Episode Transcript
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Speaker 1 (00:00):
The following is a paid podcast. iHeartRadio's hosting of this
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the ideas expressed.
Speaker 2 (00:09):
The following program is brought to you by NYU Land
Going Health. It's CATS's Corner with doctor Aaron Katz. You're
trusted expert in men's health, providing straight talk on a
wide range of men's health topics and advice on how
to live your healthiest life. Now on seven to ten WOOR.
It's the Chairman of Urology at NYU Land Gone Hospital,
(00:32):
Long Island. Here is doctor Aaron Katshy.
Speaker 3 (00:37):
Good morning everyone, Welcome the Kats's Corner here on WOR iHeartRadio.
We are live this morning. Man, if you'd like to
give me a call on this second Sunday here in September,
already the weather has diffinitely changed, feeling definitely like fall
out there this morning. I'll give you the number. It's
(00:58):
eight hundred three two one zero seven ten. That number
again is eight hundred three two one zero seven ten.
And if you've been listening to the show and wanting
to an opportunity to give me a call and ask
a question about your particular situation or a loved one,
or just a question in general. I'd love to hear
(01:19):
from you. One eight hundred three two one zero seven
ten here on Wriheart Radio. Good morning everyone. Next Sunday
is our prostate cancer Awareness seminar. If you haven't signed up,
you certainly still can. The phone number for signing up.
There's two ways you can sign up, either a phone
(01:41):
or an email, so we've tried to make it easy
for everyone, and the number is five one six six
six three twenty two seventy seven five one six six
six three two two seven seven. The email for those
of you that are digitally aware and electronically savvy and
(02:03):
want to do that rather than a phone call, I
get it. The number of the email is Men's Health
at nyulandgone dot org. Men's Health at NYU landgone dot organ.
It's going to be a great seminar. It's here in
the beautiful downtown Miniolo, just in front of our hospital,
at the research and Academic center where we actually house
(02:27):
our medical school, the Grossman Long Island School of Medicine.
It's one oh one Miniola Boulevard and it will be
from eight o'clock in the morning. To eleven thirty. We
will provide breakfast. It's all free, by the way, you
don't have to you know, credit card or cash and
all that. Just walk in and bring friend, bring a
(02:52):
loved one, bring yourselves. If you have been diagnosed with
prostate cancer or concerned, or you've had treatment, or you're
thinking about tree, or you've had a PSA that's been elevated,
and you know where you just want to education. It's
going to be terrific because I'll be there, and I'll
have my good friend from Fans for the Cure, Ed Randall,
(03:14):
who is a baseball host, an excellent guy, prostate cancer survivor,
and he has always wonderful stories to tell and runs
a terrific organization called Fans for the Cure, which promotes
prostate cancer screening around the country. Does an enormous job,
and he'll be there. My associates doctor Jonathan Hast, the
(03:37):
Chairman of Radiation Oncology, who runs the CyberKnife program for
many years here at NYU Land gone on Long Island
and runs now a bunch of clinical trials, and I'm
sure he'll talk about and his results. He will be there.
Terrific guy and known John for many years, and he
will be there as well as my good friend and colleague,
(03:58):
doctor Anthony Quok will be there. He is the director
of Urologic Oncology and does the majority of robotic surgeries
here at the NYU Hospital on Long Island and for
prostate He also is a phenomenal surgeon and a terrific guy,
I must say, and just an outstanding physician an individual
(04:23):
and does prostate cancer evaluations with different types of biopsy
techniques that we'll talk about there next Sunday, using some
of the latest and greatest techniques rather than going through
the wreck them going through the skin that the paraneum,
So we'll talk about that and the role of robotic surgery.
(04:45):
He'll talk about his outcomes and how robotic surgery is performed.
He also does lots of robotic surgery for kidney cancer.
He does segmental or partial removals of the kidney if
that could be needed, or the entire kidney if it
needs to be removed. Though actually a lot of the
patients that I see that are being done at our
hospital are being done the sparing of the remainder of
(05:11):
the kidney, which is just tremendous and just removing the cancer.
As part. He also does robotic surgery for bladder cancer
for those patients that have advanced bladder cancer that need
to have a new bladder, and all of that can
be done robotically, which is incredible these days to make
a new bladder out of a piece of your intestine
(05:34):
it's called ilium, and make a new bladder and remove
the old diseased one and make a new one and
have still an excellent quality of life. So he does
robotic surgery for all of those. But next Sunday he'll
be particularly talking about prostate cancer, and I will be
there talking about some of the ways that we can
(05:58):
treat prostate cancer holistically. A lot of patients are very
interested in active surveillance, and we have a program here
that we've used for many years called active holistic surveillance
where patients with low risk disease do not need to
be treated. We do know that it is part of
the guidelines now. I've been doing it for many years.
(06:19):
I'm probably doing this for twenty years, but it is
now currently part of the American Neurological Association's guidelines, the
NCC and guidelines for Patients with low risk of pron
state cancer and a lot of patients that we get
diagnosed these days do have low risk. We can talk
about and we will talk about in the seminar how
you know if you are diagnosed, How do you know
(06:40):
if you're low, intermediate or high? Very important question, and
how do you know if you should be treated? And
we have so I'll talk about my experience with holistic
surveillance as well as a form of therapy that I've
also used for many years which is now being widely
accepted called focal therapy. And in fact, in two weeks
(07:03):
I'm going down to Washington, d C. Because there is
a Focal Therapy Society which I'm a board member of,
Terrific society, to promote the awareness and to get doctors
in their consensus about how to do focal therapy, when
should it be done, how to follow patients, and who's
the best candidate, let's say, for focal therapy, meaning that
(07:27):
just like I was talking about robotically where you just
remove part of the kidney and you just remove part
of the cancer, well here we don't remove anything, but
we freeze or we can also heat up. It's called
haifu or cryo the area of the prostate that is malignant,
that is cancerous, and not touching or treating the rest
(07:50):
of the prostate of giving patients excellent quality of life
and excellent cancer outcomes. So we'll also talk about that,
and I've been quite passionate about that for many years.
So look forward to that again if you'd like to come.
Love to see you all. And it's great to see
a lot of a lot of patients that are there,
(08:11):
a lot of you know, patients that I you know,
that have become friends that I cared dally for and
they cared I think deeply for me and and the
programs that we have here, and it becomes a wonderful
morning also for people to meet other people that may
be going through the same thing, and you might meet
(08:32):
a new friend in life. It's never it's never too
late to meet new friends.
Speaker 4 (08:36):
You know.
Speaker 3 (08:37):
You know, you have friends for many years. Let's say,
you know, I think back in my high school. I
have one friend now still from high school, one friend
that I keep in touch with, you know, and you
going to high school, you have a bunch of friends,
and then you know, life gets in the way, and
I have one friend from high school but you know
it's nice to meet new people and to get out
and to make new friends. So the seminar next Sunday
(09:01):
here in Minniola at the Research and Academic Center one
oh one Miniola Avenue Boulevard. I can't remember its avenue
of Boulevard, but and so the Research and Academic Center.
The number. If you want more information, more detailed information,
the number is five one six six six three two
two seven seven five one six six six three twenty
(09:24):
two seventy seven. Or you can email us at Men's
Health at NYU Landgo dot org. It is all free,
educational and love to see you there. We'll go to
the phone lines this morning at eight hundred three two
one zero seven ten one eight hundred three two one
zero seven ten, and our first caller is Henry. Good morning, Henry,
(09:45):
how are you?
Speaker 5 (09:47):
Thank you and thank you, doctor Katch. You provide a
great public service to your listeners. I'm sure many of
your listeners very much appreciate listening to your program every Sunday.
Thank you, Thank you, Henry, thank you. That's a a
well deserved compliment, doctor Katz. A little bit of background.
My age is seventy nine. My weight is one age zero.
(10:08):
I am non non diabetic. Questions about nocturia and about
urgent continents. My primary care physician recommended that I take
two prescription medicines simultaneously. These two prescription medicines are prosscar
five milligrams and Flomax zero point four milligrams. He recommended
(10:33):
that I take them together every day for my urinary symptoms.
My question, doctor, are there any long term interactions or
long term side effects for taking these two medications simultaneously?
That is my question.
Speaker 3 (10:52):
That's a great question, and thank you again for the compliment.
You know, the first thing I would say, Henry, is
do you need these medications? That would be the first question.
And you know, those two medications that you mentioned have
been used since I've been in neurology for probably thirty
years together, and there were studies showing that those two
medications together with men that have urinary issues with urinary retention,
(11:19):
poor flow, getting up at night like you are, can
be used together and can be used safely for many years.
So I think that the answer to your bottom line,
to answer to your question is it's relatively safe. Yes. Now,
there can be some side effects, especially with a flomax.
(11:40):
You can get a little dizziness, that's possible. You could
you know it could affect sexual function, although I'm not
so sure at seventy nine you care about how much
you ejaculate because it can affect your ejaculation. But if
you know, and so can proscar which can shrink the prostate.
I guess My question though, is you know do you
really need these medications and what is your issue? You
(12:03):
mentioned that you're getting up at night and you mentioned
urge in continents, which means in a true definition, it
means people that are running to the bathroom urgency and leaking.
Is that your situation?
Speaker 6 (12:14):
Are you?
Speaker 3 (12:15):
Are you leaking urine?
Speaker 5 (12:17):
That is correct, basically urgency, no leakage of urine and
the fact that I get up, in my opinion, a
few times more at night for the for nocturia.
Speaker 3 (12:29):
And is your flow okay? The urine flow.
Speaker 5 (12:33):
Flow is very strong and good in my opinion, thank you,
doctor joh.
Speaker 3 (12:39):
Flow is good. But even before you started the medication,
flow is good?
Speaker 5 (12:42):
Is that right, Sagan?
Speaker 3 (12:45):
Even before you started these Have you started these medications?
Speaker 5 (12:48):
I mean I've been taking them for a number of
weeks now with no change in my uh symptoms, so
to speak. I was told it takes a few weeks
or maybe longer than that to see you. Are you improvement?
Speaker 3 (13:02):
Yeah, well, let me think again. The question is do
you need them? It could be that you just have
what's called an overactive bladder, and in that particular case,
if it's not really from your prostate issue, because you
tell me you have a good flow and maybe you
are emptying the bladder and you just have overactive bladder,
(13:23):
these medications are not going to have to be helpful
for you, frankly. And the pro scar, the one that
you mentioned, which is also called an asteroid, which I've
used again for probably thirty years, is only really beneficial
for patients that have had an ultrasound or an MRI
and showing that the prostate is very large. Have you
had that?
Speaker 5 (13:43):
Yes, I've had. I've had this sonogram the ultrasound for
the prostate recently and it chosen moderately moderate enlargement. That's correct,
moderate enlargement.
Speaker 3 (13:56):
Just an ultrasound, is that right? An abdominal ultrasound, not
a transrectal culture. Have you seen a urologist, Henry, Have
you seen a.
Speaker 5 (14:04):
Urologist not based upon the recommention of my primary care physician.
He's handling my situation at the present time.
Speaker 3 (14:13):
I think you should. I think you should only because
there can be other diagnostic testing that can show that
it's possible that the problem. See, these two medications that
you mentioned are great if the problem is just your prosty,
But if it is more of your bladder, this urgency
that's getting up at night, these medications aren't going to
(14:35):
do much. Now. Look, you just started it. I'm not
telling you to stop it. Maybe continue it for a
little bit, but I would say by the end of
this month, if you're not feeling any better, I would
get into see a urologist in your area. Okay, where
do you live?
Speaker 5 (14:52):
I live in Queen's Lastly, doctor, thank you so much
for the good advice on that one. On my reason
your analysis in the testing of leukocyte est race, it
was a trace amount out of the range. Specifically, what
is the purpose of that test and what does it
(15:12):
indicate that I had a trace amount outside of range.
Speaker 3 (15:15):
It's a good question, and that is a part of
the guidelines to get a test like that. So I'm
glad your doctor did and it shows whether or not
you have a urinary tract infection. So you know, you
have leucocyte which shows that there's white cells in your urine.
White cells is a reaction and inflammatory reaction to bacteria.
So it's possible that you may have a urinary tract infection,
(15:40):
and so you might want to get a urine culture
rather than just a urine analysis at this point. So
maybe you could tell the primary care doctor who can
do that, you know, maybe listening to doctor Katz and
he mentioned that maybe I should have a urine culture
because if you do have a urinary tract infection, then
you might need an antibate and that may be the
(16:02):
end result of your problem. Okay, Now, just to get
back to your original question, are these medications in the
long term safe? My answer is definitive yes. Okay, But
again my question for you is is this the right
medications for you? Is this the right approach for you?
(16:23):
I'm not so sure, and so I would try it
for a little bit longer, and if not, I probably
would recommend. Not probably, I would recommend that you go
into see a urologist in your area and get a
further evaluation of perhaps blodder testing, and see if it's
not a blodder trouble, like an overactive blodder, which would
be a different type of approach. I hope that helps, Henry.
Speaker 5 (16:47):
Certainly, you're very helpful on this question of mine. So
in conclusion, the two medicines that I mentioned, I fines
to Ride and the time solution don't have any specific
long term side effects when they are used simultaneously.
Speaker 3 (17:02):
That is correct. Yes, that is correct. There have been
lots of studies with that combination. That is correct.
Speaker 5 (17:08):
Yes, Okay, continue with your program.
Speaker 3 (17:12):
Thank you so much, doctor, Thank you all right, Thank
you very much, Henry. We'll go back to the phone lines.
If you'd like to give me a call. The number
is eight hundred and three two one zero seven ten
here on Katsas Corner on this rather chilly, but nice.
It's a nice feeling this September. I always feel it's
like it's a new berth almost, you know, like, Okay,
we had a nice summer. Summer is over. Let's move on.
(17:34):
We live in the Northeast and we can appreciate the
change of seasons. And if you walk outside this morning,
as I did, you can appreciate that. Let's go to Tom.
He's up next. Good morning, Tom.
Speaker 6 (17:45):
How are you good morning? I went eighty four years old.
PSA a year ago was two point eight. My question
relates to recently, my brother, who's older, has prostate cancer
which has spread to the bones. And my question is,
(18:07):
besides taking a PSA test next month or so, what
other tests would you suggest that would be necessary or
just stay with the PSA.
Speaker 3 (18:23):
Well, it's a great question. I hope your brother does well.
How old is.
Speaker 6 (18:28):
Your brother eighty nine? Wow?
Speaker 3 (18:31):
God blass, So he's eighty nine. He's got prostate cancer
in the bones, which is consulting. Yes, you know, because
you know you can get as you get older. You know,
our bones do get weaker, our testosterone levels normally go lower.
So let just like with women postman apausal, you can
wind up with osteoporosis, and then if you have weakening
(18:53):
of the bones and cancer in the bones, you're at
risk of a bone fracture or what we call a
skeleton related events. I hope that they're taking care of
his bones, not only with hormones, but also with supplements
and things like that that can strengthen his bones, and
have your brother make sure that he's physically active. To
(19:13):
answer your particular question, my friend, I'm glad to see
that your PSA is two point eight. That is completely
normal within the range. What else can you do? I think,
given your family history being so strong, I would make
sure that the doctor just does a digital exam. You know,
there are situations where prostate cancer can be aggressive, even
(19:35):
in low risk disease. You have a family history. Look,
you are in your eighties, but you sound spry, you
sound great, you sound strong. I would say maybe the
only thing that I particularly would do would probably get
a just feel your prostate, okay, and make sure that
it feels healthy, and if it didn't, I would maybe
(19:57):
consider talking to you about getting an m of your prostate.
But other than that, I wouldn't do anything. I would
probably monitor my PSA. In your case, I would probably
do it probably twice a year, giving your strong family history.
Speaker 6 (20:15):
Okay.
Speaker 3 (20:15):
Is that I'm not saying that you should do anything
else except maybe have a maybe have your internist or
if you're seeing a urologist, to have a digital rectal
exam just to feel your prostate rather than just relying
on your PSA alone.
Speaker 5 (20:29):
Okay.
Speaker 3 (20:30):
But other than that, Tom, I think that's that's all
I would do at this point.
Speaker 6 (20:34):
Okay, I appreciate your help very much.
Speaker 3 (20:39):
I assume I'll assume that you don't have any symptoms.
Is that right? I mean, obviously if you're having more
symptoms that you know, you don't have any pain in
your bones, you don't have any weight loss, you don't
have any you don't have any symptoms other than just
you know, you know, being in your eighties, you know,
which we all can have some you know, life altering
(21:00):
kind of changes. But but you have no other significant symptoms.
Is that a correct assumption.
Speaker 6 (21:05):
I've I exercise six seven days a week, including running
a few miles, plus all the good foods and you know,
things relating to the prostate lycopene so pointleto and you know,
so I do. I do get up at night. But
(21:27):
then again, I you know that I's been for years
and I have no Anyway, I thank you very much
for your help.
Speaker 3 (21:37):
How many miles a day did you say you were running.
Speaker 6 (21:40):
To two and a half miles a day?
Speaker 3 (21:42):
Wow, that's fantastic. Good for you. Okay, well, yeahs have
a wonderful Sunday. If you want come to your come
to the seminar next weekend. And if you heard the announcement,
but either you and perhaps even your brother if you
want to come or or bring your friends love to
see you. Thank you very much and have a wonderful Sunday, Tom.
Thank you.
Speaker 6 (22:00):
Buy now.
Speaker 3 (22:02):
If you're just tuning in, we have just a few
minutes left. But if we are having a prostate cancer
aware in a seminar next week, next Sunday here in Mineola.
If you'd like to attend, it is a free seminar
with breakfast and great lectures. You can give us a
call at five one six six sixty three twenty two
seventy seven, or you can sign up at Men's Health
(22:24):
at Nyulandgune dot org. Terry is on the phone on
the next caller. Good morning, Terry, how are you no?
Speaker 4 (22:32):
Good morning, doctor Katz. Doctor Katz. I'm calling in because
I'm just curious on your thoughts as well as the
American Neurological Society's guidance if any, on prosthetic massage using
the tennis ball technique to promote prostate health and retard
any development of BPH.
Speaker 3 (22:53):
Yeah, there's no guidelines about that at all, Terry. I've
had many patients I don't know about the tennis ball technique.
That's a new one. I haven't heard that one, although
you know, the US Open Men's finals is today. Maybe
in light of that, there's a tennis ball technique. I
don't but I've never never heard of that one. But
(23:13):
I certainly have had patients that they have gone on
to Amazon and they've bought certain types of prostrate massages.
They've gone for prostate massages. Unfortunately, there are no AUA
guidelines about this. There are no studies, well clinically relevant,
validated studies about prostate massage. What do I personally think
(23:39):
about it? You know, there have been some patients in
my practice over the years that have a condition called
chronic aprostatitis that have told me that they've benefited from it.
They've benefited from warm baths, they've benefited from things like
verbal agents that can reduce inflammation and can prostiate massage.
(24:00):
Do that It's possible. I just don't know about doing. Certainly,
there's no you know, there's no teaching, there's no education
about prostate massage. And then you start doing it yourself
or putting a device there, and it's possible that you
could injure yourself. So I don't really typically advise it,
(24:21):
and unfortunately there's no AUA guidelines or a statement policy
about that, so I don't know it is this something
that you've done yourself and have benefited or something you
just read about.
Speaker 4 (24:32):
Or no, yeah, it's something I haven't indulged in. But
I'm just hearing a lot of information about it, and
I'm just curious to hear a professional like yourself, especially
someone in the specific medical area about it. What your
thoughts are on.
Speaker 3 (24:50):
Yeah. No, Now, we've had patients that there are practitioners
that can do, you know, a prostate manipulations and pelvic
therapy pelvic rehabilitation therapy for patients with this tightening of
the pelvic floor muscle that can lead to a chronic
(25:16):
of prostatitis, if you will, And there have been some
studies there not necessarily a prostrate massage, but more of
pelvic therapy, and there are some physical therapists that do that.
So we have had patients that have had gone for
that and have had good results, but not necessarily prostate
(25:38):
massage in and of itself.
Speaker 4 (25:39):
Okay, Terry, sure NFYI I believe that tennis ball technique
is applied towards just as you pointed out improving flexibility
in the pelvic floor.
Speaker 3 (25:53):
Yeah, I think that. You know, I've seen in my
practice many men that have come to me with this prostate,
you know, this chronic pros, the titis, and urologists and
primary care doctors the typical response so give antibiotics. Give
antibiotics that in my opinion, never worked. It really never worked,
and it was always that tightening of the pelvic floor.
(26:14):
So there are some physicians that will do this pelvic physiotherapy,
physical therapy, perhaps this tennis ball technique, which again I
frankly i'm not aware of. I'll have to read about it,
but you know, warm baths, things like that that kind
of relax the pelvic muscles. Certainly stress. I've seen a
(26:38):
lot of young men in their early thirties that are
you know, a lot of stress in their life from
financial stress, their jobs, or marriages, relationships, whatever, and sometimes
it can cause this tightening of the pelvic floor and
can cause these urinary symptoms. But it's not an infection,
and I hope that urologists out there realize that that
it's not an infection. Anyway, Thank you very much. I
(27:00):
we have just about I'm told about thirty seconds left.
I just want to let everyone know again that the
Prostay Cancer Awareness Seminar is next Sunday. Hope to see
you there if you want to sign up, it's five
to one six six six three twenty two seventy seven
or Men's Health at NYU Landguing dot org is the
email and I'm really excited about it. I hope that
(27:21):
we get a great attendance and I hope that you'll
be out there too and come with your questions, your family,
you loved ones and your friends. It's it's always a
great event. Ed Randall from fans, so the Cure will
be there and my colleagues doctor Jonathan Hass and doctor
Anthony Corkran. Well that's the end of the show. We
want to hope you enjoy this beautiful day here. It's
a change of weather, change of sports. Now We've got
(27:44):
football starting which is which is always exciting. We've got
tennis today the men's final, which should be a great
event as well. So tune in every Sunday here on
katsus Corna. We'll be back next week with a great
show and I hope you have all have a great
day this is doctor Aaron Katz.
Speaker 2 (28:06):
You've been listening to Katz's Corner. Come back every week
to hear more straight talk on a wide range of
men's health topics and advice on how to live your
healthiest life.
Speaker 1 (28:17):
The proceeding was a paid podcast. iHeartRadio's hosting of this
podcast constitutes neither an endorsement of the products offered or
the ideas expressed.
The following is a paid podcast. iHeartRadio's hosting of this
podcast constitutes neither an endorsement of the products offered or
the ideas expressed.
Speaker 2 (00:09):
The following program is brought to you by NYU Land
Going Health. It's CATS's Corner with doctor Aaron Katz. You're
trusted expert in men's health, providing straight talk on a
wide range of men's health topics and advice on how
to live your healthiest life. Now on seven to ten WOOR.
It's the Chairman of Urology at NYU Land Gone Hospital,
(00:32):
Long Island. Here is doctor Aaron Katshy.
Speaker 3 (00:37):
Good morning everyone, Welcome the Kats's Corner here on WOR iHeartRadio.
We are live this morning. Man, if you'd like to
give me a call on this second Sunday here in September,
already the weather has diffinitely changed, feeling definitely like fall
out there this morning. I'll give you the number. It's
(00:58):
eight hundred three two one zero seven ten. That number
again is eight hundred three two one zero seven ten.
And if you've been listening to the show and wanting
to an opportunity to give me a call and ask
a question about your particular situation or a loved one,
or just a question in general. I'd love to hear
(01:19):
from you. One eight hundred three two one zero seven
ten here on Wriheart Radio. Good morning everyone. Next Sunday
is our prostate cancer Awareness seminar. If you haven't signed up,
you certainly still can. The phone number for signing up.
There's two ways you can sign up, either a phone
(01:41):
or an email, so we've tried to make it easy
for everyone, and the number is five one six six
six three twenty two seventy seven five one six six
six three two two seven seven. The email for those
of you that are digitally aware and electronically savvy and
(02:03):
want to do that rather than a phone call, I
get it. The number of the email is Men's Health
at nyulandgone dot org. Men's Health at NYU landgone dot organ.
It's going to be a great seminar. It's here in
the beautiful downtown Miniolo, just in front of our hospital,
at the research and Academic center where we actually house
(02:27):
our medical school, the Grossman Long Island School of Medicine.
It's one oh one Miniola Boulevard and it will be
from eight o'clock in the morning. To eleven thirty. We
will provide breakfast. It's all free, by the way, you
don't have to you know, credit card or cash and
all that. Just walk in and bring friend, bring a
(02:52):
loved one, bring yourselves. If you have been diagnosed with
prostate cancer or concerned, or you've had treatment, or you're
thinking about tree, or you've had a PSA that's been elevated,
and you know where you just want to education. It's
going to be terrific because I'll be there, and I'll
have my good friend from Fans for the Cure, Ed Randall,
(03:14):
who is a baseball host, an excellent guy, prostate cancer survivor,
and he has always wonderful stories to tell and runs
a terrific organization called Fans for the Cure, which promotes
prostate cancer screening around the country. Does an enormous job,
and he'll be there. My associates doctor Jonathan Hast, the
(03:37):
Chairman of Radiation Oncology, who runs the CyberKnife program for
many years here at NYU Land gone on Long Island
and runs now a bunch of clinical trials, and I'm
sure he'll talk about and his results. He will be there.
Terrific guy and known John for many years, and he
will be there as well as my good friend and colleague,
(03:58):
doctor Anthony Quok will be there. He is the director
of Urologic Oncology and does the majority of robotic surgeries
here at the NYU Hospital on Long Island and for
prostate He also is a phenomenal surgeon and a terrific guy,
I must say, and just an outstanding physician an individual
(04:23):
and does prostate cancer evaluations with different types of biopsy
techniques that we'll talk about there next Sunday, using some
of the latest and greatest techniques rather than going through
the wreck them going through the skin that the paraneum,
So we'll talk about that and the role of robotic surgery.
(04:45):
He'll talk about his outcomes and how robotic surgery is performed.
He also does lots of robotic surgery for kidney cancer.
He does segmental or partial removals of the kidney if
that could be needed, or the entire kidney if it
needs to be removed. Though actually a lot of the
patients that I see that are being done at our
hospital are being done the sparing of the remainder of
(05:11):
the kidney, which is just tremendous and just removing the cancer.
As part. He also does robotic surgery for bladder cancer
for those patients that have advanced bladder cancer that need
to have a new bladder, and all of that can
be done robotically, which is incredible these days to make
a new bladder out of a piece of your intestine
(05:34):
it's called ilium, and make a new bladder and remove
the old diseased one and make a new one and
have still an excellent quality of life. So he does
robotic surgery for all of those. But next Sunday he'll
be particularly talking about prostate cancer, and I will be
there talking about some of the ways that we can
(05:58):
treat prostate cancer holistically. A lot of patients are very
interested in active surveillance, and we have a program here
that we've used for many years called active holistic surveillance
where patients with low risk disease do not need to
be treated. We do know that it is part of
the guidelines now. I've been doing it for many years.
(06:19):
I'm probably doing this for twenty years, but it is
now currently part of the American Neurological Association's guidelines, the
NCC and guidelines for Patients with low risk of pron
state cancer and a lot of patients that we get
diagnosed these days do have low risk. We can talk
about and we will talk about in the seminar how
you know if you are diagnosed, How do you know
(06:40):
if you're low, intermediate or high? Very important question, and
how do you know if you should be treated? And
we have so I'll talk about my experience with holistic
surveillance as well as a form of therapy that I've
also used for many years which is now being widely
accepted called focal therapy. And in fact, in two weeks
(07:03):
I'm going down to Washington, d C. Because there is
a Focal Therapy Society which I'm a board member of,
Terrific society, to promote the awareness and to get doctors
in their consensus about how to do focal therapy, when
should it be done, how to follow patients, and who's
the best candidate, let's say, for focal therapy, meaning that
(07:27):
just like I was talking about robotically where you just
remove part of the kidney and you just remove part
of the cancer, well here we don't remove anything, but
we freeze or we can also heat up. It's called
haifu or cryo the area of the prostate that is malignant,
that is cancerous, and not touching or treating the rest
(07:50):
of the prostate of giving patients excellent quality of life
and excellent cancer outcomes. So we'll also talk about that,
and I've been quite passionate about that for many years.
So look forward to that again if you'd like to come.
Love to see you all. And it's great to see
a lot of a lot of patients that are there,
(08:11):
a lot of you know, patients that I you know,
that have become friends that I cared dally for and
they cared I think deeply for me and and the
programs that we have here, and it becomes a wonderful
morning also for people to meet other people that may
be going through the same thing, and you might meet
(08:32):
a new friend in life. It's never it's never too
late to meet new friends.
Speaker 4 (08:36):
You know.
Speaker 3 (08:37):
You know, you have friends for many years. Let's say,
you know, I think back in my high school. I
have one friend now still from high school, one friend
that I keep in touch with, you know, and you
going to high school, you have a bunch of friends,
and then you know, life gets in the way, and
I have one friend from high school but you know
it's nice to meet new people and to get out
and to make new friends. So the seminar next Sunday
(09:01):
here in Minniola at the Research and Academic Center one
oh one Miniola Avenue Boulevard. I can't remember its avenue
of Boulevard, but and so the Research and Academic Center.
The number. If you want more information, more detailed information,
the number is five one six six six three two
two seven seven five one six six six three twenty
(09:24):
two seventy seven. Or you can email us at Men's
Health at NYU Landgo dot org. It is all free,
educational and love to see you there. We'll go to
the phone lines this morning at eight hundred three two
one zero seven ten one eight hundred three two one
zero seven ten, and our first caller is Henry. Good morning, Henry,
(09:45):
how are you?
Speaker 5 (09:47):
Thank you and thank you, doctor Katch. You provide a
great public service to your listeners. I'm sure many of
your listeners very much appreciate listening to your program every Sunday.
Thank you, Thank you, Henry, thank you. That's a a
well deserved compliment, doctor Katz. A little bit of background.
My age is seventy nine. My weight is one age zero.
(10:08):
I am non non diabetic. Questions about nocturia and about
urgent continents. My primary care physician recommended that I take
two prescription medicines simultaneously. These two prescription medicines are prosscar
five milligrams and Flomax zero point four milligrams. He recommended
(10:33):
that I take them together every day for my urinary symptoms.
My question, doctor, are there any long term interactions or
long term side effects for taking these two medications simultaneously?
That is my question.
Speaker 3 (10:52):
That's a great question, and thank you again for the compliment.
You know, the first thing I would say, Henry, is
do you need these medications? That would be the first question.
And you know, those two medications that you mentioned have
been used since I've been in neurology for probably thirty
years together, and there were studies showing that those two
medications together with men that have urinary issues with urinary retention,
(11:19):
poor flow, getting up at night like you are, can
be used together and can be used safely for many years.
So I think that the answer to your bottom line,
to answer to your question is it's relatively safe. Yes. Now,
there can be some side effects, especially with a flomax.
(11:40):
You can get a little dizziness, that's possible. You could
you know it could affect sexual function, although I'm not
so sure at seventy nine you care about how much
you ejaculate because it can affect your ejaculation. But if
you know, and so can proscar which can shrink the prostate.
I guess My question though, is you know do you
really need these medications and what is your issue? You
(12:03):
mentioned that you're getting up at night and you mentioned
urge in continents, which means in a true definition, it
means people that are running to the bathroom urgency and leaking.
Is that your situation?
Speaker 6 (12:14):
Are you?
Speaker 3 (12:15):
Are you leaking urine?
Speaker 5 (12:17):
That is correct, basically urgency, no leakage of urine and
the fact that I get up, in my opinion, a
few times more at night for the for nocturia.
Speaker 3 (12:29):
And is your flow okay? The urine flow.
Speaker 5 (12:33):
Flow is very strong and good in my opinion, thank you,
doctor joh.
Speaker 3 (12:39):
Flow is good. But even before you started the medication,
flow is good?
Speaker 5 (12:42):
Is that right, Sagan?
Speaker 3 (12:45):
Even before you started these Have you started these medications?
Speaker 5 (12:48):
I mean I've been taking them for a number of
weeks now with no change in my uh symptoms, so
to speak. I was told it takes a few weeks
or maybe longer than that to see you. Are you improvement?
Speaker 3 (13:02):
Yeah, well, let me think again. The question is do
you need them? It could be that you just have
what's called an overactive bladder, and in that particular case,
if it's not really from your prostate issue, because you
tell me you have a good flow and maybe you
are emptying the bladder and you just have overactive bladder,
(13:23):
these medications are not going to have to be helpful
for you, frankly. And the pro scar, the one that
you mentioned, which is also called an asteroid, which I've
used again for probably thirty years, is only really beneficial
for patients that have had an ultrasound or an MRI
and showing that the prostate is very large. Have you
had that?
Speaker 5 (13:43):
Yes, I've had. I've had this sonogram the ultrasound for
the prostate recently and it chosen moderately moderate enlargement. That's correct,
moderate enlargement.
Speaker 3 (13:56):
Just an ultrasound, is that right? An abdominal ultrasound, not
a transrectal culture. Have you seen a urologist, Henry, Have
you seen a.
Speaker 5 (14:04):
Urologist not based upon the recommention of my primary care physician.
He's handling my situation at the present time.
Speaker 3 (14:13):
I think you should. I think you should only because
there can be other diagnostic testing that can show that
it's possible that the problem. See, these two medications that
you mentioned are great if the problem is just your prosty,
But if it is more of your bladder, this urgency
that's getting up at night, these medications aren't going to
(14:35):
do much. Now. Look, you just started it. I'm not
telling you to stop it. Maybe continue it for a
little bit, but I would say by the end of
this month, if you're not feeling any better, I would
get into see a urologist in your area. Okay, where
do you live?
Speaker 5 (14:52):
I live in Queen's Lastly, doctor, thank you so much
for the good advice on that one. On my reason
your analysis in the testing of leukocyte est race, it
was a trace amount out of the range. Specifically, what
is the purpose of that test and what does it
(15:12):
indicate that I had a trace amount outside of range.
Speaker 3 (15:15):
It's a good question, and that is a part of
the guidelines to get a test like that. So I'm
glad your doctor did and it shows whether or not
you have a urinary tract infection. So you know, you
have leucocyte which shows that there's white cells in your urine.
White cells is a reaction and inflammatory reaction to bacteria.
So it's possible that you may have a urinary tract infection,
(15:40):
and so you might want to get a urine culture
rather than just a urine analysis at this point. So
maybe you could tell the primary care doctor who can
do that, you know, maybe listening to doctor Katz and
he mentioned that maybe I should have a urine culture
because if you do have a urinary tract infection, then
you might need an antibate and that may be the
(16:02):
end result of your problem. Okay, Now, just to get
back to your original question, are these medications in the
long term safe? My answer is definitive yes. Okay, But
again my question for you is is this the right
medications for you? Is this the right approach for you?
(16:23):
I'm not so sure, and so I would try it
for a little bit longer, and if not, I probably
would recommend. Not probably, I would recommend that you go
into see a urologist in your area and get a
further evaluation of perhaps blodder testing, and see if it's
not a blodder trouble, like an overactive blodder, which would
be a different type of approach. I hope that helps, Henry.
Speaker 5 (16:47):
Certainly, you're very helpful on this question of mine. So
in conclusion, the two medicines that I mentioned, I fines
to Ride and the time solution don't have any specific
long term side effects when they are used simultaneously.
Speaker 3 (17:02):
That is correct. Yes, that is correct. There have been
lots of studies with that combination. That is correct.
Speaker 5 (17:08):
Yes, Okay, continue with your program.
Speaker 3 (17:12):
Thank you so much, doctor, Thank you all right, Thank
you very much, Henry. We'll go back to the phone lines.
If you'd like to give me a call. The number
is eight hundred and three two one zero seven ten
here on Katsas Corner on this rather chilly, but nice.
It's a nice feeling this September. I always feel it's
like it's a new berth almost, you know, like, Okay,
we had a nice summer. Summer is over. Let's move on.
(17:34):
We live in the Northeast and we can appreciate the
change of seasons. And if you walk outside this morning,
as I did, you can appreciate that. Let's go to Tom.
He's up next. Good morning, Tom.
Speaker 6 (17:45):
How are you good morning? I went eighty four years old.
PSA a year ago was two point eight. My question
relates to recently, my brother, who's older, has prostate cancer
which has spread to the bones. And my question is,
(18:07):
besides taking a PSA test next month or so, what
other tests would you suggest that would be necessary or
just stay with the PSA.
Speaker 3 (18:23):
Well, it's a great question. I hope your brother does well.
How old is.
Speaker 6 (18:28):
Your brother eighty nine? Wow?
Speaker 3 (18:31):
God blass, So he's eighty nine. He's got prostate cancer
in the bones, which is consulting. Yes, you know, because
you know you can get as you get older. You know,
our bones do get weaker, our testosterone levels normally go lower.
So let just like with women postman apausal, you can
wind up with osteoporosis, and then if you have weakening
(18:53):
of the bones and cancer in the bones, you're at
risk of a bone fracture or what we call a
skeleton related events. I hope that they're taking care of
his bones, not only with hormones, but also with supplements
and things like that that can strengthen his bones, and
have your brother make sure that he's physically active. To
(19:13):
answer your particular question, my friend, I'm glad to see
that your PSA is two point eight. That is completely
normal within the range. What else can you do? I think,
given your family history being so strong, I would make
sure that the doctor just does a digital exam. You know,
there are situations where prostate cancer can be aggressive, even
(19:35):
in low risk disease. You have a family history. Look,
you are in your eighties, but you sound spry, you
sound great, you sound strong. I would say maybe the
only thing that I particularly would do would probably get
a just feel your prostate, okay, and make sure that
it feels healthy, and if it didn't, I would maybe
(19:57):
consider talking to you about getting an m of your prostate.
But other than that, I wouldn't do anything. I would
probably monitor my PSA. In your case, I would probably
do it probably twice a year, giving your strong family history.
Speaker 6 (20:15):
Okay.
Speaker 3 (20:15):
Is that I'm not saying that you should do anything
else except maybe have a maybe have your internist or
if you're seeing a urologist, to have a digital rectal
exam just to feel your prostate rather than just relying
on your PSA alone.
Speaker 5 (20:29):
Okay.
Speaker 3 (20:30):
But other than that, Tom, I think that's that's all
I would do at this point.
Speaker 6 (20:34):
Okay, I appreciate your help very much.
Speaker 3 (20:39):
I assume I'll assume that you don't have any symptoms.
Is that right? I mean, obviously if you're having more
symptoms that you know, you don't have any pain in
your bones, you don't have any weight loss, you don't
have any you don't have any symptoms other than just
you know, you know, being in your eighties, you know,
which we all can have some you know, life altering
(21:00):
kind of changes. But but you have no other significant symptoms.
Is that a correct assumption.
Speaker 6 (21:05):
I've I exercise six seven days a week, including running
a few miles, plus all the good foods and you know,
things relating to the prostate lycopene so pointleto and you know,
so I do. I do get up at night. But
(21:27):
then again, I you know that I's been for years
and I have no Anyway, I thank you very much
for your help.
Speaker 3 (21:37):
How many miles a day did you say you were running.
Speaker 6 (21:40):
To two and a half miles a day?
Speaker 3 (21:42):
Wow, that's fantastic. Good for you. Okay, well, yeahs have
a wonderful Sunday. If you want come to your come
to the seminar next weekend. And if you heard the announcement,
but either you and perhaps even your brother if you
want to come or or bring your friends love to
see you. Thank you very much and have a wonderful Sunday, Tom.
Thank you.
Speaker 6 (22:00):
Buy now.
Speaker 3 (22:02):
If you're just tuning in, we have just a few
minutes left. But if we are having a prostate cancer
aware in a seminar next week, next Sunday here in Mineola.
If you'd like to attend, it is a free seminar
with breakfast and great lectures. You can give us a
call at five one six six sixty three twenty two
seventy seven, or you can sign up at Men's Health
(22:24):
at Nyulandgune dot org. Terry is on the phone on
the next caller. Good morning, Terry, how are you no?
Speaker 4 (22:32):
Good morning, doctor Katz. Doctor Katz. I'm calling in because
I'm just curious on your thoughts as well as the
American Neurological Society's guidance if any, on prosthetic massage using
the tennis ball technique to promote prostate health and retard
any development of BPH.
Speaker 3 (22:53):
Yeah, there's no guidelines about that at all, Terry. I've
had many patients I don't know about the tennis ball technique.
That's a new one. I haven't heard that one, although
you know, the US Open Men's finals is today. Maybe
in light of that, there's a tennis ball technique. I
don't but I've never never heard of that one. But
(23:13):
I certainly have had patients that they have gone on
to Amazon and they've bought certain types of prostrate massages.
They've gone for prostate massages. Unfortunately, there are no AUA
guidelines about this. There are no studies, well clinically relevant,
validated studies about prostate massage. What do I personally think
(23:39):
about it? You know, there have been some patients in
my practice over the years that have a condition called
chronic aprostatitis that have told me that they've benefited from it.
They've benefited from warm baths, they've benefited from things like
verbal agents that can reduce inflammation and can prostiate massage.
(24:00):
Do that It's possible. I just don't know about doing. Certainly,
there's no you know, there's no teaching, there's no education
about prostate massage. And then you start doing it yourself
or putting a device there, and it's possible that you
could injure yourself. So I don't really typically advise it,
(24:21):
and unfortunately there's no AUA guidelines or a statement policy
about that, so I don't know it is this something
that you've done yourself and have benefited or something you
just read about.
Speaker 4 (24:32):
Or no, yeah, it's something I haven't indulged in. But
I'm just hearing a lot of information about it, and
I'm just curious to hear a professional like yourself, especially
someone in the specific medical area about it. What your
thoughts are on.
Speaker 3 (24:50):
Yeah. No, Now, we've had patients that there are practitioners
that can do, you know, a prostate manipulations and pelvic
therapy pelvic rehabilitation therapy for patients with this tightening of
the pelvic floor muscle that can lead to a chronic
(25:16):
of prostatitis, if you will, And there have been some
studies there not necessarily a prostrate massage, but more of
pelvic therapy, and there are some physical therapists that do that.
So we have had patients that have had gone for
that and have had good results, but not necessarily prostate
(25:38):
massage in and of itself.
Speaker 4 (25:39):
Okay, Terry, sure NFYI I believe that tennis ball technique
is applied towards just as you pointed out improving flexibility
in the pelvic floor.
Speaker 3 (25:53):
Yeah, I think that. You know, I've seen in my
practice many men that have come to me with this prostate,
you know, this chronic pros, the titis, and urologists and
primary care doctors the typical response so give antibiotics. Give
antibiotics that in my opinion, never worked. It really never worked,
and it was always that tightening of the pelvic floor.
(26:14):
So there are some physicians that will do this pelvic physiotherapy,
physical therapy, perhaps this tennis ball technique, which again I
frankly i'm not aware of. I'll have to read about it,
but you know, warm baths, things like that that kind
of relax the pelvic muscles. Certainly stress. I've seen a
(26:38):
lot of young men in their early thirties that are
you know, a lot of stress in their life from
financial stress, their jobs, or marriages, relationships, whatever, and sometimes
it can cause this tightening of the pelvic floor and
can cause these urinary symptoms. But it's not an infection,
and I hope that urologists out there realize that that
it's not an infection. Anyway, Thank you very much. I
(27:00):
we have just about I'm told about thirty seconds left.
I just want to let everyone know again that the
Prostay Cancer Awareness Seminar is next Sunday. Hope to see
you there if you want to sign up, it's five
to one six six six three twenty two seventy seven
or Men's Health at NYU Landguing dot org is the
email and I'm really excited about it. I hope that
(27:21):
we get a great attendance and I hope that you'll
be out there too and come with your questions, your family,
you loved ones and your friends. It's it's always a
great event. Ed Randall from fans, so the Cure will
be there and my colleagues doctor Jonathan Hass and doctor
Anthony Corkran. Well that's the end of the show. We
want to hope you enjoy this beautiful day here. It's
a change of weather, change of sports. Now We've got
(27:44):
football starting which is which is always exciting. We've got
tennis today the men's final, which should be a great
event as well. So tune in every Sunday here on
katsus Corna. We'll be back next week with a great
show and I hope you have all have a great
day this is doctor Aaron Katz.
Speaker 2 (28:06):
You've been listening to Katz's Corner. Come back every week
to hear more straight talk on a wide range of
men's health topics and advice on how to live your
healthiest life.
Speaker 1 (28:17):
The proceeding was a paid podcast. iHeartRadio's hosting of this
podcast constitutes neither an endorsement of the products offered or
the ideas expressed.
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