This week on The Conversation, Dr. Ali Kasraeian invites Dr. David Samadi as the special guest. Since September is Prostate Cancer Awareness Month, the doctors discuss new studies, controversial procedures and everything men need to know about prostate cancer.
Jay Gray: That’s right this is The Conversation. I’m Jay Gray, joined here by Dr. Ali Kasraeian, 340-1045 that’s the number to call in. Dr. ali what do we have on our show today?
Dr. Ali Kasraeian: So Jay today, I’m very excited to have a mentor of mine and a urologist who has wide expertise in the world of prostate cancer to bring on our first show celebrating Prostate Cancer Awareness and Prostate Cancer Awareness Month here in September. I’m joined here by Dr. David Samadi who is a chair of urology and robotic surgery at Lenox Hill Hospital at New York. He’s also a FOX News medical correspondent at Medical A-Team and he’s joining us today to talk all things prostate cancer, including the screening controversies and also the surgical management of prostate cancer, and he is also one of the world’s expert robotics surgeon who will discuss some of the important things to do when looking at management options for prostate cancer. So Dr. Samadi, thank you for joining us.
Dr. David Samadi: Hey guys, thank you for having me. Great show and I know you will be helping a lot of people out there.
Dr. Ali Kasraeian: I tell ya, to jump into this. I know you and I, a couple of years ago we had the opportunity to speak at the AUA meeting where the US Preventative Task Force recommendations against prostate screenings happened and I know you made some comments on that on air afterwards. Could you give us some insights on how your thoughts have changed since those recommendations against prostate cancer screening started about 2 years ago?
Dr. David Samadi: Yeah I think there is a big debate going on right now between the American Urological Association and also the US Task Force. The urology community were recommending men out there to have their first PSA checked at the age of 40, especially if your case is high risk, family history, African American where prostate cancer is more prevalent than 3 to 1 ratio. You want to make sure you get that baseline PSA, prostate specific antigen used for screening prostate cancer at the age of 40 and then if everything is fine, and then we can start again at age of 45 and every year after that. We are seeing that, a lot of young men, in their early 40s that are coming with prostate cancer and also many studies have shown that when you find prostate cancer among young men, they also could be very aggressive. Sometimes the PSA could be very deceiving because it could be a low PSA, with gleason PSA in the blood, this is a very tricky business and for the US task force to say, to start screening at 50, they are not helping a lot of men and we’re going to see a lot of men with prostate cancer spread to their bone, etc. If you look at the history of PSA, the blood test we know that this is not prostate cancer specific, it’s only a prostate specific antigen. So we know it’s not a great test and that’s why there is some art to do this screening and use this blood test. But for the last 2 decades, PSA has been responsible for the reduction of death among men, by 35% and this is a published data. So we want men to use this opportunity in the month of September to go out, get tested, and if there is any issue looking to urologists like yourself like me in the New York area and many other good urologists out there to make sure we catch this disease early on and cure it.
Dr. Ali Kasraeian: The interesting thing that I found anecdotally in the clinic it seems those recommendations took place in those several years after, we see a lot more men than we used to show up with metastatic diseases diagnosis and for me, my baseline of comparison is my dad. I work with my dad, my dad is a urologist and he has being doing this for about 40 years and he was of the era of urologists that they diagnosed prostate cancer when they showed up with metastatic spine fractures. And so for him when he comments that’s interesting we are seeing more people show up with metastatic diseases, it opens up my mind to the fact a paradigm shift and maybe inevitable and etymologist have looked at screening in 2012 when the US Preventative Task Force made its final recommendation against screening, we would go from about 30000 men dying in a year to 6000 dying every year of prostate cancer and a most of those would have been preventable death.
Dr. David Samadi: Absolutely right, and the reason why it is hard to detect this disease is that unlike any other diseases such as colon cancer where you may see some blood in the stool, pancreatic cancer where you may see jaundice or many other weight loss, etc. This is asymptomatic cancer. Men could be walking. One out of six men is walking right now, with having prostate cancer without even knowing it. So if the US Task Force was coming out with a better study, a better test, a better screening tool, then of course we would be absolutely following it. But to say that non-PSA tests they are not serving the community, now part of the reason why they are recommending this is because they are convinced that when you find a low-risk prostate cancer, what we call a gleason 6, there could be over-treatment, over diagnosis and as a result in consequences of some preliminary and sexual functions we all understand that. We all get it. That’s why as a urologist not every prostate cancer needs surgery and radiation and not every surgery and radiation means incontinence and impotence. If it was that simple it would be very easy but you have to treat every patient individually. You have to understand the velocity of the PSA, the rise of the PSA, look at different types of prostates, decide the age… so many factors go into it, which by the way makes the prostate cancer very interesting. If everything was the same, then it won’t be fun. Again going back, I think we are going to 5 years from now switch back to what we are saying today. Get tested at the age of 40, know your PSA. When I talk to the patients and I ask them, “what is your PSA?” and the answer is “my doctor said it was okay” that’s the worst answer you can give.
If you know your social security number, you should know your PSA just like your cholesterol and your blood pressure. And sometimes you may have a PSA of 0.7 which is normal and next year it could go to 3, your medical doctor may tell you that those numbers are all normal but that rise is very concerning and you should see a urologist.
Dr. Ali Kasraeian: It’s interesting, a couple of studies that I quote to my patients. One in particular was when to start screening. The group out of Sloan Kettering did a study following 21,000 men in Mamo, Sweden during the course of their lifetime and they came back and looked at those first PSAs in their 40s and they found that the first PSA was the most prognostic of your prostate cancer risk through your lifetime. So they did a lot of statistics and found people that had a PSA of above 1.5-1.6 in their early 40s represented the highest 10% of PSAs and that translated into almost 50% of people that died of prostate cancer in their lifetime. They came up with some algorithms where you get a PSA at 45 that is less than 1, your statistical risk of prostate cancer is much lower. If it is above 1 or if you are African-American or if you have a family history of prostate cancer because your risk is so much higher you need to absolutely screen every year with a rectal exam or PSA test.
Dr. David Samadi: You got it. You said it and I hope that men follow what you were saying and the first time you saw me on FOX News, you spoke about it today, I want women to get involved and that’s why there is a whole new Facebook out there, Women For Prostate Heath. We want women to go there, change their profile to the blue color, post it and challenge three other friends, boyfriends, husbands, co-workers. That’s the Samadi challenge we put on Facebook and is taking off like wildfire.
Dr. Ali Kasraeian: And you can check that either at DavidSamadi.com, David Samadi on Facebook or you can go to Women For Prostate Cancer on Facebook and it’s a great idea of engaging women.
Dr. David Samadi: It’s actually Women For Prostate Health and the reason why I called it prostate health is because a lot these issues that we are dealing with among men, whether it is going to be enlarged prostate or getting up in the middle of the night, it’s going to affect her. If you are getting up 3-4 times, she’s not going to get any sleep. If you have sexual dysfunction, if you have low testosterone, low libido in men, it’s going to affect her sex life. Prostate cancer is going to affect her and I think if you want to get a job done, no one is better than giving it to a women, you know that. They’ll get the job done. So that’s why we have Women For Prostate Health, we’re looking for a women volunteers to spread the word and this week as you know between September 16 to 20 is prostate cancer health so we want people to encourage men out there to get tested and also September 21st, whatever you have done, tape it and you put it on Facebook as a means to raise awareness. So I think it’s going to make a huge difference. We’re going to bring a lot of awareness to the country and this is going to be a big success. And I appreciate you spreading the word about this.
Dr. Ali Kasraeian: Absolutely, we always talk about this on the show in terms of breast cancer. My mom is a breast cancer specialist so I’ve grown up watching how the transformation of women and the world addressed and deals with breast cancer. You know in October the whole world turns pink and in September, it’s quite not much. Men don’t like to talk about things that are related to their health and a lot of times, women are the ones dragging their husbands in for screenings and things of that nature. So I think women are very much in the forefront of the men in the lives health because, frankly we are very simple because unless something hurts, we’re going to see anyone if we even go then, prostate cancer does not hurt.
Dr. David Samadi: It’s well said and I agree with you. Men are very different from women, we are problem solvers, so unless there is an issue with cause, something wrong with your house, we are not going to fix it. Women are very proactive, with their mammogram, with their regular check-ups, that’s why in my practice, it’s the women that actually bring their men and get tested. That’s the reason why this whole national move for Women For Prostate Health is going to be quite successful and you know, I think it’s going to be helping men out there to prevent enlarged prostates. What should they eating in order to challenge that. What sort of screening should they do. What if you have male menopause at the age of 50, they are going to have low testosterone, should they be getting… all these low T centers which I think people have to be very careful of [Dr. Ali Kasraeian: I agree with you] testosterone like M&M cookies. You have to be very careful about getting these injections. So this is all part of prostate health and so I hope you personally being involved in this because we need a lot of good urologists like yourself that would be representing us down in Florida and help us out with this mission.
Dr. Ali Kasraeian: We will do our best and I’ll talk to my mom and see if she can get some women she knows who can get on the frontlines as well.
Dr. David Samadi: Absolutely.
Dr. Ali Kasraeian: So we got about a few seconds to go and when we come back, we are going to talk a little bit about the digital rectal exam and more things about prostate cancer as we talk about more with Dr. David Samadi.
Jay Gray: If you have any questions, give us a call 340-1045. You’re listening to The Conversation on News 1045 WOKV.
Jay Gray: Good afternoon and welcome back to The Conversation here on News 104.5 WOKV. Thanks for joining us, I’m Jay Gray joined here by Dr. Ali Kasraeian, 340-1045 is the number to call in.
Dr. Ali Kasraeian: Not quite sure why we are brought in with the soulful sounds of Richard Marx (laughs)
Jay Gray: Hard to start the momentum of a new segment with that.
Dr. Ali Kasraeian: Thank you everyone for joining us today, we are joined by a good friend Dr. David Samadi. And first of all, I want to thank you for all your mentorship through the years with not just the prostatectomy and things of the nature but for helping me figure out things to talk about on the radio show and everything like that. But you started a radio show in New York tell us about how that experience is going for you.
Dr. David Samadi: It’s going great and I appreciate your humble words, you’re a great surgeon yourself and this is a collaboration and we all learn from each other. The radio station came about, it’s WMCA this was a very popular radio station years ago and a urologist who was running the show for about 20 years or so and he just recently retired and that’s how he approached me and said, “I don’t want to see the audience to see the light go down and certainly you can continue and carry the torch. It’s been a great ride but certainly the radio is different than TV. I’m more used to, as you know, on Sundays 12:30pm New York time, we have Sunday House Calls on FOX News, which is working really well and helping tremendous number of people all over the country. Radio is a little different — looking and talking into the microphone, you don’t have all these camera’s around you, a little different. It took me a while to get used to it but I’m having fun. You saw on Facebook, I had started my whole summer line clothing, played some music and I think you can give great medical [indecipherable] to people with your hobbies.
Dr. Ali Kasraeian: You really have some time to develop topics and answer people’s questions and some of the things you do really well… we try to do as well is engaging people on social media. We have one thing on TheConversationJax, you can actually post questions that really guide with the radio show topics and we’re going to start posting answers in audio and video format and I know, Dr. Samadi, you do a lot of stuff on social media to constantly educate people about their own health.
Dr. David Samadi: You know I think it’s tremendous, if you look at the program for today for example, everything we talk about there’s a lot of research and science and tremendous amount of hours that go into it. There are a lot of medical programs out there and unfortunately a lot of them have become very commercialized, have been pushed by a lot of companies who just want to sell their vitamins, etc. We have seen some of the examples on TV. So I think when you are out there, you’re not selling anything, and you are just giving pure information to people, one of the topics today was, someone asked me what do you take for your own prostate and I just showed him a whole list of things that I do in order to keep myself happy besides all the exercise and drinking water and sleep and everything, I had a whole lost of things like dairies, which is a great diet, fruits for antioxidants. I’ve been a huge advocate of coffee, study after study shows that it’s great to reduce diabetes, Alzheimer and even prostate cancer 3-4 cups a day and one and on. People love it, they love to take notes, they come back with more questions and I think you are absolutely right, when you have an audience that’s paying attention, they want more and work hard to give them more information.
Dr. Ali Kasraeian: You know one question that always comes up with regards to prostate cancer is the dilemma of whether the PSA is enough for whether or not you need to do the rectal exam and again we have this discussion with urologists all the time and they are all over the fence, what are your thoughts on the importance of rectal exam?
Dr. David Samadi: Well as you know the PSA, the prostate screening, involves the blood test which is the PSA and then it’s the physical rectal exam. Absolutely in about 15% of the patients, men who have abnormal digital rectal exam and that’s one way to detect prostate cancer, so you can just do the blood test, you should absolutely examine your patients and I think a lot of times it’s important for men to see urologists to their exam not because medical doctors are not qualified but in today’s medicine, medicine has become so complex and they … if you give me a stethoscope to look for a murmur I may or may not be able to hear it. I don’t deal with stethoscopes all the time. So they are very subtle nodules, abnormalities that we see on exam that a urologist can pick up where a medical doctor may easily miss it. So I think it’s quite important. Also our screening tools are going to improve, we’re going to get all these MRI technology coming in to our office, our biopsy techniques are going to improve. Right now we use ultrasound to do random biopsies, we take 12-14 samples of the prostate, where as now with our new guided biopsies we may be able too see the hot spots where the digital rectal exam was abnormal or see the areas that would light up and just target that area and take good biopsies. So I think this field is going to continue because we want our men to be aware of this disease, there is no reason to lose those 30,000 men out there. If you look at what happened with ALS and the Ice bucket Challenge, it’s only about 5000 people that died from that disease every year–
Dr. Ali Kasraeian: But the attention they got was amazing!
Dr. David Samadi: Well that’s part of the reason why every woman out there, we want them to change their profile image today to that blue we posted online and encourage 3 other women to do the same thing and get their significant others. Husbands and boyfriends get tested. It’s very critical to get the message out just like ALS.
Jay Gray: This is The Conversation on News 104.5 WOKV.
Jay Gray: Good afternoon and welcome back to The Conversation on News 104.5 WOKV, thanks for joining us, I’m Jay Gray joined here by Dr. Ali Kasraeian, 340-1045 the number to call in if you want to join in on The Conversation.
Dr. Ali Kasraeian: So today we’re talking about prostate cancer and bringing forth attention, September is Prostate Cancer Awareness Month. Today I’m joined by Dr. David Samadi and some of the things I’m talking about today in addition to the screening controversy over recommendations for screening but also raising awareness Samadi started the Dr. Samadi Challenge to women engaged in prostate cancer and prostate health by going to Facebook at Women For Prostate Health or Dr. Samadi’s Facebook page and kind of see what we were asking people to do to raise awareness. Ask 3 people to do the same thing, just like the ALS challenge to raise awareness about a disease process that affects 1 out of 6 guys in their lifetime, almost a quarter of a million men are affected with prostate cancer. Unfortunately causing the passing away of 30,000 men, still with the aggressive screening system in the United States. So it’s an important disease and the best part of prostate cancer screening is prostate cancers caught early and confined to the prostate, there are many, many very successful management options including one that includes monitoring a lower prostate cancer just like you would with chronic disease. So Dr. Samadi, so we spoke a little bit about the concept of advanced diagnostics of prostate cancer with multi-parametric MRI with fusion biopsy which for our audiences, we take an MRI scan that is very specific to detecting nodules within the prostate. Take that imaging and you contour it… it’s actually merging the image with ultrasound biopsy of the prostate and you target tumors. I think, our clinic we are just beginning our multi-parametric MRI fusion biopsy program and studies have shown that it goes from a standard biopsy having a positive detection rate of 30% range up to 50% if done appropriately. What are your thoughts on some of the advanced diagnostics for prostate cancer that are emerging?
Dr. David Samadi: So I think this MRI guided biopsy, there are a lot of studies that are coming up indicating that they are not really great for detecting low risk prostate cancer but when it comes to moderate and aggressive prostate cancers, they get much better results then those are the kind of cancers that actually can metastasize and can kill someone. So I think it’s certainly going to be incorporated in all of our practices and we’re starting to use some of those and instead it’s merging MRI pictures on ultrasound in order to find the hotspots and more accurate biopsy and random ultrasound biopsy so that’s certainly is a big factor here. I also think there’s going to be a lot of genetic companies right now that are working on detecting which gleason score 6, low-risk prostate cancer has the potential to metastasize which low risk prostate cancers is truly an insolent prostate cancer that you can do watchful watching. New we are starting to realize that not every prostate cancer is the same and they have to have different treatments. Question is, if you do the biopsy and you have one core of prostate cancer and you do another biopsy and you have 10 out of 12 cores of gleason 6, these 2 patients should not treated the same way. One, maybe for watchful waiting or close surveillance but the other one needs prostate cancer out and re-radiation as a back up plan after surgery. You also have heard me talk about the treatment options and this is not a surgeon who operates on every prostate cancer but I think surgery has a lot of advantages over other treatment options. You are getting accurate statements, you find out how much cancer there is, where exactly, how far it’s gone and the PSA after surgery should be zero and I use radiation as a back-up plan in case the cancer comes back, you can give radiation, or surgery after radiation is very difficult. The biggest news that came this week is that the FDA is not going to re-approve HIFU. I know there are some doctors in Sarasota in Florida and in many other places where they taking patients from there to Mexico to Grenada to Paul St. Thomas… who knows! To do these experimental HIFU and we’re starting to find out that the FDA is not going to improve it and certainly not up to the standard of care. I would caution men out there to be careful with a lot of HIFU treatments. People are hearing about it, people are charging them over $30,000 for something that has a high risk and I’m now also very cautioned about CyberKnife. What are you thoughts about the CyberKnife treatment option because they are advertised like crazy out there?
Dr. Ali Kasraeian: Sure, in Florida out there there are some groups in South Georgia that do a lot of radio advertising and things of that nature. I think with prostate cancer like you’re talking about, it’s a really personalized treatment option. I think focal therapy in terms of just treating the portions of the prostate, HIFU, focal cryotherapy and things of that nature have the role for really low risk cancer that’s really well studied that you know with genomic testing like Polaris and onco type DX that you know these are not aggressive actors. Those are quality of life decisions that people make for treatments. When people look at decisions between surgery and radiation therapy that you were looking at, surgery is the only treatment option that allows you to evaluate the whole prostate afterwards. We know that more than 30% of the prostate cancers upstage and upgrade, meaning the cancer is going to be more aggressive on the final evaluation of the pathology than the biopsy predicted. Hopefully with these MRI technologies we can do a little bit better job of not under diagnosing prostate cancer. But with the radiation therapy option there are basically four. There’s brachytherapy, where you use seeds to implant into the prostate. You have external beam radiation therapy that uses image guidance and computer softwares to focus treatments to the prostate. Proton therapy is another one. The challenge with CyberKnife or its generic name stereotactic body radiation therapy gives you slightly higher doses with each treatment so it gives you treatment over five days. The problem we have with that is that we hadn’t studied it for 10-15 years like we have with surgery and radiation therapy. So we don’t have the data for what the long term outcome for this treatment is going to be. And the studies that look promising are short-term studies in low and intermediate cancers and those cancers one could argue did nothing. The people would die in 10 years. So the data is really, really early so there is no way to say that. I think if you have intermediate to high risk prostate cancer, doing something like CyberKnife hasn’t been studied for such a long time put you little at risk, not that these studies won’t show a benefit, it’s just that we don’t have then right now and so you’re taking a little bit of a risk with… in fact sometimes a lot of a risk in terms of that.
Dr. David Samadi: Yeah and so it’s very interesting. There’s a new study that just came out in the Journal of Clinical Oncology this week and they are comparing the old fashioned IMRT, old fashioned radiation to CyberKnife head to head. And they find that CyberKnife has higher urinary toxicity compared to old types of radiation. Now old fashioned radiation was a problem because they’re going for 50 days and for a lot of patients that could be a burden. Now, for certain patients I agree with you, that radiation works well. Radiation comes sometimes with hormonal treatments that has its own side effects but a lot of times they call CyberKnife robotic radiosurgery and I want people to know that CyberKnife or robotic radiosurgery is not robotic radiosurgery, it’s another form of radiation and we want to make sure they know about this. There’s a lot of confusion out there, a lot of ads out there saying come in for 5 days, bring your folks, music and radio and have fun and you’re done. And as you mentioned, we don’t have a longterm data and we have to be careful. Once we stick with CyberKnife treatment, once the cancer returns, it’s very difficult to do surgery after radiation.
Dr. Ali Kasraeian: And you mentioned that in terms and what you are talking about in terms of salvage prostatectomy, meaning if you have a primary treatment such as radiation therapy and you go back to do a salvage surgical procedure, one has to keep in mind that your side-effect profile is much, much higher. Risk of incontinence goes from 10-15% and actually nowadays we’re seeing incontinence rates much less than 10% after robotic prostatectomy, that goes to about 30% with salvage prostatectomy. Erectile dysfunction becomes more or less the rule because all the plains of the meticulous are scarred in from the radiation therapy. Rectal injury rates become higher and all because of the tissue around that plain isn’t as precisely delineated when everything is scarred in. With your robotic prostatectomy technique when you’re looking at people to advice them about the techniques and when you are looking at the operating room, what are some things that you take into account when you are performing the operation balancing the patient’s pathology with their quality of life outcome goals?
Dr. David Samadi: Well, our operating room at Lenox Hill Hospital is very unique because as you know I perform an entire operation and I take a lot of. You know it’s a meticulous operation, I’ve dedicated my whole career to this and it’s a very high volume program. In a given week, I maybe doing somewhere between 15-20 of these robotic surgeries for prostate cancer and the physiologist, the staff, everything is pulled into this an I don’t do a lot of other urologic procedures. Typically, we see patients somewhere in the range of 40 year old to 75 years old, they are usually very healthy and they come in different sizes. Even a very large prostate is not a very big issue for me, I think for surgeons that start to do robotic surgery, at the beginning you want to be very selective and choose the right patients. Patients that are not too obese, etc. But this point we’re taking care of patients who have had previous operations, I have a laparoscopic group that work with me and were able to get in with previous operation with hernia, with mesh, enlarged prostate, big-medium-large — all of these challenging cases they come from all over US and we’re able to take care of them. Typically I’m in the operating room for about an hour and half. They go through a private wing at the hospital dedicated only to these patients, they have a private concierge and low risk of infections. And they stay in New York for about 8 days, the catheter comes out a week after and again, at that point they know exactly how much cancer they have, what type of cancer and very accurate staging. Once they leave the center here at Lenox Hill, they are dedicated to a certain nurse and that nurse stays with them so all the follow ups are still done by us. We get all the data, the PSAs that go into our research and follow ups. So it’s been working out really well. People come from all over US and also all over the world and they have great outcome. I’ve been very fortunate, 97% of the patients are getting the continence back and that’s within the first year and they get 8-% of their sexual function with or without the use of oral medication such as Viagra or Cialis. So it’s been a very successful series. But Ali as you know, you have followed my career, for a long time. Now you are looking at the end result of this. This was as a result of being open surgeon, I was at Sloan Kettering when we met years ago and then went on to laparoscopic surgery in France and now close to 6,000 cases later, it’s working really well for our patients.
Dr. Ali Kasraeian: I always ask people this when we kinda go into our next segment. What got you into urology and the world of prostate cancer and prostatectomy when you were starting your career?
Dr. David Samadi: You know it’s a very interesting question. I was a young resident looking at bladder cancer, kidney cancer and certainly prostate cancer and you know bladder and kidney were interesting, very challenging. But the outcome with bladder cancer was always dysmal. This cancer is very difficult, it involves chemo therapy, radiation afterwards. Kidney cancer was also exciting but was not a whole lot to it. It was the artery and the vein and again, I don’t to put it down, but it was not a very challenging operation. Prostate on the other hand was very interesting. It’s the deepest organ in the body. So somehow when god created our body, he put this organ where nobody can get to it. So deep, right over the rectum, attached to the urethra, the other side had a bladder hooked to it, right under the pubic bone and in case one day, one of us wants to get to this prostate with a robot, you have wrapped around the whole prostate with this sensitive nerve that nobody can get to it. So it was extremely challenging, it was difficult to get to it. Every prostate is different, in all these patients, not one prostate that’s exactly the same as the other–[Dr. Ali Kasraeian: That’s true] — which makes it interesting, makes it fun and that’s why I decided to pursue it, that at the time when we were doing surgery, it was not fun. There was a big incision, a lot of blood, and we were pushing transfusion, etc. And when the laparoscopic series came in in 1999-2000 in France, that’s how I got interested. That’s why I went there, spent a year in France and learned laparoscopic surgery from them and you know to be honest with you, I was doing a lot of laparoscopic prostate surgery before robotics and then when the robots came, it was no brainer. 3-dimensional view, magnification, blood loss and that’s how we did it. Now, unfortunately there are a lot of these robotic programs, I know some in Florida, some in other places where it runs like a factory, you know the surgeon runs 3-4 rooms and that’s part of it. If it works for them it’s fine, I’m not a big fan of room-to-room and this is one time operation, has to be done very accurately, you want a dedicated surgeon that is there. Usually he’s doing the pathology, he’s doing the surgery, he’s closing sections, paying attention to where the cancer is and doing what’s best for the patient so–
Dr. Ali Kasraeian: The things you mentioned are really right. I think for me, prostate cancer is a very personal disease in the relationships you form with the patient and both from the decision to screen, decision to undergo biopsy, discussing the results, coming up with a treatment option and even with every surgery like you say is different and both in terms of the anatomy and the patients goals and so I think, like you are saying, the relationship that you form with your patient and the surgery is very, very personal. And I think for me that’s one of the things that makes prostate cancer a very fun disease to take care of because you do these relationships with your patients.
Jay Gray: Coming right back here with The Conversation on News 104.5 WOKV. We’re going to come back and take your phone calls at 340-1045. This is The Conversation on News 104.5 WOKV.
Jay Gray: Welcome back to The Conversation on News 104.5 WOKV, thanks for joining us I’m Jay Gray joined here by Dr. Ali Kasraeian.
Dr. Ali Kasraeian: Welcome to the Richard Marx station on WOKV. Thank you everyone for joining us today on The Conversation, I’m joined by a friend of mine and a mentor Dr. David Samadi and we have been talking about prostate cancer and some interesting things going on in the world of prostate cancer and also some interesting things in terms of the awareness. Dr. Samadi, any parting words for our audience today?
Dr. David Samadi: No, I think what they need to know is that prostate cancer is, as we discussed, a silent killer when it’s caught early on it cure rate is extremely high with a good outcome. You should not be scared of urinary control issues or sexual dysfunction. They have to choose wisely the person behind the robot who performs the surgery and I think for the week of prostate cancer awareness, we want women out there… there’s a Facebook page called Women For Prostate Health, go out there and change their profile to the color blue and also bring in their girlfriends to be involved. September 21st, we’re calling this Women For Prostate Health National Day and they can take a picture or video of what they have done or wear a blue shirt and get their videos out there online and encourage everyone to be aware of this disease. If you can do that you can bring it to the frontline and make men aware of this disease just as in breast cancer for women.
Dr. Ali Kasraeian: For men and for women, I think screening is a very important thing to keep in mind. There are controversies with all kind of screening tests because the goal of them is not to cure a symptom that you are feeling or noticing, it’s basically to catch something early enough where you can intervene or be aware of what going on ahead of time that our management options have good success rates. So get your rectal exam, get your PSA. Start in your 40s, if you have a family history of prostate cancer, if you have prostate cancer tell your family, tell your sons, be open with your doctors with these discussions and go to your doctor and get checked out. Prostate cancer is an important disease and make sure you don’t fall behind and get discovered when it’s too late.
Jay Gray: Thanks for joining us on The Conversation on News 104.5 WOKV.[End of audio]