Thanks for tuning in to the Armor Men’s Health Hour Podcast today, where we bring you the latest and greatest in urology care and the best urology humor out there.
In this segment, Dr. Mistry and Donna Lee answer a listener's question about possible connections between swollen lymph nodes found in his lower stomach/pelvis region and his ED symptoms. He asks, "Can these lymph nodes be putting pressure on my prostate?" To answer his question, Dr. Mistry explains what the lymph nodes do in the body and what it means when they become swollen and/or painful. As the tiny "immune stations" in our bodies, the lymph nodes check for diseases that may be circulating in the fluids leaked from blood cells. When they become swollen and painful, it's often a sign that they've detected an infection which can then be treated with proper medication, such as antibiotics. Unfortunately, cancer also loves our lymph nodes. When swollen lymph nodes are found but aren't painful, it can sometimes be an indication that nearby cancer has spread to the lymph nodes. At that point, regardless of the cancer's primary origin, an oncologist is likely to be the doctor who determines the course of your cancer treatment. Dr. Mistry explains that this patient was likely referred to both a urologist and an oncologist because they suspect the cancer originates in a urologic organ (like the testis or bladder, for example), but has already spread to the surrounding lymph nodes. Both providers can help ensure that his course of treatment will have the best possible results. Regarding the ED symptoms, Dr. Mistry argues that it is unlikely that his swollen lymph nodes are pressing on nerves and causing his ED symptoms. It's more likely that his cancer is causing reduced blood flow which could interfere with his erections, or that the general fatigue that accompanies major illnesses is compromising his sexual performance. No matter the cause, a cancer diagnosis does not mean you should ignore your ED symptoms. After all, a loving and fulfilling sexual relationship can be of great emotional benefit during the cancer treatment and recovery process. If you or someone you love has a urologic cancer diagnosis, symptoms of ED, or both, please contact us for an appointment today.
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Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.
We enjoy hearing from you! Email us at armormenshealth@gmail.com and we’ll answer your question in an upcoming episode!
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Speaker 1:
Welcome back to the Armor Men's Health Hour with Dr. Mistry and Donna Lee.
Dr. Mistry:
Welcome to the Armor Men's Health Hour. I'm Dr. Mistry, your host, here as always with my cohost, the very funny Donna Lee.
Donna Lee:
That's right, that's me! I'm the board certified co-host in this operation over here.
Dr. Mistry:
Certifiable. I am a board certified urologist. This is a men's health show. This show is brought to you by NAU Urology Specialists. Urology, a specialty clinic that I started in 2007 and have grown to the second largest urology practice in Austin.
Donna Lee:
Did you ever think that you would be involved with the second most amazing men's wellness podcast in the entire internet?
Dr. Mistry:
No. Actually I did.
Donna Lee:
You were like podcast heavy back then when there weren't podcasts?
Dr. Mistry:
I can't believe there's somebody out there that's regarded better than us.
Donna Lee:
Oh, well he's a loser and he's not funny at all.
Dr. Mistry:
Well, we don't know who he is.
Donna Lee:
No, we don't.
Dr. Mistry:
I think that you're our ACE in the hole. You have, you're a professional comedienne. You were voted the seventh funniest...
Donna Lee:
...mom in America by Nick at Night.
Dr. Mistry:
I mean, not just Nick, but Nick at Night.
Donna Lee:
At night. I told my mom that story once my little Asian mom and she was very upset. And when she said no, no. Who is Nick Edna at the night? She didn't know what that meant. I was also, by the way on the funny show. What was that called?
Dr. Mistry:
Oh my Lord.
Donna Lee:
Oh my God. I just forgot the name of the show.
Dr. Mistry:
It must've been very funny. You know what? You should be, you should take some memory pills.
Donna Lee:
I should. Are you on memory pills?
Dr. Mistry:
I am. I remember...
Donna Lee:
Do you remember what they are?
Dr. Mistry:
I remember, I do. I remember. They're called memory pro.
Donna Lee:
Last Comic Standing. Oh my God. There it is. I was season three. Go ahead.
Dr. Mistry:
Very good.
Donna Lee:
I need that pill.
Dr. Mistry:
Donna, why don't you tell people where our offices are and how to get a hold of us?
Donna Lee:
That's right. You can call us for a good, good joke or a good time. My number is(512) 238-0762. We're in Round Rock, North Austin, South Austin, and Dripping Springs, Texas. Our website is armormenshealth.com and you can send us your questions. They're all amazing and insightful to armormenshealth@gmail.com. If you have a particular interest, check out our podcast, you can probably just Google Armor Men's Health Hour, and then whatever your question is like Peyronie's or erectile dysfunction or anything in particular. But you can find our podcasts wherever you listen to free podcasts, and that impresses me. Because sometimes I'm like in my car and I listen to our podcast and our little picture pops up like we're Brittany Spears or something. I love it.
Dr. Mistry:
Nice. That's wonderful.
Donna Lee:
You don't do that. Do you?
Dr. Mistry:
No. You may wonder what, what makes our practice and our approach different. And that really is reflected by the kinds of people that we've hired, which includes more than just urologist physicians. We have functional medicine-trained practitioners. We have pelvic floor physical therapy. We have nutritional therapy. We have supplement guidance.
Donna Lee:
Sex therapy.
Dr. Mistry:
Sex therapy. We really care about what's going on with you. If you're diagnosed with prostate cancer in our practice, the first place you're going to be sent to, besides staging imaging and giving treatment options, is going to be our nutritionist to talk about what, what you should eat and what your supplements look, look like.
Donna Lee:
Because you always said, when you diagnose a patient with something, anything, their first question...
Dr. Mistry:
The first thing they ask is,"What do I eat?"
Donna Lee:
Yeah, that's fascinating.
Dr. Mistry:
Because, because I think inherently, we all know that what we put in our body does have an impact on our, on our health. When it comes to something like male fertility, it's not just, I mean, when it comes to men's fertility, it's not just a little bit of medicine or a little bit of something. You need to have, you need to know that lifestyle modification is going to be a very important part. Just like you would naturally assume a woman who was unhealthy, who smoked, who was overweight--she might have difficulty getting pregnant. That I think is very easy for us to understand, but the same goes for a man. And so if you want a more comprehensive approach to your care, if you want to find a way to get off medicines, if you want to find a way to pee better or get better erections, then please come and see us as a patient.
Donna Lee:
You know, every now and again, you say something that stands out to me, cause I'd never heard it until I started working with you. But that you are, you evaluate the patient and making the patient's sperm healthy.
Dr. Mistry:
That's right.
Donna Lee:
That always fascinates me because I never thought about it at that level. Like the sperm level, I just thought about making the patient healthy, and then the next thing that happens is he has a baby.
Dr. Mistry:
Well, we look at sperm all the time and we know, we know when the sperm is not looking healthy. I mean, if, if you get somebody who's like a chronic marijuana smoker, the sperm look like that guy's a chronic marijuana smoker.
Donna Lee:
Really? Like slow?
Dr. Mistry:
Lazily, like slow. You know, they don't know where they're going, and making little circles.
Donna Lee:
They have a little couch.
Dr. Mistry:
Eating sandwiches.
Donna Lee:
Cheetos.
Dr. Mistry:
Playing video games. That sperm.
Donna Lee:
That's interesting. What about a guy who's really like super, super healthy? And he, I mean, I guess their sperm are just super crazy fast.
Dr. Mistry:
Yeah. You, you like, you, you will see that. Like a person who is like fit, but, and eats well and has really good parameters--oftentimes they'll have extreme, extremely good sperm. But then you'll see that people that are overboard, right? The guys that are running like 50 miles, an ultra marathon. I mean, those patients, although extraordinarily physically fit, oftentimes they're doing things to them or training at the edges so that their body's taking resources from the testicle. So I do have a lot of guys like who are super athletes in their fifties who have very low sperm counts because...
Donna Lee:
Yeah, because their sperm's tired.
Dr. Mistry:
And because they're doing great physically at 50, but the body's taking resources from something else.
Donna Lee:
So they're overdoing it or..?
Dr. Mistry:
They're overdoing it. And same with women. I mean, you know, like professional gymnast and those very high, like a highly trained athletes often are not, are infertile at the time of their high, high training times because the body's sapping resources from the reproductive system.
Donna Lee:
You know, we have one of those little gyms across the street from us now. It's like acro or something where all those little girls get together and they're like cheerleading and it's like this whole sport. And I always tell my husband that I'm waiting for the day that the police come over and they're, they knock on the door and say,"Ma'am your husband's at the gym again at the cheerleading gym. And we found out he doesn't have any children. Please come get him." Anyway, stop doing that, Michael.
Dr. Mistry:
Stop doing that, Michael. Questions really drive the practice and the show. And so, do we have any questions that we'd like to answer today?
Donna Lee:
We do. We have a, we always have an interesting question, but this particular one from a gentlemen who's been listening to us for a while. He said that he found out he has lymph nodes in his lower stomach area and left wall of his pelvis. His doctors referred him to an oncologist and a urologist. So I thought we could talk about the difference of those two doctors."I have a problem maintaining an erection now for a couple of years. And I guess my question is, can these lymph nodes be putting pressure on my prostate?"
Dr. Mistry:
That's a great question. So first let's just talk about what lymph nodes mean or what lymphadenopathy refers to. The lymph nodes are little bitty immune stations in our system that collect fluid that leaks out of blood vessels. As that fluid goes back and gets circulated into the circulatory system, they go through a series of checkpoints where our immune system can check it for disease. And so the lymph nodes are often where infectious diseases as well as cancerous diseases can go to because the, the, the cancerous cells have an affinity for these lymph nodes.
Donna Lee:
So lymph nodes aren't bad in and of themselves.
Dr. Mistry:
Lymph nodes are good in and of themselves. When they get big, it means that something is wrong.
Donna Lee:
Inflammation.
Dr. Mistry:
That's right now. Now the most common reason that people find lymph nodes is because of an infection. So when a lymph node hurts, that's actually a good thing. It usually means an infection and that can usually be treated with either antibiotics or through some diagnosis. When they're not painful, that that usually for us, when we feel lymph nodes in the groin area, for example, that are not painful, we worry a lot about something cancerous. If you have lymph nodes that are along the groin and on the inner pelvic sidewall, you do worry about a urologic cause. So, testis, penile, scrotal cancer, and then even some types of prostate and bladder cancer could be associated with those enlarged lymph nodes. So when this patient's asking about that and why he was referred to an oncologist as well as a urologist, it's because oncologists generally are the ones that help take care of cancer that's already spread to the lymph nodes. And because of the location of the lymph nodes, it's felt that a urologic cause is most likely. And so the urologist's role may be to do a biopsy or to help, you know, determine the underlying cause of it. But if it's cancer, then more than likely the oncologist is the one that's going to be prescribing a treatment. So that's obviously, you know, the elephant in the room for this particular patient. But when it comes to erectile dysfunction, it's unlikely that the lymph nodes along the side wall of the pelvis are encroaching on the nerves to lead to a poor erection.
Donna Lee:
But it's a whole different issue?
Dr. Mistry:
It's a different issue, but it could be the case that an advanced prostate cancer or something interfering with the blood flow to the penis, separate from the lymph nodes could be causing erectile dysfunction. And it could be that you're sick. Lymphoma, which is a blood cancer that affects the lymph nodes, could be sapping you of energy, causing you to have lower testosterone levels, an overall level of illness that's causing more erectile dysfunction, for example.
Donna Lee:
Oh, that makes sense.
Dr. Mistry:
And so, and frequently, it, that an underlying cancer diagnosis is associated with some type of other symptom. So we hope that you find the best of care. If you need a urologist, we're happy to see you. And, even if you're going through a tough medical illness, don't think that caring for your erectile dysfunction is something that you shouldn't do. Like if, if, if we can help you get a better erection while you're going through this tough time, we're happy to do it.
Donna Lee:
Oh, good point. So giving of you.
Dr. Mistry:
Well, I mean, that's what--you can't forget what makes you happy when you're going through tough times, right?
Donna Lee:
I guess it's why you're a doctor. You're board certified and all that.
Dr. Mistry:
I'm never bored. So if you need a doctor, you need advice, Donna, how do people get ahold of us and how do they hear our free podcast?
Donna Lee:
That's right, listen to our free podcast, wherever you listen to podcasts. And somebody please tell Joe Rogan that we're ready to talk to him about his testosterone topics that we keep hearing he talks about.
Dr. Mistry:
Anytime.
Donna Lee:
Anytime. We are at(512) 238- 0762. Our website's armormenshealth.com and our email address for these incredible questions are, it's armormenshealth@gmail.com and keep sending those questions and listen to our podcasts. Thank you!
Speaker 1:
Dr. Mistry wants to hear from you. Email questions to armormenshealth@gmail.com. We'll be right back with the armor men's health hour.