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WEBVTT
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Music.
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Hello, my beautiful people. It's me, Jenny D, from Spill With Me,
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Jenny D Podcast, a new episode this week.
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Today's episode is sponsored by St. Clair Health.
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We are joined by Dr. David Hepps at St. Clair Medical Group Urology.
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He is the first urologist in the greater Pittsburgh region to implant the BioProtect
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Balloon. I can't wait to hear about this.
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An innovative device that helps
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protect healthy tissue during radiation treatment for prostate cancer.
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Welcome, Dr. Heffs. It's also September is Prostate Cancer Awareness Month.
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It's time to shed some light, one of the most common cancers among men,
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and to highlight the progress being made in early detection and treatment of the disease.
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So we are at the end of September, Dr.
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Heffs, but there's no time but any time to talk about the screenings of prostate cancer.
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Yeah, thanks for having me, Jenny. I really appreciate it. Yeah,
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and prostate cancer is something that we treat all the time here at St. Clair.
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We have five urologists. Everybody treats prostate cancer, and we're very passionate
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about helping men and their families.
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Attack this problem, and we provide top-notch care to help families.
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So how long have you been here at St. Clair House? So we've been here for about
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five, seven years. Five, seven. Okay.
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Yeah. And it's been a good relationship. Well, I mean, here's the thing.
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Like, for listeners who may not be familiar, can you explain prostate cancer
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and how common it is among men? because, you know, a lot of times people don't
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understand like, oh, you should get screenings or we should be telling the men
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in our life, you should be getting a screening.
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So can you tell us a little bit about prostate cancer?
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Yeah, sure. So maybe what we'll do is just start with a little bit of what the
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prostate is because it's kind of this like cloudy nebulous thing like,
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oh, yeah, prostate, what the hell? Don't, you know, drop the conversation.
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But yeah, so the prostate is a reproductive organ. and it's a gland. It sits in the pelvis.
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Only men have prostates. It's kind of underneath the pubic bone.
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So it sits between the bladder and the urethra.
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And the prostate sort of increases in size as we age.
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First off, it's really a reproductive organ that helps the sperm fertilize the egg.
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It produces fluid that helps the sperm fertilize the egg. So that's why we have it.
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And Downhill from there.
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Yes, it just causes trouble. So as we all get older in age, in our 40s,
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50s, and beyond, the prostate will grow.
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And that's when you hear about prostate enlargement. And that's predominantly
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benign prostate, non-cancerous enlargement, right?
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But what can happen in some men is that certain cells can proliferate and be
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abnormal, and that's prostate cancer.
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And I feel like our role as urologists is to help identify and differentiate.
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Are we dealing with a benign problem, non-cancerous, or cancerous problem?
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And the problem with cancer, sometimes those cancers can spread to other areas
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and cause other trouble, pain,
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organ damage, whereas benign prostate enlargement doesn't cause that.
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And so we as urologists treat both and can help men figure out what's going on.
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Right. And now, what are some of the warning signs of prostate cancer?
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Because that men may be aware of, like, how important is routine screening?
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Because, for instance, like, you know, I have two boys.
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I mean, what age is it? Like, when do you tell someone? Because I know it's
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not on the first thing on their list. Like, oh, I think I'll go get my prostate exam. Right.
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Hopefully it's not the first thing on anybody's list, but yeah, for sure.
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So I think it can be somewhat controversial, but I try and make it easy and
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tell folks that around the age of 40,
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at least this is our philosophy in general, most urologists,
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you should get a baseline test. Okay.
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And that baseline test entails really a blood work test called a PSA.
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And so if you had a couple of, if you're a brother, if you're an uncle,
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if you're a dad, we may start you at the age of 40.
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Family history is important. If you're having some symptoms, maybe 45.
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Load full transcript
And if you're doing fine and have no family history, maybe age 50.
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But my philosophy is it's a blood work test.
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It's not hard to get. Just get a baseline in your 40s. And based on that,
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we can decide, hey, is this kind of elevated? Should we watch it a little bit closer?
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Is it normal? Oh, don't worry about it. Get another one when you're 50.
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So I think there's some guidelines. There's no rules. And you really have to
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individualize it to each person.
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That's true. But there's no warning signs. Like, for instance,
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you know, you wouldn't feel it or you wouldn't feel like.
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Yeah. So, even before I was into urology and during my training,
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the PSA wasn't available.
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So, my old school professors would say, hey, before we had the PSA,
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men would come in and it would be already spread.
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Oh, it's great. So, once you develop symptoms, the problem is you're already
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kind of behind the eight ball with prostate cancer.
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That being said, if you're having blood in the urine, if you're having significant
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urinary symptoms, meaning that you're struggling to pee, you're having pain,
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those are things you should get checked out. Okay.
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Predominantly, PSA will predict, I make the analogy, it's kind of like that
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earthquake Richter scale.
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We are not going to feel a very low-grade little minor earthquake,
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but the PSA, it'll measure it.
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But by the time that you're feeling something, you're already the golden gate breaker.
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Early detection. Just go for the blood. Right, so that's an easy test.
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Get checked out and we'll just go on from there. Yes.
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Now, how does prostate cancer affect not just the patient, but also their loved ones? So, yes.
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The prostate cancer can affect, it's really, we try and bring in the whole family
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when we talk about prostate cancer.
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Obviously, it's a relationship between the gentleman and the doc.
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But prostate cancer can affect sexual function.
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It can affect urinary function. So it really can affect the relationship that
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that man has, that that couple has.
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And we try here at St. Clair to really work early on, if the patient wishes,
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with his family, with his wife, with his partner, to let them know what to expect.
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So I think being open and honest and confronting those potential issues is essential.
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I love that. It's St. Clair Health that, you know, you guys,
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that you're all giving communication and you're really helping,
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you know, the families, not just the patient, but, you know,
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because a lot of people don't understand.
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What does this mean? What does this mean in the future?
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You know, what kind of things do I need to do for this?
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So how has prostate cancer care advanced in recent years and what excites you
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most about the treatments now available at St. Clair Health? Sure.
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So, we've been treating prostate cancer for a long time, and there's four urologists
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here that use different types of treatments,
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ranging from laparoscopic robotic surgery to treat the appropriate gentleman.
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We also work with a radiation oncologist.
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Oh, right. closely because radiation is a great option for the right patient.
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And kind of circling back, in the diagnosis, when we diagnose prostate cancer,
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it's not guaranteed that you even need to treat this.
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Because a lot of men will have kind of dormant, latent prostate cancer.
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So we have a robust so-called active surveillance program where we may just
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monitor that, trying to avoid.
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Potential issues that are associated with treatment, like those sexual issues, those urinary issues.
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On the other hand, we don't want to ignore something. So we have high-tech options,
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minimally invasive options, like I said, ranging from robotic surgery to really
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forward-thinking options for gentlemen who choose radiation to try and optimize
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cancer outcomes, minimizing potential.
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Dr. Hess, when you were saying robotic, what did you mean by that?
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So robotic surgery, there's a system called the Da Vinci robotic system.
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And so really it's a fancy term for a type of laparoscopic surgery.
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So when we do this type of surgery, the goal is to remove the prostate.
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Now traditional surgery, you made an incision and went in, there were a higher
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rate of potential
problems, complications such as sexual problems and urinary problems.
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And men stayed in the hospital for a while. With robotic surgery,
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we can go in with a few keyhole incisions, and the robot enables us to do not
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only remove the prostate,
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but reconstruct the bladder, urethra. So everything's functioning.
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So they can optimize the function. So we have a couple of robots here at St.
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Clair that are helping us. And this is something new that has just happened?
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It's been around for a while, but I think we do a lot of this type of surgery.
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Like I said, we have four sort of great urologists that do a lot of this type
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of surgery, and I think we do a really good job of this. Oh, yes.
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So you are the first urologist in the greater Pittsburgh region to implant the
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BioProtect balloon. Can you explain what device it is and how it works and what
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it means for prostate cancer patients' ongoing radiation treatment?
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Yeah, so... I got to look that up when I saw that. Oh, yeah,
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yeah. It's not something that's right on the front of your tongue there. Yeah.
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So, the balloon system, it's really, we use this in collaboration with the radiation oncologist.
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So, for example, a gentleman comes in.
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He decides, we find that there's some significant prostate cancer.
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He decides, hey, you know, I'm going to go move forward with radiation for my prostate.
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I want the best treatment possible. So the prostate and the rectum are very
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close, a couple of millimeters away.
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Okay. And the radiation oncologist is saying, well, I want to deliver radiation
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to the prostate without injuring that tissue, the rectal tissue.
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And if it's only a couple millimeters away, the worry is I'm applying radiation
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to the backside of the prostate. I don't want to friendly fire and injure the rectum.
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So that space in there is very narrow.
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So what we can do as urologists is find a way to increase the space between
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the rectum and the prostate.
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And the concept is we place this.
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We placed this device called a spacer. Okay, spacer.
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And there's different types of these spacers,
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but we found that this balloon system,
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we can surgically and very precisely place it into that space between the prostate
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and the rectum and creating elevation of the prostate so that the radiation
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doctor can now deliver appropriate amount of radiation to the back of that prostate
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without injuring the adjacent tissues.
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Wow, that's amazing. Yeah, so it's pretty cool.
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I mean, it's kind of a nuanced thing, but I think in terms of optimizing cancer
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control and preserving patient outcomes with a minimal side effect,
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it can make a huge difference.
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Yes, I mean, and this is brand new. Like, did this just come about?
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Yeah, this is the bioengineers, the clever bioengineers figured this out.
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And it's really cool. No, it wasn't me. I wish I did.
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No, no, it wasn't me. But it's a really cool little system. And,
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yeah, so we've done this in a number of patients.
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And guys have done really well, really well. So it's been around for,
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would you say, like a couple of years?
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It's probably been around for a couple of years. But it's really the concept
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of creating that space has been around for a few years.
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But this technology has been available to give us a more consistent,
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precise placement to achieve, again, the best outcomes. Right.
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Oh, my goodness. That's great.
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What has been the response from the patients, like the benefits from this technology?
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What have you heard from them? Yeah, I think the best response is that they
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really have minimal side effects.
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Oh, that's good. The goal is, because guys would come in and they say,
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oh, you know, I'm having a lot of symptoms sometimes after radiation.
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Or I'm having some issues with this new device, guys are really coming in.
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They get a place. They go on, get their radiation, and they really have much
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less side effects and hopefully better outcomes.
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We're continuing to monitor this because it's new.
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Well, let me ask. This might be a stupid question I'm asking you,
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but what happens with the balloon? Does it dissolve or does it, I mean?
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Yeah, so the balloon, it's kind of cool. You think, oh, where does it
stay in
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there? I don't want that balloon in me.
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So in any event, the balloon's made of the same material that an absorbable stitch is used.
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Oh, okay. And then we fill the balloon with sterile water.
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So everything absorbs within a few months. Oh, wow. So, yeah.
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That's incredible. I know. I wasn't sure. I was like, I'm thinking,
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imagining in your head, like, what does this look like? Yeah, yeah.
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It's kind of weird and crazy at the same time.
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But it's, you know, urology has been a good field in that we,
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especially here at St. and Claire, I think are,
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Again, forward thinking that we're willing to adopt technologies.
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We don't want to be necessarily the first to use it.
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But if it's showing promise and we think it's a better option for our patients, hey, let's do it.
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Yes. So we're quick to pull the trigger in that sense. You've got a great team here.
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Facing cancer can feel overwhelming. And what advice do you give men and their
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families as they begin this journey?
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Yeah well i think that one of the things we are
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good at is trying to work in a collaborative fashion
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so my philosophy hey if you're going to do surgery or radiation my you know
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everybody hears about the rehab after surgeries or whatever they do my philosophy
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hey let's do prehab when we're so this getting ready for the surgery so not
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only that means trying to get in better shape Oh,
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so weight had to do with...
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You know, if you have that extra few pounds, it's going to be a springboard
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to going out and exercise.
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Okay. You know, people are anxious, waiting, they're eating nervously,
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and for good reason, but taking care of yourself.
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Stop smoking, lose weight, exercise.
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Three low hanging fruit, they say, while you're waiting for treatment or we're
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monitoring this, that's what's
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going to be the biggest thing to move the needle in terms of your health.
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Because with prostate cancer, it's kind of tricky.
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We're treating you usually five years down the road. This isn't going to spread
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typically on a year or two. We're treating you for five years out.
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Yeah, it's a good point. Prostate cancer, we diagnose this in about 200,000 people a year.
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Oh my gosh. So a lot of these men, and it's behind skin cancer,
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it's the leading cause of cancer diagnosis of cement.
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Oh, I did not think of that. It's very common.
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And a lot of people think, oh, you know, it's not going to kill me.
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It's, you know, I'm just going to live with it and it's not going to.
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So you have to balance the commonality of this with the fact that it's the second
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leading cause of cancer, death cement. So it kills 30,000 men a year.
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So how do we determine who you really need to treat aggressively versus,
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hey, maybe we can just watch this, you know?
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So that's the art of the medicine, I guess, in trying to figure that out.
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And the screenings. I mean, if you're not getting your screenings,
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then how would you even know where you are in the process? Right.
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And so it's kind of a collaborative effort, letting not only the guy know what's
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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.