June 1, 2025 • 39 mins
Tonight, on Your Health First Dr. Galati continues the discussion of prostate cancer. He has Certified Urologist Dr. Brian Miles join the show to talk about the PSA screening tool in men over the age of 50 and the weight we put on it. Dr. Galati spends the last segment discussing a New York Times article about exercise and depression.
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Episode Transcript
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(02:21):
All right, so on the program tonight, we are going
to be continuing our discussion on prostate cancer. We have
on the phone a little later this evening, a true
expert in prostate cancer, doctor Brian Miles, who is at
Houston Methodist Hospital here in the Texas Medical Center, a
(02:41):
pioneer and not only robotic surgery for prostate cancer, but
the approach to patients with prostate cancer. And certainly with
the revelation of what was disclosed about President Biden a
couple of weeks ago in his prostate we're going to
get an opinion or suggestion of what may have actually
(03:03):
happened with President Biden and learn about that. The one
thing I want to chat about is and this really
gets into prostate cancer or any cancer where you're getting
a second opinion. The New York Times had an article
talking about logging on for a second or third opinion,
(03:25):
so logging on meeting, going to Google or somewhere on
the internet for a second opinion. And I have always
been a big advocate of getting a second opinion. So
many of the patients that I see, I am seeing
them as a second, third, or even a fourth opinion.
So it is important that you if you're confronted with
(03:47):
a diagnosis, whether it's life threatening or not life threatening,
that you consider getting a second opinion. But in this
day and age, so many people are going online and
looking for a second opinion.
Speaker 3 (04:02):
And the amount of Google.
Speaker 4 (04:06):
Searches that have to do with health and wellness is
really quite predominant. And this is what we are all
doing now. It is a good thing. I'm not going
to say don't do it, but I would believe that
there is information that you can get that is inaccurate,
(04:30):
and so you don't want to search thinking that you're
going to find information that's going to be helpful to you,
but then at the end of the day end up
penalizing yourself.
Speaker 2 (04:44):
So the.
Speaker 4 (04:48):
Current strategy out there is that so many people that
have a particular disease, whether it's prostate cancer, whether it's
multiple sclerosis, whether it is breast cancer, people are posting
information about their own case, their own treatment, their own
(05:09):
sort of follow up after surgery. And by creating this
community around a certain disease, there is a benefit to this.
There is the opportunity to see what other people went through,
but you have to keep it in the context of
your own case, your own particulars with regard to your
(05:32):
health and wellness, and have a really healthy conversation with
your physician. But when you look at the different websites
that you could look at, there are basically five categories
of websites that you want to look at. The first
would be general interest websites, something like WebMD or even
(05:56):
the New York Times health site. It is of value
and so this is where you're going to get information
about a particular disease, news and lifestyle advice, and learn
from medical institutions like Mayo clinics, so that's a general interest.
(06:18):
The second is a medical research site. So if you
want to learn about what is being done or published
within research, you're going to have to go to a
website like PubMed, which is done which is really organized
under the National Library of Medicine, but if you just
(06:41):
type in PubMed you will find out. The other is
a website called Clinicaltrials dot gov, which will track various
research protocols, and you can actually type in a disease
and where you live and it will narrow down something
that's in your particular neighborhood. Then there are a number
(07:03):
of patient sites, and this is really what is booming.
There's the Association of Cancer Online Resources. There is something
called epatients dot net, as well as a site patients
like me and Trusira t r U s e r
(07:28):
a dot com which provides a bit of a Facebook
style like social connection for patients. Then you get into
the disease specific sites, which would be American Heart Association,
American Cancer Society, American Diabetes Association, which will sort of
target a particular disease. And then lastly there are web
(07:53):
tools that will help you learn about nutrition, disease risk, factors,
certain medications that you will be on. So there's a
lot there. I'm going to post this article on the
Facebook page which is at doctor Joe Galotti.
Speaker 3 (08:15):
But it's interesting. So again, we.
Speaker 4 (08:17):
Don't want you to not search online. I believe you
have to be a good consumer and open to all
of this information and trying to sort of out. All right,
we're going to take a quick break right now. You
tuned into your health First. Every Sunday between seven and
eight pm, visit doctor Joegalotti dot com for more information
(08:40):
about me, our team and our Livid Disease practice. Doctor
Brian Miles talking about prostate cancer coming up in just
a minute before all right, Well, as I've been saying
this evening, we have a true expert and need I
say a legend in the world of urology is a
very modest gentleman, doctor Brian Miles, who his credentials are
(09:03):
impeccable where he is the vice chair of Urology at
Euston Methodist Hospital, He's a professor of urology, he's the
director of Robotic Surgery at Houston Methodist Hospital and truly
an individual that in the field of medicine when you
talk about prostate cancer. Doctor Brian Miles's name comes up,
So Dodtor Miles. So great to have you on the
(09:26):
program this evening.
Speaker 2 (09:27):
Jill, thank you so much for including me, and this
is a wonderful opportunity to talk about something that is
foremost in many men's minds in this time.
Speaker 4 (09:38):
Yes, for sure, and certainly with the revelation of President
Biden and his diagnosis, it's raised questions but also some
confusion as to what I should do, and we will
certainly get to that. So you know, the basic issue
is every man over fifty, let's say, know what their
(10:01):
PSA is, prostate specific antigen. And even this has become
a little controversial. So what is your explanation everybody tonight
about PSA?
Speaker 3 (10:12):
Who should get it?
Speaker 4 (10:13):
And how much weight do we put on it if
it is indeed elevated?
Speaker 2 (10:18):
Well, PSA is an important screening tool. There's no other
wonderful blood test like this for any other cancer, breast
cancer or colon cancer. Could find a blood test like this,
it would be a huge help. But PSA just gives
us an idea that someone might be at increased risk
(10:40):
right now. The guidelines say you should start at age fifty,
and they tend to say stop at age seventy five.
If you have a family history of prostate cancer or
you're African American, I believe you need to start getting
tested at age forty because your risk is substantially higher.
(11:01):
I would also add it, I my Joe, that PSA
is a screening tool. If someone has an elevated PSA,
I don't rush to biopsy. In the old days, we would.
What I do now is another specialized test. There are
many varieties, but the one I use is called a
four K test that looks at all aspects of PSA
(11:23):
and one of the proteins of the Cali crime family.
That PSA is a part of that family. That helps
us predict whether someone has a true risk of cancer.
Right if someone has a mildly elevated PSA, Joe, chance
of having cancer is twenty eight to thirty percent, you know,
I mean between four and nine. But I'm biasing one
(11:44):
hundred men to find those. If I do a four
K test, I only have to do I only have
to buy the sixty men to find the same number
the same thirty. It's a very helpful test.
Speaker 4 (11:54):
So I would say over the past ten years or so,
or maybe fifteen years. Organizations like the American Cancer Society
have come out somewhat to the chagrin of experts like you,
that maybe we don't need to check PSA. Too many
biopsies are being done. What do you say to that today,
(12:15):
with the knowledge that you all.
Speaker 2 (12:16):
Have, that's wrong. That's wrong. We found when the US
Prevented the Task Force came out with their recommendations, like
the American Cancer Society, five years later, we found that
the increase in people presenting with metastatic disease like President
(12:37):
Biden shot almost straight up as you would predict. Five
years is about the time it takes from inception of
a disease that's fairly aggressive to metastatic disease, so that
they're wrong. And you know, it's hard for many of
us to admit, perhaps we were wrong, but this was wrong. Unfortunately,
(13:01):
it is still in the mindset of some primary care doctors.
But I think that with President Biden, we should all
wake up.
Speaker 4 (13:12):
Yeah, yeah, And I would say you're right that sometimes
when these these new rules come down or suggestions, it
becomes the word of the land, and it is more
difficult and more problematic to unravel that thinking you almost
have an entire generation of physicians trained that PSA really
(13:32):
isn't that important and they're not getting it done.
Speaker 2 (13:36):
I couldn't agree more. Couldn't agree more.
Speaker 4 (13:38):
Yeah, Now, with regard to risk factors for prostate cancer,
you mentioned African American and that certainly is significant. But
what are some of the other risk factors, be it
obesity or diabetes, smoking, alcohol, things like that.
Speaker 2 (13:54):
Well, it's certainly family history is the next big one
after AfOR race being African American, But obesity, for instance,
there's really not an increase in prostate cancer disease so
much as there is an increased risk of being more
(14:15):
aggressive disease. Meaning if you're diabetic it doesn't or obese
it doesn't mean you have a higher risk of getting it,
but if you do get it, there's a higher risk
that it's a much more aggressive cancer. Diet Diet is always,
as you know, everything in life eventually comes down to
diet because diet is what can we as individuals do
(14:39):
to modify our risk. And unfortunately there's no real good
data on this. I will tell you that in this country,
people spend over one trillion dollars on nutraceuticals meaning vitamins
(14:59):
and very substances to help modify their risk of cancer,
prostate cancer being very high on that list, and yet
none of them have really been studied well enough to
show what the true benefit is. So there's nothing you
can really do there. Keep your weight good, be active,
keep your immune system good, so even if you get
(15:20):
prostate cancer, it'll be easily managed.
Speaker 4 (15:22):
Right, right, And that's so general for everything, cardiovascular disease,
liver disease, lung diseases.
Speaker 3 (15:30):
Got it.
Speaker 4 (15:31):
You want to have a healthy diet, stay active, and
keep your weight down. Now, symptoms of prostate cancer, because
a lot of people will say, well, gee, my PSA
may be elevated, but I feel fine. What are the
symptoms that may be very mild and nonspecific, and what
are the absolute red flags to say you need to
(15:53):
get in see an expert like yourself with regard to
their prostate health.
Speaker 2 (15:58):
None.
Speaker 3 (16:01):
Okay, that's that's very easy.
Speaker 2 (16:04):
Because when we ask questions, we always ask questions like
are you getting up too often at night? Is your
stream week? Are you having urgency? These are signs of
benign growth of the prostate, but any they are not
signs of someone having increased risk of prostate cancer. Fact
the matter is that, as in most cancers that you
(16:27):
know of, Joe, if you get symptoms that are directly
related to that cancer, it is most likely already.
Speaker 4 (16:34):
Spread, right right, Yeah, exactly. So again it gets back
to early intervention and really awareness. Would you would you
say that when you look at prostate and if you
just want to compare it to breast cancer, which certainly
everybody is aware of, it's on everyone's mind, do you
find that the general awareness of men and prostate cancer
(16:56):
is lacking?
Speaker 2 (16:57):
Oh? Absolutely, Men. Breast cancer, by the way, and prostate
cancer a fairly similar. Breast cancer tends me a little more,
a little more aggressive, but also found a little later.
It doesn't have blood tests, it doesn't have that PSA test.
But men are still historically fairly stoic and at some
(17:19):
level whims I don't want to go to the doctor,
They don't want to go to the doctor that I have,
and they certainly don't want me examining their prostate rect right.
But women are much more proactive. I think this comes
from motherhood and all of those things. Perhaps where you're
taking care of the family, a caregiver, and the family's
mom and breast cancer and women coordinate better they you know,
(17:43):
the breast cancer walks are so important. You won't find
much of that. And men it's it's but women tend
to take care of their husbands. Nine times out of
the ten. A guy coming in to see me, if
he doesn't have an elevated PSA already, is because his
wife wants me to examine it.
Speaker 3 (18:01):
Yeah, excited, you know, speaking of the examination.
Speaker 4 (18:04):
And you know, we've gotten so much more technology and
scanning and fancy blood works. Is the digital rectal exam
a dead item or should we still be Should we
still be doing these on our man and encouraging primary
care physicians to do a rectal exam to say, on
(18:26):
that digital exam, you may find a prostate cancer.
Speaker 3 (18:30):
What do you think?
Speaker 2 (18:32):
Well, you know, this becomes generational. I'm a bit older,
So I was raised with a digital rectal exam. PSA
came out just after I finished residency, and so we
only found prostate cancer through the digital rectal exam, right,
And so that's what would lead to a biopsy. But
back then, fifty percent of the de men already had
(18:53):
advanced disease beyond the prostate So thank god with PSA
that's changed dramatically, and so I still recommended yours little
rectal exam. But is it critical. No, if you have
an equivocal PSA, I think it's very important. But if
you've got to do one test, do the PSA not
directly right?
Speaker 3 (19:13):
Exactly? All right, We're going to take a quick break.
Speaker 4 (19:16):
We're talking with doctor Brian Miles, a world renowned urologist
and prostate cancer expert, on your Health First this Sunday
evening on.
Speaker 3 (19:24):
Doctor Joe Galotti.
Speaker 4 (19:25):
Don't forget doctor Jogalotti dot com is our website. Stay
tuned more prostrate discussion in a moment. Welcome back everybody,
doctor Joe Glotti, thanks for tuning in on this glorious
Sunday evening to your Health First. We hear every Sunday
between seven and eight pm bringing you.
Speaker 3 (19:45):
The best in health and wellness.
Speaker 4 (19:47):
We want to raise your health IQ, make you better
consumers of healthcare, making sure that you have all of
the facts you need to stay healthy, to stay on
top of your health and all of the important topics
such as prostate cancer, which sometimes is just in a
black box that we just don't want to talk about things.
(20:10):
But tonight on the program, we have been chatting with
doctor Brian Miles, a true expert in prostate cancer here
in Houston, Texas at Houston Methodist Hospital where he is
the Professor of Urology and the director of the Division
of Robotic Surgery. And it's so great to have him
(20:31):
on the program tonight explaining to us what we need
to know about prostate cancer. So take me through a
sixty year old gentleman that has on routine screening PSA
is elevated, and maybe over the last five years the
PSA was sort of in the normal range and this
year it jumped up a little bit and either the
(20:54):
primary care or the guy's wife said, wait a second,
we have to get this worked up. They come and
see you or some other eurologic expert, and what is
the plan of care. How do you approach a patient
like this?
Speaker 2 (21:11):
Well, as I said said earlier, besides doing a digital
rec exam, I also do the four K tests and
advanced test that is looking at total PSA, free PSA,
complex PSA and HK two that protein within the calikrin
family that PSA is a part of. That tells me
(21:33):
whether this person really has an increased risk of prostate cancer,
or whether it's just related to the genetics of his
family and his age. As we get older, the PSA
tends to go up within families. There are PSA patterns.
I can think of a family I once that with
six brothers, and they all as each brother got to
(21:56):
age sixty, their PSA got to ten of a big number.
None of them ever had positive cancer. So there is
a familial trend to some of these things, and you
have to fit that into the pattern of what you're
doing with the patient. But a sixty year old I'm
going to get a four K test of it shows
an intermediate elevated risk, I'll get an MRI of the prostrate.
(22:20):
If it's elevated risk, they're going to get a biopsy.
Whether the MRI is positive or not. If the four
K test says intermediate risk for aggressive disease or disease,
it should be treated. The MRI is negative, I'll watch
them for intermediate group. So you know, you don't want
to be you don't want to be doing what the
American Cancer Society said, we were always doing, over diagnosing,
(22:44):
over biopsing, this sort of thing. You want to do
it with some thought process that has value for the
patient without putting them in harm's way by scaring them
because they have a really low grade disease, or by
a scaring them the all negative bio scenes. But are
still wonder to be harboring cancer.
Speaker 4 (23:05):
There right right now, you have been one of the pioneers. Gosh,
it's probably been twenty plus years with robotic surgery on
the prostate. And what is the current state of affair
with regard to prostate surgery? Because I would think that
men are petrified of having that prostate cut out. They
(23:25):
may have trouble with impotence and urinary incontinence, and they
would almost well, I can't speak for them. They would
almost say, forget about it, this is not for me.
I'll take chemo, I'll take radiation. Where are we at
with state of the art prostate cancer technology?
Speaker 2 (23:47):
Well, I would say that with appropriate informed consent, which
form consent means you expose the patient to risk. What's
the potential for risk, So risk knowledge and then risk
acceptance and whether you get Chemotherapy has no role in
(24:10):
prostate cancer till very late. So your choices are doing radiation,
having me remove the prostrate or having me treat the
prostrate with what are called a BLATI of therapies like
high intensity focused ultra scenography or cryosurgery. Right, those localized
treatments all have risk impotence, incontinence, and problems with the
(24:39):
rectum or bladder depending on the treatment options. And the
fact of the matter is that they are generally minor
minimal if you will accept for impotence. Impotence is the
one thing where you know, at least the third of
men will in general depending on age, but in general
(25:02):
we'll have problems getting back to normal rectile capacity. We're
still studying that. I have. I've created what's called a
survivorship clinic for my patients, trying to find ways to
get their erections back if they were sexually potent and
and interested remain interested in being intimate with their partner, Okay,
(25:26):
And so there's a lot going on there because that
is that is the key. I don't want to cure
cancer and yet create another disease us, and so we
have to focus on that.
Speaker 4 (25:40):
Yeah, So with removal of the prostate, the rates of
cure are very good, would you say that?
Speaker 2 (25:50):
Yeah? I mean, you know, they're not one hundred percent
whether you're radiated or remove it. But the thing I
always catch it early and treat the primary disease. The
chance of death from prostate cancer is very unusual.
Speaker 4 (26:08):
So now that segues into the recent news a week
or so ago with President Biden, this revelation out of
nowhere that he has prostate cancer, let alone it is
advanced to his bones apparently. So there's all kinds of
speculation and we are not here to create some political
(26:30):
chaos and be controversial. But what do you think went
on there from a professional standpoint.
Speaker 2 (26:39):
Well, it is really hard to explain that It's easy
to judge, but you have to be careful having not
been there and what you were allowed to do or
not allowed to do. Possibly the person who's taking care
of the president. The primary care doc was a firm
(27:01):
believer that when you're older, you don't need to get
a PSA. I am, as you know, different than that.
I wrote a paper quite a few years ago, still
have to get a published because people didn't want to
buy it. That age is an independent predictor of getting
high risk disease. You're over the age of seventy five,
(27:22):
your chance of having high risk cancer is fifty percent
as opposed to twenty or twenty five percent. And so
that was not well received because I do PSAs based
on the patient's robustness and their willingness to do that. Again,
getting older, I've noticed that the years pile up, but
(27:42):
I don't get old and you don't. And so anyhow,
somebody missed the ball and didn't do a PSA on
this man, because I can tell you he is his
PSA is very high, over fifty, over fifty at least
I would expect. And you know, it's unfortunate because he
(28:03):
will die of this disease or his treatment, his treatment
with hormone therapy and all will further impact his cognition.
Speaker 3 (28:12):
Right, And so your.
Speaker 4 (28:15):
Generalized theory is that going back ten years, his PSA
may have been creeping up until it got to a
critical point of the amount of disease in the pro
state where it sort of broke loose.
Speaker 3 (28:30):
Correct, correct, Yeah.
Speaker 4 (28:32):
So is there is there, and you know it's you
hate to hear that somebody like this, especially somebody as
so much under the microscope as any president or dignitary
or famous person that that right in a sense, right
before us, this took place. But is there a lesson
(28:54):
for everybody tuning in tonight to have them recalibrate how
they are looking at prostate cancer for themselves or a
parent or another loved one.
Speaker 2 (29:04):
Yes, I think they should. That this would hopefully enlighten
your average mail out there that you know it's this
is something that can sneak up on you and suddenly
you're eighty and you're feeling like you're sixty and some
and you never got your PSA checked because you know,
the government task force said I don't have to do that,
(29:26):
and you suddenly have metastatic disease and your life as
you knew it it's not the same anymore. So it's
it's something that men should take cautiously, should be aware of,
but don't be afraid of getting a PSA and going
to an expert, because elevated PSA doesn't mean someone's going
to put needles in your prostate. It means they're going
(29:48):
to look at it a little more closely and see
what your risk are. What can we do do other
studies like MRIs or PET scans and help reassure you
that your life is still yours.
Speaker 4 (30:01):
Right and certainly you want that expert care. And so
here in Texas and certainly in Houston, you and your
colleagues are definitely the go to people. But if somebody
is living in Colorado or New England somewhere, is it
in a sense adequate enough to go to a general urologist.
Speaker 3 (30:23):
Should they look.
Speaker 4 (30:24):
Up somebody that specializes in prostate cancer? How do you
give direction?
Speaker 2 (30:29):
Well, my sense of that is that a board certified
urologist is well trained to deal with this and move
forward with it. If a man has prostate cancer, always,
of course seek a second opinion. If someone does that
with me, it doesn't that's not an insult to me.
That's a rational thing that people should do, and it's
(30:51):
when But when you're dealing with an abnormal LAMB value,
what you want to do is go to a urologist.
Have the mixam in you. You know, the community urologists
who refer to me are terrific surgeons are terrific docs, right,
And I would have no problem at all with anyone
(31:12):
who has an elevated PSA going to the nourish urology
and talking with them about this.
Speaker 4 (31:18):
All right, Well, Brian Miles from Houston Method Hospital, you
know years ago, Brian, when I first started getting on
the radio, they had said, you know what you for
me this show. We don't have guests on the program.
We have experts, and you certainly and you certainly fit
that bill, Doctor Brian Miles, Houston Methodist Hospital expert Urologists,
(31:42):
thanks so much for it. It's always great and we
do need to get together and cook up some pizza together.
Speaker 2 (31:47):
And I am counting on that, Doctor Galotti.
Speaker 4 (31:50):
All right, Brian, thank you so much. All right, final
segment of this week's Your Hell First is coming up
in just a moment, thanks to doctor Bryan Miles.
Speaker 3 (32:00):
Don't forget.
Speaker 4 (32:01):
Doctor Joeglotti dot com is our website, center for our newsletter,
everything that we do, our team, it's all there on
doctor Joe Galotti dot com. We'll be right back. Final
segment of Your Health First on this Sunday evening, Doctor
Joe Galotti. Don't forget go to doctor Joe Galotti dot com.
Doctor Joe Galotti dot com. Now you may be sitting
(32:22):
there saying, well, how does this guy spell his name?
G A l A t I Doctor Joe Galotti. No spaces,
no periods, just doctor Joe Galotti dot com. Me I
don't pay by mills.
Speaker 1 (32:40):
What do I think got growth?
Speaker 2 (32:49):
All? Right?
Speaker 4 (32:49):
Final segment here, I hope you're having a good Sunday
night and getting planned for the weekend. You know, for
so many years, what I've been doing is we've always
used Sunday night as the time to plan the week out.
(33:10):
What are we eating, what are our activities? Looking at
a calendar and planning it would be around not only
what we were doing, but what about eating. It's always very,
very important that you have that plan for you, your family,
your kids, and those that you care most about. In
(33:34):
the final segment here, I found an article which was
in the New York Times column in their health section
in their fizz ed area, and I would say, if
you are interested in health and wellness, this is a
very nice column by Gretchen Reynolds, and it has to
(33:59):
do with exercise and depression. Now, the slight twist here
is this is a study that I don't think has
really ever been done to this level. Now, there have
been studies in the past that show exercise, one form
(34:20):
or another is good for your mood, makes you a
little happier, and it doesn't make you as depressed. Maybe
you sleep a little better. You tend to wake up
a little bit more refreshed when you exercise. I think
we all know this, but this particular study got into
(34:41):
it way deeper, and it's pretty interesting. They get into
this Mendelian randomization. And what they did was they went
into a database of I believe four one hundred thousand
men and women, and we carry a little piece of
(35:05):
genetic material that is encoded for whether or not you
are at risk for depression, and also whether you were
going to be active or more sedentary. And so what
they did was they looked at the people that had
(35:26):
the more active gene and the depression gene, and lo
and behold, they found that the people that were less
depressed exercised more and vice versa. Now, there's still a
lot of questions that one would have when you look
(35:49):
at something to this grand scale. And what they found
is that about fifteen minutes a day is enough to
reduce the chance of developing depression. Now, if you had
less taxing exercise, let's say say housework, walking fast, you
(36:16):
needed about an hour to cut down and make a
dent in the depression. So for those that now, again
you're not going to go to the laboratory tomorrow and say, hey,
test me, test my genes for depression, or test my
genes if I should be more active or not. The
(36:39):
bottom line is, somehow we all need to carve out
time a little every day for some vigorous exercise. And
there's so many ways to do that. Ride a bike,
get a stationary bike, go running, get on a treadmill,
(37:02):
do some workouts, play basketball, play a little tennis, play
a little handball. There's so many things.
Speaker 3 (37:09):
That we all could do.
Speaker 4 (37:12):
And realize that it may have a definite impact on
your depression. Now, the reason I brought this up and
the reason that caught my eye, so many of my
patients say or report that they are depressed. They just
are not happy. They feel like they have the weight
of the world on their shoulders, the glass is half empty,
(37:35):
and I do not understand why I do talk with them. Now,
I am not a psychiatrist, but I believe I need
to take a few minutes and talk with my patients
and try to understand what's going on, because if they're depressed,
it's going to interfere with what I have to do
with them. If they're depressed, they're not going to eat well.
(37:56):
If they're depressed, they're probably not going to exercise. If
they're depressed, they're less likely.
Speaker 3 (38:02):
To follow up.
Speaker 4 (38:05):
And and so I do take tremendous interest in this.
But so many people out there, many of you listening tonight,
just feel that their life is just not right.
Speaker 3 (38:17):
They wish they were happier.
Speaker 4 (38:22):
And that's a that's a that's a tough nut to solve.
But can we fix some of this with exercise and
and getting down to the to the basics. I just
don't know. So I think what you need to do
is you have to be mindful with regard to not
only what you're eating. And as I said at the
very beginning of the program tonight, we have to get
(38:44):
to a point where we are listening to our bodies.
Are you getting these signals? Are you appreciating that little
bit of abdominal pain or that pain in your leg,
that pain in your neck, that pain in your side,
the shortness of breath, a wheezing that you may be getting.
And again, you don't want to become a hypochondrias, but
(39:04):
you need to listen to what's going on. All right,
we're gonna close out for tonight I'm gonna pick a
song that should make you a little happy as we
as we go out of here tonight.
Speaker 3 (39:17):
I'm doctor Joglotti.
Speaker 4 (39:18):
Don't forget dot go to doctor joglotti dot com. We'll
see you next Sunday night. Have a great week. Truly,
I do mean that. Stay well now
Initialize sequencing coming to you live from Houston, Texas, home
to the world's largest medical center.
Speaker 2 (00:09):
Phrase everything.
Speaker 1 (00:09):
Look, this is your Health First, the most beneficial health
program on radio with doctor Joe Bellotti. During the next hour,
you'll learn about health, wellness and the prevention of disease.
(00:30):
Now here's your host, doctor Joe Bellotti.
Speaker 3 (00:40):
Well, the good Sunday evening to everybody.
Speaker 4 (00:41):
Doctor Joe Gillotti, thanks for tuning in this Sunday evening.
And if you're new to this program, you're new to
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(01:01):
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Speaker 3 (01:12):
Make sure you.
Speaker 4 (01:14):
Set your calendar and schedule every Sunday at seven pm
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we've been on the radio every Sunday night, we are
(01:35):
going to provide you with actionable information that you can
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on the spot to follow along with all of us
(01:57):
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(02:21):
All right, so on the program tonight, we are going
to be continuing our discussion on prostate cancer. We have
on the phone a little later this evening, a true
expert in prostate cancer, doctor Brian Miles, who is at
Houston Methodist Hospital here in the Texas Medical Center, a
(02:41):
pioneer and not only robotic surgery for prostate cancer, but
the approach to patients with prostate cancer. And certainly with
the revelation of what was disclosed about President Biden a
couple of weeks ago in his prostate we're going to
get an opinion or suggestion of what may have actually
(03:03):
happened with President Biden and learn about that. The one
thing I want to chat about is and this really
gets into prostate cancer or any cancer where you're getting
a second opinion. The New York Times had an article
talking about logging on for a second or third opinion,
(03:25):
so logging on meeting, going to Google or somewhere on
the internet for a second opinion. And I have always
been a big advocate of getting a second opinion. So
many of the patients that I see, I am seeing
them as a second, third, or even a fourth opinion.
So it is important that you if you're confronted with
(03:47):
a diagnosis, whether it's life threatening or not life threatening,
that you consider getting a second opinion. But in this
day and age, so many people are going online and
looking for a second opinion.
Speaker 3 (04:02):
And the amount of Google.
Speaker 4 (04:06):
Searches that have to do with health and wellness is
really quite predominant. And this is what we are all
doing now. It is a good thing. I'm not going
to say don't do it, but I would believe that
there is information that you can get that is inaccurate,
(04:30):
and so you don't want to search thinking that you're
going to find information that's going to be helpful to you,
but then at the end of the day end up
penalizing yourself.
Speaker 2 (04:44):
So the.
Speaker 4 (04:48):
Current strategy out there is that so many people that
have a particular disease, whether it's prostate cancer, whether it's
multiple sclerosis, whether it is breast cancer, people are posting
information about their own case, their own treatment, their own
(05:09):
sort of follow up after surgery. And by creating this
community around a certain disease, there is a benefit to this.
There is the opportunity to see what other people went through,
but you have to keep it in the context of
your own case, your own particulars with regard to your
(05:32):
health and wellness, and have a really healthy conversation with
your physician. But when you look at the different websites
that you could look at, there are basically five categories
of websites that you want to look at. The first
would be general interest websites, something like WebMD or even
(05:56):
the New York Times health site. It is of value
and so this is where you're going to get information
about a particular disease, news and lifestyle advice, and learn
from medical institutions like Mayo clinics, so that's a general interest.
(06:18):
The second is a medical research site. So if you
want to learn about what is being done or published
within research, you're going to have to go to a
website like PubMed, which is done which is really organized
under the National Library of Medicine, but if you just
(06:41):
type in PubMed you will find out. The other is
a website called Clinicaltrials dot gov, which will track various
research protocols, and you can actually type in a disease
and where you live and it will narrow down something
that's in your particular neighborhood. Then there are a number
(07:03):
of patient sites, and this is really what is booming.
There's the Association of Cancer Online Resources. There is something
called epatients dot net, as well as a site patients
like me and Trusira t r U s e r
(07:28):
a dot com which provides a bit of a Facebook
style like social connection for patients. Then you get into
the disease specific sites, which would be American Heart Association,
American Cancer Society, American Diabetes Association, which will sort of
target a particular disease. And then lastly there are web
(07:53):
tools that will help you learn about nutrition, disease risk, factors,
certain medications that you will be on. So there's a
lot there. I'm going to post this article on the
Facebook page which is at doctor Joe Galotti.
Speaker 3 (08:15):
But it's interesting. So again, we.
Speaker 4 (08:17):
Don't want you to not search online. I believe you
have to be a good consumer and open to all
of this information and trying to sort of out. All right,
we're going to take a quick break right now. You
tuned into your health First. Every Sunday between seven and
eight pm, visit doctor Joegalotti dot com for more information
(08:40):
about me, our team and our Livid Disease practice. Doctor
Brian Miles talking about prostate cancer coming up in just
a minute before all right, Well, as I've been saying
this evening, we have a true expert and need I
say a legend in the world of urology is a
very modest gentleman, doctor Brian Miles, who his credentials are
(09:03):
impeccable where he is the vice chair of Urology at
Euston Methodist Hospital, He's a professor of urology, he's the
director of Robotic Surgery at Houston Methodist Hospital and truly
an individual that in the field of medicine when you
talk about prostate cancer. Doctor Brian Miles's name comes up,
So Dodtor Miles. So great to have you on the
(09:26):
program this evening.
Speaker 2 (09:27):
Jill, thank you so much for including me, and this
is a wonderful opportunity to talk about something that is
foremost in many men's minds in this time.
Speaker 4 (09:38):
Yes, for sure, and certainly with the revelation of President
Biden and his diagnosis, it's raised questions but also some
confusion as to what I should do, and we will
certainly get to that. So you know, the basic issue
is every man over fifty, let's say, know what their
(10:01):
PSA is, prostate specific antigen. And even this has become
a little controversial. So what is your explanation everybody tonight
about PSA?
Speaker 3 (10:12):
Who should get it?
Speaker 4 (10:13):
And how much weight do we put on it if
it is indeed elevated?
Speaker 2 (10:18):
Well, PSA is an important screening tool. There's no other
wonderful blood test like this for any other cancer, breast
cancer or colon cancer. Could find a blood test like this,
it would be a huge help. But PSA just gives
us an idea that someone might be at increased risk
(10:40):
right now. The guidelines say you should start at age fifty,
and they tend to say stop at age seventy five.
If you have a family history of prostate cancer or
you're African American, I believe you need to start getting
tested at age forty because your risk is substantially higher.
(11:01):
I would also add it, I my Joe, that PSA
is a screening tool. If someone has an elevated PSA,
I don't rush to biopsy. In the old days, we would.
What I do now is another specialized test. There are
many varieties, but the one I use is called a
four K test that looks at all aspects of PSA
(11:23):
and one of the proteins of the Cali crime family.
That PSA is a part of that family. That helps
us predict whether someone has a true risk of cancer.
Right if someone has a mildly elevated PSA, Joe, chance
of having cancer is twenty eight to thirty percent, you know,
I mean between four and nine. But I'm biasing one
(11:44):
hundred men to find those. If I do a four
K test, I only have to do I only have
to buy the sixty men to find the same number
the same thirty. It's a very helpful test.
Speaker 4 (11:54):
So I would say over the past ten years or so,
or maybe fifteen years. Organizations like the American Cancer Society
have come out somewhat to the chagrin of experts like you,
that maybe we don't need to check PSA. Too many
biopsies are being done. What do you say to that today,
(12:15):
with the knowledge that you all.
Speaker 2 (12:16):
Have, that's wrong. That's wrong. We found when the US
Prevented the Task Force came out with their recommendations, like
the American Cancer Society, five years later, we found that
the increase in people presenting with metastatic disease like President
(12:37):
Biden shot almost straight up as you would predict. Five
years is about the time it takes from inception of
a disease that's fairly aggressive to metastatic disease, so that
they're wrong. And you know, it's hard for many of
us to admit, perhaps we were wrong, but this was wrong. Unfortunately,
(13:01):
it is still in the mindset of some primary care doctors.
But I think that with President Biden, we should all
wake up.
Speaker 4 (13:12):
Yeah, yeah, And I would say you're right that sometimes
when these these new rules come down or suggestions, it
becomes the word of the land, and it is more
difficult and more problematic to unravel that thinking you almost
have an entire generation of physicians trained that PSA really
(13:32):
isn't that important and they're not getting it done.
Speaker 2 (13:36):
I couldn't agree more. Couldn't agree more.
Speaker 4 (13:38):
Yeah, Now, with regard to risk factors for prostate cancer,
you mentioned African American and that certainly is significant. But
what are some of the other risk factors, be it
obesity or diabetes, smoking, alcohol, things like that.
Speaker 2 (13:54):
Well, it's certainly family history is the next big one
after AfOR race being African American, But obesity, for instance,
there's really not an increase in prostate cancer disease so
much as there is an increased risk of being more
(14:15):
aggressive disease. Meaning if you're diabetic it doesn't or obese
it doesn't mean you have a higher risk of getting it,
but if you do get it, there's a higher risk
that it's a much more aggressive cancer. Diet Diet is always,
as you know, everything in life eventually comes down to
diet because diet is what can we as individuals do
(14:39):
to modify our risk. And unfortunately there's no real good
data on this. I will tell you that in this country,
people spend over one trillion dollars on nutraceuticals meaning vitamins
(14:59):
and very substances to help modify their risk of cancer,
prostate cancer being very high on that list, and yet
none of them have really been studied well enough to
show what the true benefit is. So there's nothing you
can really do there. Keep your weight good, be active,
keep your immune system good, so even if you get
(15:20):
prostate cancer, it'll be easily managed.
Speaker 4 (15:22):
Right, right, And that's so general for everything, cardiovascular disease,
liver disease, lung diseases.
Speaker 3 (15:30):
Got it.
Speaker 4 (15:31):
You want to have a healthy diet, stay active, and
keep your weight down. Now, symptoms of prostate cancer, because
a lot of people will say, well, gee, my PSA
may be elevated, but I feel fine. What are the
symptoms that may be very mild and nonspecific, and what
are the absolute red flags to say you need to
(15:53):
get in see an expert like yourself with regard to
their prostate health.
Speaker 2 (15:58):
None.
Speaker 3 (16:01):
Okay, that's that's very easy.
Speaker 2 (16:04):
Because when we ask questions, we always ask questions like
are you getting up too often at night? Is your
stream week? Are you having urgency? These are signs of
benign growth of the prostate, but any they are not
signs of someone having increased risk of prostate cancer. Fact
the matter is that, as in most cancers that you
(16:27):
know of, Joe, if you get symptoms that are directly
related to that cancer, it is most likely already.
Speaker 4 (16:34):
Spread, right right, Yeah, exactly. So again it gets back
to early intervention and really awareness. Would you would you
say that when you look at prostate and if you
just want to compare it to breast cancer, which certainly
everybody is aware of, it's on everyone's mind, do you
find that the general awareness of men and prostate cancer
(16:56):
is lacking?
Speaker 2 (16:57):
Oh? Absolutely, Men. Breast cancer, by the way, and prostate
cancer a fairly similar. Breast cancer tends me a little more,
a little more aggressive, but also found a little later.
It doesn't have blood tests, it doesn't have that PSA test.
But men are still historically fairly stoic and at some
(17:19):
level whims I don't want to go to the doctor,
They don't want to go to the doctor that I have,
and they certainly don't want me examining their prostate rect right.
But women are much more proactive. I think this comes
from motherhood and all of those things. Perhaps where you're
taking care of the family, a caregiver, and the family's
mom and breast cancer and women coordinate better they you know,
(17:43):
the breast cancer walks are so important. You won't find
much of that. And men it's it's but women tend
to take care of their husbands. Nine times out of
the ten. A guy coming in to see me, if
he doesn't have an elevated PSA already, is because his
wife wants me to examine it.
Speaker 3 (18:01):
Yeah, excited, you know, speaking of the examination.
Speaker 4 (18:04):
And you know, we've gotten so much more technology and
scanning and fancy blood works. Is the digital rectal exam
a dead item or should we still be Should we
still be doing these on our man and encouraging primary
care physicians to do a rectal exam to say, on
(18:26):
that digital exam, you may find a prostate cancer.
Speaker 3 (18:30):
What do you think?
Speaker 2 (18:32):
Well, you know, this becomes generational. I'm a bit older,
So I was raised with a digital rectal exam. PSA
came out just after I finished residency, and so we
only found prostate cancer through the digital rectal exam, right,
And so that's what would lead to a biopsy. But
back then, fifty percent of the de men already had
(18:53):
advanced disease beyond the prostate So thank god with PSA
that's changed dramatically, and so I still recommended yours little
rectal exam. But is it critical. No, if you have
an equivocal PSA, I think it's very important. But if
you've got to do one test, do the PSA not
directly right?
Speaker 3 (19:13):
Exactly? All right, We're going to take a quick break.
Speaker 4 (19:16):
We're talking with doctor Brian Miles, a world renowned urologist
and prostate cancer expert, on your Health First this Sunday
evening on.
Speaker 3 (19:24):
Doctor Joe Galotti.
Speaker 4 (19:25):
Don't forget doctor Jogalotti dot com is our website. Stay
tuned more prostrate discussion in a moment. Welcome back everybody,
doctor Joe Glotti, thanks for tuning in on this glorious
Sunday evening to your Health First. We hear every Sunday
between seven and eight pm bringing you.
Speaker 3 (19:45):
The best in health and wellness.
Speaker 4 (19:47):
We want to raise your health IQ, make you better
consumers of healthcare, making sure that you have all of
the facts you need to stay healthy, to stay on
top of your health and all of the important topics
such as prostate cancer, which sometimes is just in a
black box that we just don't want to talk about things.
(20:10):
But tonight on the program, we have been chatting with
doctor Brian Miles, a true expert in prostate cancer here
in Houston, Texas at Houston Methodist Hospital where he is
the Professor of Urology and the director of the Division
of Robotic Surgery. And it's so great to have him
(20:31):
on the program tonight explaining to us what we need
to know about prostate cancer. So take me through a
sixty year old gentleman that has on routine screening PSA
is elevated, and maybe over the last five years the
PSA was sort of in the normal range and this
year it jumped up a little bit and either the
(20:54):
primary care or the guy's wife said, wait a second,
we have to get this worked up. They come and
see you or some other eurologic expert, and what is
the plan of care. How do you approach a patient
like this?
Speaker 2 (21:11):
Well, as I said said earlier, besides doing a digital
rec exam, I also do the four K tests and
advanced test that is looking at total PSA, free PSA,
complex PSA and HK two that protein within the calikrin
family that PSA is a part of. That tells me
(21:33):
whether this person really has an increased risk of prostate cancer,
or whether it's just related to the genetics of his
family and his age. As we get older, the PSA
tends to go up within families. There are PSA patterns.
I can think of a family I once that with
six brothers, and they all as each brother got to
(21:56):
age sixty, their PSA got to ten of a big number.
None of them ever had positive cancer. So there is
a familial trend to some of these things, and you
have to fit that into the pattern of what you're
doing with the patient. But a sixty year old I'm
going to get a four K test of it shows
an intermediate elevated risk, I'll get an MRI of the prostrate.
(22:20):
If it's elevated risk, they're going to get a biopsy.
Whether the MRI is positive or not. If the four
K test says intermediate risk for aggressive disease or disease,
it should be treated. The MRI is negative, I'll watch
them for intermediate group. So you know, you don't want
to be you don't want to be doing what the
American Cancer Society said, we were always doing, over diagnosing,
(22:44):
over biopsing, this sort of thing. You want to do
it with some thought process that has value for the
patient without putting them in harm's way by scaring them
because they have a really low grade disease, or by
a scaring them the all negative bio scenes. But are
still wonder to be harboring cancer.
Speaker 4 (23:05):
There right right now, you have been one of the pioneers. Gosh,
it's probably been twenty plus years with robotic surgery on
the prostate. And what is the current state of affair
with regard to prostate surgery? Because I would think that
men are petrified of having that prostate cut out. They
(23:25):
may have trouble with impotence and urinary incontinence, and they
would almost well, I can't speak for them. They would
almost say, forget about it, this is not for me.
I'll take chemo, I'll take radiation. Where are we at
with state of the art prostate cancer technology?
Speaker 2 (23:47):
Well, I would say that with appropriate informed consent, which
form consent means you expose the patient to risk. What's
the potential for risk, So risk knowledge and then risk
acceptance and whether you get Chemotherapy has no role in
(24:10):
prostate cancer till very late. So your choices are doing radiation,
having me remove the prostrate or having me treat the
prostrate with what are called a BLATI of therapies like
high intensity focused ultra scenography or cryosurgery. Right, those localized
treatments all have risk impotence, incontinence, and problems with the
(24:39):
rectum or bladder depending on the treatment options. And the
fact of the matter is that they are generally minor
minimal if you will accept for impotence. Impotence is the
one thing where you know, at least the third of
men will in general depending on age, but in general
(25:02):
we'll have problems getting back to normal rectile capacity. We're
still studying that. I have. I've created what's called a
survivorship clinic for my patients, trying to find ways to
get their erections back if they were sexually potent and
and interested remain interested in being intimate with their partner, Okay,
(25:26):
And so there's a lot going on there because that
is that is the key. I don't want to cure
cancer and yet create another disease us, and so we
have to focus on that.
Speaker 4 (25:40):
Yeah, So with removal of the prostate, the rates of
cure are very good, would you say that?
Speaker 2 (25:50):
Yeah? I mean, you know, they're not one hundred percent
whether you're radiated or remove it. But the thing I
always catch it early and treat the primary disease. The
chance of death from prostate cancer is very unusual.
Speaker 4 (26:08):
So now that segues into the recent news a week
or so ago with President Biden, this revelation out of
nowhere that he has prostate cancer, let alone it is
advanced to his bones apparently. So there's all kinds of
speculation and we are not here to create some political
(26:30):
chaos and be controversial. But what do you think went
on there from a professional standpoint.
Speaker 2 (26:39):
Well, it is really hard to explain that It's easy
to judge, but you have to be careful having not
been there and what you were allowed to do or
not allowed to do. Possibly the person who's taking care
of the president. The primary care doc was a firm
(27:01):
believer that when you're older, you don't need to get
a PSA. I am, as you know, different than that.
I wrote a paper quite a few years ago, still
have to get a published because people didn't want to
buy it. That age is an independent predictor of getting
high risk disease. You're over the age of seventy five,
(27:22):
your chance of having high risk cancer is fifty percent
as opposed to twenty or twenty five percent. And so
that was not well received because I do PSAs based
on the patient's robustness and their willingness to do that. Again,
getting older, I've noticed that the years pile up, but
(27:42):
I don't get old and you don't. And so anyhow,
somebody missed the ball and didn't do a PSA on
this man, because I can tell you he is his
PSA is very high, over fifty, over fifty at least
I would expect. And you know, it's unfortunate because he
(28:03):
will die of this disease or his treatment, his treatment
with hormone therapy and all will further impact his cognition.
Speaker 3 (28:12):
Right, And so your.
Speaker 4 (28:15):
Generalized theory is that going back ten years, his PSA
may have been creeping up until it got to a
critical point of the amount of disease in the pro
state where it sort of broke loose.
Speaker 3 (28:30):
Correct, correct, Yeah.
Speaker 4 (28:32):
So is there is there, and you know it's you
hate to hear that somebody like this, especially somebody as
so much under the microscope as any president or dignitary
or famous person that that right in a sense, right
before us, this took place. But is there a lesson
(28:54):
for everybody tuning in tonight to have them recalibrate how
they are looking at prostate cancer for themselves or a
parent or another loved one.
Speaker 2 (29:04):
Yes, I think they should. That this would hopefully enlighten
your average mail out there that you know it's this
is something that can sneak up on you and suddenly
you're eighty and you're feeling like you're sixty and some
and you never got your PSA checked because you know,
the government task force said I don't have to do that,
(29:26):
and you suddenly have metastatic disease and your life as
you knew it it's not the same anymore. So it's
it's something that men should take cautiously, should be aware of,
but don't be afraid of getting a PSA and going
to an expert, because elevated PSA doesn't mean someone's going
to put needles in your prostate. It means they're going
(29:48):
to look at it a little more closely and see
what your risk are. What can we do do other
studies like MRIs or PET scans and help reassure you
that your life is still yours.
Speaker 4 (30:01):
Right and certainly you want that expert care. And so
here in Texas and certainly in Houston, you and your
colleagues are definitely the go to people. But if somebody
is living in Colorado or New England somewhere, is it
in a sense adequate enough to go to a general urologist.
Speaker 3 (30:23):
Should they look.
Speaker 4 (30:24):
Up somebody that specializes in prostate cancer? How do you
give direction?
Speaker 2 (30:29):
Well, my sense of that is that a board certified
urologist is well trained to deal with this and move
forward with it. If a man has prostate cancer, always,
of course seek a second opinion. If someone does that
with me, it doesn't that's not an insult to me.
That's a rational thing that people should do, and it's
(30:51):
when But when you're dealing with an abnormal LAMB value,
what you want to do is go to a urologist.
Have the mixam in you. You know, the community urologists
who refer to me are terrific surgeons are terrific docs, right,
And I would have no problem at all with anyone
(31:12):
who has an elevated PSA going to the nourish urology
and talking with them about this.
Speaker 4 (31:18):
All right, Well, Brian Miles from Houston Method Hospital, you
know years ago, Brian, when I first started getting on
the radio, they had said, you know what you for
me this show. We don't have guests on the program.
We have experts, and you certainly and you certainly fit
that bill, Doctor Brian Miles, Houston Methodist Hospital expert Urologists,
(31:42):
thanks so much for it. It's always great and we
do need to get together and cook up some pizza together.
Speaker 2 (31:47):
And I am counting on that, Doctor Galotti.
Speaker 4 (31:50):
All right, Brian, thank you so much. All right, final
segment of this week's Your Hell First is coming up
in just a moment, thanks to doctor Bryan Miles.
Speaker 3 (32:00):
Don't forget.
Speaker 4 (32:01):
Doctor Joeglotti dot com is our website, center for our newsletter,
everything that we do, our team, it's all there on
doctor Joe Galotti dot com. We'll be right back. Final
segment of Your Health First on this Sunday evening, Doctor
Joe Galotti. Don't forget go to doctor Joe Galotti dot com.
Doctor Joe Galotti dot com. Now you may be sitting
(32:22):
there saying, well, how does this guy spell his name?
G A l A t I Doctor Joe Galotti. No spaces,
no periods, just doctor Joe Galotti dot com. Me I
don't pay by mills.
Speaker 1 (32:40):
What do I think got growth?
Speaker 2 (32:49):
All? Right?
Speaker 4 (32:49):
Final segment here, I hope you're having a good Sunday
night and getting planned for the weekend. You know, for
so many years, what I've been doing is we've always
used Sunday night as the time to plan the week out.
(33:10):
What are we eating, what are our activities? Looking at
a calendar and planning it would be around not only
what we were doing, but what about eating. It's always very,
very important that you have that plan for you, your family,
your kids, and those that you care most about. In
(33:34):
the final segment here, I found an article which was
in the New York Times column in their health section
in their fizz ed area, and I would say, if
you are interested in health and wellness, this is a
very nice column by Gretchen Reynolds, and it has to
(33:59):
do with exercise and depression. Now, the slight twist here
is this is a study that I don't think has
really ever been done to this level. Now, there have
been studies in the past that show exercise, one form
(34:20):
or another is good for your mood, makes you a
little happier, and it doesn't make you as depressed. Maybe
you sleep a little better. You tend to wake up
a little bit more refreshed when you exercise. I think
we all know this, but this particular study got into
(34:41):
it way deeper, and it's pretty interesting. They get into
this Mendelian randomization. And what they did was they went
into a database of I believe four one hundred thousand
men and women, and we carry a little piece of
(35:05):
genetic material that is encoded for whether or not you
are at risk for depression, and also whether you were
going to be active or more sedentary. And so what
they did was they looked at the people that had
(35:26):
the more active gene and the depression gene, and lo
and behold, they found that the people that were less
depressed exercised more and vice versa. Now, there's still a
lot of questions that one would have when you look
(35:49):
at something to this grand scale. And what they found
is that about fifteen minutes a day is enough to
reduce the chance of developing depression. Now, if you had
less taxing exercise, let's say say housework, walking fast, you
(36:16):
needed about an hour to cut down and make a
dent in the depression. So for those that now, again
you're not going to go to the laboratory tomorrow and say, hey,
test me, test my genes for depression, or test my
genes if I should be more active or not. The
(36:39):
bottom line is, somehow we all need to carve out
time a little every day for some vigorous exercise. And
there's so many ways to do that. Ride a bike,
get a stationary bike, go running, get on a treadmill,
(37:02):
do some workouts, play basketball, play a little tennis, play
a little handball. There's so many things.
Speaker 3 (37:09):
That we all could do.
Speaker 4 (37:12):
And realize that it may have a definite impact on
your depression. Now, the reason I brought this up and
the reason that caught my eye, so many of my
patients say or report that they are depressed. They just
are not happy. They feel like they have the weight
of the world on their shoulders, the glass is half empty,
(37:35):
and I do not understand why I do talk with them. Now,
I am not a psychiatrist, but I believe I need
to take a few minutes and talk with my patients
and try to understand what's going on, because if they're depressed,
it's going to interfere with what I have to do
with them. If they're depressed, they're not going to eat well.
(37:56):
If they're depressed, they're probably not going to exercise. If
they're depressed, they're less likely.
Speaker 3 (38:02):
To follow up.
Speaker 4 (38:05):
And and so I do take tremendous interest in this.
But so many people out there, many of you listening tonight,
just feel that their life is just not right.
Speaker 3 (38:17):
They wish they were happier.
Speaker 4 (38:22):
And that's a that's a that's a tough nut to solve.
But can we fix some of this with exercise and
and getting down to the to the basics. I just
don't know. So I think what you need to do
is you have to be mindful with regard to not
only what you're eating. And as I said at the
very beginning of the program tonight, we have to get
(38:44):
to a point where we are listening to our bodies.
Are you getting these signals? Are you appreciating that little
bit of abdominal pain or that pain in your leg,
that pain in your neck, that pain in your side,
the shortness of breath, a wheezing that you may be getting.
And again, you don't want to become a hypochondrias, but
(39:04):
you need to listen to what's going on. All right,
we're gonna close out for tonight I'm gonna pick a
song that should make you a little happy as we
as we go out of here tonight.
Speaker 3 (39:17):
I'm doctor Joglotti.
Speaker 4 (39:18):
Don't forget dot go to doctor joglotti dot com. We'll
see you next Sunday night. Have a great week. Truly,
I do mean that. Stay well now
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