments now available at St. Clair Health? Sure. 00:08:27.062 --> 00:08:34.762 So, we've been treating prostate cancer for a long time, and there's four urologists 00:08:34.762 --> 00:08:39.422 here that use different types of treatments, 00:08:39.722 --> 00:08:44.582 ranging from laparoscopic robotic surgery to treat the appropriate gentleman. 00:08:44.902 --> 00:08:46.882 We also work with a radiation oncologist. 00:08:47.622 --> 00:08:52.942 Oh, right. closely because radiation is a great option for the right patient. 00:08:53.282 --> 00:09:00.842 And kind of circling back, in the diagnosis, when we diagnose prostate cancer, 00:09:01.162 --> 00:09:04.062 it's not guaranteed that you even need to treat this. 00:09:04.422 --> 00:09:09.362 Because a lot of men will have kind of dormant, latent prostate cancer. 00:09:09.522 --> 00:09:14.182 So we have a robust so-called active surveillance program where we may just 00:09:14.182 --> 00:09:16.842 monitor that, trying to avoid. 00:09:17.747 --> 00:09:23.707 Potential issues that are associated with treatment, like those sexual issues, those urinary issues. 00:09:24.407 --> 00:09:30.027 On the other hand, we don't want to ignore something. So we have high-tech options, 00:09:30.547 --> 00:09:35.987 minimally invasive options, like I said, ranging from robotic surgery to really 00:09:35.987 --> 00:09:41.547 forward-thinking options for gentlemen who choose radiation to try and optimize 00:09:41.547 --> 00:09:44.587 cancer outcomes, minimizing potential. 00:09:44.847 --> 00:09:48.687 Dr. Hess, when you were saying robotic, what did you mean by that? 00:09:49.407 --> 00:09:54.427 So robotic surgery, there's a system called the Da Vinci robotic system. 00:09:54.667 --> 00:09:59.647 And so really it's a fancy term for a type of laparoscopic surgery. 00:09:59.847 --> 00:10:04.247 So when we do this type of surgery, the goal is to remove the prostate. 00:10:04.667 --> 00:10:08.487 Now traditional surgery, you made an incision and went in, there were a higher 00:10:08.487 --> 00:10:15.027 rate of potential

problems, complications such as sexual problems and urinary problems. 00:10:15.247 --> 00:10:18.847 And men stayed in the hospital for a while. With robotic surgery, 00:10:18.847 --> 00:10:24.927 we can go in with a few keyhole incisions, and the robot enables us to do not 00:10:24.927 --> 00:10:26.187 only remove the prostate, 00:10:26.387 --> 00:10:30.507 but reconstruct the bladder, urethra. So everything's functioning. 00:10:30.767 --> 00:10:35.627 So they can optimize the function. So we have a couple of robots here at St. 00:10:35.747 --> 00:10:38.727 Clair that are helping us. And this is something new that has just happened? 00:10:38.867 --> 00:10:44.827 It's been around for a while, but I think we do a lot of this type of surgery. 00:10:45.087 --> 00:10:50.787 Like I said, we have four sort of great urologists that do a lot of this type 00:10:50.787 --> 00:10:54.687 of surgery, and I think we do a really good job of this. Oh, yes. 00:10:54.927 --> 00:10:59.667 So you are the first urologist in the greater Pittsburgh region to implant the 00:10:59.667 --> 00:11:05.327 BioProtect balloon. Can you explain what device it is and how it works and what 00:11:05.327 --> 00:11:08.447 it means for prostate cancer patients' ongoing radiation treatment? 00:11:08.947 --> 00:11:12.147 Yeah, so... I got to look that up when I saw that. Oh, yeah, 00:11:12.247 --> 00:11:15.567 yeah. It's not something that's right on the front of your tongue there. Yeah. 00:11:15.887 --> 00:11:22.587 So, the balloon system, it's really, we use this in collaboration with the radiation oncologist. 00:11:22.767 --> 00:11:24.507 So, for example, a gentleman comes in. 00:11:24.747 --> 00:11:28.467 He decides, we find that there's some significant prostate cancer. 00:11:28.467 --> 00:11:33.367 He decides, hey, you know, I'm going to go move forward with radiation for my prostate. 00:11:33.667 --> 00:11:40.027 I want the best treatment possible. So the prostate and the rectum are very 00:11:40.027 --> 00:11:42.487 close, a couple of millimeters away. 00:11:42.587 --> 00:11:47.427 Okay. And the radiation oncologist is saying, well, I want to deliver radiation 00:11:47.427 --> 00:11:52.387 to the prostate without injuring that tissue, the rectal tissue. 00:11:52.667 --> 00:11:56.607 And if it's only a couple millimeters away, the worry is I'm applying radiation 00:11:56.607 --> 00:12:02.007 to the backside of the prostate. I don't want to friendly fire and injure the rectum. 00:12:02.167 --> 00:12:05.447 So that space in there is very narrow. 00:12:05.667 --> 00:12:12.107 So what we can do as urologists is find a way to increase the space between 00:12:12.107 --> 00:12:13.307 the rectum and the prostate. 00:12:13.607 --> 00:12:17.427 And the concept is we place this. 00:12:18.306 --> 00:12:21.586 We placed this device called a spacer. Okay, spacer. 00:12:21.786 --> 00:12:25.766 And there's different types of these spacers, 00:12:25.866 --> 00:12:29.766 but we found that this balloon system, 00:12:29.766 --> 00:12:36.346 we can surgically and very precisely place it into that space between the prostate 00:12:36.346 --> 00:12:41.766 and the rectum and creating elevation of the prostate so that the radiation 00:12:41.766 --> 00:12:46.966 doctor can now deliver appropriate amount of radiation to the back of that prostate 00:12:46.966 --> 00:12:49.386 without injuring the adjacent tissues. 00:12:49.606 --> 00:12:52.206 Wow, that's amazing. Yeah, so it's pretty cool. 00:12:52.546 --> 00:12:58.486 I mean, it's kind of a nuanced thing, but I think in terms of optimizing cancer 00:12:58.486 --> 00:13:03.326 control and preserving patient outcomes with a minimal side effect, 00:13:03.526 --> 00:13:05.206 it can make a huge difference. 00:13:05.666 --> 00:13:08.966 Yes, I mean, and this is brand new. Like, did this just come about? 00:13:09.006 --> 00:13:13.706 Yeah, this is the bioengineers, the clever bioengineers figured this out. 00:13:13.926 --> 00:13:18.166 And it's really cool. No, it wasn't me. I wish I did. 00:13:18.366 --> 00:13:21.506 No, no, it wasn't me. But it's a really cool little system. And, 00:13:21.626 --> 00:13:25.286 yeah, so we've done this in a number of patients. 00:13:25.506 --> 00:13:29.966 And guys have done really well, really well. So it's been around for, 00:13:30.046 --> 00:13:31.706 would you say, like a couple of years? 00:13:31.986 --> 00:13:37.986 It's probably been around for a couple of years. But it's really the concept 00:13:37.986 --> 00:13:40.646 of creating that space has been around for a few years. 00:13:40.646 --> 00:13:45.126 But this technology has been available to give us a more consistent, 00:13:45.126 --> 00:13:49.926 precise placement to achieve, again, the best outcomes. Right. 00:13:50.066 --> 00:13:51.386 Oh, my goodness. That's great. 00:13:51.686 --> 00:13:56.326 What has been the response from the patients, like the benefits from this technology? 00:13:56.466 --> 00:14:00.426 What have you heard from them? Yeah, I think the best response is that they 00:14:00.426 --> 00:14:02.126 really have minimal side effects. 00:14:02.306 --> 00:14:05.566 Oh, that's good. The goal is, because guys would come in and they say, 00:14:05.706 --> 00:14:09.786 oh, you know, I'm having a lot of symptoms sometimes after radiation. 00:14:09.786 --> 00:14:15.966 Or I'm having some issues with this new device, guys are really coming in. 00:14:16.106 --> 00:14:21.646 They get a place. They go on, get their radiation, and they really have much 00:14:21.646 --> 00:14:24.846 less side effects and hopefully better outcomes. 00:14:24.906 --> 00:14:27.386 We're continuing to monitor this because it's new. 00:14:27.806 --> 00:14:30.666 Well, let me ask. This might be a stupid question I'm asking you, 00:14:30.706 --> 00:14:35.766 but what happens with the balloon? Does it dissolve or does it, I mean? 00:14:36.006 --> 00:14:39.426 Yeah, so the balloon, it's kind of cool. You think, oh, where does it

stay in 00:14:39.426 --> 00:14:41.106 there? I don't want that balloon in me. 00:14:41.306 --> 00:14:47.286 So in any event, the balloon's made of the same material that an absorbable stitch is used. 00:14:47.406 --> 00:14:50.386 Oh, okay. And then we fill the balloon with sterile water. 00:14:50.586 --> 00:14:55.206 So everything absorbs within a few months. Oh, wow. So, yeah. 00:14:55.546 --> 00:14:57.926 That's incredible. I know. I wasn't sure. I was like, I'm thinking, 00:14:58.106 --> 00:15:01.446 imagining in your head, like, what does this look like? Yeah, yeah. 00:15:01.586 --> 00:15:04.446 It's kind of weird and crazy at the same time. 00:15:04.566 --> 00:15:07.866 But it's, you know, urology has been a good field in that we, 00:15:08.206 --> 00:15:10.526 especially here at St. and Claire, I think are, 00:15:11.221 --> 00:15:14.821 Again, forward thinking that we're willing to adopt technologies. 00:15:14.821 --> 00:15:18.321 We don't want to be necessarily the first to use it. 00:15:18.461 --> 00:15:25.001 But if it's showing promise and we think it's a better option for our patients, hey, let's do it. 00:15:25.241 --> 00:15:29.361 Yes. So we're quick to pull the trigger in that sense. You've got a great team here. 00:15:29.941 --> 00:15:34.601 Facing cancer can feel overwhelming. And what advice do you give men and their 00:15:34.601 --> 00:15:36.581 families as they begin this journey? 00:15:37.601 --> 00:15:41.761 Yeah well i think that one of the things we are 00:15:41.761 --> 00:15:44.961 good at is trying to work in a collaborative fashion 00:15:44.961 --> 00:15:49.801 so my philosophy hey if you're going to do surgery or radiation my you know 00:15:49.801 --> 00:15:54.841 everybody hears about the rehab after surgeries or whatever they do my philosophy 00:15:54.841 --> 00:16:00.221 hey let's do prehab when we're so this getting ready for the surgery so not 00:16:00.221 --> 00:16:03.541 only that means trying to get in better shape Oh, 00:16:04.241 --> 00:16:05.621 so weight had to do with... 00:16:05.621 --> 00:16:08.581 You know, if you have that extra few pounds, it's going to be a springboard 00:16:08.581 --> 00:16:10.701 to going out and exercise. 00:16:11.021 --> 00:16:15.281 Okay. You know, people are anxious, waiting, they're eating nervously, 00:16:15.541 --> 00:16:18.621 and for good reason, but taking care of yourself. 00:16:18.761 --> 00:16:21.261 Stop smoking, lose weight, exercise. 00:16:21.761 --> 00:16:26.241 Three low hanging fruit, they say, while you're waiting for treatment or we're 00:16:26.241 --> 00:16:29.241 monitoring this, that's what's 00:16:29.241 --> 00:16:33.041 going to be the biggest thing to move the needle in terms of your health. 00:16:33.221 --> 00:16:36.281 Because with prostate cancer, it's kind of tricky. 00:16:36.481 --> 00:16:40.601 We're treating you usually five years down the road. This isn't going to spread 00:16:40.601 --> 00:16:45.261 typically on a year or two. We're treating you for five years out. 00:16:45.861 --> 00:16:51.181 Yeah, it's a good point. Prostate cancer, we diagnose this in about 200,000 people a year. 00:16:51.401 --> 00:16:58.081 Oh my gosh. So a lot of these men, and it's behind skin cancer, 00:16:58.281 --> 00:17:01.881 it's the leading cause of cancer diagnosis of cement. 00:17:02.101 --> 00:17:04.821 Oh, I did not think of that. It's very common. 00:17:05.141 --> 00:17:08.161 And a lot of people think, oh, you know, it's not going to kill me. 00:17:08.301 --> 00:17:11.061 It's, you know, I'm just going to live with it and it's not going to. 00:17:11.461 --> 00:17:17.481 So you have to balance the commonality of this with the fact that it's the second 00:17:17.481 --> 00:17:21.281 leading cause of cancer, death cement. So it kills 30,000 men a year. 00:17:21.701 --> 00:17:27.281 So how do we determine who you really need to treat aggressively versus, 00:17:27.801 --> 00:17:30.721 hey, maybe we can just watch this, you know? 00:17:30.981 --> 00:17:35.701 So that's the art of the medicine, I guess, in trying to figure that out. 00:17:35.741 --> 00:17:38.681 And the screenings. I mean, if you're not getting your screenings, 00:17:38.801 --> 00:17:42.081 then how would you even know where you are in the process? Right. 00:17:42.281 --> 00:17:47.061 And so it's kind of a collaborative effort, letting not only the guy know what's 00:17:47.061 --> 00:17:51.861 going on, but also if we can incorporate his family, make sure he gets in good shape. 00:17:51.861 --> 00:17:56.881 Because if you're in lousy shape and you're going to have a high, 00:17:56.881 --> 00:18:01.581 I always tell guys, hey, you got to get your heart and lungs and your overall body in good shape. 00:18:01.741 --> 00:18:05.701 Because I need you to live for at least five years before the prostate cancer gets you. 00:18:05.921 --> 00:18:10.181 So I always do the comparison. You know, if you're picking up the pennies on the train tracks. 00:18:10.870 --> 00:18:18.070 You don't see the train coming. Right. So trying to put it in perspective is sort of part of my role. 00:18:18.190 --> 00:18:20.270 You don't want to give them that panic, like, you better, you know, 00:18:20.530 --> 00:18:24.630 but you also want to tell them, hey, these are the steps you need to take in 00:18:24.630 --> 00:18:27.470 order to feel better. It's like that's how you approach life. 00:18:27.670 --> 00:18:30.690 You don't want to, you know, perseverate on the little things. 00:18:30.690 --> 00:18:33.490 You've got to see the big picture sometimes. Right. It's so true. True. 00:18:33.910 --> 00:18:37.910 Now, I think we already sort of covered this, but how do patients balance treatment 00:18:37.910 --> 00:18:41.150 with maintaining the quality of life during and after prostate cancer? 00:18:41.170 --> 00:18:42.250 I was thinking about that too. 00:18:42.390 --> 00:18:45.410 Like, are they homebound or can they? 00:18:45.610 --> 00:18:52.110 No. So in terms of, you

know, from a surgical component, guys are usually in 00:18:52.110 --> 00:18:53.150 the hospital overnight. 00:18:53.590 --> 00:18:57.250 Yeah, it's a recuperation over that next week or two. 00:18:57.470 --> 00:19:02.810 But most men are up and about that day of surgery, if not the next day, 00:19:02.810 --> 00:19:05.530 They're home and they come back. 00:19:05.950 --> 00:19:09.450 They do have this, you know, guys get freaked out about this catheter, 00:19:09.590 --> 00:19:12.050 understandably, but that's essential for about a week. 00:19:12.670 --> 00:19:17.650 And after that, the biggest thing they battle is usually to deal with erectile 00:19:17.650 --> 00:19:20.370 dysfunction and some urinary issues. 00:19:20.450 --> 00:19:24.410 But most men will recuperate significant function. 00:19:24.890 --> 00:19:28.910 That's the thought. But we don't want to be silly and say every guy is going to be perfect. 00:19:29.110 --> 00:19:33.030 It is a change. So, I think part of it is just being honest with the patient 00:19:33.030 --> 00:19:36.890 and the family and tell them what to expect. Yes. You know? 00:19:37.250 --> 00:19:41.110 And that's the best, you know, medicine for you to, you know, talk to the patient. 00:19:41.270 --> 00:19:44.130 Like, listen, here's the cards on the table, you know? Right. 00:19:44.130 --> 00:19:46.730 This is what you're going to go through and this is how we're going to help you. 00:19:47.110 --> 00:19:49.330 Yeah. Yeah, you just, I mean, that's what people want. I mean, 00:19:49.670 --> 00:19:52.610 you're the expert. You know, anytime, like, a patient comes in, 00:19:52.710 --> 00:19:54.750 I'm sure they're just, like, overwhelmed. 00:19:55.050 --> 00:19:59.870 Yeah. Once you hear a cancer diagnosis, I've done this long enough to say, 00:19:59.990 --> 00:20:03.450 all you hear is cancer and everything else is... You're like, 00:20:03.510 --> 00:20:04.990 I didn't hear anything that you said. 00:20:05.250 --> 00:20:11.370 So, right. It's kind of a process. And luckily with prostate cancer, we can have that. 00:20:11.470 --> 00:20:15.830 We have a little bit more time to tease through it, tease through the options. 00:20:16.290 --> 00:20:20.130 Hey, go home, talk to your family, bring them back. Let's sit down and have 00:20:20.130 --> 00:20:23.550 a powwow so everybody's on the same page. Yes, absolutely. 00:20:24.450 --> 00:20:28.250 What do you want patients and their loved ones to know about the care and the 00:20:28.250 --> 00:20:30.250 support available here at St. Clair Health? 00:20:30.892 --> 00:20:36.732 Well, I think the key thing to know is that we have a great group of guys in 00:20:36.732 --> 00:20:39.692 the urology department. I really enjoy working with them. 00:20:39.992 --> 00:20:46.892 We each function independently, but we're all like brothers in the sense that, 00:20:46.952 --> 00:20:51.292 hey, I have something that doesn't look right, does appear. What do you think about this gentleman? 00:20:51.572 --> 00:20:55.592 So we really can do that in a very comfortable way if necessary. 00:20:55.592 --> 00:21:01.592 We also have a good team in terms of, there's something called pelvic floor physical therapy. 00:21:01.792 --> 00:21:04.952 And that's something that you guys have probably, that's a pretty cool thing 00:21:04.952 --> 00:21:10.592 that during my training is very powerful and gives patients something to do. 00:21:10.852 --> 00:21:15.512 And so we work in collaboration with them. We work in collaboration with oncology 00:21:15.512 --> 00:21:18.092 teams, both radiation and medical oncology. 00:21:18.172 --> 00:21:22.892 So I found that working together really enhances the overall experience. 00:21:22.892 --> 00:21:27.512 And the goal is, my goal is that treatment of prostate cancer, 00:21:27.672 --> 00:21:30.572 if it needs treated, is just a bump in the road. 00:21:30.792 --> 00:21:33.532 Right. That you go on with your life. This is a little bump. 00:21:33.672 --> 00:21:34.992 This doesn't define you. 00:21:35.372 --> 00:21:41.372 This is something that you're going to deal with. And then we just kind of move on and go from there. 00:21:41.612 --> 00:21:45.532 I love the fact that, you know, St. Clair Health, I mean, you come here for anything. 00:21:45.812 --> 00:21:48.692 And instead of running to all these different doctors and hospitals, 00:21:48.912 --> 00:21:52.372 you have it all here. And everybody's communicating. Everybody's talking. 00:21:52.892 --> 00:21:56.272 I've had on, you know, a number of doctors, you know, teaching hospital and, 00:21:56.312 --> 00:22:00.832 you know, you're just really, you know, making patients feel at ease that they're 00:22:00.832 --> 00:22:02.812 here and they've got the expert care, right? 00:22:03.092 --> 00:22:06.412 Yeah, I think in general, we're kind of just regular guys. 00:22:06.432 --> 00:22:11.032 Maybe we have a little training in our specialties, but we understand I don't 00:22:11.032 --> 00:22:13.612 want to sit in a doctor's office more than I have to. 00:22:13.892 --> 00:22:19.072 So if we can make things as efficient as possible for you and streamline it, 00:22:19.252 --> 00:22:23.412 we'll try and do it. And our goal is to always improve upon that. 00:22:24.284 --> 00:22:27.044 Now, is there anything else that we didn't talk about that maybe, 00:22:27.244 --> 00:22:32.004 I know we were talking about testosterone and some like hormone replacement and UTIs. 00:22:32.124 --> 00:22:34.624 Is there anything else you'd like to tell the listeners and viewers today? 00:22:35.624 --> 00:22:39.584 Yeah, I think number one, make sure you get checked out. 00:22:39.884 --> 00:22:46.144 I think that there are a couple of, again, I use the analogy, low-hanging fruit. 00:22:46.304 --> 00:22:52.744 There are three main cancers that we can screen for easily in men. 00:22:53.264 --> 00:22:57.384 Number one, lung cancer, the number one killer. So don't smoke. 00:22:57.624 -->

00:23:01.204 And if you do. Is that really the number one killer? That's the number one killer 00:23:01.204 --> 00:23:04.724 of men across the board. Yes. So what can you do? 00:23:04.944 --> 00:23:07.644 Right. Stop smoking or don't start smoking. 00:23:07.984 --> 00:23:12.204 And if you are a smoker, there's things you can do like get screened. 00:23:12.304 --> 00:23:14.684 Get a CT scan, talk with your PCP. 00:23:15.164 --> 00:23:18.784 Again, early screening. Right. Number two is prostate cancer. 00:23:20.044 --> 00:23:25.324 So get your PSA, get checked out. it's an easy blood work test, right? 00:23:25.884 --> 00:23:30.844 And number three is colon cancer. So get your colonoscopy. 00:23:31.344 --> 00:23:34.664 Right. You know, those are three easy low-hanging fruit. They're not, 00:23:34.824 --> 00:23:37.704 the colonoscopy is kind of a pain in the ass, but literally. 00:23:38.344 --> 00:23:42.164 But, you know, just get checked out, and that's easy. It's so fast. 00:23:42.444 --> 00:23:46.164 It's really, I've already had one. So I've, you know, to me, 00:23:46.264 --> 00:23:49.284 it wasn't that bad. Yeah, it's easy. I think everybody makes them feel like 00:23:49.284 --> 00:23:51.084 it's going to be worse than it is. It's not. 00:23:51.264 --> 00:23:55.204 They do it so well. All these guys are such professionals who do it, 00:23:55.284 --> 00:23:59.524 the GI and colorectal team that, yeah, don't even think twice about it. Right. 00:23:59.804 --> 00:24:03.204 And I think that's the one thing, too, is a lot of people don't know, 00:24:03.304 --> 00:24:06.884 like, do I go to my primary care doctor and then they give me a script or can 00:24:06.884 --> 00:24:07.924 I just call the hospital? 00:24:08.204 --> 00:24:11.564 Like, what would they do for the steps of just getting the blood work? 00:24:11.984 --> 00:24:16.324 So you can get the blood work for the prostate. You can just ask your primary care. 00:24:16.504 --> 00:24:20.524 Okay. And you can do a screening PSA. And if something's goofy or doesn't know 00:24:20.524 --> 00:24:23.944 how to interpret it, he'll say, hey, maybe you should go see a urologist. 00:24:24.544 --> 00:24:29.884 If you prefer to talk with a urologist directly, you can call up St. 00:24:29.984 --> 00:24:33.904 Clair and they'll direct you. But you can do it easily. You just piggyback it 00:24:33.904 --> 00:24:38.044 onto your other blood work if your primary care hasn't been doing it already. 00:24:38.304 --> 00:24:39.684 Right. Yeah. That's so true. 00:24:39.984 --> 00:24:44.144 So, yeah, I mean, if there's anything else, a doctor in place. 00:24:44.144 --> 00:24:49.604 You know, I'm a big advocate of hormone replacement in the right man, 00:24:49.824 --> 00:24:55.744 so I make the analogy also that oftentimes with breast cancer, 00:24:56.104 --> 00:24:59.444 they can be estrogen sensitive, hormone sensitive. 00:24:59.564 --> 00:25:07.024 So one of the foundations that one back in the early 1900s, they found out is 00:25:07.024 --> 00:25:10.024 that prostate cancer is also hormone sensitive. 00:25:10.284 --> 00:25:12.104 Oh, really? It's sensitive to testosterone. 00:25:13.068 --> 00:25:19.788 So in those gentlemen who have prostate cancer that spread, one of the primary 00:25:19.788 --> 00:25:25.188 treatments is to take away their testosterone and that prostate cancer shrinks. 00:25:25.928 --> 00:25:32.308 Wow. So in men who want to go on testosterone replacement or have questions, 00:25:32.668 --> 00:25:36.388 you need to make sure there's no hidden prostate cancer there. 00:25:36.628 --> 00:25:41.248 Because the theory is not that testosterone causes prostate cancer, 00:25:41.288 --> 00:25:47.168 but if you have some prostate cancer that's harboring in the prostate and you 00:25:47.168 --> 00:25:49.128 start to supplement your testosterone, 00:25:49.468 --> 00:25:53.028 you want to know if that's going to proliferate or what's going to go on. 00:25:53.288 --> 00:25:58.168 So although I treat many men for low testosterone with hormonal therapy, 00:25:58.388 --> 00:25:59.828 one of the foundational things are, 00:26:00.188 --> 00:26:04.068 hey, we have to check your PSA, do a prostate exam before we start you on this, 00:26:04.148 --> 00:26:09.068 make sure there's nothing hitting going on there before we start you on testosterone replacement. 00:26:09.488 --> 00:26:14.608 So I know there's a lot of things available now with the hormone replacement, 00:26:14.768 --> 00:26:19.928 so don't just walk into a place, get your testosterone without going through the blood work. 00:26:19.928 --> 00:26:24.688 Most places are pretty legitimate, but I think if, you know, 00:26:24.788 --> 00:26:30.588 if I'm recommending to my family member, I say, you need to check out a doc 00:26:30.588 --> 00:26:32.628 that you trust and appreciate. 00:26:33.008 --> 00:26:36.728 Just don't go make it a transactional environment. Right. 00:26:37.028 --> 00:26:42.868 You know, because the worry is something's going to get missed and you're going to be in trouble. 00:26:42.868 --> 00:26:48.468 So, yeah, there's plenty of good urologists, endocrinologists, 00:26:48.828 --> 00:26:53.728 or even primary cares who you can trust and may talk to you about, 00:26:53.868 --> 00:26:56.768 hey, is testosterone replacement right for me? Is it not? 00:26:57.068 --> 00:27:00.888 And that's a whole other conversation. Right. But in the right man, 00:27:00.908 --> 00:27:04.348 that can be pretty transformative and really improve their quality of life, 00:27:04.548 --> 00:27:08.908 their overall health, their sexual function, many different things. Right. 00:27:09.468 --> 00:27:12.528 Well, I thank you so much for, you know, all this information. 00:27:13.128 --> 00:27:17.728 Thank you again for joining us today and for sharing your expertise, Dr. Hepps. 00:27:17.928 --> 00:27:23.128 Your commitment to advancing prostate cancer treatment is giving patients new options and new hope. 00:27:23.268 --> 00:27:27.708 For anyone listening, if your loved one are due for prostate cancer screening 00:27:27.708 --> 00:27:33.268 or if you're seeking expert care for diagnosis, the St. Clair Health team is here to help. 00:27:33.508 --> 00:27:37.788 Taking their first step towards screening and early detection could make all 00:27:37.788 --> 00:27:41.048 the difference. To learn more and schedule an appointment with Dr. 00:27:41.208 --> 00:27:48.188 Hepps or another St. Clair Medical Group urologist, provider, call 412-942-4100. 00:27:49.048 --> 00:27:52.588 Thanks again for listening to Spill With Me, Jenny D. Thanks, 00:27:52.688 --> 00:27:55.348 Jenny. Thanks for being on. Appreciate it. Take care. 00:27:55.760 --> 00:28:40.226 Music.