September 23, 2024 • 17 mins
We are talking MEN's health at Hartford Healthcare's Bone & Joint Institute.
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Episode Transcript
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Speaker 1 (00:00):
All right, all right, we'll hold off the daily How
fascinating is that it's the daily pickle?
Speaker 2 (00:07):
We're going to replace your olog doctor wagon. We got
you right here, right here front.
Speaker 1 (00:12):
But yeah, we were going to do a daily pickle
with doctor or doctor, but a different kind of daily
pickle with doctor Joseph Wagger.
Speaker 2 (00:21):
How you doing, sir?
Speaker 3 (00:22):
I'm doing great. Nothing better than hearing yourself introduced on
eighty four and some traffic.
Speaker 1 (00:27):
All right, fantastic, thanks for I hope you didn't speed
here perfectly over here now we were talking. It's Prostate
cancer Awareness month. Has this been getting its due at all?
Or is this one of the cancer awareness months that
kind of takes a backseat to everything else?
Speaker 3 (00:43):
Yeah, I suppose it depends on who you ask. You know, certainly,
breast cancer I think still gets appropriately the play that
it deserves. The numbers for prostate cancer are the same,
almost an equal number of men diagnosed every year, equal
number of deaths.
Speaker 2 (00:57):
It's still a certain breast cancer yep, equal number.
Speaker 3 (01:00):
Yeah, very very very similar diseases. Men just don't talk
about their diseases as often as women do. It doesn't
get the research money that breast cancer does I think
breast cancer Awareness month. You look at the runs and
the walks, et cetera. You know they raise a lot
of money and good for them, and we need to
do a better job with that too.
Speaker 4 (01:19):
Let me ask you about the prostate cancer stuff, because
I know a good friend of my weight box is
just diagnosed with a lot of ex baseball players have
been diagnosed with prostate cancer, anything related to tobacco usage
or anything. And what age do you start getting regular
checkups for prostate cancer?
Speaker 3 (01:36):
Yeah, so men at average risk that means not a
family history. Not black men should start at age fifty
and men at higher risks that would be a family
history or black men should start at age forty.
Speaker 2 (01:47):
But you're right.
Speaker 3 (01:48):
If you look at any major league starting lineup right now,
one and eight men get prostate cancer one in four
black men. So you're gonna have one or two guys
on each starting lineup right now being diagnosed with prostate.
Speaker 4 (02:00):
Answer why the black men? Why are they so susceptible
to prostate cancer?
Speaker 3 (02:03):
We really don't know. It's some combination of genes and environment.
So if you look at Nigerian Africans, they have one
of the lowest rates of prostate cancer in the world.
If you look at Nigerian African Americans, they have one
of the highest rate. So it's some interplay of environmental
factors and genes that we just don't understand.
Speaker 2 (02:22):
All right, I have crossed the threshold.
Speaker 1 (02:24):
I'm in that age group that needs to have a
prostate exam.
Speaker 2 (02:28):
Dibbs has been scaring me. I am not trying to
scare you. What am I in for?
Speaker 1 (02:34):
Should I just you know, close my eyes and then
hopefully you wake me up When it's over.
Speaker 3 (02:39):
You'll be awake.
Speaker 2 (02:40):
Okay.
Speaker 3 (02:41):
The most important thing is a blood test called the
PSA that's a prostate specific antigen test. Very few cancers
develop without the PSA rising, but there are some that
do so. A digital rectal exam is also important, which
is why you're wincing and wanting to be asleep.
Speaker 2 (02:58):
What I U I digital?
Speaker 4 (03:01):
But the other doctor, Wagner, doesn't look like it's got
big hands.
Speaker 3 (03:06):
For guys that are afraid, I usually hold up a
finger in your mind, and this is smaller than other things.
Speaker 4 (03:10):
Okay, yeah, Well, because when I was in the Major League,
they did a prostate exam every year in spring training,
and there's.
Speaker 2 (03:16):
No way one.
Speaker 4 (03:17):
Yeah, ever, all players and because we you know, a
lot older coaches and stuff like that, Like I said,
a lot of smokers, dippers, everything. And there's one dude
that was like six foot six, and then there's one
guy doctor, one of the doctors. Yeah, so there's two
and then there's another guy that's like five foot four,
and you're.
Speaker 2 (03:31):
Like, I'm going to that guy. Yeah, you know that
used to be a big joke. But no, listen.
Speaker 4 (03:36):
You know I've had colon cancer, so you know, I'm
big on early detection and things like That's actually saved me.
I was, uh, you know, uh, you know, the first
first level of colon cancer and so, but as far
as prostate cancer goes, is it about the same with
the colon colonoscopes, the prostate exams, things like that, About
the same age between forty and fifty you should be
(03:57):
getting regularly checked.
Speaker 3 (03:58):
Yeah, that's really when things right start in life. Colon cancer,
breast cancer, heart disease around that age.
Speaker 1 (04:05):
All right, tell me more about the other part of
this exam. The HIFU high intensity focused ultrasound, some of
the latest technology to prostate research of just detecting this stuff.
Speaker 2 (04:18):
What can you tell me about this.
Speaker 3 (04:19):
Yeah, So, high frequency ultra sound is a treatment. So
when men are diagnosed with prostate cancer, we go through
a decision making process. A lot of the cancers can
just be monitored. So about twenty five percent of men
that I see now we just keep an eye on
their cancer, monitor, their PSA monitor, the rectal exam, do
occasional biopses, and those men are very apt to die
(04:40):
with rather than from their cancer. But the other subset
needs to be treated, and there are different treatment modalities available.
Which one we pick depends on your age, your health concerns,
how bad is your cancer, et cetera, et cetera.
Speaker 2 (04:54):
But one of those is high.
Speaker 3 (04:55):
Frequency ultrasound, and to do that treatment, we put a
probe in the rectum. We emit high frequency ultrasound waves.
Those are different than the ultrasound waves to do an
ultrasound of a baby or something along those lines, and
it heats up the tissue and kills it. So we
just treat that area of the prostate that's involved with cancer.
We spare the rest of the prostate and that minimizes
(05:16):
side effects, and the main side effects are impotence, not
being able to get an erection and incontinence, which is
leakage of urine. So we see that less with the
focal therapy.
Speaker 4 (05:26):
Talking to doctor Joseph Wagner, chief urologist here at Harford Hospital,
talk about some of the the symptoms, Doc that you know,
somebody might be early stages of prostate cancer, don't even
know it, you know, obviously, they might think they have
a bladder infection or something like that, you know, a
urinary track infession, you know, give give the specifics for
(05:47):
some of our listeners that are out there.
Speaker 3 (05:48):
Yeah, so anybody with symptoms like that should certainly see
their doctor or eurologists. But it's probably not from prostate cancer.
Usually those things are from an enlarged prostate.
Speaker 2 (05:58):
You know.
Speaker 3 (05:58):
Prostate cancer is really a silent disease, a lot like
high blood pressure. So most of the symptoms that are
associated with it, getting up at night, going off and
comes out a little slow. Those are things that come
with age, usually bring the patient to the doctor, but
usually aren't caused by the cancer itself.
Speaker 1 (06:16):
Some men have told me that all of us men
are at least going to die by the age of
one hundred and twenty years old, because that's as long
as your prostate lives.
Speaker 2 (06:24):
Is that true.
Speaker 3 (06:25):
That's not true. It's true of your kidneys, though. I
have heard one of my doctor professors when I was
in med school say, it doesn't matter how well we
fix everything else. Your kidneys have a shelf life and
that's about one hundred and twenty years old.
Speaker 2 (06:37):
And that's not true for the prostate.
Speaker 3 (06:39):
No, you don't really need it, you know. I mean,
the main function of the prostate is it makes a
fluid that helps the sperm survive better, so it's mostly
for procreation. It also helps guys with their urine control.
That's why guys as they get older, they tend to
have more urinary retention issues holding on to the urine
was whereas women tend to leak more because they don't
(06:59):
have that extra thing in there holding back their urine.
Speaker 4 (07:02):
As far as men go, why are men so like
not wanting to go to the doctor. It seems like,
you know, women will go go to the doctor and
get regular checkups and stuff like that, but men are
kind of like, I'm tough, I can't do it. Or
is it getting better?
Speaker 2 (07:15):
Are men?
Speaker 4 (07:16):
Are men starting to take care of themselves and be
more self aware?
Speaker 3 (07:19):
I do think men are getting better at it. But
I think if you want to get that answer, you
should ask the psychiatrist probably or it's some sort of
professor in that realm that could answer that question for you.
I think it's just society. I think different societies are
different with it. There's also different ethnic and race groups
that are different about it, and we know we need
(07:40):
to break down those barriers just so that people get care,
you know, and live longer, happier lives.
Speaker 1 (07:46):
And again, just like Gibbs is saying early prevention, that's
the best thing. Tell people where they can go, what
they can do as far as getting the process started,
and just maybe even having the conversation.
Speaker 3 (07:55):
Yeah, so the best thing is just talk it over
with your primary care physician. They're more than capable of
doing a rectal examination. They can order the blood tests
that you need. If everything's fine, great, and it is
for most men. If it isn't, then they'll send you
to an appropriate specialist.
Speaker 2 (08:09):
Harford Healthcare bone En Joint Institute.
Speaker 1 (08:12):
I don't know how much you hang at this part
of the Hartford Healthcare.
Speaker 2 (08:16):
But it always does.
Speaker 1 (08:18):
We always find out that, like everybody works together, you
might be seeing the same patient that just had a
knee operation. And then those things kind of work together
as well, because the body is just one machine that's
all working together. Do you spend any time over here
with the ortho guys, or is this just kind of
a once in a year visit that.
Speaker 3 (08:36):
It's almost once in a year visit. I do have
a nephew who's actually going to be part of bone
and joint he's doing a fellowship next year. But he's
a trauma orthopedic surgeon and have friends.
Speaker 2 (08:45):
But you're right.
Speaker 3 (08:46):
I saw a patient today just had his hip replaced
about six weeks ago. He said his golf game is
already better from getting his head fixed. So, yeah, you
cross paths.
Speaker 1 (08:55):
We're trying to develop, and well I am. I'm trying
to develop a new product. My dad and my uncle
have this situation.
Speaker 2 (09:03):
That's why my.
Speaker 1 (09:04):
Family history, my age. I'm probably should be in your
office tomorrow. Pea bottles are hot right now for my family.
And this is no joke, man, Like, this is the
thing I mean beside the bed pea bottle I'm saying.
In the truck, I'm saying like a trucker. You know,
the truckers that try to drive twelve hours a day.
They don't want to stop. And these pea bottles have
(09:24):
always existed. Now the men like Dibbs is saying, these
dudes would rather deal with it rather go with the
pea bottle situation for ten years before they even compute
that this could be something wrong with the prostate. I mean,
have you seeing this as well? Because I'm seeing it
more than just my family.
Speaker 3 (09:42):
Yeah, there's a lot of denial, you know, out there,
I think for all diseases. So sure I do say
things like that. So do you wonder what kept you?
Speaker 1 (09:49):
I'm wondering what keeps me from putting this product out
in the market. I want to make Ben Darnell pea bottles.
Speaker 4 (09:55):
Rob Double show pea bottle Doctor Joe just here at
Harford Hospital. Do you deal with the testicles and things
like that as well?
Speaker 3 (10:04):
The last time I was on the show, I don't
know if you guys recall, but Yadio Molina, Oh that's right.
Speaker 2 (10:11):
The last time I need to say.
Speaker 4 (10:15):
One of my baseball players just got injured in a
football game and got hit in the test. But a
lot of my baseball guys refused to wear cups. Do
you see a lot of injuries. Now the football season
is back, even soccer and some of this other stuff.
We could get kicked in the groin and things like that.
Is there, like now that school is back, you see
a lot more of these male athletes coming through.
Speaker 3 (10:37):
You do you do? And there's certain sports obviously that
should more think about wearing a protective cup. Clearly a
baseball catcher positions, yeah, I mean you should think hard
about it. It's as a former soccer player, tougher in soccer, yep,
goalies probably shouldn't and do other positions. It's kind of
hard to do catching.
Speaker 2 (10:57):
I was used to it football. I stopped in eighth
grade being a protective cart.
Speaker 1 (11:02):
After eighth grade, I just again, you know, I'm not
trying to tell people this is what you should do,
this is what you should not do. It was very
uncomfortable the one I had playing football. Have they gotten better?
Have they gotten more comfortable? This is something you could invent.
Because I knew pitching in the major leagues. I hated
where whether it was the banana cup or the flat
one with my high light kick, there was never a
(11:23):
comfortable cup.
Speaker 2 (11:24):
Now, as soon as you get hit in the nuts,
you think different.
Speaker 1 (11:27):
But I got hit right above there the line drive,
but we never chilled and didn't do it.
Speaker 2 (11:32):
I listen, I have three kids. I'm blessed. But it's
not because we're stupid. No, it's because of the comfort thing.
Speaker 1 (11:38):
We didn't want to perform, like our performance meant more
than taking one to the groin. Like I'd take couple
of the groin if I catch three touchdowns.
Speaker 2 (11:46):
You'd take couple of the groin if you throw no hitter. Absolutely,
so like have they gotten better? Have they?
Speaker 3 (11:51):
I really don't think so.
Speaker 2 (11:53):
I don't.
Speaker 3 (11:53):
And when you look at the I think percentage of
you know young men were talking about right now that
wear them, it's low. I think for all sports I do,
and for just the reasons that you're saying.
Speaker 1 (12:05):
Yeah, we got we gotta get better at that. I
definitely think that holds people back. Did y'ada get a prosthetic?
Speaker 3 (12:10):
I have no idea.
Speaker 2 (12:12):
Where did you tell us that these things existed? They
do exist, have no idea, they have no idea that
that world was.
Speaker 3 (12:20):
You know, they're made of different things silicone or or
saline filled and you would never know.
Speaker 4 (12:26):
To get to so they put they insert that right
in your your scroll them exactly.
Speaker 3 (12:31):
So sometimes I do it after you know, aspout yacht
laying down and this happens.
Speaker 2 (12:40):
Listen.
Speaker 4 (12:40):
One of my teammates, Cerusebo, had testicular cancer, John Kruck
had testicular cancer. To bring him up, and I don't
know if they got like a prostetic thing, you know,
I never really thought about it though.
Speaker 1 (12:53):
Speaking of that, what is like the ages he told
us about prostate Well, what age should you start thinking
about a testicular can through exam?
Speaker 3 (13:00):
Yeah, that's younger, that's in your teenage years, and that's
a self exam, you know, once a year.
Speaker 2 (13:05):
All right, how would you know?
Speaker 3 (13:07):
You do an exam just like women do once a
month for breast cancer, but guys should do an exam
once a month in the shower and you're just feeling
for any new lumps or bumps.
Speaker 2 (13:16):
Dude, you are talent. Us we are so far behind.
Speaker 4 (13:18):
Oh my god, I'm not gonna I don't want to
get into this too much. I'm not like one that
likes to touch down there either exactly.
Speaker 1 (13:25):
And like via doctorate, men aren't doing that. But men
need to be wearing more protective cups. Men need to
go get more exams, and we need to spread the
awareness and get the thing.
Speaker 4 (13:37):
I did not know that about the testiculate cancer. I
just told you something kind.
Speaker 3 (13:41):
Of you know, if you think about it when you're
wondering about these diseases. You know, I'm a big sports fan, right,
All you have to do is think of people you
know that are famous that got these things and when
they got him, and statistically that's probably roughly when people
get these.
Speaker 4 (13:56):
Things, well, they got him in their twenties, that's particular.
That's all my guys got.
Speaker 3 (14:00):
So you start in your teens, but your highest rate
is in your twenties and thirties. Prostate cancer. Wade Bogs
sixty six had the you know, pleasure working with Joe
Torre when I worked in.
Speaker 2 (14:10):
New York City and we go it.
Speaker 3 (14:12):
Baker got it, yeh, Dusty Baker. Yeah, I mean yeah,
Ryan Sign Sandberg had metastatic disease, right.
Speaker 4 (14:20):
Yeah, and Ryan and Ryan uh he just I think
he's clear now. But with with let me ask you this,
with the with the prostate why is it so fatal
when it gets to the final stages? What what is
happening internally that has taken your life? Yeah?
Speaker 3 (14:35):
So you know, a lot of cancers once they're metastatic,
when they spread to other regions of your body, they're.
Speaker 2 (14:41):
Tough to cure.
Speaker 3 (14:42):
You know, one of the most curable ones. Getting back
to testicular cancer is testicular cancer. It melts away with
chemotherapy for most men. Why don't know, it's just more susceptible.
Part of it is, I think when you look at
testicular cancer, the cell turnover rate is very fast, doubling
very quickly, so they're not in these sort of a
(15:04):
sleep stages when the chemotherapy can't hit them. Prostate cancer
is very slow, and that might be one of the reasons.
But once it's metastatic, there are some men that are cured,
but most men were going for more of a control
state than a cure.
Speaker 1 (15:18):
We're talking to urologist doctor Joseph Wagner. I got one
more stupid question before we get into other serious stuff
to talk about all.
Speaker 2 (15:25):
These mass in the pea bottle or yes, that's worse
than the pea bottle.
Speaker 1 (15:28):
So let's say you do take one there like you
get kicked right in the nuts. We always used to say, well,
you're not going to have any girls as children there
are boys as children. You're only gonna have girls as
children because that's what's gonna happen.
Speaker 2 (15:41):
Fels.
Speaker 1 (15:42):
What are the things like when you get when you
take one. There the things that you should be worried
about why you should wear a cup other than the
initial pain that you're going to feel.
Speaker 3 (15:52):
Yeah, so we all know is guys, that hurts. If
you get severe swelling, if you get bruising, that's severe,
then you should see a urologist, and you should see
someone sooner, you know, rather than later. Sometimes what we
worry about the most is a testicular rupture that the
testicle's fractured, and those can be repaired. Those can be
(16:13):
repaired if you get to them soon enough.
Speaker 2 (16:14):
Man, you what about blood? You're urine? What could that
be a sign of?
Speaker 3 (16:18):
Yeah, So that's a lot of things, and again how
worried you are about it depends on the patient's age
and history. So things just to run a list would
be kidney stones, very common growth in the kidney or
the urinary tract like the bladder, problems with the prostate.
So the older the patient, the more you're concerned about
a cancer. If their tobacco use does matter, a lot
(16:42):
so bladder cancer. The primary cause is tobacco use.
Speaker 2 (16:46):
Wow, we've learned so much man, just this twenty minute
we needed to.
Speaker 1 (16:49):
Be faced out the right conversation, Doctor Joseph Wagner. Right,
let's run through it again. September is Prostate Cancer Awareness month.
If you are a man over forty with family history,
or a man over fifty, you need to talk to
your doctor about getting a prostate screen Testicular screening should
be done as a teenager all throughout your life. If
you feel something, you should have it, go get checked out.
(17:12):
The best thing is prevention, way before it actually happens.
What else am I missing here that men have to
start doing instead of just being a tough guy and
saying it's gonna be okay.
Speaker 3 (17:25):
I mean, that's really it, And I just want to
throw in again. Black men should start at age forty
as well. Right, they have a one and four chance
of getting prostate cancer. I just think healthy lifestyles. You know,
when you look at Americans in general and you look
at their body mass index, you know, the ratio of
their heightened weights. You know we're an overall overweight society.
So just eat well, exercise, you know, be healthy. If
(17:48):
you ever do get one of these cancers, it makes
them a lot easier to treat.
Speaker 2 (17:52):
Doctor Wagner, thank you, God, bless you for what you do.
I appreciate it.
All right, all right, we'll hold off the daily How
fascinating is that it's the daily pickle?
Speaker 2 (00:07):
We're going to replace your olog doctor wagon. We got
you right here, right here front.
Speaker 1 (00:12):
But yeah, we were going to do a daily pickle
with doctor or doctor, but a different kind of daily
pickle with doctor Joseph Wagger.
Speaker 2 (00:21):
How you doing, sir?
Speaker 3 (00:22):
I'm doing great. Nothing better than hearing yourself introduced on
eighty four and some traffic.
Speaker 1 (00:27):
All right, fantastic, thanks for I hope you didn't speed
here perfectly over here now we were talking. It's Prostate
cancer Awareness month. Has this been getting its due at all?
Or is this one of the cancer awareness months that
kind of takes a backseat to everything else?
Speaker 3 (00:43):
Yeah, I suppose it depends on who you ask. You know, certainly,
breast cancer I think still gets appropriately the play that
it deserves. The numbers for prostate cancer are the same,
almost an equal number of men diagnosed every year, equal
number of deaths.
Speaker 2 (00:57):
It's still a certain breast cancer yep, equal number.
Speaker 3 (01:00):
Yeah, very very very similar diseases. Men just don't talk
about their diseases as often as women do. It doesn't
get the research money that breast cancer does I think
breast cancer Awareness month. You look at the runs and
the walks, et cetera. You know they raise a lot
of money and good for them, and we need to
do a better job with that too.
Speaker 4 (01:19):
Let me ask you about the prostate cancer stuff, because
I know a good friend of my weight box is
just diagnosed with a lot of ex baseball players have
been diagnosed with prostate cancer, anything related to tobacco usage
or anything. And what age do you start getting regular
checkups for prostate cancer?
Speaker 3 (01:36):
Yeah, so men at average risk that means not a
family history. Not black men should start at age fifty
and men at higher risks that would be a family
history or black men should start at age forty.
Speaker 2 (01:47):
But you're right.
Speaker 3 (01:48):
If you look at any major league starting lineup right now,
one and eight men get prostate cancer one in four
black men. So you're gonna have one or two guys
on each starting lineup right now being diagnosed with prostate.
Speaker 4 (02:00):
Answer why the black men? Why are they so susceptible
to prostate cancer?
Speaker 3 (02:03):
We really don't know. It's some combination of genes and environment.
So if you look at Nigerian Africans, they have one
of the lowest rates of prostate cancer in the world.
If you look at Nigerian African Americans, they have one
of the highest rate. So it's some interplay of environmental
factors and genes that we just don't understand.
Speaker 2 (02:22):
All right, I have crossed the threshold.
Speaker 1 (02:24):
I'm in that age group that needs to have a
prostate exam.
Speaker 2 (02:28):
Dibbs has been scaring me. I am not trying to
scare you. What am I in for?
Speaker 1 (02:34):
Should I just you know, close my eyes and then
hopefully you wake me up When it's over.
Speaker 3 (02:39):
You'll be awake.
Speaker 2 (02:40):
Okay.
Speaker 3 (02:41):
The most important thing is a blood test called the
PSA that's a prostate specific antigen test. Very few cancers
develop without the PSA rising, but there are some that
do so. A digital rectal exam is also important, which
is why you're wincing and wanting to be asleep.
Speaker 2 (02:58):
What I U I digital?
Speaker 4 (03:01):
But the other doctor, Wagner, doesn't look like it's got
big hands.
Speaker 3 (03:06):
For guys that are afraid, I usually hold up a
finger in your mind, and this is smaller than other things.
Speaker 4 (03:10):
Okay, yeah, Well, because when I was in the Major League,
they did a prostate exam every year in spring training,
and there's.
Speaker 2 (03:16):
No way one.
Speaker 4 (03:17):
Yeah, ever, all players and because we you know, a
lot older coaches and stuff like that, Like I said,
a lot of smokers, dippers, everything. And there's one dude
that was like six foot six, and then there's one
guy doctor, one of the doctors. Yeah, so there's two
and then there's another guy that's like five foot four,
and you're.
Speaker 2 (03:31):
Like, I'm going to that guy. Yeah, you know that
used to be a big joke. But no, listen.
Speaker 4 (03:36):
You know I've had colon cancer, so you know, I'm
big on early detection and things like That's actually saved me.
I was, uh, you know, uh, you know, the first
first level of colon cancer and so, but as far
as prostate cancer goes, is it about the same with
the colon colonoscopes, the prostate exams, things like that, About
the same age between forty and fifty you should be
(03:57):
getting regularly checked.
Speaker 3 (03:58):
Yeah, that's really when things right start in life. Colon cancer,
breast cancer, heart disease around that age.
Speaker 1 (04:05):
All right, tell me more about the other part of
this exam. The HIFU high intensity focused ultrasound, some of
the latest technology to prostate research of just detecting this stuff.
Speaker 2 (04:18):
What can you tell me about this.
Speaker 3 (04:19):
Yeah, So, high frequency ultra sound is a treatment. So
when men are diagnosed with prostate cancer, we go through
a decision making process. A lot of the cancers can
just be monitored. So about twenty five percent of men
that I see now we just keep an eye on
their cancer, monitor, their PSA monitor, the rectal exam, do
occasional biopses, and those men are very apt to die
(04:40):
with rather than from their cancer. But the other subset
needs to be treated, and there are different treatment modalities available.
Which one we pick depends on your age, your health concerns,
how bad is your cancer, et cetera, et cetera.
Speaker 2 (04:54):
But one of those is high.
Speaker 3 (04:55):
Frequency ultrasound, and to do that treatment, we put a
probe in the rectum. We emit high frequency ultrasound waves.
Those are different than the ultrasound waves to do an
ultrasound of a baby or something along those lines, and
it heats up the tissue and kills it. So we
just treat that area of the prostate that's involved with cancer.
We spare the rest of the prostate and that minimizes
(05:16):
side effects, and the main side effects are impotence, not
being able to get an erection and incontinence, which is
leakage of urine. So we see that less with the
focal therapy.
Speaker 4 (05:26):
Talking to doctor Joseph Wagner, chief urologist here at Harford Hospital,
talk about some of the the symptoms, Doc that you know,
somebody might be early stages of prostate cancer, don't even
know it, you know, obviously, they might think they have
a bladder infection or something like that, you know, a
urinary track infession, you know, give give the specifics for
(05:47):
some of our listeners that are out there.
Speaker 3 (05:48):
Yeah, so anybody with symptoms like that should certainly see
their doctor or eurologists. But it's probably not from prostate cancer.
Usually those things are from an enlarged prostate.
Speaker 2 (05:58):
You know.
Speaker 3 (05:58):
Prostate cancer is really a silent disease, a lot like
high blood pressure. So most of the symptoms that are
associated with it, getting up at night, going off and
comes out a little slow. Those are things that come
with age, usually bring the patient to the doctor, but
usually aren't caused by the cancer itself.
Speaker 1 (06:16):
Some men have told me that all of us men
are at least going to die by the age of
one hundred and twenty years old, because that's as long
as your prostate lives.
Speaker 2 (06:24):
Is that true.
Speaker 3 (06:25):
That's not true. It's true of your kidneys, though. I
have heard one of my doctor professors when I was
in med school say, it doesn't matter how well we
fix everything else. Your kidneys have a shelf life and
that's about one hundred and twenty years old.
Speaker 2 (06:37):
And that's not true for the prostate.
Speaker 3 (06:39):
No, you don't really need it, you know. I mean,
the main function of the prostate is it makes a
fluid that helps the sperm survive better, so it's mostly
for procreation. It also helps guys with their urine control.
That's why guys as they get older, they tend to
have more urinary retention issues holding on to the urine
was whereas women tend to leak more because they don't
(06:59):
have that extra thing in there holding back their urine.
Speaker 4 (07:02):
As far as men go, why are men so like
not wanting to go to the doctor. It seems like,
you know, women will go go to the doctor and
get regular checkups and stuff like that, but men are
kind of like, I'm tough, I can't do it. Or
is it getting better?
Speaker 2 (07:15):
Are men?
Speaker 4 (07:16):
Are men starting to take care of themselves and be
more self aware?
Speaker 3 (07:19):
I do think men are getting better at it. But
I think if you want to get that answer, you
should ask the psychiatrist probably or it's some sort of
professor in that realm that could answer that question for you.
I think it's just society. I think different societies are
different with it. There's also different ethnic and race groups
that are different about it, and we know we need
(07:40):
to break down those barriers just so that people get care,
you know, and live longer, happier lives.
Speaker 1 (07:46):
And again, just like Gibbs is saying early prevention, that's
the best thing. Tell people where they can go, what
they can do as far as getting the process started,
and just maybe even having the conversation.
Speaker 3 (07:55):
Yeah, so the best thing is just talk it over
with your primary care physician. They're more than capable of
doing a rectal examination. They can order the blood tests
that you need. If everything's fine, great, and it is
for most men. If it isn't, then they'll send you
to an appropriate specialist.
Speaker 2 (08:09):
Harford Healthcare bone En Joint Institute.
Speaker 1 (08:12):
I don't know how much you hang at this part
of the Hartford Healthcare.
Speaker 2 (08:16):
But it always does.
Speaker 1 (08:18):
We always find out that, like everybody works together, you
might be seeing the same patient that just had a
knee operation. And then those things kind of work together
as well, because the body is just one machine that's
all working together. Do you spend any time over here
with the ortho guys, or is this just kind of
a once in a year visit that.
Speaker 3 (08:36):
It's almost once in a year visit. I do have
a nephew who's actually going to be part of bone
and joint he's doing a fellowship next year. But he's
a trauma orthopedic surgeon and have friends.
Speaker 2 (08:45):
But you're right.
Speaker 3 (08:46):
I saw a patient today just had his hip replaced
about six weeks ago. He said his golf game is
already better from getting his head fixed. So, yeah, you
cross paths.
Speaker 1 (08:55):
We're trying to develop, and well I am. I'm trying
to develop a new product. My dad and my uncle
have this situation.
Speaker 2 (09:03):
That's why my.
Speaker 1 (09:04):
Family history, my age. I'm probably should be in your
office tomorrow. Pea bottles are hot right now for my family.
And this is no joke, man, Like, this is the
thing I mean beside the bed pea bottle I'm saying.
In the truck, I'm saying like a trucker. You know,
the truckers that try to drive twelve hours a day.
They don't want to stop. And these pea bottles have
(09:24):
always existed. Now the men like Dibbs is saying, these
dudes would rather deal with it rather go with the
pea bottle situation for ten years before they even compute
that this could be something wrong with the prostate. I mean,
have you seeing this as well? Because I'm seeing it
more than just my family.
Speaker 3 (09:42):
Yeah, there's a lot of denial, you know, out there,
I think for all diseases. So sure I do say
things like that. So do you wonder what kept you?
Speaker 1 (09:49):
I'm wondering what keeps me from putting this product out
in the market. I want to make Ben Darnell pea bottles.
Speaker 4 (09:55):
Rob Double show pea bottle Doctor Joe just here at
Harford Hospital. Do you deal with the testicles and things
like that as well?
Speaker 3 (10:04):
The last time I was on the show, I don't
know if you guys recall, but Yadio Molina, Oh that's right.
Speaker 2 (10:11):
The last time I need to say.
Speaker 4 (10:15):
One of my baseball players just got injured in a
football game and got hit in the test. But a
lot of my baseball guys refused to wear cups. Do
you see a lot of injuries. Now the football season
is back, even soccer and some of this other stuff.
We could get kicked in the groin and things like that.
Is there, like now that school is back, you see
a lot more of these male athletes coming through.
Speaker 3 (10:37):
You do you do? And there's certain sports obviously that
should more think about wearing a protective cup. Clearly a
baseball catcher positions, yeah, I mean you should think hard
about it. It's as a former soccer player, tougher in soccer, yep,
goalies probably shouldn't and do other positions. It's kind of
hard to do catching.
Speaker 2 (10:57):
I was used to it football. I stopped in eighth
grade being a protective cart.
Speaker 1 (11:02):
After eighth grade, I just again, you know, I'm not
trying to tell people this is what you should do,
this is what you should not do. It was very
uncomfortable the one I had playing football. Have they gotten better?
Have they gotten more comfortable? This is something you could invent.
Because I knew pitching in the major leagues. I hated
where whether it was the banana cup or the flat
one with my high light kick, there was never a
(11:23):
comfortable cup.
Speaker 2 (11:24):
Now, as soon as you get hit in the nuts,
you think different.
Speaker 1 (11:27):
But I got hit right above there the line drive,
but we never chilled and didn't do it.
Speaker 2 (11:32):
I listen, I have three kids. I'm blessed. But it's
not because we're stupid. No, it's because of the comfort thing.
Speaker 1 (11:38):
We didn't want to perform, like our performance meant more
than taking one to the groin. Like I'd take couple
of the groin if I catch three touchdowns.
Speaker 2 (11:46):
You'd take couple of the groin if you throw no hitter. Absolutely,
so like have they gotten better? Have they?
Speaker 3 (11:51):
I really don't think so.
Speaker 2 (11:53):
I don't.
Speaker 3 (11:53):
And when you look at the I think percentage of
you know young men were talking about right now that
wear them, it's low. I think for all sports I do,
and for just the reasons that you're saying.
Speaker 1 (12:05):
Yeah, we got we gotta get better at that. I
definitely think that holds people back. Did y'ada get a prosthetic?
Speaker 3 (12:10):
I have no idea.
Speaker 2 (12:12):
Where did you tell us that these things existed? They
do exist, have no idea, they have no idea that
that world was.
Speaker 3 (12:20):
You know, they're made of different things silicone or or
saline filled and you would never know.
Speaker 4 (12:26):
To get to so they put they insert that right
in your your scroll them exactly.
Speaker 3 (12:31):
So sometimes I do it after you know, aspout yacht
laying down and this happens.
Speaker 2 (12:40):
Listen.
Speaker 4 (12:40):
One of my teammates, Cerusebo, had testicular cancer, John Kruck
had testicular cancer. To bring him up, and I don't
know if they got like a prostetic thing, you know,
I never really thought about it though.
Speaker 1 (12:53):
Speaking of that, what is like the ages he told
us about prostate Well, what age should you start thinking
about a testicular can through exam?
Speaker 3 (13:00):
Yeah, that's younger, that's in your teenage years, and that's
a self exam, you know, once a year.
Speaker 2 (13:05):
All right, how would you know?
Speaker 3 (13:07):
You do an exam just like women do once a
month for breast cancer, but guys should do an exam
once a month in the shower and you're just feeling
for any new lumps or bumps.
Speaker 2 (13:16):
Dude, you are talent. Us we are so far behind.
Speaker 4 (13:18):
Oh my god, I'm not gonna I don't want to
get into this too much. I'm not like one that
likes to touch down there either exactly.
Speaker 1 (13:25):
And like via doctorate, men aren't doing that. But men
need to be wearing more protective cups. Men need to
go get more exams, and we need to spread the
awareness and get the thing.
Speaker 4 (13:37):
I did not know that about the testiculate cancer. I
just told you something kind.
Speaker 3 (13:41):
Of you know, if you think about it when you're
wondering about these diseases. You know, I'm a big sports fan, right,
All you have to do is think of people you
know that are famous that got these things and when
they got him, and statistically that's probably roughly when people
get these.
Speaker 4 (13:56):
Things, well, they got him in their twenties, that's particular.
That's all my guys got.
Speaker 3 (14:00):
So you start in your teens, but your highest rate
is in your twenties and thirties. Prostate cancer. Wade Bogs
sixty six had the you know, pleasure working with Joe
Torre when I worked in.
Speaker 2 (14:10):
New York City and we go it.
Speaker 3 (14:12):
Baker got it, yeh, Dusty Baker. Yeah, I mean yeah,
Ryan Sign Sandberg had metastatic disease, right.
Speaker 4 (14:20):
Yeah, and Ryan and Ryan uh he just I think
he's clear now. But with with let me ask you this,
with the with the prostate why is it so fatal
when it gets to the final stages? What what is
happening internally that has taken your life? Yeah?
Speaker 3 (14:35):
So you know, a lot of cancers once they're metastatic,
when they spread to other regions of your body, they're.
Speaker 2 (14:41):
Tough to cure.
Speaker 3 (14:42):
You know, one of the most curable ones. Getting back
to testicular cancer is testicular cancer. It melts away with
chemotherapy for most men. Why don't know, it's just more susceptible.
Part of it is, I think when you look at
testicular cancer, the cell turnover rate is very fast, doubling
very quickly, so they're not in these sort of a
(15:04):
sleep stages when the chemotherapy can't hit them. Prostate cancer
is very slow, and that might be one of the reasons.
But once it's metastatic, there are some men that are cured,
but most men were going for more of a control
state than a cure.
Speaker 1 (15:18):
We're talking to urologist doctor Joseph Wagner. I got one
more stupid question before we get into other serious stuff
to talk about all.
Speaker 2 (15:25):
These mass in the pea bottle or yes, that's worse
than the pea bottle.
Speaker 1 (15:28):
So let's say you do take one there like you
get kicked right in the nuts. We always used to say, well,
you're not going to have any girls as children there
are boys as children. You're only gonna have girls as
children because that's what's gonna happen.
Speaker 2 (15:41):
Fels.
Speaker 1 (15:42):
What are the things like when you get when you
take one. There the things that you should be worried
about why you should wear a cup other than the
initial pain that you're going to feel.
Speaker 3 (15:52):
Yeah, so we all know is guys, that hurts. If
you get severe swelling, if you get bruising, that's severe,
then you should see a urologist, and you should see
someone sooner, you know, rather than later. Sometimes what we
worry about the most is a testicular rupture that the
testicle's fractured, and those can be repaired. Those can be
(16:13):
repaired if you get to them soon enough.
Speaker 2 (16:14):
Man, you what about blood? You're urine? What could that
be a sign of?
Speaker 3 (16:18):
Yeah, So that's a lot of things, and again how
worried you are about it depends on the patient's age
and history. So things just to run a list would
be kidney stones, very common growth in the kidney or
the urinary tract like the bladder, problems with the prostate.
So the older the patient, the more you're concerned about
a cancer. If their tobacco use does matter, a lot
(16:42):
so bladder cancer. The primary cause is tobacco use.
Speaker 2 (16:46):
Wow, we've learned so much man, just this twenty minute
we needed to.
Speaker 1 (16:49):
Be faced out the right conversation, Doctor Joseph Wagner. Right,
let's run through it again. September is Prostate Cancer Awareness month.
If you are a man over forty with family history,
or a man over fifty, you need to talk to
your doctor about getting a prostate screen Testicular screening should
be done as a teenager all throughout your life. If
you feel something, you should have it, go get checked out.
(17:12):
The best thing is prevention, way before it actually happens.
What else am I missing here that men have to
start doing instead of just being a tough guy and
saying it's gonna be okay.
Speaker 3 (17:25):
I mean, that's really it, And I just want to
throw in again. Black men should start at age forty
as well. Right, they have a one and four chance
of getting prostate cancer. I just think healthy lifestyles. You know,
when you look at Americans in general and you look
at their body mass index, you know, the ratio of
their heightened weights. You know we're an overall overweight society.
So just eat well, exercise, you know, be healthy. If
(17:48):
you ever do get one of these cancers, it makes
them a lot easier to treat.
Speaker 2 (17:52):
Doctor Wagner, thank you, God, bless you for what you do.
I appreciate it.
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