June 25, 2025 • 41 mins
Urologic Oncologist, Dr. Yaw Nyame, joins us to discuss the critical yet often overlooked aspects of men's urologic health. We explore how modern detection methods can identify problems before symptoms appear, potentially saving lives through early intervention.
• Urologic health involves the entire urinary system plus male sexual organs
• Prostate cancer affects 1 in 8 men overall, but 1 in 6 Black men
• Black men are 60% more likely to get prostate cancer and twice as likely to die from it
• Waiting for symptoms before seeking care is often "waiting until it's too late"
• Early relationship-building with primary care physicians supports better lifelong health
• Testosterone replacement therapy carries significant risks and isn't appropriate for most men
• Cancer screening can often detect issues before symptoms develop
• Patient-partnered research helps create interventions that better serve community needs
• Simple practices like testicular self-examination should begin in your 20s
Talk to your family about cancer history, establish a medical home early in life, and don't wait for pain before seeking healthcare. Prevention is always better than treatment.
Bad Science: Changes in politics and ideology do not change our need to be vigilant.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Grantley Martelly (00:11):
This is the Re al Health Black Men podcast,
where we empower men to takecontrol of their health.
We provide vital informationand build community support.
Join us as we discusseverything from major health
challenges to mental wellness tophysical fitness.
So if you're ready to level upyour health and your life,
you're in the right place.
(00:31):
Let's get started.
Welcome to another episode ofReal Health Black Men.
Thank you for listening.
Today, my guest is a friend, Dr.
(00:52):
Yaw Nyame.
He is a part of the Universityof Washington School of Medicine
and the Fred Hutch CancerCenter.
According to the stuff I readabout you, it says that you are
a surgeon, a researcher,educator, a patient advocate.
So we're going to talk aboutall of those things there.
(01:12):
But instead of me trying todefine you or what other people
define you by in the writings,maybe we'll begin by letting you
introduce yourself, telling uswho you are, where you're from.
Dr. Yaw Nyame (01:23):
Sure, I was worried you were about to read
that really long bio.
You know our academic bios arealways awkward.
I feel like we probably couldborrow from other industries
where the bios sound less stiff.
But let's see, how would Idescribe myself?
So I would describe myselffirst as Ghanaian American.
I'm really proud to identify asboth.
(01:48):
I grew up in the great state ofOklahoma Great sometimes, not so
great, others Great right now,because the thunder are rolling.
And let's see, I went toundergrad at Duke University, so
that's my alma mater.
And then I went to graduateschool, both in DC and in
(02:09):
Chicago.
So Northwestern is where I didmy training for medical school
and business school.
How our training works, right,but I I was like a medical
student, so I was paying moneyto become a doctor in chicago,
at northwestern, and then yougraduate, but then you're still
(02:32):
learning and training, but thatat least you're getting paid.
Then it's a small salary butyou're officially a doctor and
that's residency.
And I did that at cleveland.
And then, after six short yearsof training, just the brief
six-year period of being anapprentice I came out here to
(02:52):
Seattle and did more training,actually two more years, and
then stayed, but finally I gotmy first quote-unquote real job
where I practice urology.
I take care of patients whohave urologic problems.
My extra two years of trainingwas basically to become a cancer
specialist, so, um, that's whatI do.
(03:14):
I take care of cancer patients,um, that have cancers that are
specific to your urologic organs, if you will.
So urology takes care ofurinary and male sexual organs,
and the prostate is by far oneof the most common sites of
cancer of any type, and that's alot of what I manage and that's
(03:38):
how we met.
Grantley Martelly (03:39):
That's how we met yes.
So tell us a little bit aboutyour family.
Are you married?
Do you have kids?
Dr. Yaw Nyame (03:45):
Yeah, I'm married , been married to my beautiful
wife, uh, Christy.
We met she met me at the verybeginning of that short six-year
journey uh, in Cleveland,that's where she's from and we
got married towards the end ofthat journey.
And we also had my daughter, mymy oldest of my two kids at the
(04:06):
end of that journey.
So now we we have aneight-year-old and an almost
six-year-old and, as you canimagine, our lives are busy and
full, you know full of, yeah,lots of stuff going on at that
age.
Oh man, you wouldn't believe it,but they keep you grounded and
(04:27):
humbled and the best part of myday is the on-haul Hearing what
they've been up to and I try toread to them if the days hasn't
been too long and we all havethe energy for it.
Grantley Martelly (04:43):
Well, that's good.
At least you get the time tospend with them.
Um, you know, those 18 yearsare very important and they go
pretty fast.
Dr. Yaw Nyame (04:52):
Take it from somebody who's on the other side
the iphone is like the worstand best thing and it keeps
giving me these reminders.
You know, four years ago, fiveyears ago, and it's like you
know, it's hard to believe thatmuch time has passed so quickly.
So I really am trying tocherish every day with them.
Grantley Martelly (05:12):
Well, I applaud you and I encourage you.
So our topic today is men'surologic health.
Our discussion is going tofocus around that topic and it's
not a topic that I've heardmuch about at least focused from
that area, men's urologichealth.
So if you could give us anintroduction to what is urologic
(05:33):
health and what is men'surologic health, and how we
approach that topic, I'dappreciate it.
Dr. Yaw Nyame (05:39):
It's funny you mentioned this and I'm smiling
because when I got into urology,that was furthest from what I
thought I would be like when I,when I got into urology, I was
like that was furthest from whatI thought I would be doing as a
when I entered medical schoolRight In fact, we used to have
these teaching modules where weum did physical exams and
interviewed patients in medicalschool and they were these paid
(05:59):
actors that would help give usfeedback on our bedside manner.
And I remember, after we didthe urology block, I called my
dad and I said, dad, no matterwhat I do, it's not going to be
urology, it's not going to bewhat we did.
Today, man, I'm not doing anyof this.
But as I got further into myeducation, what I realized was
there was a special bond betweenthe urologist and his patient.
(06:23):
You know, touching on reallysensitive issues, managing like
really impactful quality of lifeissues, um, that I really
enjoyed.
And I enjoyed being able to be,uh, that trusted source for for
men and you know, guys, we'renot always seeking health advice
(06:44):
, we don't foster relationshipswith doctors in that way.
So I felt like maybe I had likea more natural inclination and
gift to have a bond with apatient in general, but with
guys, and maybe I could use thatto be their advocate, help them
seek health.
(07:04):
So what is urologic health?
Well, you know, really, it'surinary function.
Right, that's number one.
So when you think urology, yougot to think kidneys, the tubes
that drain the kidneys, theureters and bladder, and then
the bladder is kind of like arepository for urine that has to
empty, and so the urethra iswhat empties it.
Okay, so that's on the urinarystand, uh, function standpoint,
(07:29):
and we all know like bladderissues are really common.
If you think about what likeimpacts your quality of life the
most, you know once you getbeyond, like having a clear mind
, being able to walk and youknow like have general function,
like your urinary function andyour bowel function, those are
like important parts of your day, right?
(07:50):
So anyone who has a disruptionof that is starting to think
like, hey, man, you know thethings that I hear from friends,
close friends, but happy a lot,is that a problem?
Or, like you know it's I'venoticed my stream is slow, or
you any variation?
That, right, and that's, uh,what your urologists take care
of for men.
Our bladder is empty throughthe prostate, right, so the
(08:13):
prostate ends up being like hasthe potential to be a dam for
urine flow.
So when we talk about men'shealth issues on the urinary
standpoint, it's it becomes therisk of having difficulty
urinating when you get older, uh, and then kind of some classic
urinary symptoms that people canhave in all ages of life, which
(08:34):
is kind of that overactivity,like am I going to the bathroom
too much, um.
The second component of it issexual health, right, because I
said u said urologists take careof urinary issues and sexual
function related issues,especially for men, and so
erectile dysfunction andfertility, those are things that
(09:00):
you may seek a urologist foryou may seek a urologist for.
There are obviously diagnoses.
I have to say this here right,if you have blood in your urine,
that's not normal.
You're supposed to see aurologist for that, okay?
So there are things like that,right, kidney stones.
There's a lot of stuff you maysee for a urologist for, but
(09:20):
when I think of men's healthreally from a quality standpoint
, it's about urinary function,it's about erectile function,
it's about fertility and thoseare probably like the three big
categories that I would throwthere.
As a cancer specialist, I'd beremiss not to say that there is
also probably a responsibilityfor most males to be thinking,
(09:45):
as they get older, about theircancer screening and cancer
surveillance.
Prostate cancer is just socommon that I think a good lens
towards men's health is also thepreventative things that you
can do to avoid, you know,serious illnesses such as
prostate cancer or eventesticular cancer, right?
So for the 20 and 30 year oldguys who are listening, yeah,
you should be checking yourcancer, right?
So for the 20 and 30 year oldguys who are listening, yeah,
(10:06):
you should be checking yourjewels, you know, in the shower
at least once a week.
Maybe there's not a hard spotor anything weird Cause.
That's good, that's just goodmaintenance right Um to to make
sure you're keeping yourself ingood health.
Grantley Martelly (10:20):
So we got to the blood in the urine and
people doing cancer screening.
We're talking about everythingfrom the urinary system to the
sexual health, to how we allfunction.
Dr. Yaw Nyame (10:34):
from that urological standpoint, and you
know it's interesting.
We're talking about urologichealth and men's health, but
also there's some hormonefunction too, right?
Testosterone levels.
Testosterone levels can be lowin some men for a variety of
reasons, and sometimesnormalizing that can really
(10:55):
improve quality of life.
I'll plug this.
I mean, this is not what wetypically manage ourselves as
doctors in the urology space.
But you also want to thinkabout the importance of mental
health too, and I think thatthere are different types of
(11:16):
shops that exist across thecountry that provide men's
health support, and I think manyof them are going to touch on
from a urologist standpoint.
Many of them are going to touchon from a urologist standpoint.
Many of them are going to touchon all the different aspects of
care and life that I justmentioned, and so it's a really
important topic.
(11:37):
I think as a group and men ofcolor you know, as a group,
right and men of color sometimeswe only take care of things
when they're at an extreme right.
There's no preventative mindset,that maintenance mindset as
much.
I don't want to over generalize, but definitely that's what we
(11:57):
hear when we're in our peergroups right, like when we have
our advocacy group together, youand I.
We hear the guys share that.
So I think it was a reallytimely topic to just put out
into the universe that you knowif you're if you're a guy in
your 20s, 30s, there's a rolefor you to be checking in with a
(12:19):
doctor and asking questions andgetting a better understanding
of how all those things work,you know, and not waiting until
you're 65 and not able to pee tobe thinking about your prostate
for the first time, right, orfeeling hopeless if you're
experiencing something likeerectile dysfunction or sexual
dysfunction in your 20s or 30s,to know that there are
(12:42):
specialists out there and peoplewho can help and think about it
holistically.
So that's part of what I hopedour discussion would be about
today.
Grantley Martelly (12:55):
So let's continue in that vein.
How does a person go aboutassessing their urologic health
with their doctors?
I mean, how would that start?
Is that like a part of aregular annual exam, or is it a
separate process?
Dr. Yaw Nyame (13:10):
Yeah, I mean, I think it depends on what station
you're in in life.
I will say that probably themost important person in the
discussion around men's healthand many of these topics I've
talked about and maintenance andprevention, is your primary
care doctor.
They're trained specialists,often much better communicators,
(13:33):
have a broad understanding ofmedicine and your health can be
your biggest advocate.
And so I think establishing amedical home meaning like having
(13:54):
a doctor that you build arelationship with in the primary
care setting, someone you seefrequently is critical.
And then I think, utilizingthat person, hopefully you can
make sure that you're getting inany questions or concerns you
have about, you know, urologyrelated health, you know.
So those questions you know.
Again, it's interesting I wasstarting to go down this path
but when I got the job to forurology in Cleveland, one of my
(14:21):
buddies, his dad, pulled measide.
He said hey, man, these guysall your friends here, they're
giving you a hard time aboutbecoming a urologist.
Like, why are you going intothis?
They're all going to be callingyou in 30 years.
And I was laughing and itdidn't take 30 years, it would
be.
Literally took about five orsix before the first guy phone
and said hey, I got this problem.
Is this normal?
So, um, you know, I think theways the, the, the primary care,
and having that relationship iscritical and then just not
(14:44):
being afraid to put it out thereright, asking that doctor if
something you're experiencing isnormal or abnormal, because
they're going to be the onestypically that will say, okay,
hey, we've checked yourtestosterone and slow, maybe you
should go see a urologist oryou know what, let's try this
medicine for your urine flow.
If it isn't better Now we'regoing to kick it to someone like
(15:05):
Dr Nyame.
Grantley Martelly (15:07):
So it's not a separate set of tests.
It's part of the primary careand then.
So I'm trying to get at.
You don't have to set aseparate appointment and say I'm
going for my urology test.
Dr. Yaw Nyame (15:18):
It's just part of your normal care, I think you
can establish this to be part ofyour normal care.
Now there are men's healthclinics all around the country,
so I think if you feel like youneed that specialist, you go to
their website.
Hey, they take care of an issuethat I want direct from a
specialist information on.
(15:38):
You certainly can request areferral, and people approach it
that way.
But I also want to normalizethat men's health doesn't have
to happen in a specialty men'shealth clinic.
I think men's health is what anaverage primary care doctor is
going to be providing his malepatient when he comes in to see
him.
Problem is, too many of youguys don't have a primary care
(15:59):
doctor right, so you don't havethe opportunity to get that
tailored men's health treatmentor advice or care.
So that's really what I wantedto answer your question.
You know, I think you couldhave it both ways.
Probably the easiest is justgetting a doctor right and
seeing somebody regular.
Grantley Martelly (16:21):
Okay.
So we see a lot of ads on TV oror sometimes I hear on the
radio about you know, as you getolder, that you need you were
talking about men's health,men's clinics.
You know that you need to gobecause you need more
testosterone and you got to getmore testosterone because
testosterone is what keeps youalive.
Is there something to that orthat as we get older, we need to
(16:45):
be bulking up on testosterone?
Dr. Yaw Nyame (16:49):
oh man, this is not my specialty at all.
What I will say is there's alot of misinformation in the
world.
The one thing abouttestosterone replacement is that
it's not benign, right.
So remember, if you are, uh, ofage where you're really wanting
to be fertile and fertility isimportant to you, that if you
(17:12):
take exogenous testosterone,that you know that any form of
of that external supplement it'sgoing to take, it's going to
drive your sperm counts way down, okay, um, and so that that's
not benign and definitely don'ttake it if you're trying to
start a family or have kids.
The second thing is that it cancause your blood to get too
(17:34):
thick, okay, so that's anotherreason, uh, to be weary and
careful about.
You know, advertising that justsays, hey, any problem, you
have, just take testosterone,right and three it's.
You know advertising that justsays, hey, any problem, you have
, just take testosterone rightand three it's.
You know the effectiveness hasonly been shown in patients who
actually have low T levels, okay, and have symptoms, okay.
(17:57):
Both those things have to betrue.
So, if you have symptoms andyour testosterone is normal, oh,
I feel tired all the time andyou know, know, I feel like I'm
losing muscle mass.
But you get your t checked andit's like you know, 400 and it's
normal.
Don't go replacing becausethere's no proof that that's
going to be beneficial.
And the same is true too if yougo get tested.
(18:18):
Your t is like 150 or low anduh, but you like are a
marathoner, you feel great andenergized and whatever.
I'm not sure replacement is whatyou need.
So I think a lot of it has tobe getting your your levels from
.
If they are low to a normal,and then um, and you have to be
(18:40):
symptomatic from or havesymptoms, so feel tired, feel
like you're having a decrease inmuscle mass, less libido from
having low levels.
And also don't forget and Ithink this is really critical
that testosterone isn't just afreebie.
Now, right, that there are realside effects.
I mentioned, too, the fertilitything.
(19:01):
Maybe some guys are like great,but I wasn't worried about that
, but that thick blood can causestrokes and other issues if
it's not being monitored.
So this isn't like a medicationyou just want to be on and not
worry about it.
You definitely should begetting routine blood checks to
make sure your blood's not toothick, yeah that's good.
Grantley Martelly (19:20):
Thanks for clarifying that, because we hear
lots of ads about that.
Now some men say that if I'mnot having any pain, everything
feels good.
You know everything is workinggood.
Why should I go to the doctor?
Why should I care about myurologic health?
Dr. Yaw Nyame (19:42):
That's a great question, right.
Health that's a great question,right.
And the truth is that we havemade so many advances in
medicine that some of the thingswe're able to pick up don't
present with symptoms anymore.
We pick them up because you getblood work.
I treat a lot of kidney cancerhere in Seattle, right, and a
lot of kidney cancers are pickedup because we have cat scans
(20:03):
now.
So you go into the ed, yourbelly hurts or I don't feel very
good, I have a little bit ofdiarrhea they get a cat scan,
right, because we have thatability.
Oh, by the way, no, thediarrhea probably just something
bad.
You ate, but you've got a smalllump on your kidney, right.
So part of the reason you wantto be getting checked in is like
(20:25):
there's some critical bloodwork that can get checked as
part of your primary care visitsthat help you stay on top and
ahead of some potential issues.
One of those is prostate cancer.
Right, we've kind of alluded toit.
We're talking about men'shealth.
I think 315,000 people aregoing to be diagnosed with
prostate cancer in the UnitedStates this year.
(20:46):
To me, you can't talk aboutmen's health, men's urologic
health, and not talk about therisk of prostate cancer.
Well, you know, if you want tobeat it, one of the best ways to
do it is to screen, andcertainly you should at least be
in a position to talk to yourdoctor about whether or not you
want to get a simple blood testto be on the lookout for a
(21:09):
cancer that affects one in eightmen in the United States.
I would say you have symptoms,as often waiting until it's too
late.
From my perspective, from myperspective.
Grantley Martelly (21:23):
Yeah, thank you for making that
clarification, because that's agreat way to say it.
Obviously, you're better at itthan me, but there's so much
technology out there.
Part of the reason for thispodcast is helping men to see
that the technology and thescience is growing so fast that
a lot of the things that theyused to think about that they
have to do.
Now you don't have to do.
(21:44):
Your blood tests will pick itup and your screenings will pick
it up, and waiting for painsometimes means that you're
letting things progress in yourbody that you could have learned
about if you were just payingattention or having your
physicals or going to yourdoctor.
Because I keep getting thatquestion Once people find out
(22:06):
that I have prostate cancer.
The next question half of thetime is well, how much pain did
you have?
You know why did you go in?
Did you have pain?
I was like no, there was nopain.
There wasn't any pain until Igot out of the surgery, right,
and they're like well, how didyou know I?
Dr. Yaw Nyame (22:23):
hear that all the time with newly diagnosed
patients Like, doc, how can yoube telling me I don't have I had
this bad cancer, I don't haveany symptoms?
And I always say good becauseyou know when you have symptoms
it's usually too late or it'slike too far advanced and so if
you have no symptoms, have thein my opinion, oftentimes the
(22:47):
maximum opportunity to help.
Now you know, we could have twofull podcasts on prostate
cancer screening.
It's not that simple, right,because certainly there is some
potential downsides to havingthe blood test.
But look, you can't find out ifit's good or bad for you unless
(23:08):
you go see somebody.
Right, right?
I think that's kind of the keymessage for today.
The other thing is like Thingshave changed right, when I
started in medical school andurology a finger exam, good old
prostate check, dr Dre, as ourfriend Kojo calls it, dr Dre the
(23:28):
digital rect work if it'sabnormal.
We tend to get MRI right.
We get a picture.
All of this is non-invasive, itdoesn't require any physical
examination.
Now, biopsy is invasive I'msaving that for later as part of
(23:52):
the topic still.
But at least by the time youget to that, biopsy, if you need
it as part of your men's health, biopsy, if you need it as part
of your men's health Usuallyhave lots of corroborating data
to say, hey, the risk is highenough that we should do this
right and that's the kind ofmedicine we're trying to
practice these days.
So I would say, you know, whenit comes to how to do men's
(24:13):
health, you know the first stepis make an appointment with a
doctor and the best time to dothat honestly, for all the guys
who are listening don't waittill you're in your you know,
forties, fifties.
You know, build thatrelationship early, because the
more of an establishedrelationship you have with a
primary care doctor, the morethey can serve you.
(24:36):
The more they know your values,the more they have of your
history, the better therelationship they have with you
to be your advocate.
So I'm a big, big, bigproponent of you know building
these relationships early andyou probably don't need to see
them every year when you're inyour thirties, every other year,
(24:57):
every three years, somethinglike that, and then they will be
able to say, hey, you're duefor your colonoscopy, hey,
you're due for your PSA checkand you know, hey, you're 45,
now Probably should see eachother every year, you know, and
they're going to tailor it towhat you need to us.
I think that's a really niceapproach to think of using for
(25:19):
men's health care.
Grantley Martelly (25:21):
So any other topics on the men's urologic
health that we need, any otherareas we need to touch on.
We touched on the you know, thebladder and the urethra, the
urine, the cancer screening.
Dr. Yaw Nyame (25:33):
Fertility is the only thing we haven't talked
about right, and I'm not afertility specialist about,
right and I'm not a fertilityspecialist.
There are a lot of couples inamerica who want to be pregnant,
who want to get pregnant, whocan't, or have difficulty.
Um, and this, like many topicsin medicine, this is one of
those quiet sufferings that alot of people go through, a lot
(25:53):
of young people who go through.
I think, if, if we cannormalize the discussion, you
know that this happens and thatthere are doctors and
specialists that help it is agreat forum to do that.
And so what does a men's healthurologist do in the fertility
(26:15):
setting?
Well, they usually do theevaluation of the guy, right.
So that's as you, as youlistener, and and that that's
good to have somebody who checksyou out to make sure that, from
a fertility standpoint, thingsare working well.
And I can say I, I myself, havegone through that process like
that, right, it's awkward andyou know, but it's, it's, it's
(26:37):
good to do, right, because,listen, I'll tell you, whatever
you think you have to do, thatis challenging as a guy, the
female workup is really intenseand and so oftentimes it's uh,
it's important to know that youhave a doc that looks you over
and make sure that things areworking for you from a fertility
(26:59):
standpoint if you're not ableto get not able to get pregnant,
and I think again, that's partof men's health.
I will say that we defineinfertility so the difficulty to
achieve pregnancy.
We define that usually as acouple who have been attempting
for a year.
Grantley Martelly (27:15):
A year.
Okay, Another question here istell us a little bit about your
research and some of the otherthings you do.
Dr. Yaw Nyame (27:22):
So you're a clinician and you're also a
researcher have a 50% of my timedoing research, which really,
for us, has been building aprogram.
That's a little bit unique inprostate cancer research in that
(27:47):
we really value the partnershipwith cancer survivors and,
specifically for us, we've beenworking with black cancer
survivors, prostate cancersurvivors, to co-develop a
research.
Co-develop, you know we callthem interventions it makes it
sound fancy.
(28:08):
We're co-developing essentially, you know, plans of action that
we get to study and test andperfect together.
So you know, for instance, I'vebeen preaching about PSA
testing and you know we've beenworking on a project where we're
trying to figure out what's thebest way to do screening for
(28:30):
black people across the country,and we've been putting in a lot
of work over the last two yearsto come up with a research plan
, as we call it, so that we canfigure out hey, is it, you know,
is approach one or approach twogoing to be the one that helps
the most people?
So it's a fun research practice.
(28:51):
It's a little bit different.
I'm working with test tubes.
I'm collecting a lot of samplespresently.
I mean, I used to do that kindof research but right now it's a
lot about getting guys like youtogether, talking about your
experience as cancer patients.
Having you guys help usunderstand where the need is and
(29:13):
what tools are going to make adifference in making cancer care
better for black patients.
But ultimately, if we make itbetter for those that are at the
margins, we make it better foreverybody.
I really believe that, as anequity researcher, if we take
care of the people who have thehardest time accessing health
(29:35):
care, then we improve it foreverybody else as well.
That's really my mission.
Grantley Martelly (29:42):
So you talk a little bit about
patient-informed research, andwhy is that important?
Why do you think that'simportant?
Dr. Yaw Nyame (29:50):
Yeah, I mean, I think as clinicians it's easy
for us to sit in the ivory towerand you know, everybody tells
you oh doc, you're the expert,right?
A lot of the things that weadminister we don't live through
.
And so you have a 7, let's sayyou got a 9 am appointment with
(30:11):
me.
I don't know what happened onMonday.
I don't know what your Sundaylooks like.
I'm new to Washington State-ish.
I know I've been here five, uh,seven years.
Actually I got to stop sayingI'm new.
But you know, I don't know whatit was like to drive over, you
know the pass or to get herefrom Yakima or whatever.
(30:32):
So, um, I don't know how muchtime you had to take off from
work.
I don't know who's in yoursocial circle that you've talked
to about your diagnosis.
I know very little about whatit's like to have incontinence
after surgery.
I tell a lot of men what I'veheard it's like, but I haven't
lived it, and so it's reallyimportant to me that we go
(30:54):
straight to the source tounderstand what these problems
are like.
The source to understand whatthese problems are like.
When we do this, what we learnis how to modify our research so
that it's better right, so thatif we decide to open a study,
people sign up for it.
If we ask a question, it's onethat's important and is going to
have the most impact if weanswer it right.
(31:16):
And our field is littered withstudies where really smart
people got millions of dollarsto do something but people
wouldn't sign up for it or theresults ended up not being that
useful because I think theyweren't as informed by patients
as they needed to be, and youand I we've talked a lot about
(31:37):
this.
My analogy is like if I wasgoing to open a coffee shop in
your neighborhood, could youimagine if I didn't knock on a
few doors and ask people whatkind of coffee they like, if
they thought they needed anothercoffee shop on the block?
And what we do is theequivalent of just open a coffee
stand, sometimes right next tothe Starbucks, and then we're
like, hey, how come we're nothelping, how come we're not
(31:58):
selling any coffee?
Grantley Martelly (31:59):
Not selling much coffee.
Yeah, you didn't do yourhomework, you didn't do the
homework right?
Dr. Yaw Nyame (32:05):
No, I think so.
It's just not about beingpatient-informed, honestly,
right, but it's about beingpatient-partnered.
I think that the coffee shopanalogy is a good one, that the
coffee shop analogy is a goodone and that you could imagine
if you really had a targetdemographic that you wanted to
(32:26):
sell your coffee to, maybe youngpeople, you might open that
venture with kind of a younginfluencer or someone who has a
pulse on that community in thatneighborhood.
So that's like taking it onestep further than just talking
to some young people.
But you know what, why don'tyou help me with the design of
the interior and the menu?
(32:47):
And like, hey, do you thinklike young people care if the
coffee is from Ethiopia orBrazil or whatever?
Right, that's what I thinkwe're doing.
That's different in theresearch is that we're taking it
one step further than justsaying what do you think is
important?
But it's like come along forthe whole ride and we've seen
(33:08):
that how fun and impactful thisprocess has been.
And I think between you and mewe're on the verge of something
really big developing within thenext year or two for our
research team, which includesyou, and that's exciting.
Grantley Martelly (33:25):
I think we do some good, interesting work on
interesting teams and the stuffthat we are studying is very
interesting.
You talk about your research isfocused mainly on black men,
because prostate cancer affectsmen.
Why do you think focusing onthat subset is so important?
Dr. Yaw Nyame (33:46):
Yeah, black men are 60% more likely to be
diagnosed with prostate cancerin the United States.
I said one in eight men woulddevelop prostate cancer in the
US, one in six if they're blackor have a strong family history.
The reason for that we don'tknow right.
So I think oftentimes we jumpstraight to the biology.
(34:07):
But you know, biologydefinitely plays a factor.
But not all of this risk iswhat you're born with, right?
So there's got to be some otherenvironmental components.
So when I say environmental, Iuse that as a big catchphrase
for a lot of different externalfactors.
I don't know, is it stress?
Is it the water?
(34:27):
Is it the air?
I mean it could be or is itsome combinational all of that?
Probably the most sobering thingis black prostate cancer
patients are twice as likely todie from prostate cancer as
their peers.
This has been true for over 50years.
I have a student who is doing aproject with me and you know we
(34:49):
were calculating the burden ofprostate cancer death among
black people and it came out to1.5 million years of life lost
over the last 50 years per 100000 black people right, like men
over that time period.
That's a staggering amount ofburden that has been shouldered
(35:16):
by the community.
To me, this is like a publichealth crisis.
You know, this isn't just aninteresting statistic on
disparities.
This is something that we areliving through, we've lived
through for 50 years.
It needs to be addressed.
And you know, I think when Ithink about what we're losing,
(35:38):
we're losing culture, we'relosing economic stability,
social stability, often when welose men in their 40s, 50s, 60s
and 70s to prostate cancer.
So to me, this is somethingthat's critical to address.
You know, I said, my equitylens always has me thinking how
(35:59):
do we make it better?
How do all boats rise?
And I think, if we can reallyaddress this particular
disparity by figuring out waysto better inform patients about
screening, how to support betteraccess to treatment, how to
access better survivorship careonce you've been treated, making
sure you have the latest andgreatest, and we can make those
(36:22):
tools available to our mostvulnerable populations, it's
kind of a slam dunk that thatkind of information could also
help other people and otherpopulations.
So that's the drive.
We talk about quality care allthe time, right.
One of the key tenets ofquality care, as defined by the
(36:42):
National Academies of Science,is that it be equitable.
I know that's a bad word thesedays, but you're not delivering
something of high quality ifit's not equitable, and so
that's the focus of what we do.
Grantley Martelly (36:57):
Just to wrap this up, what would I mean?
What would you say are thethree takeaways that you would
like the audience to get fromthis conversation today?
Dr. Yaw Nyame (37:05):
I think, learn to be curious about your own body
and health, especially for theyoung fellows out there.
I mean, I'm not embarrassed toadmit that I didn't know very
much about the prostate or men'shealth until I was well into my
, you know, almost 20s, late 20s, right In medical school.
And so be curious about what'sgoing on with your body and
(37:28):
protect it.
You know, take good care of it.
Number two you know it's nevertoo early to establish a medical
home.
Doctors, we're here to help.
We want to help, we want to getto know you too and know what's
important to you and supportthose things right.
So building a foundation and amedical home early allows you to
(37:51):
get knowledge and get reputable, credited knowledge in your
back pocket and then also,hopefully, you build a
relationship that sustains youfor a long time, because that's
important.
And then number three you know Ithink a key tenant of men's
health is selfishly, I'm goingto say is prostate cancer, and I
(38:12):
think I want to increaseawareness about that as an issue
to include with all the otherthings that are important to
men's health from a urologystandpoint.
You know, making sure you peegood, making sure the erections
work, making sure that you havegood fertility and that your
testosterone works well.
(38:33):
But don't forget, you know, tobe curious about your prostate
cancer risk.
You know, talk to your family,talk to your siblings.
You know, talk to grandpa.
Just make sure you understandwhat your risk is, because you
know screening may be somethingthat you want to consider at an
early age, like 45 or 50.
Grantley Martelly (38:55):
Well, thank you very much and I look forward
to us having anotherconversation in the near future,
but thank you for your timetoday To support this podcast.
(39:17):
Go to buymeacoffeecom forwardslash real health black men
Buymeacoffeecom real healthblack men and to become a
corporate sponsor.
Send us an email.
Bye.
This is the Re al Health Black Men podcast,
where we empower men to takecontrol of their health.
We provide vital informationand build community support.
Join us as we discusseverything from major health
challenges to mental wellness tophysical fitness.
So if you're ready to level upyour health and your life,
you're in the right place.
(00:31):
Let's get started.
Welcome to another episode ofReal Health Black Men.
Thank you for listening.
Today, my guest is a friend, Dr.
(00:52):
Yaw Nyame.
He is a part of the Universityof Washington School of Medicine
and the Fred Hutch CancerCenter.
According to the stuff I readabout you, it says that you are
a surgeon, a researcher,educator, a patient advocate.
So we're going to talk aboutall of those things there.
(01:12):
But instead of me trying todefine you or what other people
define you by in the writings,maybe we'll begin by letting you
introduce yourself, telling uswho you are, where you're from.
Dr. Yaw Nyame (01:23):
Sure, I was worried you were about to read
that really long bio.
You know our academic bios arealways awkward.
I feel like we probably couldborrow from other industries
where the bios sound less stiff.
But let's see, how would Idescribe myself?
So I would describe myselffirst as Ghanaian American.
I'm really proud to identify asboth.
(01:48):
I grew up in the great state ofOklahoma Great sometimes, not so
great, others Great right now,because the thunder are rolling.
And let's see, I went toundergrad at Duke University, so
that's my alma mater.
And then I went to graduateschool, both in DC and in
(02:09):
Chicago.
So Northwestern is where I didmy training for medical school
and business school.
How our training works, right,but I I was like a medical
student, so I was paying moneyto become a doctor in chicago,
at northwestern, and then yougraduate, but then you're still
(02:32):
learning and training, but thatat least you're getting paid.
Then it's a small salary butyou're officially a doctor and
that's residency.
And I did that at cleveland.
And then, after six short yearsof training, just the brief
six-year period of being anapprentice I came out here to
(02:52):
Seattle and did more training,actually two more years, and
then stayed, but finally I gotmy first quote-unquote real job
where I practice urology.
I take care of patients whohave urologic problems.
My extra two years of trainingwas basically to become a cancer
specialist, so, um, that's whatI do.
(03:14):
I take care of cancer patients,um, that have cancers that are
specific to your urologic organs, if you will.
So urology takes care ofurinary and male sexual organs,
and the prostate is by far oneof the most common sites of
cancer of any type, and that's alot of what I manage and that's
(03:38):
how we met.
Grantley Martelly (03:39):
That's how we met yes.
So tell us a little bit aboutyour family.
Are you married?
Do you have kids?
Dr. Yaw Nyame (03:45):
Yeah, I'm married , been married to my beautiful
wife, uh, Christy.
We met she met me at the verybeginning of that short six-year
journey uh, in Cleveland,that's where she's from and we
got married towards the end ofthat journey.
And we also had my daughter, mymy oldest of my two kids at the
(04:06):
end of that journey.
So now we we have aneight-year-old and an almost
six-year-old and, as you canimagine, our lives are busy and
full, you know full of, yeah,lots of stuff going on at that
age.
Oh man, you wouldn't believe it,but they keep you grounded and
(04:27):
humbled and the best part of myday is the on-haul Hearing what
they've been up to and I try toread to them if the days hasn't
been too long and we all havethe energy for it.
Grantley Martelly (04:43):
Well, that's good.
At least you get the time tospend with them.
Um, you know, those 18 yearsare very important and they go
pretty fast.
Dr. Yaw Nyame (04:52):
Take it from somebody who's on the other side
the iphone is like the worstand best thing and it keeps
giving me these reminders.
You know, four years ago, fiveyears ago, and it's like you
know, it's hard to believe thatmuch time has passed so quickly.
So I really am trying tocherish every day with them.
Grantley Martelly (05:12):
Well, I applaud you and I encourage you.
So our topic today is men'surologic health.
Our discussion is going tofocus around that topic and it's
not a topic that I've heardmuch about at least focused from
that area, men's urologichealth.
So if you could give us anintroduction to what is urologic
(05:33):
health and what is men'surologic health, and how we
approach that topic, I'dappreciate it.
Dr. Yaw Nyame (05:39):
It's funny you mentioned this and I'm smiling
because when I got into urology,that was furthest from what I
thought I would be like when I,when I got into urology, I was
like that was furthest from whatI thought I would be doing as a
when I entered medical schoolRight In fact, we used to have
these teaching modules where weum did physical exams and
interviewed patients in medicalschool and they were these paid
(05:59):
actors that would help give usfeedback on our bedside manner.
And I remember, after we didthe urology block, I called my
dad and I said, dad, no matterwhat I do, it's not going to be
urology, it's not going to bewhat we did.
Today, man, I'm not doing anyof this.
But as I got further into myeducation, what I realized was
there was a special bond betweenthe urologist and his patient.
(06:23):
You know, touching on reallysensitive issues, managing like
really impactful quality of lifeissues, um, that I really
enjoyed.
And I enjoyed being able to be,uh, that trusted source for for
men and you know, guys, we'renot always seeking health advice
(06:44):
, we don't foster relationshipswith doctors in that way.
So I felt like maybe I had likea more natural inclination and
gift to have a bond with apatient in general, but with
guys, and maybe I could use thatto be their advocate, help them
seek health.
(07:04):
So what is urologic health?
Well, you know, really, it'surinary function.
Right, that's number one.
So when you think urology, yougot to think kidneys, the tubes
that drain the kidneys, theureters and bladder, and then
the bladder is kind of like arepository for urine that has to
empty, and so the urethra iswhat empties it.
Okay, so that's on the urinarystand, uh, function standpoint,
(07:29):
and we all know like bladderissues are really common.
If you think about what likeimpacts your quality of life the
most, you know once you getbeyond, like having a clear mind
, being able to walk and youknow like have general function,
like your urinary function andyour bowel function, those are
like important parts of your day, right?
(07:50):
So anyone who has a disruptionof that is starting to think
like, hey, man, you know thethings that I hear from friends,
close friends, but happy a lot,is that a problem?
Or, like you know it's I'venoticed my stream is slow, or
you any variation?
That, right, and that's, uh,what your urologists take care
of for men.
Our bladder is empty throughthe prostate, right, so the
(08:13):
prostate ends up being like hasthe potential to be a dam for
urine flow.
So when we talk about men'shealth issues on the urinary
standpoint, it's it becomes therisk of having difficulty
urinating when you get older, uh, and then kind of some classic
urinary symptoms that people canhave in all ages of life, which
(08:34):
is kind of that overactivity,like am I going to the bathroom
too much, um.
The second component of it issexual health, right, because I
said u said urologists take careof urinary issues and sexual
function related issues,especially for men, and so
erectile dysfunction andfertility, those are things that
(09:00):
you may seek a urologist foryou may seek a urologist for.
There are obviously diagnoses.
I have to say this here right,if you have blood in your urine,
that's not normal.
You're supposed to see aurologist for that, okay?
So there are things like that,right, kidney stones.
There's a lot of stuff you maysee for a urologist for, but
(09:20):
when I think of men's healthreally from a quality standpoint
, it's about urinary function,it's about erectile function,
it's about fertility and thoseare probably like the three big
categories that I would throwthere.
As a cancer specialist, I'd beremiss not to say that there is
also probably a responsibilityfor most males to be thinking,
(09:45):
as they get older, about theircancer screening and cancer
surveillance.
Prostate cancer is just socommon that I think a good lens
towards men's health is also thepreventative things that you
can do to avoid, you know,serious illnesses such as
prostate cancer or eventesticular cancer, right?
So for the 20 and 30 year oldguys who are listening, yeah,
you should be checking yourcancer, right?
So for the 20 and 30 year oldguys who are listening, yeah,
(10:06):
you should be checking yourjewels, you know, in the shower
at least once a week.
Maybe there's not a hard spotor anything weird Cause.
That's good, that's just goodmaintenance right Um to to make
sure you're keeping yourself ingood health.
Grantley Martelly (10:20):
So we got to the blood in the urine and
people doing cancer screening.
We're talking about everythingfrom the urinary system to the
sexual health, to how we allfunction.
Dr. Yaw Nyame (10:34):
from that urological standpoint, and you
know it's interesting.
We're talking about urologichealth and men's health, but
also there's some hormonefunction too, right?
Testosterone levels.
Testosterone levels can be lowin some men for a variety of
reasons, and sometimesnormalizing that can really
(10:55):
improve quality of life.
I'll plug this.
I mean, this is not what wetypically manage ourselves as
doctors in the urology space.
But you also want to thinkabout the importance of mental
health too, and I think thatthere are different types of
(11:16):
shops that exist across thecountry that provide men's
health support, and I think manyof them are going to touch on
from a urologist standpoint.
Many of them are going to touchon from a urologist standpoint.
Many of them are going to touchon all the different aspects of
care and life that I justmentioned, and so it's a really
important topic.
(11:37):
I think as a group and men ofcolor you know, as a group,
right and men of color sometimeswe only take care of things
when they're at an extreme right.
There's no preventative mindset,that maintenance mindset as
much.
I don't want to over generalize, but definitely that's what we
(11:57):
hear when we're in our peergroups right, like when we have
our advocacy group together, youand I.
We hear the guys share that.
So I think it was a reallytimely topic to just put out
into the universe that you knowif you're if you're a guy in
your 20s, 30s, there's a rolefor you to be checking in with a
(12:19):
doctor and asking questions andgetting a better understanding
of how all those things work,you know, and not waiting until
you're 65 and not able to pee tobe thinking about your prostate
for the first time, right, orfeeling hopeless if you're
experiencing something likeerectile dysfunction or sexual
dysfunction in your 20s or 30s,to know that there are
(12:42):
specialists out there and peoplewho can help and think about it
holistically.
So that's part of what I hopedour discussion would be about
today.
Grantley Martelly (12:55):
So let's continue in that vein.
How does a person go aboutassessing their urologic health
with their doctors?
I mean, how would that start?
Is that like a part of aregular annual exam, or is it a
separate process?
Dr. Yaw Nyame (13:10):
Yeah, I mean, I think it depends on what station
you're in in life.
I will say that probably themost important person in the
discussion around men's healthand many of these topics I've
talked about and maintenance andprevention, is your primary
care doctor.
They're trained specialists,often much better communicators,
(13:33):
have a broad understanding ofmedicine and your health can be
your biggest advocate.
And so I think establishing amedical home meaning like having
(13:54):
a doctor that you build arelationship with in the primary
care setting, someone you seefrequently is critical.
And then I think, utilizingthat person, hopefully you can
make sure that you're getting inany questions or concerns you
have about, you know, urologyrelated health, you know.
So those questions you know.
Again, it's interesting I wasstarting to go down this path
but when I got the job to forurology in Cleveland, one of my
(14:21):
buddies, his dad, pulled measide.
He said hey, man, these guysall your friends here, they're
giving you a hard time aboutbecoming a urologist.
Like, why are you going intothis?
They're all going to be callingyou in 30 years.
And I was laughing and itdidn't take 30 years, it would
be.
Literally took about five orsix before the first guy phone
and said hey, I got this problem.
Is this normal?
So, um, you know, I think theways the, the, the primary care,
and having that relationship iscritical and then just not
(14:44):
being afraid to put it out thereright, asking that doctor if
something you're experiencing isnormal or abnormal, because
they're going to be the onestypically that will say, okay,
hey, we've checked yourtestosterone and slow, maybe you
should go see a urologist oryou know what, let's try this
medicine for your urine flow.
If it isn't better Now we'regoing to kick it to someone like
(15:05):
Dr Nyame.
Grantley Martelly (15:07):
So it's not a separate set of tests.
It's part of the primary careand then.
So I'm trying to get at.
You don't have to set aseparate appointment and say I'm
going for my urology test.
Dr. Yaw Nyame (15:18):
It's just part of your normal care, I think you
can establish this to be part ofyour normal care.
Now there are men's healthclinics all around the country,
so I think if you feel like youneed that specialist, you go to
their website.
Hey, they take care of an issuethat I want direct from a
specialist information on.
(15:38):
You certainly can request areferral, and people approach it
that way.
But I also want to normalizethat men's health doesn't have
to happen in a specialty men'shealth clinic.
I think men's health is what anaverage primary care doctor is
going to be providing his malepatient when he comes in to see
him.
Problem is, too many of youguys don't have a primary care
(15:59):
doctor right, so you don't havethe opportunity to get that
tailored men's health treatmentor advice or care.
So that's really what I wantedto answer your question.
You know, I think you couldhave it both ways.
Probably the easiest is justgetting a doctor right and
seeing somebody regular.
Grantley Martelly (16:21):
Okay.
So we see a lot of ads on TV oror sometimes I hear on the
radio about you know, as you getolder, that you need you were
talking about men's health,men's clinics.
You know that you need to gobecause you need more
testosterone and you got to getmore testosterone because
testosterone is what keeps youalive.
Is there something to that orthat as we get older, we need to
(16:45):
be bulking up on testosterone?
Dr. Yaw Nyame (16:49):
oh man, this is not my specialty at all.
What I will say is there's alot of misinformation in the
world.
The one thing abouttestosterone replacement is that
it's not benign, right.
So remember, if you are, uh, ofage where you're really wanting
to be fertile and fertility isimportant to you, that if you
(17:12):
take exogenous testosterone,that you know that any form of
of that external supplement it'sgoing to take, it's going to
drive your sperm counts way down, okay, um, and so that that's
not benign and definitely don'ttake it if you're trying to
start a family or have kids.
The second thing is that it cancause your blood to get too
(17:34):
thick, okay, so that's anotherreason, uh, to be weary and
careful about.
You know, advertising that justsays, hey, any problem, you
have, just take testosterone,right and three it's.
You know advertising that justsays, hey, any problem, you have
, just take testosterone rightand three it's.
You know the effectiveness hasonly been shown in patients who
actually have low T levels, okay, and have symptoms, okay.
(17:57):
Both those things have to betrue.
So, if you have symptoms andyour testosterone is normal, oh,
I feel tired all the time andyou know, know, I feel like I'm
losing muscle mass.
But you get your t checked andit's like you know, 400 and it's
normal.
Don't go replacing becausethere's no proof that that's
going to be beneficial.
And the same is true too if yougo get tested.
(18:18):
Your t is like 150 or low anduh, but you like are a
marathoner, you feel great andenergized and whatever.
I'm not sure replacement is whatyou need.
So I think a lot of it has tobe getting your your levels from
.
If they are low to a normal,and then um, and you have to be
(18:40):
symptomatic from or havesymptoms, so feel tired, feel
like you're having a decrease inmuscle mass, less libido from
having low levels.
And also don't forget and Ithink this is really critical
that testosterone isn't just afreebie.
Now, right, that there are realside effects.
I mentioned, too, the fertilitything.
(19:01):
Maybe some guys are like great,but I wasn't worried about that
, but that thick blood can causestrokes and other issues if
it's not being monitored.
So this isn't like a medicationyou just want to be on and not
worry about it.
You definitely should begetting routine blood checks to
make sure your blood's not toothick, yeah that's good.
Grantley Martelly (19:20):
Thanks for clarifying that, because we hear
lots of ads about that.
Now some men say that if I'mnot having any pain, everything
feels good.
You know everything is workinggood.
Why should I go to the doctor?
Why should I care about myurologic health?
Dr. Yaw Nyame (19:42):
That's a great question, right.
Health that's a great question,right.
And the truth is that we havemade so many advances in
medicine that some of the thingswe're able to pick up don't
present with symptoms anymore.
We pick them up because you getblood work.
I treat a lot of kidney cancerhere in Seattle, right, and a
lot of kidney cancers are pickedup because we have cat scans
(20:03):
now.
So you go into the ed, yourbelly hurts or I don't feel very
good, I have a little bit ofdiarrhea they get a cat scan,
right, because we have thatability.
Oh, by the way, no, thediarrhea probably just something
bad.
You ate, but you've got a smalllump on your kidney, right.
So part of the reason you wantto be getting checked in is like
(20:25):
there's some critical bloodwork that can get checked as
part of your primary care visitsthat help you stay on top and
ahead of some potential issues.
One of those is prostate cancer.
Right, we've kind of alluded toit.
We're talking about men'shealth.
I think 315,000 people aregoing to be diagnosed with
prostate cancer in the UnitedStates this year.
(20:46):
To me, you can't talk aboutmen's health, men's urologic
health, and not talk about therisk of prostate cancer.
Well, you know, if you want tobeat it, one of the best ways to
do it is to screen, andcertainly you should at least be
in a position to talk to yourdoctor about whether or not you
want to get a simple blood testto be on the lookout for a
(21:09):
cancer that affects one in eightmen in the United States.
I would say you have symptoms,as often waiting until it's too
late.
From my perspective, from myperspective.
Grantley Martelly (21:23):
Yeah, thank you for making that
clarification, because that's agreat way to say it.
Obviously, you're better at itthan me, but there's so much
technology out there.
Part of the reason for thispodcast is helping men to see
that the technology and thescience is growing so fast that
a lot of the things that theyused to think about that they
have to do.
Now you don't have to do.
(21:44):
Your blood tests will pick itup and your screenings will pick
it up, and waiting for painsometimes means that you're
letting things progress in yourbody that you could have learned
about if you were just payingattention or having your
physicals or going to yourdoctor.
Because I keep getting thatquestion Once people find out
(22:06):
that I have prostate cancer.
The next question half of thetime is well, how much pain did
you have?
You know why did you go in?
Did you have pain?
I was like no, there was nopain.
There wasn't any pain until Igot out of the surgery, right,
and they're like well, how didyou know I?
Dr. Yaw Nyame (22:23):
hear that all the time with newly diagnosed
patients Like, doc, how can yoube telling me I don't have I had
this bad cancer, I don't haveany symptoms?
And I always say good becauseyou know when you have symptoms
it's usually too late or it'slike too far advanced and so if
you have no symptoms, have thein my opinion, oftentimes the
(22:47):
maximum opportunity to help.
Now you know, we could have twofull podcasts on prostate
cancer screening.
It's not that simple, right,because certainly there is some
potential downsides to havingthe blood test.
But look, you can't find out ifit's good or bad for you unless
(23:08):
you go see somebody.
Right, right?
I think that's kind of the keymessage for today.
The other thing is like Thingshave changed right, when I
started in medical school andurology a finger exam, good old
prostate check, dr Dre, as ourfriend Kojo calls it, dr Dre the
(23:28):
digital rect work if it'sabnormal.
We tend to get MRI right.
We get a picture.
All of this is non-invasive, itdoesn't require any physical
examination.
Now, biopsy is invasive I'msaving that for later as part of
(23:52):
the topic still.
But at least by the time youget to that, biopsy, if you need
it as part of your men's health, biopsy, if you need it as part
of your men's health Usuallyhave lots of corroborating data
to say, hey, the risk is highenough that we should do this
right and that's the kind ofmedicine we're trying to
practice these days.
So I would say, you know, whenit comes to how to do men's
(24:13):
health, you know the first stepis make an appointment with a
doctor and the best time to dothat honestly, for all the guys
who are listening don't waittill you're in your you know,
forties, fifties.
You know, build thatrelationship early, because the
more of an establishedrelationship you have with a
primary care doctor, the morethey can serve you.
(24:36):
The more they know your values,the more they have of your
history, the better therelationship they have with you
to be your advocate.
So I'm a big, big, bigproponent of you know building
these relationships early andyou probably don't need to see
them every year when you're inyour thirties, every other year,
(24:57):
every three years, somethinglike that, and then they will be
able to say, hey, you're duefor your colonoscopy, hey,
you're due for your PSA checkand you know, hey, you're 45,
now Probably should see eachother every year, you know, and
they're going to tailor it towhat you need to us.
I think that's a really niceapproach to think of using for
(25:19):
men's health care.
Grantley Martelly (25:21):
So any other topics on the men's urologic
health that we need, any otherareas we need to touch on.
We touched on the you know, thebladder and the urethra, the
urine, the cancer screening.
Dr. Yaw Nyame (25:33):
Fertility is the only thing we haven't talked
about right, and I'm not afertility specialist about,
right and I'm not a fertilityspecialist.
There are a lot of couples inamerica who want to be pregnant,
who want to get pregnant, whocan't, or have difficulty.
Um, and this, like many topicsin medicine, this is one of
those quiet sufferings that alot of people go through, a lot
(25:53):
of young people who go through.
I think, if, if we cannormalize the discussion, you
know that this happens and thatthere are doctors and
specialists that help it is agreat forum to do that.
And so what does a men's healthurologist do in the fertility
(26:15):
setting?
Well, they usually do theevaluation of the guy, right.
So that's as you, as youlistener, and and that that's
good to have somebody who checksyou out to make sure that, from
a fertility standpoint, thingsare working well.
And I can say I, I myself, havegone through that process like
that, right, it's awkward andyou know, but it's, it's, it's
(26:37):
good to do, right, because,listen, I'll tell you, whatever
you think you have to do, thatis challenging as a guy, the
female workup is really intenseand and so oftentimes it's uh,
it's important to know that youhave a doc that looks you over
and make sure that things areworking for you from a fertility
(26:59):
standpoint if you're not ableto get not able to get pregnant,
and I think again, that's partof men's health.
I will say that we defineinfertility so the difficulty to
achieve pregnancy.
We define that usually as acouple who have been attempting
for a year.
Grantley Martelly (27:15):
A year.
Okay, Another question here istell us a little bit about your
research and some of the otherthings you do.
Dr. Yaw Nyame (27:22):
So you're a clinician and you're also a
researcher have a 50% of my timedoing research, which really,
for us, has been building aprogram.
That's a little bit unique inprostate cancer research in that
(27:47):
we really value the partnershipwith cancer survivors and,
specifically for us, we've beenworking with black cancer
survivors, prostate cancersurvivors, to co-develop a
research.
Co-develop, you know we callthem interventions it makes it
sound fancy.
(28:08):
We're co-developing essentially, you know, plans of action that
we get to study and test andperfect together.
So you know, for instance, I'vebeen preaching about PSA
testing and you know we've beenworking on a project where we're
trying to figure out what's thebest way to do screening for
(28:30):
black people across the country,and we've been putting in a lot
of work over the last two yearsto come up with a research plan
, as we call it, so that we canfigure out hey, is it, you know,
is approach one or approach twogoing to be the one that helps
the most people?
So it's a fun research practice.
(28:51):
It's a little bit different.
I'm working with test tubes.
I'm collecting a lot of samplespresently.
I mean, I used to do that kindof research but right now it's a
lot about getting guys like youtogether, talking about your
experience as cancer patients.
Having you guys help usunderstand where the need is and
(29:13):
what tools are going to make adifference in making cancer care
better for black patients.
But ultimately, if we make itbetter for those that are at the
margins, we make it better foreverybody.
I really believe that, as anequity researcher, if we take
care of the people who have thehardest time accessing health
(29:35):
care, then we improve it foreverybody else as well.
That's really my mission.
Grantley Martelly (29:42):
So you talk a little bit about
patient-informed research, andwhy is that important?
Why do you think that'simportant?
Dr. Yaw Nyame (29:50):
Yeah, I mean, I think as clinicians it's easy
for us to sit in the ivory towerand you know, everybody tells
you oh doc, you're the expert,right?
A lot of the things that weadminister we don't live through
.
And so you have a 7, let's sayyou got a 9 am appointment with
(30:11):
me.
I don't know what happened onMonday.
I don't know what your Sundaylooks like.
I'm new to Washington State-ish.
I know I've been here five, uh,seven years.
Actually I got to stop sayingI'm new.
But you know, I don't know whatit was like to drive over, you
know the pass or to get herefrom Yakima or whatever.
(30:32):
So, um, I don't know how muchtime you had to take off from
work.
I don't know who's in yoursocial circle that you've talked
to about your diagnosis.
I know very little about whatit's like to have incontinence
after surgery.
I tell a lot of men what I'veheard it's like, but I haven't
lived it, and so it's reallyimportant to me that we go
(30:54):
straight to the source tounderstand what these problems
are like.
The source to understand whatthese problems are like.
When we do this, what we learnis how to modify our research so
that it's better right, so thatif we decide to open a study,
people sign up for it.
If we ask a question, it's onethat's important and is going to
have the most impact if weanswer it right.
(31:16):
And our field is littered withstudies where really smart
people got millions of dollarsto do something but people
wouldn't sign up for it or theresults ended up not being that
useful because I think theyweren't as informed by patients
as they needed to be, and youand I we've talked a lot about
(31:37):
this.
My analogy is like if I wasgoing to open a coffee shop in
your neighborhood, could youimagine if I didn't knock on a
few doors and ask people whatkind of coffee they like, if
they thought they needed anothercoffee shop on the block?
And what we do is theequivalent of just open a coffee
stand, sometimes right next tothe Starbucks, and then we're
like, hey, how come we're nothelping, how come we're not
(31:58):
selling any coffee?
Grantley Martelly (31:59):
Not selling much coffee.
Yeah, you didn't do yourhomework, you didn't do the
homework right?
Dr. Yaw Nyame (32:05):
No, I think so.
It's just not about beingpatient-informed, honestly,
right, but it's about beingpatient-partnered.
I think that the coffee shopanalogy is a good one, that the
coffee shop analogy is a goodone and that you could imagine
if you really had a targetdemographic that you wanted to
(32:26):
sell your coffee to, maybe youngpeople, you might open that
venture with kind of a younginfluencer or someone who has a
pulse on that community in thatneighborhood.
So that's like taking it onestep further than just talking
to some young people.
But you know what, why don'tyou help me with the design of
the interior and the menu?
(32:47):
And like, hey, do you thinklike young people care if the
coffee is from Ethiopia orBrazil or whatever?
Right, that's what I thinkwe're doing.
That's different in theresearch is that we're taking it
one step further than justsaying what do you think is
important?
But it's like come along forthe whole ride and we've seen
(33:08):
that how fun and impactful thisprocess has been.
And I think between you and mewe're on the verge of something
really big developing within thenext year or two for our
research team, which includesyou, and that's exciting.
Grantley Martelly (33:25):
I think we do some good, interesting work on
interesting teams and the stuffthat we are studying is very
interesting.
You talk about your research isfocused mainly on black men,
because prostate cancer affectsmen.
Why do you think focusing onthat subset is so important?
Dr. Yaw Nyame (33:46):
Yeah, black men are 60% more likely to be
diagnosed with prostate cancerin the United States.
I said one in eight men woulddevelop prostate cancer in the
US, one in six if they're blackor have a strong family history.
The reason for that we don'tknow right.
So I think oftentimes we jumpstraight to the biology.
(34:07):
But you know, biologydefinitely plays a factor.
But not all of this risk iswhat you're born with, right?
So there's got to be some otherenvironmental components.
So when I say environmental, Iuse that as a big catchphrase
for a lot of different externalfactors.
I don't know, is it stress?
Is it the water?
(34:27):
Is it the air?
I mean it could be or is itsome combinational all of that?
Probably the most sobering thingis black prostate cancer
patients are twice as likely todie from prostate cancer as
their peers.
This has been true for over 50years.
I have a student who is doing aproject with me and you know we
(34:49):
were calculating the burden ofprostate cancer death among
black people and it came out to1.5 million years of life lost
over the last 50 years per 100000 black people right, like men
over that time period.
That's a staggering amount ofburden that has been shouldered
(35:16):
by the community.
To me, this is like a publichealth crisis.
You know, this isn't just aninteresting statistic on
disparities.
This is something that we areliving through, we've lived
through for 50 years.
It needs to be addressed.
And you know, I think when Ithink about what we're losing,
(35:38):
we're losing culture, we'relosing economic stability,
social stability, often when welose men in their 40s, 50s, 60s
and 70s to prostate cancer.
So to me, this is somethingthat's critical to address.
You know, I said, my equitylens always has me thinking how
(35:59):
do we make it better?
How do all boats rise?
And I think, if we can reallyaddress this particular
disparity by figuring out waysto better inform patients about
screening, how to support betteraccess to treatment, how to
access better survivorship careonce you've been treated, making
sure you have the latest andgreatest, and we can make those
(36:22):
tools available to our mostvulnerable populations, it's
kind of a slam dunk that thatkind of information could also
help other people and otherpopulations.
So that's the drive.
We talk about quality care allthe time, right.
One of the key tenets ofquality care, as defined by the
(36:42):
National Academies of Science,is that it be equitable.
I know that's a bad word thesedays, but you're not delivering
something of high quality ifit's not equitable, and so
that's the focus of what we do.
Grantley Martelly (36:57):
Just to wrap this up, what would I mean?
What would you say are thethree takeaways that you would
like the audience to get fromthis conversation today?
Dr. Yaw Nyame (37:05):
I think, learn to be curious about your own body
and health, especially for theyoung fellows out there.
I mean, I'm not embarrassed toadmit that I didn't know very
much about the prostate or men'shealth until I was well into my
, you know, almost 20s, late 20s, right In medical school.
And so be curious about what'sgoing on with your body and
(37:28):
protect it.
You know, take good care of it.
Number two you know it's nevertoo early to establish a medical
home.
Doctors, we're here to help.
We want to help, we want to getto know you too and know what's
important to you and supportthose things right.
So building a foundation and amedical home early allows you to
(37:51):
get knowledge and get reputable, credited knowledge in your
back pocket and then also,hopefully, you build a
relationship that sustains youfor a long time, because that's
important.
And then number three you know Ithink a key tenant of men's
health is selfishly, I'm goingto say is prostate cancer, and I
(38:12):
think I want to increaseawareness about that as an issue
to include with all the otherthings that are important to
men's health from a urologystandpoint.
You know, making sure you peegood, making sure the erections
work, making sure that you havegood fertility and that your
testosterone works well.
(38:33):
But don't forget, you know, tobe curious about your prostate
cancer risk.
You know, talk to your family,talk to your siblings.
You know, talk to grandpa.
Just make sure you understandwhat your risk is, because you
know screening may be somethingthat you want to consider at an
early age, like 45 or 50.
Grantley Martelly (38:55):
Well, thank you very much and I look forward
to us having anotherconversation in the near future,
but thank you for your timetoday To support this podcast.
(39:17):
Go to buymeacoffeecom forwardslash real health black men
Buymeacoffeecom real healthblack men and to become a
corporate sponsor.
Send us an email.
Bye.
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