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 talk about HIFU, or high intensity focused ultrasound, as a treatment for prostate cancer. This amazing procedure can target localized prostate cancer and oblate cancerous tissue while leaving the surrounding areas untouched. This approach minimizes the risks of incontinence and erectile dysfunction, which can be side effects of other prostate cancer treatments. Dr. Mistry explains that one in three patients put on "watchful waiting" to monitor their prostate cancer will go on to need treatment for that cancer, so please always follow up with your urologist. Importantly, not every urologist offers HIFU as a treatment option, so if you have prostate cancer and haven't been offered HIFU, you may want to seek a second opinion. At NAU Urology Specialists, we are huge fans of the second opinion and will gladly point you in the direction of another provider if you want to do your research. We find that our patients come back to us time and time again because the level of care and expertise we offer is outstanding and our holistic approach to men's wellness is so unique. If you or a loved one has a major urologic condition like prostate cancer and would like to learn more about their options, including HIFU, 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.
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Speaker 1:
Welcome 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, joining you again with my wonderful cohost, Donna Lee.
Donna Lee:
That's right. Hello everybody! Happy day to everybody out there in podcast land.
Dr. Mistry:
In podcast land.
Donna Lee:
And the radio station.
Dr. Mistry:
I've given some renewed interest in becoming a stand-up comedian, just like you.
Donna Lee:
Really?
Dr. Mistry:
Yes.
Donna Lee:
What are you going to do?
Dr. Mistry:
I don't know. People tell me I'm funny all the time.
Donna Lee:
Go to our TikTok page. You're pretty funny. The Armor Men's Health Hour TikTok page.
Dr. Mistry:
I don't know if this demographic that we're speaking to really does a lot of TikToks.
Donna Lee:
No? Some of them.
Dr. Mistry:
They're probably more saying,"Get off that TikTok!"
Donna Lee:
"Get off my front yard!"
Dr. Mistry:
Get off...I say get off TikTok all the time.
Donna Lee:
That's true. I tell you that.
Dr. Mistry:
I'm a board certified urologist. This is a men's health show. This show is brought to you by NAU Urology Specialists, which is the urology specialty practice started in 2007. We are the second biggest urology group in the greater Austin area.
Donna Lee:
That means we are the best because the second always tries a little harder.
Dr. Mistry:
We try a little harder. Don't be a number. Come to our practice.
Donna Lee:
That's right. What did that patient say? We're number two at trying to figure out your number one...?
Dr. Mistry:
That's right. I still don't think that's really great.
Donna Lee:
Something we need to fix there.
Dr. Mistry:
I would ask the listeners to please keep the jokes to ourselves.
Donna Lee:
We're paid around here.
Dr. Mistry:
Our urology practice focuses on all the urologic issues for both men and women. They could include kidney stones, urinary issues, enlarged prostate--only men have a prostate--sexual issues that are encountered by both men and women equally for men. For men, we do a lot of low testosterone. We do hormone treatment for women as well, but for men, a lot of low testosterone, we do penile abnormalities like Peyronie's disease. We do a lot of prostate cancer.
Donna Lee:
That's right. People are surprised that we treat as many women as we do. It's a lot of womens. A lot of ladies.
Dr. Mistry:
Yeah. But, but you know, a radio show really focused towards men's health is kind of what our original goal was, even though our practice kind of takes care of men and women. We do on the show, on this show, at least, we do talk a lot about women's sexual dysfunction, because it does have a lot of overlap with men. But, whether you're a man or a woman, or identify as something in between, we're more than happy to help take care of you and your urologic needs. But I thought today, we talked a little bit about prostate cancer.
Donna Lee:
A lot of guys were interested in something special that you do, but not all urologists do.
Dr. Mistry:
That's right. In the last four years, we've been doing quite a bit of a type of a procedure called high intensity focused ultrasound, or HIFU therapy for prostate cancer. And I think a lot of this, you, you would have thought really that in the last 30 years, we would have come up with something else for prostate cancer except for just taking it out and radiating it. But for many, many years, there were only three options for prostate cancer: watchful waiting, which means that you just get repeat tests and don't do anything about the cancer.
Donna Lee:
Also called active surveillance.
Dr. Mistry:
That's right. We had a patient once they got mad that I didn't use that. They said,"I'm, I'm leaving you, Dr. Mistry. You only want to do watchful waiting. This other doctor does active surveillance." It took me, it took a lot not to laugh.
Donna Lee:
Did you at least tell him it's the same thing before he walked out?
Dr. Mistry:
I said,"It's the same thing." But what..."I prefer their approach--active surveillance," as if the doctor was going to be perched on a ledge, like overlooking them all day, 24 hours a day, seven days a week."I need that, I need that, that close, that close, you know, comfort of knowing that you're going to be watching me all the time." When you do active surveillance in our practice, you'll do a repeat biopsy of your prostate at a year, a regular PSA measurements. And then we do a very active management of your nutrition. That's a big part of it, making sure that you're taking the supplements that you need. You're doing the things that you can, that are in your control, weight loss, things of that nature.
Donna Lee:
Sleep good.
Dr. Mistry:
And about 30% of patients, they ultimately need treatment. So even though you may be put on watchful waiting initially, you can't disappear, because you have a one in three chance that you're going to need treatment because the cancer is going to be worse than they thought. Next, you can get your prostate removed, a radical prostatectomy. About 96% are done robotically nowadays. I've been doing that for 20 years. It's a great case. And I do quite a few of them.
Donna Lee:
How long does that take?
Dr. Mistry:
It takes about two and a half hours.
Donna Lee:
How long does it HIFU take?
Dr. Mistry:
HIFU can take anywhere between 30 minutes and two hours. And there's radiation therapy. For one reason or another. A lot of men don't like radiation therapy because they don't like the idea of radiation. Oftentimes the hormones you get during radiation can cause you to be very fatigued or get hot flashes or go through"manopause."
Donna Lee:
"Manopause."
Dr. Mistry:
Manopause.
Donna Lee:
My husband goes through that all the time.
Dr. Mistry:
You're his biggest cause of manopause, I think.
Donna Lee:
Donnapause.
Dr. Mistry:
Donnapause. The radiation therapy takes anywhere between seven and nine weeks. There are some types of therapy that can be done in five days, like CyberKnife. A lot of people ask me about proton therapy, which is offered in a couple of different facilities. There's really no difference in terms of side effects or anything in the machine just has some prettier lights, I tell them.
Donna Lee:
What's proton therapy?
Dr. Mistry:
Proton just uses a different type of, you know, molecule instead of the molecule that's used standard x-ray therapy. So there's not really that much of a difference. The image guidance that we have, you know, locally is very good. And so if you want radiation, that's certainly an option for you. But if you're looking for an alternative then what we offer something called high intensity focused ultrasound. And it's a lot like, instead of using, like, a magnifying glass will take light waves and focus them on a particular area. This technology uses sound waves and focus on a certain area, and that can be quite destructive. For any of you that follow science out there, we can, you know, kill people with sound waves.
Donna Lee:
Right? Especially in Havana.
Dr. Mistry:
In Havana, the Havana syndrome. But what we do with sound waves in urology is we use ultrasound to image things, like the prostate or kidney. We use ultrasound to break up stones, it's called shockwave lithotripsy. We use ultrasound waves to help regenerate penile tissue. That's our low-intensity shockwave therapy that we do for erectile dysfunction. And then the last one that we do more, most commonly is HIFU, where we use ultrasound energy to break up and kill cancer tissue that's in the prostate.
Donna Lee:
Right. And it's amazing because the side effects are pretty minimal.
Dr. Mistry:
Compared to the other ones. So when you take out the prostate, you're concerned about incontinence and impotence. When you take, when you do radiation, you, you're worried about side effects, like impotence at about 50%. And you're worried about the radiation hitting some other organ, like the colon or the skin or the bladder or any surrounding organs. And with high intensity focused ultrasound, we're able to shield the nerves from damage. So there's a lot less likelihood of erectile dysfunction. We can stay away from the sphincter that reduces your likelihood of getting urinary incontinence. We can keep away from the bladder and keep away from your colon and all sorts of other organs, and limit damage to the rectum as well. So it's a, it's a great targeted way. It's, it's really on the forefront of this, this newer methodology, which is called focal therapy, where instead of treating the whole prostate, we just treat where the cancer is. And we can fuse the images with an MRI and do all these really great, you know, cutting edge things. So, you know, it's too short talk about it during the show, the full, comprehensive benefits of it. But if you've been diagnosed with prostate cancer or you have a loved one that's been diagnosed, or if you've had radiation therapy and the cancer's back, because this is another area where HIFU can be used, then, then you should give us a call. You should always consider getting a second opinion for prostate cancer diagnosis because it's, it's good to know what other therapies are out there. And for those of you on a watchful waiting protocol, if you haven't gone back to see your urologist, then you could be that one in three that you know, where the cancer is getting worse and you don't know about it. And there are side effects to watchful waiting, namely taking a disease that was easily controllable, and now it's not. And so, although it's the right step for a lot of patients, you need to make sure that you're under the proper care of a doctor and getting the right therapy you need.
Donna Lee:
Is it safe to say that in the watchful waiting period or active surveillance that sometimes patients don't know what the, that they might be exacerbating the issue or speeding up the cancer?
Dr. Mistry:
I think there are some instances where they are. I certainly think that if you have a prostate cancer diagnosis and you're not on some type of nutritional program, we want you to avoid lots of sugar, we want you to control your diabetes, and you have to lose weight because nothing, you know, nothing that you can control is more kind of excitatory to cancer, almost of all types, then gaining weight, having that high fat content in your, in your, in your body mass. And it time after time, research has shown that this makes the cancer worse.
Donna Lee:
Because cancer wants you to be unhealthy. And it's like gonna thrive off of that.
Dr. Mistry:
It's not there to help you. That's right.
Donna Lee:
It's like,"We're gonna get you."
Dr. Mistry:
And as we get better and better about managing heart disease, cancer, like prostate cancer, these kinds of diseases are going to become more prevalent as we live longer and grow older. And, you don't want to like start making those changes after you get diagnosed. You'd like to think about some ways that you could get healthier and prevent or get, you know, have a diagnosis earlier in the, in the process, by, you know, taking the recommendations that we have in terms of diet. And so a lot of patients do come to us for advice on just prostate health, you know, and so eating right, losing weight and many, many times to the best things that you can do for your prostate health.
Donna Lee:
Sadly, that is true. I don't let my husband listen to the specific episodes when we talk about that. And then if you want a second opinion, though, you've been diagnosed with prostate cancer and you want that second opinion to, to specifically discuss HIFU, Dr. Mistry's happy to help you with that. You can call us during the week and let us know that you want a second opinion on HIFU. 512-238-0762. That would be in this country. If you're in another country, I don't know if we can schedule that discussion, but if you're here, give us a call. Our website is armormenshealth.com, and our email address to send your questions that we'll answer anonymously is armormenshealth@gmail.com.
Speaker 1:
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, ed gmail.com.