Episode Transcript
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Speaker 1 (00:00):
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 ten WOOR.
It's the Chairman of Urology at NYU Land Going Hospital,
(00:32):
Long Island. Here is doctor Aaron Katz.
Speaker 3 (00:36):
Well let's get to it. Everyone. Good morning and welcome
again to Kansas Corner here on wr iHeartRadio. So glad
you could join me. We are live here in this
second Sunday of December December eighth, one day after December seventh.
Amazing to me how many of the young people don't
really you know, December seventh, they don't they don't even
(00:58):
know about December seventh. You know, they know it, they
don't really understand it, or it's not on their radar.
I don't know. It's certainly something that we clearly need
to remember in our minds in our hearts on that horrible,
horrific day in our history. We are live. If you
want to give me a Call'd love to hear from you.
(01:20):
Eight hundred three two one zero seven ten. Eight hundred
three two one zero seven ten. And I have some
important news to tell all my listeners this morning, which
is that, unfortunately, I've been doing this or radio show
on a Sunday morning for probably I don't know, I
(01:41):
guess twenty years, and it really took off from me
when I was taking care of the late don Imus,
who actually passed away nearly five years ago, almost to
the day now, and don became and dead to his
wife became very clear friends of mine. I had the
(02:02):
privilege and the honor of taking care of the great
don Imus, who allowed me to flourish on the radio
and also on his TV show. I was on several times,
and it really gave me an additional enthusiasm and inspiration
(02:24):
to bring the latest and greatest, as I say, of
men's health care to the audience here every Sunday, and
I have really enjoyed it. I will continue to do it,
unfortunately not on this particular space, but I'm going to
do what I guess a lot of people are doing
(02:44):
now which are the podcasts on Spotify, So I will
continue to let you know about that on Spotify. I
will have a CATS's Corner page on Spotify. It's not
you don't have to pay for it. If I understand,
it is free. You have to just go into Spotify
and look for Katz's Corner. Unfortunately, it won't be live,
(03:06):
but I will be able to take emails and can
answer your questions, and we'll again try to bring you
all the latest and greatest, probably a few times a
week because it's not going to be a dedicated segment
on a Sunday morning. So yes, sad news for me. Again,
it's been part of my life. People say, how do
(03:28):
you do it? You know, you wake up on a
Sunday morning, but how do you do anything? You know,
it's routine. And I'm kind of a routine guy. And
you know, I've get up, do the show, and then
I go and do exercise, swim, yoga. And I told
my patients and my relatives and my friends there are
three basic things in life to keep you healthy. I
(03:49):
think one is good sleep, the other is a good
healthy diet, and the other is continued exercise multiple times
a week as much as you can. You can never
get as much exercise, I think as possible, especially as
we see in this society the number of people that
(04:10):
have a significant obesity, diabetes, and the explosion of cancer.
And you know, obviously I'm a urologist, I deal with
prostate cancer every day of the week. And you know,
in addition to prostate cancer, we do see a lot
of other cancers, but certainly in men, prostate cancer continues
(04:33):
to be the number one cancer. Do I think it's
diet related? Not all the time, not clearly, not all
the time, but certainly there is no doubt in my
mind that diet can play a role. And even if
you have a prostate cancer, as I've talked about many
times and i've you know, in my career, feel that
(04:55):
in patients that have prostate cancer, that this can be
modified by a diet reducing red meat, reducing fats, reducing
fried foods, eating more of a Mediterranean diet, more fresh
vegetables and fish. So there's my quick thoughts on that. So, unfortunately,
(05:21):
I will be leaving this particular venue at the end
of the month and moving on to Spotify eight hundred
three two one zero seven ten is my number. It
is December eighth, twenty twenty four. We're entering the we're
entering a new year, and I'd love to hear from you,
(05:43):
so give me a call. We have a call on
the line now, so we'll go ahead and take that.
And I believe it is Steve. Good morning, Steve, and
welcome to the show.
Speaker 4 (05:56):
Good morning doctor. It's a pleasure to speak to you.
I'm not quite away yet, but I wanted to talk
to you. I'm glad I was able to get on
before you reach you know, the station. I'll make it
very quick. I am seventy shick may the condition my
it's basically a cut to the chase a limes and
(06:19):
p say been followed by mauologist and he said it's
all within an arranged like three three, play five and
it went down a little up. You know, that's normal,
all right, here's the big thing that went from three
point three six, it went to five three six five.
(06:41):
When I had the five, he said, this is what
I'd like to repeat it. Repeat the PSA and get
an MRI with contrast with that contrast which I did.
The PSA stay the same five. The MRI I, this
is my concern. The MRI I was what they call
the pirates three pirates three two small regions, it said,
(07:04):
one with five and then whatever, the other with millimeters.
Speaker 3 (07:08):
Yeah, yet small, very small.
Speaker 4 (07:12):
Pirate story. He said, you have two options. You can
just wait if you vate six months or whatever. But
if your nervous answers, which I am, you can get
a biopsy. I will throw you to one of our specialists.
He does, you know, target it? But I'm concerned. And
the reason it's simple. I read that some doctor say,
(07:32):
and your biopsy or three four five, and obviously too
many biopsies for pirates three.
Speaker 3 (07:41):
What's your takee Okay, good question, and I appreciate your
phone call. And it it brings up a very timely
issue in elderly not elderly okay, I mean healthly. I'm
gonna change that word. Scratch that. And men that are
a little older okay, seventy six Okay. The question comes
about is there clinical is there concern for actionable or
(08:05):
clinically significant cancer with a Pyrade's three. So then I
would ask you a do you have a family history
of prostate cancer? And you would say.
Speaker 4 (08:17):
Not saying you know, but I don't know.
Speaker 3 (08:21):
You don't know, Okay, fine, you don't know. And then
I would ask B what was the size of the
prostate at the time of the mrity.
Speaker 4 (08:33):
You want me to read it to.
Speaker 3 (08:34):
You, Well, just tell me what the size was. How
many ccs? Forty six forty you're saying.
Speaker 4 (08:39):
Yes, it's his plastic gland site four point five, three
point five, four point eight equal, yeah, forty one long whatever.
Speaker 3 (08:49):
Forty one okay, forty forty ccs. So now you had
a PSA of five, okay, and I you know what
I do is I do calculate what's called the ps density.
So if you take a PSA of five and you
divide it by forty one, okay, you come up with
a number of point one two, So you have a
(09:09):
normal density, okay at seventy six, meaning that your PSA
matches your size, okay if your prostate And yes, that's correct.
So now you have a normal size. You have a
normal PSA density PSA divided by your size point one two.
Anything below point one five is normal. So then the
question is do you need a biopsy? You know, with
(09:31):
a normal PSA density at seventy six years old. I'm
not really so sure on that. Your PSA is not
that high, you have no other risk factors. If you
are anxious about it, my friend, if you say I
cannot sleep, this says really bothering me. I need to
know if I have prostate cancer. Well, then, my friend,
you're going to need to have a biopsy. I would
do a trans perineal biopsy, which is not going through
(09:54):
the rectum, It's going through the skin, which is safer
for you, all right, with less known side effects such
as infection. You might have a little blood in the
urine afterwards.
Speaker 5 (10:05):
Uh, And I.
Speaker 3 (10:06):
Usually do these under a little sedation. Okay, But I
think if you are anxious about it, yeah, I think
the chances of you having cancer is about twenty five
or thirty percent. But even if you did, the likelihood
of you having clinically significant or concerning cancer that you
(10:27):
would need treatment for is probably around ten or fifteen
percent of those. Okay, So not that high, all right.
So even if you had a biopsy, and even if
it did come back cancer, you probably are not going
to do anything about it, as I say, probably, Okay,
So I hope that helps you.
Speaker 4 (10:45):
Steve, and I guess you one last thing got oh.
Speaker 3 (10:49):
Okay, fine, my god ahead if you don't.
Speaker 4 (10:52):
If I don't, because he said, my doctor is one
that downs just like but he said, if you don't
do it, now, what do you do?
Speaker 3 (11:02):
Then you you do active surveillance, which means get a
PSA every six months. The other thing that you could do,
my friend, with a PSA of five, is you could
get another blood test called a four K. Have you
ever heard of that four K?
Speaker 5 (11:14):
Yes?
Speaker 3 (11:14):
I have, So you know, the question is you know,
I'm not so sure to biopsy you or not. You know.
I look, if you were younger, I'd say yes, But
at seventy six, I'm not so sure. So you know,
you could do another test, another blood test called a
four K score. You can do a urinary test called
an exosome DX. You could do that. Either one of
those is fine. I would probably consider a four K
(11:37):
and then it would tell you the likelihood of you
having concerning prostate cancer, and then that could maybe make
you a little bit less anxious to say, eh, you
know what, even if I had prostate cancer, I'm not
going to do anything about it. Four K score is okay,
density is okay. Leave it alone. On the other hand,
if the four K comes back concerning boom, scare yourself
for a biopsy. All right, Steve, thank.
Speaker 4 (11:59):
You, so you're the best. I really appreciate the times. Relaxedly,
I'm gonna go back this week.
Speaker 3 (12:04):
No good, that's what you need to do. Relax So okay,
all right, see, thank you very much. I have a
wonderful Sunday, and I'm glad that I was able to
help you. That's why I love doing this show, frankly,
because I can put patients, you know, anxiety a little
bit away. Okay, not you know, we all live in
a stressful world. I get it, we all have lots
(12:25):
of stress. But you know doctors saying, oh you may
have cancer, you may have a biopsy. You know, really,
what do you really need? And so hopefully I can
help you The numbers eight hundred and three two one
zero seven ten Cats is corner here on what's turning
out to be a rather balmy sunday here in December.
Let's go to a Sean my friend is up next
(12:48):
the good morning, sir, How are you.
Speaker 5 (12:51):
All right? Doctor Katz? And like many people in this audience,
I was introduced to you to the Imish show. Is
that right? And get okay excellent, Get yeah you also
and tremendous with when you have your own show and
you know, but people have to know where you are.
(13:13):
Go through the internet and you will be on Spotify,
you have a podcast. You're going to be successful, just
like you were here.
Speaker 4 (13:21):
And I know some of some of the.
Speaker 5 (13:23):
Older crowd, you know, they're not too familiar with it,
but past somebody maybe younger, somebody knows to help you
out and you can get doctor Kats. Don't want to
miss the show.
Speaker 4 (13:33):
Uh, good point.
Speaker 5 (13:35):
I just want to say it is the most important. Yeah, sure,
you're great. The first I want to say something. It
was December seventh, was Saturday, but it was actually December
seventh on a Sunday morning when Pearl Lava was bombed.
And we will never forget those American boys, the ones
obviously died in their sleep, the ones with the tapping
(13:56):
on the on the ships who were trapped below and
they couldn't get out. Some of them did get out
and the tap and went on and the boys perished
inside unfortunately, and the people who survived it and helped
you guys will never get December seven, will never be forgotten.
And the thing is, I want to emphasize something because
(14:17):
I've listened to your show. I still think that the
PSA is the bell weather for men. I think anybody
trying to sure change that is ridiculous. It's such an
easy test for a guy to take. It's I've had
it done plenty of times, only a blood sample and
they tested out for you. And that's the beginning of
(14:39):
the process. But listen, let's face the fact. Let's be honest,
bruly honest here, most men the first physical they take
is an autopsy. The women are better at it than
we all. When it comes to the health improven fact, it's.
Speaker 3 (14:53):
A proven fact, that's true. And you know, listen, I
appreciate your words about myself and per Harbor. Of course.
Do you have this particular question this morning, my friend.
Speaker 5 (15:04):
Oh yes, I did. I did. The thing is like
the other call, there was a little worried about this
and that couldn't somebody get the PSA. Wouldn't also an
MRI of the p s A. I mean, you know,
the insurance companies we know has been in the in
the you know, out in the publicity the last few
days and everything an MRI of the prostate. Wouldn't that
(15:28):
be a great advantage for you and everybody else to
look at it and see what's going on there. It's
such a great ability to see what's going on.
Speaker 3 (15:39):
You're you're absolutely right. The question is, as you point out,
the insurance companies are and who is going to pay
for all of that, And they are starting some programs
like that even without a p s A in England,
believe it or not. But in this country, I mean,
if you think about the cost of it, you know,
(16:02):
I don't know if it's going to really be able
to fly. You know, let's say everybody at the age
of fifty gets an MRI or something like that. We'll
forget about the PSA. Just look at the MRI.
Speaker 5 (16:11):
Right.
Speaker 3 (16:13):
But at this point in time, your points are very
well taken. The MRI has completely changed the landscape of
how we are detecting prostate cancer. I mean, I can't
tell you. I had a patient this week at a
PSA of one point two and it went up from
one point it was zero point nine, went to one
point two and the doctor said, you maybe should get
(16:34):
an MRI, and he had significant prostate cancer with grade
group three Gleason score seven and I was like, wow,
I mean that's you know, you know what it was.
It was they were doing a test just like what
you're saying. They were doing at another hospital. They were
doing a program just greening with MRI. And he says,
(16:54):
you know, my PSA was one point two and I
got this MRI and it turned out to be as
a call us at a pirade's five and he had
significant cancer on MRI. Wow, you know, and these are
the people that we could save their lives by detecting
this cancer early. So you're you know, it's really a
(17:15):
great discussion and a great debate, and I think it
comes about to who's gonna pay for it and cover it?
And you know a lot of times you could do
these MRIs without contrasts because people say, oh, you know,
you're gonna give all these people contrasts, it's gonna affect
their kidneys, which the studies have shown that that really
is not the case. But so I think time will tell,
my friend. But I do appreciate showing all of your
(17:38):
points and questions, and thanks for calling this morning. I
appreciate it. Thank you, you got it. Thank you, my friend,
have a great day. Next up is doctor Bob from
Long Island. You're listening to CATS's Corner here, and if
you're just turning in a little bit late, I did
let the listeners know that unfortunately my time here on
WOR will be ending at the end of this month,
(18:00):
and Kats's Corner will still be alive, but we'll be
moving to Spotify and you can find me there and
track me down there. It's going to be new for you,
it's going to be new for me. I really have
never done a podcast before. I've only done this radio show.
So we'll we'll manage together and continue to be great friends.
Doctor Bob, You're up next from Long Island. How are you.
Speaker 6 (18:22):
I'm doctor Kats. Yeah, it's a very sweet morning hearing
the news where you will still be active podcasts. Get
into the word out. I followed you from the earliest
days when you were at Columbia and then to Long Island.
And yes, yes, competing, I'm in an alternate field, a
(18:44):
cardiothoracic and vascular surgery at a competing system is really
it's been very enlightening and you've been such an exceptional
physician and human being. I just want to compliment you well,
thank you how personally with six of my friends, or
by offering the program that you have the exceptional program
(19:05):
at NYU langone, and just wants you to thank you
for that and for all the information you're impart to
all of us in the audience and really you are
really a pinnacle of information and will remain so, I'm
sure in the future. I did meet you at one
of the seminars and I was so glad about that,
(19:25):
and I just want to wish you well in the
future endeavors and unfortunately things change.
Speaker 3 (19:33):
We do right exactly well, you know, it's it's something
that and I can't say how much I appreciate you're
calling me and telling me these words. You know, I
get up, I do the show, and you don't realize,
you know, in you as as a heart surgeon, I mean,
you know, there are certain people in medicine that I've
always had the highest respect for, and it was neurosurgeon
(19:55):
and cardiac surgeon, and you know, as as a general
surgery resident, because you know, in urology, I had to
do two years of general surgery and then four years
of urology and you see the work that the cardiac
surgeons do in and out every day and people say
to me, oh, you know, doctor catch, you saved my life.
You know, you know, maybe, but you know, with car
(20:16):
heart surgery, there's no doubt you're saving people's lives when
you bring them onto that operating room table and opening
up their chest and putting their heart on bypass.
Speaker 5 (20:25):
You know.
Speaker 3 (20:25):
Interestingly, Doc, we had a patient this week who had
a kidney tumor that went up into the cava, into
the into the renal vein, into the IV see infrayor
vena cava and up into the right atrium of the
heart and into the right ventricle, which I've never heard of.
Patient had to be yes, yes, And the patient was
(20:47):
put on circulatory arrest, cardiac arrest, and the kidney tumor
and and the tumor that was going up into the
heart was all removed. It all came out in one
long tumor threat and the patient has done extraordinarily well.
But again the point being that I have the utmost
respect for you and people in your field because I see,
(21:12):
you know, as a physician, as a surgeon, you know,
you get to see what other doctors are doing, and
you know, the vascular surgeons, cardiovascular neurosurgeons who are here
day and night and coming in at all hours of
the night.
Speaker 6 (21:26):
Irrespects you to say, but we're so lucky that we
live in this area where we have all this tertiary
and quaternary care available around the corner from all of us.
Speaker 3 (21:35):
That's true.
Speaker 6 (21:36):
I think we site of that sometimes, how expertises in
the immediate area.
Speaker 3 (21:41):
That's true. Yeah, we are fortunate. I mean we're not
in you know, some in Idaho or somewhere in Wyoming
or somewhere out and you know, the Midwest or some
certain parts of the South and even in the Northwest.
And yeah, you're absolutely right, Doc, So I probably.
Speaker 6 (21:59):
Will come in to see you when my friend who's
finishing up is he's actually finished. They care for his
prostate cancer, Doctor Carpenter and your group, who is an
exceptional group. So I want to just wish you the
best and keep up the great work that you're doing.
Speaker 3 (22:18):
Thank you very much, Doc. I will and you yourself
and have wonderful holidays as well, and thank you for
your words. And yes, doctor Carpenter and doctor Jonathan Hass
who runs the program here at NYU Land going on
long Island. You know, I tell you know, I've been
out here is chair now in February. I came here
(22:38):
in February of twenty and twelve, continued on with the
radio show I was. Prior to that, I was at
Columbia University for I guess about twenty years and then
came here as chair, which was then at the time
Winthrop University Hospital. And then you know, over the last
few years, NYU has taken over here and now is
(23:01):
expanding further out east, and my responsibilities will be not
only to run the program here in Minneola, but also
to run the program in patchob very exciting for people
that live on the eastern part of Long Island. NYU
is going to have all of their physicians out there.
The hospital, we believe in March will be fully merged
(23:24):
with NYU and I will be in charge of the
Eurology department. I will actually have go out there and
see patients there. We bring all of our treatments there.
We're hiring new robotic surgeons there and a new complement
of physicians that will follow all of the NYU quality
metrics that we are so proud of here at NYU.
(23:48):
In Minneola, which is now and in terms of hospitals,
the number one hospital in New York and number two
in the country. Phenomenal of what NYU really has done.
And I'm super proud of being part of the NYU team.
And can I know that it will only continue to
(24:09):
grow and to expand. If you want to give me
a call, the number is eight hundred three two one
zero seven ten. That number again is eight hundred three
two one zero is seven ten. And we continue to
see lots of patients that are interested in, you know,
ways of improving their overall health. And certainly testosterone is
(24:34):
something that men are concerned about their levels. If they're
feeling low on energy, they don't feel the pep, or
they're not performing well sexually, they have less energy or
drive to have sex, they are not performing as well.
We do testosterone levels on them, and sometimes not all
the time. The testosteron level is less than three hundred
(24:57):
if you are thinking about getting a testosterol level, which
has been shown and I was just talking to a
cardiac surgeon a dear friend here, that it has been
shown that men that have lower testosterone levels are at
an increased risk of having some heart issues in the future,
as well as bone issues, as well as memory issues,
(25:19):
cognitive function. There's a whole host of reasons that men
should get a testosterone level. Please get the level in
the morning, that's where it's most valuable. And if your
level is under three hundred, you may be a candidate.
You may be a candidate, not an absolute, but you
may be a candidate for a testosterone replacement. We have
to do some blood tests. We check your what's called
(25:42):
your hemoglobin level, because when you take testosterone, your hemoglobin
will go up, so you want to be careful for that.
We want to check your PSA level because if there
is an underlying abnormality with the PSA that has to
be managed first to make sure that you don't have
prostate cancer. And I will I'll tell you that just
because you do. If you are having prostate cancer, or
(26:03):
being treated for prostate cancer, or have low risk prostate cancer,
you still can get you know, this is the way
that the myths that happen in medicine, where it used
to be oh no, you can't get testosterone if you
have prosta cant that's not true anymore. You can. It
has to be managed closely it has to be managed
appropriately with a urologist. But there are many, many times
(26:25):
where I have given testosterone back to patients who are
on active surveillance, who have had radiation, who have had surgery,
and it is fine. It is fine, and a lot
of the studies support this. So there are different ways
of doing it. There are gels, there are injections, there's
nasal sprays. What's best. I don't know what's best. I
(26:48):
think that overall, the injections are probably going to give
you the best level. I use very commonly in my practice.
If you want to look it up, it's called a
vid A v EED even once injection every ten weeks.
It is covered by insurance, and it can get your
levels up to the normal levels of five six hundred.
(27:12):
It's not going to raise your level up into the thousands. Again,
you'd have to monitor your PSA and your blood counts.
I guess that's the end of the show. I didn't
realize it. A wow, Well, okay, everyone, have a wonderful Sunday.
I'll be back here next week. And well, unfortunately this
will be the last month for Cats on Kats's Corner,
but we're moving to Spotify, so I'll tell you more
(27:34):
about that. Listen. Have a great day everyone. Thanks so
much for all your kind words.
Speaker 2 (27:38):
You've been listening to Katzer'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 (27:48):
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 ten WOOR.
It's the Chairman of Urology at NYU Land Going Hospital,
(00:32):
Long Island. Here is doctor Aaron Katz.
Speaker 3 (00:36):
Well let's get to it. Everyone. Good morning and welcome
again to Kansas Corner here on wr iHeartRadio. So glad
you could join me. We are live here in this
second Sunday of December December eighth, one day after December seventh.
Amazing to me how many of the young people don't
really you know, December seventh, they don't they don't even
(00:58):
know about December seventh. You know, they know it, they
don't really understand it, or it's not on their radar.
I don't know. It's certainly something that we clearly need
to remember in our minds in our hearts on that horrible,
horrific day in our history. We are live. If you
want to give me a Call'd love to hear from you.
(01:20):
Eight hundred three two one zero seven ten. Eight hundred
three two one zero seven ten. And I have some
important news to tell all my listeners this morning, which
is that, unfortunately, I've been doing this or radio show
on a Sunday morning for probably I don't know, I
(01:41):
guess twenty years, and it really took off from me
when I was taking care of the late don Imus,
who actually passed away nearly five years ago, almost to
the day now, and don became and dead to his
wife became very clear friends of mine. I had the
(02:02):
privilege and the honor of taking care of the great
don Imus, who allowed me to flourish on the radio
and also on his TV show. I was on several times,
and it really gave me an additional enthusiasm and inspiration
(02:24):
to bring the latest and greatest, as I say, of
men's health care to the audience here every Sunday, and
I have really enjoyed it. I will continue to do it,
unfortunately not on this particular space, but I'm going to
do what I guess a lot of people are doing
(02:44):
now which are the podcasts on Spotify, So I will
continue to let you know about that on Spotify. I
will have a CATS's Corner page on Spotify. It's not
you don't have to pay for it. If I understand,
it is free. You have to just go into Spotify
and look for Katz's Corner. Unfortunately, it won't be live,
(03:06):
but I will be able to take emails and can
answer your questions, and we'll again try to bring you
all the latest and greatest, probably a few times a
week because it's not going to be a dedicated segment
on a Sunday morning. So yes, sad news for me. Again,
it's been part of my life. People say, how do
(03:28):
you do it? You know, you wake up on a
Sunday morning, but how do you do anything? You know,
it's routine. And I'm kind of a routine guy. And
you know, I've get up, do the show, and then
I go and do exercise, swim, yoga. And I told
my patients and my relatives and my friends there are
three basic things in life to keep you healthy. I
(03:49):
think one is good sleep, the other is a good
healthy diet, and the other is continued exercise multiple times
a week as much as you can. You can never
get as much exercise, I think as possible, especially as
we see in this society the number of people that
(04:10):
have a significant obesity, diabetes, and the explosion of cancer.
And you know, obviously I'm a urologist, I deal with
prostate cancer every day of the week. And you know,
in addition to prostate cancer, we do see a lot
of other cancers, but certainly in men, prostate cancer continues
(04:33):
to be the number one cancer. Do I think it's
diet related? Not all the time, not clearly, not all
the time, but certainly there is no doubt in my
mind that diet can play a role. And even if
you have a prostate cancer, as I've talked about many
times and i've you know, in my career, feel that
(04:55):
in patients that have prostate cancer, that this can be
modified by a diet reducing red meat, reducing fats, reducing
fried foods, eating more of a Mediterranean diet, more fresh
vegetables and fish. So there's my quick thoughts on that. So, unfortunately,
(05:21):
I will be leaving this particular venue at the end
of the month and moving on to Spotify eight hundred
three two one zero seven ten is my number. It
is December eighth, twenty twenty four. We're entering the we're
entering a new year, and I'd love to hear from you,
(05:43):
so give me a call. We have a call on
the line now, so we'll go ahead and take that.
And I believe it is Steve. Good morning, Steve, and
welcome to the show.
Speaker 4 (05:56):
Good morning doctor. It's a pleasure to speak to you.
I'm not quite away yet, but I wanted to talk
to you. I'm glad I was able to get on
before you reach you know, the station. I'll make it
very quick. I am seventy shick may the condition my
it's basically a cut to the chase a limes and
(06:19):
p say been followed by mauologist and he said it's
all within an arranged like three three, play five and
it went down a little up. You know, that's normal,
all right, here's the big thing that went from three
point three six, it went to five three six five.
(06:41):
When I had the five, he said, this is what
I'd like to repeat it. Repeat the PSA and get
an MRI with contrast with that contrast which I did.
The PSA stay the same five. The MRI I, this
is my concern. The MRI I was what they call
the pirates three pirates three two small regions, it said,
(07:04):
one with five and then whatever, the other with millimeters.
Speaker 3 (07:08):
Yeah, yet small, very small.
Speaker 4 (07:12):
Pirate story. He said, you have two options. You can
just wait if you vate six months or whatever. But
if your nervous answers, which I am, you can get
a biopsy. I will throw you to one of our specialists.
He does, you know, target it? But I'm concerned. And
the reason it's simple. I read that some doctor say,
(07:32):
and your biopsy or three four five, and obviously too
many biopsies for pirates three.
Speaker 3 (07:41):
What's your takee Okay, good question, and I appreciate your
phone call. And it it brings up a very timely
issue in elderly not elderly okay, I mean healthly. I'm
gonna change that word. Scratch that. And men that are
a little older okay, seventy six Okay. The question comes
about is there clinical is there concern for actionable or
(08:05):
clinically significant cancer with a Pyrade's three. So then I
would ask you a do you have a family history
of prostate cancer? And you would say.
Speaker 4 (08:17):
Not saying you know, but I don't know.
Speaker 3 (08:21):
You don't know, Okay, fine, you don't know. And then
I would ask B what was the size of the
prostate at the time of the mrity.
Speaker 4 (08:33):
You want me to read it to.
Speaker 3 (08:34):
You, Well, just tell me what the size was. How
many ccs? Forty six forty you're saying.
Speaker 4 (08:39):
Yes, it's his plastic gland site four point five, three
point five, four point eight equal, yeah, forty one long whatever.
Speaker 3 (08:49):
Forty one okay, forty forty ccs. So now you had
a PSA of five, okay, and I you know what
I do is I do calculate what's called the ps density.
So if you take a PSA of five and you
divide it by forty one, okay, you come up with
a number of point one two, So you have a
(09:09):
normal density, okay at seventy six, meaning that your PSA
matches your size, okay if your prostate And yes, that's correct.
So now you have a normal size. You have a
normal PSA density PSA divided by your size point one two.
Anything below point one five is normal. So then the
question is do you need a biopsy? You know, with
(09:31):
a normal PSA density at seventy six years old. I'm
not really so sure on that. Your PSA is not
that high, you have no other risk factors. If you
are anxious about it, my friend, if you say I
cannot sleep, this says really bothering me. I need to
know if I have prostate cancer. Well, then, my friend,
you're going to need to have a biopsy. I would
do a trans perineal biopsy, which is not going through
(09:54):
the rectum, It's going through the skin, which is safer
for you, all right, with less known side effects such
as infection. You might have a little blood in the
urine afterwards.
Speaker 5 (10:05):
Uh, And I.
Speaker 3 (10:06):
Usually do these under a little sedation. Okay, But I
think if you are anxious about it, yeah, I think
the chances of you having cancer is about twenty five
or thirty percent. But even if you did, the likelihood
of you having clinically significant or concerning cancer that you
(10:27):
would need treatment for is probably around ten or fifteen
percent of those. Okay, So not that high, all right.
So even if you had a biopsy, and even if
it did come back cancer, you probably are not going
to do anything about it, as I say, probably, Okay,
So I hope that helps you.
Speaker 4 (10:45):
Steve, and I guess you one last thing got oh.
Speaker 3 (10:49):
Okay, fine, my god ahead if you don't.
Speaker 4 (10:52):
If I don't, because he said, my doctor is one
that downs just like but he said, if you don't
do it, now, what do you do?
Speaker 3 (11:02):
Then you you do active surveillance, which means get a
PSA every six months. The other thing that you could do,
my friend, with a PSA of five, is you could
get another blood test called a four K. Have you
ever heard of that four K?
Speaker 5 (11:14):
Yes?
Speaker 3 (11:14):
I have, So you know, the question is you know,
I'm not so sure to biopsy you or not. You know.
I look, if you were younger, I'd say yes, But
at seventy six, I'm not so sure. So you know,
you could do another test, another blood test called a
four K score. You can do a urinary test called
an exosome DX. You could do that. Either one of
those is fine. I would probably consider a four K
(11:37):
and then it would tell you the likelihood of you
having concerning prostate cancer, and then that could maybe make
you a little bit less anxious to say, eh, you
know what, even if I had prostate cancer, I'm not
going to do anything about it. Four K score is okay,
density is okay. Leave it alone. On the other hand,
if the four K comes back concerning boom, scare yourself
for a biopsy. All right, Steve, thank.
Speaker 4 (11:59):
You, so you're the best. I really appreciate the times. Relaxedly,
I'm gonna go back this week.
Speaker 3 (12:04):
No good, that's what you need to do. Relax So okay,
all right, see, thank you very much. I have a
wonderful Sunday, and I'm glad that I was able to
help you. That's why I love doing this show, frankly,
because I can put patients, you know, anxiety a little
bit away. Okay, not you know, we all live in
a stressful world. I get it, we all have lots
(12:25):
of stress. But you know doctors saying, oh you may
have cancer, you may have a biopsy. You know, really,
what do you really need? And so hopefully I can
help you The numbers eight hundred and three two one
zero seven ten Cats is corner here on what's turning
out to be a rather balmy sunday here in December.
Let's go to a Sean my friend is up next
(12:48):
the good morning, sir, How are you.
Speaker 5 (12:51):
All right? Doctor Katz? And like many people in this audience,
I was introduced to you to the Imish show. Is
that right? And get okay excellent, Get yeah you also
and tremendous with when you have your own show and
you know, but people have to know where you are.
(13:13):
Go through the internet and you will be on Spotify,
you have a podcast. You're going to be successful, just
like you were here.
Speaker 4 (13:21):
And I know some of some of the.
Speaker 5 (13:23):
Older crowd, you know, they're not too familiar with it,
but past somebody maybe younger, somebody knows to help you
out and you can get doctor Kats. Don't want to
miss the show.
Speaker 4 (13:33):
Uh, good point.
Speaker 5 (13:35):
I just want to say it is the most important. Yeah, sure,
you're great. The first I want to say something. It
was December seventh, was Saturday, but it was actually December
seventh on a Sunday morning when Pearl Lava was bombed.
And we will never forget those American boys, the ones
obviously died in their sleep, the ones with the tapping
(13:56):
on the on the ships who were trapped below and
they couldn't get out. Some of them did get out
and the tap and went on and the boys perished
inside unfortunately, and the people who survived it and helped
you guys will never get December seven, will never be forgotten.
And the thing is, I want to emphasize something because
(14:17):
I've listened to your show. I still think that the
PSA is the bell weather for men. I think anybody
trying to sure change that is ridiculous. It's such an
easy test for a guy to take. It's I've had
it done plenty of times, only a blood sample and
they tested out for you. And that's the beginning of
(14:39):
the process. But listen, let's face the fact. Let's be honest,
bruly honest here, most men the first physical they take
is an autopsy. The women are better at it than
we all. When it comes to the health improven fact, it's.
Speaker 3 (14:53):
A proven fact, that's true. And you know, listen, I
appreciate your words about myself and per Harbor. Of course.
Do you have this particular question this morning, my friend.
Speaker 5 (15:04):
Oh yes, I did. I did. The thing is like
the other call, there was a little worried about this
and that couldn't somebody get the PSA. Wouldn't also an
MRI of the p s A. I mean, you know,
the insurance companies we know has been in the in
the you know, out in the publicity the last few
days and everything an MRI of the prostate. Wouldn't that
(15:28):
be a great advantage for you and everybody else to
look at it and see what's going on there. It's
such a great ability to see what's going on.
Speaker 3 (15:39):
You're you're absolutely right. The question is, as you point out,
the insurance companies are and who is going to pay
for all of that, And they are starting some programs
like that even without a p s A in England,
believe it or not. But in this country, I mean,
if you think about the cost of it, you know,
(16:02):
I don't know if it's going to really be able
to fly. You know, let's say everybody at the age
of fifty gets an MRI or something like that. We'll
forget about the PSA. Just look at the MRI.
Speaker 5 (16:11):
Right.
Speaker 3 (16:13):
But at this point in time, your points are very
well taken. The MRI has completely changed the landscape of
how we are detecting prostate cancer. I mean, I can't
tell you. I had a patient this week at a
PSA of one point two and it went up from
one point it was zero point nine, went to one
point two and the doctor said, you maybe should get
(16:34):
an MRI, and he had significant prostate cancer with grade
group three Gleason score seven and I was like, wow,
I mean that's you know, you know what it was.
It was they were doing a test just like what
you're saying. They were doing at another hospital. They were
doing a program just greening with MRI. And he says,
(16:54):
you know, my PSA was one point two and I
got this MRI and it turned out to be as
a call us at a pirade's five and he had
significant cancer on MRI. Wow, you know, and these are
the people that we could save their lives by detecting
this cancer early. So you're you know, it's really a
(17:15):
great discussion and a great debate, and I think it
comes about to who's gonna pay for it and cover it?
And you know a lot of times you could do
these MRIs without contrasts because people say, oh, you know,
you're gonna give all these people contrasts, it's gonna affect
their kidneys, which the studies have shown that that really
is not the case. But so I think time will tell,
my friend. But I do appreciate showing all of your
(17:38):
points and questions, and thanks for calling this morning. I
appreciate it. Thank you, you got it. Thank you, my friend,
have a great day. Next up is doctor Bob from
Long Island. You're listening to CATS's Corner here, and if
you're just turning in a little bit late, I did
let the listeners know that unfortunately my time here on
WOR will be ending at the end of this month,
(18:00):
and Kats's Corner will still be alive, but we'll be
moving to Spotify and you can find me there and
track me down there. It's going to be new for you,
it's going to be new for me. I really have
never done a podcast before. I've only done this radio show.
So we'll we'll manage together and continue to be great friends.
Doctor Bob, You're up next from Long Island. How are you.
Speaker 6 (18:22):
I'm doctor Kats. Yeah, it's a very sweet morning hearing
the news where you will still be active podcasts. Get
into the word out. I followed you from the earliest
days when you were at Columbia and then to Long Island.
And yes, yes, competing, I'm in an alternate field, a
(18:44):
cardiothoracic and vascular surgery at a competing system is really
it's been very enlightening and you've been such an exceptional
physician and human being. I just want to compliment you well,
thank you how personally with six of my friends, or
by offering the program that you have the exceptional program
(19:05):
at NYU langone, and just wants you to thank you
for that and for all the information you're impart to
all of us in the audience and really you are
really a pinnacle of information and will remain so, I'm
sure in the future. I did meet you at one
of the seminars and I was so glad about that,
(19:25):
and I just want to wish you well in the
future endeavors and unfortunately things change.
Speaker 3 (19:33):
We do right exactly well, you know, it's it's something
that and I can't say how much I appreciate you're
calling me and telling me these words. You know, I
get up, I do the show, and you don't realize,
you know, in you as as a heart surgeon, I mean,
you know, there are certain people in medicine that I've
always had the highest respect for, and it was neurosurgeon
(19:55):
and cardiac surgeon, and you know, as as a general
surgery resident, because you know, in urology, I had to
do two years of general surgery and then four years
of urology and you see the work that the cardiac
surgeons do in and out every day and people say
to me, oh, you know, doctor catch, you saved my life.
You know, you know, maybe, but you know, with car
(20:16):
heart surgery, there's no doubt you're saving people's lives when
you bring them onto that operating room table and opening
up their chest and putting their heart on bypass.
Speaker 5 (20:25):
You know.
Speaker 3 (20:25):
Interestingly, Doc, we had a patient this week who had
a kidney tumor that went up into the cava, into
the into the renal vein, into the IV see infrayor
vena cava and up into the right atrium of the
heart and into the right ventricle, which I've never heard of.
Patient had to be yes, yes, And the patient was
(20:47):
put on circulatory arrest, cardiac arrest, and the kidney tumor
and and the tumor that was going up into the
heart was all removed. It all came out in one
long tumor threat and the patient has done extraordinarily well.
But again the point being that I have the utmost
respect for you and people in your field because I see,
(21:12):
you know, as a physician, as a surgeon, you know,
you get to see what other doctors are doing, and
you know, the vascular surgeons, cardiovascular neurosurgeons who are here
day and night and coming in at all hours of
the night.
Speaker 6 (21:26):
Irrespects you to say, but we're so lucky that we
live in this area where we have all this tertiary
and quaternary care available around the corner from all of us.
Speaker 3 (21:35):
That's true.
Speaker 6 (21:36):
I think we site of that sometimes, how expertises in
the immediate area.
Speaker 3 (21:41):
That's true. Yeah, we are fortunate. I mean we're not
in you know, some in Idaho or somewhere in Wyoming
or somewhere out and you know, the Midwest or some
certain parts of the South and even in the Northwest.
And yeah, you're absolutely right, Doc, So I probably.
Speaker 6 (21:59):
Will come in to see you when my friend who's
finishing up is he's actually finished. They care for his
prostate cancer, Doctor Carpenter and your group, who is an
exceptional group. So I want to just wish you the
best and keep up the great work that you're doing.
Speaker 3 (22:18):
Thank you very much, Doc. I will and you yourself
and have wonderful holidays as well, and thank you for
your words. And yes, doctor Carpenter and doctor Jonathan Hass
who runs the program here at NYU Land going on
long Island. You know, I tell you know, I've been
out here is chair now in February. I came here
(22:38):
in February of twenty and twelve, continued on with the
radio show I was. Prior to that, I was at
Columbia University for I guess about twenty years and then
came here as chair, which was then at the time
Winthrop University Hospital. And then you know, over the last
few years, NYU has taken over here and now is
(23:01):
expanding further out east, and my responsibilities will be not
only to run the program here in Minneola, but also
to run the program in patchob very exciting for people
that live on the eastern part of Long Island. NYU
is going to have all of their physicians out there.
The hospital, we believe in March will be fully merged
(23:24):
with NYU and I will be in charge of the
Eurology department. I will actually have go out there and
see patients there. We bring all of our treatments there.
We're hiring new robotic surgeons there and a new complement
of physicians that will follow all of the NYU quality
metrics that we are so proud of here at NYU.
(23:48):
In Minneola, which is now and in terms of hospitals,
the number one hospital in New York and number two
in the country. Phenomenal of what NYU really has done.
And I'm super proud of being part of the NYU team.
And can I know that it will only continue to
(24:09):
grow and to expand. If you want to give me
a call, the number is eight hundred three two one
zero seven ten. That number again is eight hundred three
two one zero is seven ten. And we continue to
see lots of patients that are interested in, you know,
ways of improving their overall health. And certainly testosterone is
(24:34):
something that men are concerned about their levels. If they're
feeling low on energy, they don't feel the pep, or
they're not performing well sexually, they have less energy or
drive to have sex, they are not performing as well.
We do testosterone levels on them, and sometimes not all
the time. The testosteron level is less than three hundred
(24:57):
if you are thinking about getting a testosterol level, which
has been shown and I was just talking to a
cardiac surgeon a dear friend here, that it has been
shown that men that have lower testosterone levels are at
an increased risk of having some heart issues in the future,
as well as bone issues, as well as memory issues,
(25:19):
cognitive function. There's a whole host of reasons that men
should get a testosterone level. Please get the level in
the morning, that's where it's most valuable. And if your
level is under three hundred, you may be a candidate.
You may be a candidate, not an absolute, but you
may be a candidate for a testosterone replacement. We have
to do some blood tests. We check your what's called
(25:42):
your hemoglobin level, because when you take testosterone, your hemoglobin
will go up, so you want to be careful for that.
We want to check your PSA level because if there
is an underlying abnormality with the PSA that has to
be managed first to make sure that you don't have
prostate cancer. And I will I'll tell you that just
because you do. If you are having prostate cancer, or
(26:03):
being treated for prostate cancer, or have low risk prostate cancer,
you still can get you know, this is the way
that the myths that happen in medicine, where it used
to be oh no, you can't get testosterone if you
have prosta cant that's not true anymore. You can. It
has to be managed closely it has to be managed
appropriately with a urologist. But there are many, many times
(26:25):
where I have given testosterone back to patients who are
on active surveillance, who have had radiation, who have had surgery,
and it is fine. It is fine, and a lot
of the studies support this. So there are different ways
of doing it. There are gels, there are injections, there's
nasal sprays. What's best. I don't know what's best. I
(26:48):
think that overall, the injections are probably going to give
you the best level. I use very commonly in my practice.
If you want to look it up, it's called a
vid A v EED even once injection every ten weeks.
It is covered by insurance, and it can get your
levels up to the normal levels of five six hundred.
(27:12):
It's not going to raise your level up into the thousands. Again,
you'd have to monitor your PSA and your blood counts.
I guess that's the end of the show. I didn't
realize it. A wow, Well, okay, everyone, have a wonderful Sunday.
I'll be back here next week. And well, unfortunately this
will be the last month for Cats on Kats's Corner,
but we're moving to Spotify, so I'll tell you more
(27:34):
about that. Listen. Have a great day everyone. Thanks so
much for all your kind words.
Speaker 2 (27:38):
You've been listening to Katzer'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 (27:48):
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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