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 discuss the causes of kidney and bladder cancer. Bladder cancer affects the stretchy, transitional cells of the bladder, which allow it to shrink and expand as bladders so wonderfully do. This transitional cell epithelium exists from the inside of the kidney, through the ureters, into the inner lining of the bladder and the first part of the urethra. Consequently, bladder cancer can actually exist anywhere from the kidney all the way down the ureters and even underneath the bladder. The number one symptom of bladder cancer is visible blood in the urine without any accompanying pain. Blood in the urine should always 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. Having cancer of the bladder makes you much more likely to develop cancer of the kidney, and vice versa. Once a cancer of this kind has been diagnosed, you will require careful monitoring for the rest of your life. 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!
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!
Round Rock Office 970 Hester’s Crossing Road Suite 101 Round Rock, TX 78681
South Austin Office 6501 South Congress Suite 1-103 Austin, TX 78745
Lakeline Office 12505 Hymeadow Drive Suite 2C Austin, TX 78750
Dripping Springs Office 170 Benney Lane Suite 202 Dripping Springs, TX 78620
Speaker 1:
Welcome back to the Armor Men's Health Hour with Dr. Mistry and Donna Lee.
Dr. Mistry:
Hello and welcome to the Armor Men's Health Hour. I'm Dr. Mistry, your host, here as always with my incredible cohost, Donna Lee.
Donna Lee:
No insult today?
Dr. Mistry:
Nothing, nothing.
Donna Lee:
I couldn't think of anything quick enough?
Dr. Mistry:
Absolutely not.
Donna Lee:
Okay. Move on.
Dr. Mistry:
This is a men's health show. I'm a board certified urologist. This show is brought to you by the urology group that I started in 2007, NAU Urology Specialists. Donna, we have some amazing providers in our office.
Donna Lee:
We do, and they've been with us, like, forever. We have zero provider turnover, which I love.
Dr. Mistry:
So we have me. I've been in practice....
Donna Lee:
And you can't quit, so...
Dr. Mistry:
Yeah. I can't, I can't quit. My name's on the door. 14 years is how long we've been in practice. Then we have Dr. Stacy Ong.
Donna Lee:
She's been with us seven, eight years now.
Dr. Mistry:
And she used to be like the entire, entire department at Brackenridge Hospital, the university trauma hospital that existed in Austin since the beginning of Austin, I guess.
Donna Lee:
If you've been in Austin Long enough, you remember the word Brackenridge, and you would shudder. Your spine would shudder a little bit and you didn't want to go there.
Dr. Mistry:
Well, we love that place. As a, as a place to practice, it was a lot of fun. And then we have Dr. Christopher Yang. He joined us right out of fellowship, where he did a special fellowship in reconstructive urology, doing prosthetics and all sorts of advanced erectile dysfunction.
Donna Lee:
Making pee-pees bigger all across the country, he was.
Dr. Mistry:
He works predominantly in our south Austin office. He's excellent. He has the best ratings of any doctor in the whole practice. It hurts my feelings.
Donna Lee:
That guy. 4.8 stars. We, we're up to four. We're moving on up.
Dr. Mistry:
Our patients do love Dr. Yang, and he also practices out of our Dripping Springs office. And then we have Dr. Lucas Jacomides. He's the newest addition to Jurassic Park.
Donna Lee:
A urologosaurus?
Dr. Mistry:
Urologosaurus. He was with the Baylor Scott and White for a number of years, including their chief of staff and, and played such a big role with the, the galactic empire.
Donna Lee:
Yeah. He ran like the surgery department. Sounds so smart.
Dr. Mistry:
And so we're really fortunate to have him. He's an exceptionally great urologist, very personable and...
Donna Lee:
Tells good jokes.
Dr. Mistry:
And he, yes, and he speaks Spanish.
Donna Lee:
He speaks five languages, this guy: English, Greek, Spanish, French, and some other fifth one.
Dr. Mistry:
I don't know about the French.
Donna Lee:
Maybe something else, but there's five.
Dr. Mistry:
We'll have to question him on the French.
Donna Lee:
Maybe it's Russian. I don't know.
Dr. Mistry:
He does know the Greek, though. And then we have five amazing physician assistant and nurse practitioners. Dustin Fontenot has been with us for a number of years. He does a lot of our men's health. Jason Ramsdell. He was in the coast guard.
Donna Lee:
Please visit our website and see these guys. They have epic beards.
Dr. Mistry:
Yes. They have amazing beards. And then we have Heather Lenz. She's the newest PA that has joined us. Doing an amazingly bang up job. Very, very great. And then of course, Leanora Brown, who's been with me for 11 years. You know how you have a kid? Who's your favorite? I feel like she's your favorite She might be my favorite. You know, you're not supposed to tell everybody who's your favorite, but they know the truth.
Donna Lee:
That's true.
Dr. Mistry:
And almost entirely the words that come out of her mouth sound like they just came out of my mouth. So I love, I love the fact that all of these providers, the care that they have is virtually identical to that which, which the physicians provide.
Donna Lee:
And we're looking for more providers. If you're a provider and you want to go into urology, give me a call. Hit me up.
Dr. Mistry:
We needed a place. And then Shefaly Ravula, she's our nutritionist and kind of integrative health specialist. You may not think that urology is the right place to get that integrative health kind of approach, but truth be told, almost every disease process we take care of, the patient's first or second question is how should they change their lifestyle?
Donna Lee:
Right. What do I eat?
Dr. Mistry:
What do I eat? You know, if, if you have infertility issues and you, you know, you're struggling to have a child, you're, you're going to make those changes in your diet and your exercise and your routine. If you're diagnosed with cancer, you're going to want to know what to do. Instead of just giving you kind of bland,"Well, you should eat healthier," or this or that...
Donna Lee:
Right. Go Google it.
Dr. Mistry:
...we have like specific recommendations. We will put you on a program. You will be part of a, a group of patients that are going through the same thing as you are. And we're really proud of being able to provide that. We have three pelvic floor physical therapists: Angela Treadway, Kendel Lipe, and Collette Rhoden. They are amazing. They all have doctorates in physical therapy. And then we always have sexual health medicine and sleep medicine. So if you're looking for a comprehensive approach to your urologic needs, visit the second largest urology group in Austin.
Donna Lee:
That's right. With the most fun personalities. And everything is intertwined, interconnected. That's why we offer so many amazing holistic things.
Dr. Mistry:
Donna, I thought we would let this segment be some, some questions that you have about patients that you've seen kind of roaming around or disease process that we take care of.
Donna Lee:
That's a good question. I, when I started with you, I was never really, I don't have a large understanding of cancers. Thank God. Knock on wood. But more specifically kidney cancer and bladder cancer. I don't think I understand enough about those. So tell me, like, what, did you have a patient recently who had bladder cancer that you took through the process and what does that look like? And what causes it?
Dr. Mistry:
It's a great question. So bladder cancer is traditionally a type of cancer called a transitional cell carcinoma. It's a, that the lining of the bladder wall, those are called transitional cells. The bladder wall is amazing. It like it can go from small to big. There are a few organs in our body--we have the stomach, we have...
Donna Lee:
The penis.
Dr. Mistry:
...things that get bigger, we like.
Donna Lee:
We make them bigger.
Dr. Mistry:
And so the bladder, it gets bigger. And so those cells, those transition cells, have to have the ability to stretch out. And the cells that make up that transitional cell epithelium, it exists from the inside of the kidney through the tubes, the ureters, and then the inner lining of the bladder, and the first part of the urethra where you pee out of. So that, that, so bladder cancer, quote unquote, can exist all the way from the kidney all the way down the ureters, all the way down under the bladder.
Donna Lee:
I didn't know that.
Dr. Mistry:
And so, uh, when you have that type of tumor, fortunately, about 70% will, will show up, and it's just something that you can easily pluck off or resect or remove.
Donna Lee:
Show up where? From imaging or from a blood test?
Dr. Mistry:
That's a great question. Most often we find bladder cancer because you have blood in the urine.
Donna Lee:
Okay. Hematuria.
Dr. Mistry:
So almost all of, about 30% of patients that have painless hematuria--that means they don't have any pain and they have blood in the urine--about 30% of them can have bladder cancer.
Donna Lee:
Okay. So when you go to your PCP and you're just randomly asked to pee in a cup, is that what the PCP is looking for, specifically?
Dr. Mistry:
A lot of times, they are looking for sugar or they're looking for blood. But if you cannot see it, then your chance of having, if you have blood in the urine, you can't see it, then the chance of having bladder cancer is much lower.
Donna Lee:
And that's microscopic hematuria.
Dr. Mistry:
Microscopic hematuria. And we get a lot of referrals for patients because of microscopic hematuria. But if you can see it and there's no pain, then we worry that you have something more dangerous going on. We diagnose it with a cat scan and we put a camera in your bladder to look around. Oftentimes...
Donna Lee:
Oh, the cystoscopy?
Dr. Mistry:
That's the cystoscopy. We do, I don't know, hundreds of those a month. So they're very commonly performed. We're looking for inside your bladder, it looks like almost like a, like a bush that's growing off the side of the bladder.
Donna Lee:
A bush.
Dr. Mistry:
A Bush. It looks like a bush.
Donna Lee:
That's what the cancer looks like?
Dr. Mistry:
It looks like a bush. Like, like a, like a pompom. And this pompom can exist even, like I said, in the kidney or the ureters or the bladder. And then we go and we use special instruments in the operating room to resect it. It's a little cutting loop that we go and cut, cut the tumor out. And what's important about bladder cancer is how deep it goes into the bladder wall. If it doesn't go very deep, then usually just removing it takes care of it. But if it goes deeper than sometimes, we've got to do something more invasive, even removing the bladder.
Donna Lee:
Oh, my. So it can spread like any other type of cancer.
Dr. Mistry:
That's right.
Donna Lee:
But you're saying that the cancer cells need to be flexible because it's so stretchy in there.
Dr. Mistry:
The cancer cells come from this stretchy, the stretchy skin. Now what causes cancers? You know, we scientifically think of, there's usually a genetic predisposition plus something else. We call it the two hit hypothesis: that the cells have to be genetically predisposed to cancer, and then some environmental thing that can kind of switch it into cancer mode. And smoking is the number one risk factor for bladder cancer.
Donna Lee:
You're saying smoking's bad for you?
Dr. Mistry:
Apparently. And...
Donna Lee:
I better cut that out.
Dr. Mistry:
...and when you have, when you have one type of bladder cancer or one tumor in the bladder, that means the entirety of your whole urinary system has...
Donna Lee:
Is affected?
Dr. Mistry:
...is affected. So you can get a tumor in the bladder and you have a higher chance of getting that similar tumor in the kidney. If you have one in the kidney, you have a higher chance of having it in the bladder. And so then we have to surveil or look after tumors that develop all throughout the urinary system almost for your entire life.
Donna Lee:
Oh my heavens.
Dr. Mistry:
So you become a patient of ours forever.
Donna Lee:
That's why we have so many patients I've seen before so many times.
Dr. Mistry:
And we have to look at them over and over again. We have to make sure that they're making those appropriate dietary changes, stop smoking--which is why we, you know, prescribed Chantix in our office for people who are trying to stop smoking.
Donna Lee:
Right. Does this affect the sexual desire and ED issues?
Dr. Mistry:
Well, certainly if you smoke, you're probably more likely to have diminished blood flow and things of that nature. But fortunately the bladder cancer itself does not do that. But being repeatedly instrumented with something in your pee-pee can, you know, certainly...
Donna Lee:
Psychologically...
Dr. Mistry:
...take some of the fun out.
Donna Lee:
A little PTSD.
Dr. Mistry:
So, understanding the role that your nutrition and lifestyle has on your future cancer risk, cancer rate of recurrence, as well as making sure that you're being followed appropriately, is a very important job that we have. Bladder cancer is one of the top, I think, six cancers that affect men in the United States. It affects women to a lesser degree. Probably something to do with genetics, but something also probably do with rates of smoking.
Donna Lee:
Oh, good point.
Dr. Mistry:
And if you have blood in the urine that you can see, and you've been putting off an evaluation, I would highly encourage you not to put it off any longer.
Donna Lee:
Don't put it off. Come on, we'll be happy to help.
Dr. Mistry:
You may not like the answers, but, Donna, how do people get a hold of us and make an appointment?
Donna Lee:
Our number is(512) 238-0762. You can also send us a question about bladder cancer or anything else you're thinking about to armormenshealth@gmail.com. Our website of course, is armormenshealth.com, and you can listen to this podcast and all of the others wherever you listen to free podcasts. Thank you, Dr. Mistry.
Dr. Mistry:
Thank you, Donna.
:
The Armor Men's Health Hour is brought to you by Urology Specialists. For questions, or to schedule an appointment, please call(512) 238-0762 or online at armormenshealth.com.