If You're Seeing Red (In Your Urine), Watch Out For Bladder Cancer: Dr. Jacomides Explains the Risk Factors and Warning Signs

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, Donna Lee is joined by NAU Urology Specialist's own Dr. Lucas Jacomides. Today, Dr. Jacomides explains the warning signs of bladder cancer. Blood in the urine should be treated as an alarming symptom and its cause identified. While it could be something like an infection or kidney stone, it could also be an indication of something much worse. Smokers or those exposed to cigarette smoke are at a higher risk of developing bladder cancer. If your doctor suspects you might be at risk for bladder cancer, a simple CT Scan can help them determine whether further testing, such as a cystoscopy, is necessary. When a tumor is found, it must be removed and examined under a microscope to determine how advanced the cancer is. If you or someone you love have recently seen or are currently seeing blood in your urine, with or without accompanying pain, please give us a call today! And if you've recently been diagnosed with bladder cancer, you can also check out a helpful book written by one of Dr. Jacomides' former patients, "For Bladder or Worse," by Gene Vasconi (2013).

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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.

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Transcript

Speaker 1: 0:09

Welcome back to the Armor Men's Health Hour with Dr. Mistry and Donna Lee.

Donna Lee: 0:15

Welcome to the Armor Men's Health Hour. I'm Donna Lee, and Dr. Mistry has stepped away so that we could bring in one of our favorite humans on this planet. Dr. Lucas Jacomides.

Dr. Jacomides: 0:25

This planets, any planets. Yes.

Donna Lee: 0:27

Welcome.

Dr. Jacomides: 0:28

Welcome. Thank you.

Donna Lee: 0:29

Thanks for...

Dr. Jacomides: 0:30

I'm glad we chased the away Dr. Mistry.

Donna Lee: 0:31

He just disappears at the most random, opportune times.

Dr. Jacomides: 0:35

Like a little piece of candy, like here, go, go...

Donna Lee: 0:38

He just walked away. So, let's talk about some fun stuff. But first, we have to tell you how to reach Dr. Jacomides, if you need an appointment. And I guess we, really quickly, you can tell everybody, under the umbrella of urology, everything we kind of do and treat, things that you especially love, but you can call during the week to reach out to Dr. Jacomides at(512) 238-0762. You can visit our website, armormenshealth.com, and you can send him questions to armormenshealth@gmail.com. Our podcast--oh, have I mentioned to you, we just got another award. We'll take that out. We just got another award. We are the second, most interesting sexual health podcast on the internet according to feedspot.com.

Dr. Jacomides: 1:16

Who is the first?

Donna Lee: 1:17

It was I don't. I studied it and I don't know if I've ever heard of them, but we'll knock them off the charts soon.

Dr. Jacomides: 1:23

I don't always listen to podcasts, but when I do, that's the most interesting man to listen to podcasts.

Donna Lee: 1:27

You're the most interesting man in this room.

Dr. Jacomides: 1:29

Yes. Well, I have stiff competition.

Donna Lee: 1:33

But per FeedSpot, we were also the second, most interesting men's wellness podcast and the seventh most interesting prostate cancer podcast.

Dr. Jacomides: 1:42

Normally in medicine, I tell people it's not good to be interesting.

Donna Lee: 1:46

No?

Dr. Jacomides: 1:46

You want to be boring in healthcare. You want to say like, you know, when do you want to go your doctors, like,"You know, that is the most interesting problem that you have." Like, nobody wants to hear that. I want to hear like,"This is the 30th one I've seen this today, you know, and I'm not gonna worry." But, but in this case, I think it's good to be interesting.

Donna Lee: 2:02

In this case, it's good to be interesting. Not if you have a urology issue.

Dr. Jacomides: 2:05

No, we, uh, we hope to keep this next segment interesting, somehow. I hope.

Donna Lee: 2:10

That's right. Well, we'll talk about some interesting stuff. But you are a board certified urologist of how many years?

Dr. Jacomides: 2:15

Oh, gosh. I...board certification, I got out of residency in aught four--that's what old people say, zero. And I've been certified since aught five, I guess. I remember that vividly because that was, I did that board certification and board certification, mind you, is a very creepy, weird experience for those who do surgical specialists. You have to meet in a hotel room in Dallas, Texas. And there's you and this examiner. Now, I don't know with COVID what has happened since then. But it's weird. You're going literally to a hotel room and then...

Donna Lee: 2:47

With a stranger.

Dr. Jacomides: 2:48

With a stranger. And you know, I always thought,"If this goes badly, I'm just going to make some, some sexual abuse..."

Donna Lee: 2:55

Bend over.

Dr. Jacomides: 2:55

Something like, yeah, I'm going to pass these boards one way or the other, if you know what I mean? But in essence, no. And then I flew from that Dallas Fort Worth airport to interview here in Austin then got my job here when I moved here.

Donna Lee: 3:06

Interesting. I've never heard this before. What a seedy way to get a license that

Dr. Jacomides: 3:10

It is, it is bizarre. And like, it's like,"Wait a minute. They have like underpants on their floor?" And I'm like, you know, walking into this room, like,"Could they've cleaned up a little bit, you know?" It's bizarre. Very bizarre. But yeah, the hotel room in Dallas. Very legendary.

Donna Lee: 3:23

Oh my goodness. Well, you're an actual board certified urologist now.

Dr. Jacomides: 3:29

The things I did to get board certified in that hotel room.

Donna Lee: 3:29

Slept his way right to the top, right?

Dr. Jacomides: 3:31

That's right.

Donna Lee: 3:31

Oh my goodness. So you have a really extensive background with Baylor, Scott and White, and then you were on your own for a while, and then we scooped you up as soon as we could.

Dr. Jacomides: 3:38

Yes, we did. You know, I flew to that interview. Ironically, I sat next to one of the assistant coaches--the other interesting part of that story--who, who literally just told me, he just recruited Kevin Duran to the University of Texas. You know, that's how old and long I've been board certified. That was before he was like a high school senior. But yes, I interviewed there and that was a memorable time. And we had a freeze and we were defrosted sitting in the airplane. Anyway, enough of that. But I'm trying to make this interesting because we are interesting.

Donna Lee: 4:04

We are interesting. Well, I thought we talked about something interesting that you know all about--sadly, that you know all about: bladder cancer.

Dr. Jacomides: 4:10

Yeah. That is a great segue, by the way. No. Yeah, bladder cancer is interesting and I've had a run lately of it. And it seems like these things kind of run in threes. I, one thing that we have to clarify is that we as surgeons, as urologists, rather, we use the word bladder cancer pretty much all the time. You hear colon and colon polyps, but really people getting a, just got a polyp removed they're, you know, it's not cancerous, but just know that that polyp is precancerous. And I think bladder cancer, in many ways probably could be called bladder polyps, because there are some of these that don't behave very aggressively and tend to recur like colon polyps do, but they tend, they can progress if not caught early and gotten to get them out.

Donna Lee: 4:48

Interesting. So what signs would a patient have symptoms?

Dr. Jacomides: 4:52

So I think the big one is blood. You know, so if you see blood in your urine, that is not normal. That's should not be anything earth shattering. So don't ignore a one-time bleed. Or if your primary care provider or somebody says,"You know, we keep seeing blood in your urine at least a couple of times," that's probably is worth checking out as well. A lot of people say,"Oh, it's probably just an infection." Or,"Maybe it's a kidney stone." And maybe they're right, but maybe they're really, really wrong, and they have a very bad bladder cancer. So don't, that's the biggest thing to take home from today besides the fact that I board-certified and we're interesting is that blood is bad. Blood in urine is bad.

Donna Lee: 5:27

Even if it's a tiny bit that you see.

Dr. Jacomides: 5:27

Even a little bit, even microscopic. I've seen people get diagnosed with three red cells with bad bladder cancer. My own aunt died of bladder cancer.

Donna Lee: 5:34

Oh, really? I didn't know.

Dr. Jacomides: 5:35

Yeah. Cause she was a smoker and that's the big risk, that people who smoke will damage their bladder linings. Because anything you put in your mouth has to come out of one of two ways: either you smoke it, it goes in your lungs and it causes lung cancer; but bladder cancer goes down into your esophagus, into your stomach, it's got to come out number one or number two. And if you have tar and nicotine sitting in your bladder for hours on end, that can cause bladder cancer so much so, Donna Lee, that bladder cancer actually, smoking, rather has a higher relative risk with bladder cancer than lung cancer.

Donna Lee: 6:03

Really?

Dr. Jacomides: 6:04

Yeah.

Donna Lee: 6:05

I didn't know that.

Dr. Jacomides: 6:05

You're going to see people who just never smoked get lung cancer, but you don't necessarily see people very often that it get bladder cancer who never smoked or weren't around smokers. So, yeah, the relative risk is much higher, surprisingly.

Donna Lee: 6:18

That's interesting. So if, if you're a guy and you're peeing and you see just a tiny little bit of blood...

Dr. Jacomides: 6:23

Or a girl.

Donna Lee: 6:24

Or a girl. I think people equate pain--so it's not necessarily that you have a ton of blood and you have a ton of pain. You might have a lot of pain, a little bit of blood, or vice versa.

Dr. Jacomides: 6:31

That's right: gross, painless hematuria. And it hurts maybe if you're passing clots, but no, typically painless blood is potentially assigned at tobacco, of bladder cancer. So that's what we have to do. We have to bring you in and find out where it's coming from. So what I do is typically top of kidneys to end of urethra, you know. So we scan, I personally scan the kidneys and making sure that you don't have a mass in your kidneys. The bottom line is we want to find out what's common and what could kill you.

Donna Lee: 6:54

So when you say scan just a real easy imaging?

Dr. Jacomides: 6:56

CT, you know, just a cat scan. Just run through and make sure it's not a stone, make sure it's not a mass. You want to find things that are common, too. You know, what's causing it, if it's not cancer? That's it. But for S for, for bladder cancer, most of the time, we're going to tell you to look inside. And I think that's an important step that a lot of people say,"Well, can't you see it?" Like, that's why we do colonoscopies. Not we, but gastroenterologists, because you can't see little tumors inside of other organs. So a bladder cancer is hard to see on CT, unless it's huge.

Donna Lee: 7:23

Interesting.

Dr. Jacomides: 7:24

See if you keep saying"interesting," then people will think we're interesting. So that's the secret.

Donna Lee: 7:29

That's the plan. That's my catch phrase."Interesting." What happens then, so patient comes in, you figure out they have some sort of terrible bladder cancer--what's, what options are there.

Dr. Jacomides: 7:38

Well, we don't know. That's interesting--because I said interesting, it is interesting--that, you know, once we look in and we, it's one of these diagnoses that you're going to know what you have more or less when you look in. But until you get that tumor out, which is a surgery, you don't know how bad it is. So that's where you have to cut it out and see how ugly it looks on a microscope and how deep into the muscle it goes. So those are important steps to know. And that's the surgery soon after that to say,"Okay, where is this tumor? How bad is it?" And then, you know, um, you know, that's, that's how we tell how bad it is. You know, one thing about bladder cancer, I got to tell you the sidebar that's also interesting, is that two of my patients with bladder cancer, they, you get to know these patients because they have a very high rate of recurrence. So you need it, you're not done with the first look in, if you have bladder cancer, we're going to be looking in again. One of them was an author. I won't mention his name, but every time I found bladder cancer in him, he was writing books and he liked my name and he would use me in his books.

Donna Lee: 8:42

Oh, really?

Dr. Jacomides: 8:42

And then if, if I gave him good news, he'd write me like a romantic lead, you know? And then I was like,"Oh, this is good."

Donna Lee: 8:51

And if you gave him bad news...

Dr. Jacomides: 8:51

If I gave him bad news, he would write...

Donna Lee: 8:53

You were the pool boy who wasn't getting any action.

Dr. Jacomides: 8:56

Pool boy...I was sodomized by pirates, and it was just a horrible fate. And then eventually we got sort of a neutral ending there. But my other patient actually wrote a book and I'll mention it because he was a dear good friend and I know his, his wife, Pam, wouldn't mind, Gene Vasconi, who sadly passed away from advanced, not necessarily related to bladder cancer. But he actually wrote a book called for better, For Bladder or Worse. And you can still get this book and they'll pitch it out there, cause I want people to go out there, because I used to give a copy of this book to every single patient who came in and got diagnosed with bladder cancer.

Donna Lee: 9:27

I remember you saying that. For Bladder or For Worse.

Dr. Jacomides: 9:29

For Bladder or Worse. And I think you can go on forbladderorworst.com and, you know, and check it out. But he kind of gave a humorous look about what it's like to go through the procedure of cystoscopy and from a patient perspective. And it's really cool. And he talked about nutrition and some of the other things that we probably don't have time to talk about on this little bit. We'll get maybe Shefaly to talk about that at some point.

Donna Lee: 9:47

Interesting. So one more time: For bladder...

Dr. Jacomides: 9:49

For Bladder or Worse.

Donna Lee: 9:50

...Or Worse.

Dr. Jacomides: 9:50

Yeah. Yeah. Shout out to my good friend Gene. He was a good guy.

Donna Lee: 9:54

So what a good way to end the segment, Dr. Jacomides. Thank you for coming in and recording with this. We'll have you back soon. And thank you for listening to our show. It is the Armor Men's Health Hour with Dr. Mistry and Donna Lee, and our website is armormenshealth.com. Our email address is armormenshealth@gmail.com.

Dr. Jacomides: 10:11

And they know how to find us?

Donna Lee: 10:12

And they know how to find us at Round Rock, North Austin, South Austin, and Dripping Springs, Texas. Our podcasts have just skyrocketed. Thank you guys so much for making it so popular and interesting, and you can listen to our podcasts wherever you listen to free podcasts. And we hope to be on the Joe Rogan show.

Dr. Jacomides: 10:27

Yes, Joe, get us out here, man. We're too interesting not to.

: 10:30

The Armor men's health hour. We'll be right back. If you have questions for Dr. Mystery, email him at armor men's health@gmail.com.