Nov 5, 2013|
Men’s Health New England is a weekly radio show dedicated to giving you the straight talk on Men’s Health. Hosted by Dr. Stephen Scionti, the Director of the Scionti Prostate Center of Boston, Dr. Scionti is globally recognized for his work in advanced prostate cancer diagnostics and minimally invasive prostate cancer therapy. From cardiac care to prostate issues, from sexual health to prevention and wellness, host Dr. Stephen Scionti will be discussing the topics on everyone’s mind, but what everyone’s afraid to talk about – their health! Men’s Health New England will cut through the confusing and often contradictory messages you hear about how to live a healthy lifestyle.
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Joining doctor CI the and his guests as they discuss topics from cardiac care to prostate issues from sexual health to prevention and wellness. Post doctor Stephen C -- we will be discussing the topics on everyone's mind but when everyone's afraid to talk about -- else. For questions about your health or if you worried about your prostate and wanna make an appointment call doctor CI -- -- -- 6176961826. At 6176961826. Or go to DR CIT dot com that's DE RS EIL and T -- dot com. And now here's your host doctor Stephen CID in Boston's most experienced prostate cancer physician. Welcome to men's health the way when I'm your host doctor Stephen -- director of the CI AMP prostate Centre of Boston that massive bait urology Milton Massachusetts. Join us every weekend at this time for the most advanced in up to -- discussion of topics most important -- health. Join us every week as we discussed topics like. Prostate cancer prostate disease. Sexual health. A lifestyle and diet weight management. Heart health and hormone will help. Every week we were interviewed national experts in men's health. And empower you with up to date scientific of progressive information that you can use to improve your overall health. Achieve weight loss lower your risk for heart disease. Maximize your sexual performance and deal with prostate problems. Now in today's show army special guest is doctor Cesar. She's the head of the out of that strata DX. And we're going to be talking about. Diagnostics diagnosis diagnostic techniques in prostate cancer. We'll talk a little about the PSA controversy. We'll talk about why an accurate diagnosis is so important. In terms of understanding. Your prostate cancer and really understand what treatment options may be available for you. So it's going to be an exciting show on an invite you to submit any questions you have -- WR KL dot com slash men's health. -- if she goes on the air or can answer the emails directly to you. Learn more about prostate disease and prostate cancer my website at. DR CRD that's DR SEI ON TI dot com. My prostate center is located at mass may urology a division of Greater Boston urology in Milton Massachusetts. We are at the phone number 6176961826. That's DR CIT dot com DR ICI a when TI dot com or by phone at 6176961826. Stay tuned -- be right -- -- my special guest doctor -- are from strata DX stay tuned. Struck a DX is one of the most trusted technology labs in New England specializing in advanced testing for prostate cancer kidney cancer and other diseases of the urinary tract. It was over 25 years of experience started DX has a proven history of delivering accurate and timely patient results. Making it one of physicians most trusted labs throughout the northeast. Strategy X is backed by all major health insurance plans and its affiliated with the best doctors in Boston and throughout New England. Which reliable diagnoses strata DX is a lab positions Jews and patient's request. Whether it's a routine problem or cancer -- DX can detective and desist your doctor in giving you optimal treatment options. If you want timely and reliable results ask your doctor about -- DX it's the right choice. For more information visit -- DX dot com and see for yourself. That's ST RA TA DX dot com. Welcome back. This is doctor Stephens county founder and director of the Seattle beat prostate Centre of Boston. And your host up. Men's -- the -- and today we have a special guest doctor -- from -- that diagnostic strategy DX. Especially -- laboratory. -- special expertise and prostate cancer diagnosis. Finishing delicacy -- to profit Centre of Boston. We are in. Very concerned about it in the proper diagnosis for our guys -- one of our it is important partners in -- -- the action and most of our technology work. So without further I do let me introduce doctor -- -- DX welcome. Good morning. Good morning thanks for joining us at this early hour. Thank you so -- -- -- Telus will tell the audience. What she'd do extranet. So I am. See you which is on genital urinary pathology and Eli and pathology as well. -- for the opportunity. Between them get a lot of prostate biopsies from all over the country. New England won't feel that we get specimens from the read all around the country. We've talked system that same day and we you can't stand microscopically. And we diagnosed with. Whether there's cancer and are not. We do we can do something special he when they -- testing as well. Two. If Mattingly feet propped militants on a -- -- prostate cancer. As well as we do you -- the psychology examinations of control bladder cancer. I am indeed direct. The psychology in molecular pathology units of traffic at the end. As well as being a senior general pathologists. So a lot of the work that you do really a curse kind of beyond behind the scenes is that right. Exactly. Yes -- I mean so leave the patient knows who typically come and see the urologists in the office will do prostate biopsy. And then him magically. You know that soon you know some has some I think some some elves in the background. We'll process that tissue and give us an expert diagnose and that's really what we can do it strata is that right. Yes yes and just didn't briefly to catch -- on their own movement. I don't know if you've been quite an elf before I thought. Daddy -- The go live theater trying to tie it at 24 hour -- so we're really committed to. Turning up biopsies and given a diagnosis -- -- -- -- who -- -- the patient I'm anxious. To get the results of the -- and do everything we can to provide. An accurate and fast. Results. So just to briefly I know it was a big black hole and left of the biopsy is taken at the doctor's office. It's just -- -- -- -- -- you know with the department mean we need to in diameter and maybe. Half an inch and and land. To these -- he. When they come to the lab they get. Accession day. They've given a unique patient identification number. Embarq to reduce food -- outstanding mix up in any of the patients on any of the violence it's from the same patience. And then their process to put them in profits as we have. Maybe. The gold standard left to do it processes that are. Microwave processors something to. The -- -- in an hour or less. And then these tissue are embedded in a small passing blocked. Divides his -- -- so you know we get good morphology -- and then their cup with a microphone and we put them to stay in her. And then there custom -- on the line and up to that the phones and it. Than we look at them under the microscope that they. Substantive level and we. -- -- -- -- -- -- -- -- -- -- -- Right so it you know the pathology laboratory is a critical. A part of this entire process so in providing men with an accurate diagnosis. Can go -- absolutely and you know -- You know the more. Expertise you have to more accurate the diagnosis I'm going to be and the faster. It. Give and that's probably why I've seen that are difficult that some of the cancers as you know about those counties they have. Very very long for fighting cancer really moment. We're talking then my crohn's. So would leave you know they need sometimes some special stand firm extra authority and so. Right so there's I think there's nothing more important thing getting in our patients. An accurate diagnosis. Absolutely. Absolutely and so that does take you know it's a committed to pathology laboratory is well as a committed in -- and now I would at a highly experienced a pathologist to really focuses on. -- prostate cancer absolutely. -- excited I don't think that happens all the time you know in in many many senators. -- and I you know by you by virtue of the volume of biopsies we do to achieve. It. We just and I can at least see a lot of the virus season that treaty gives us a good thing huge experience. So either. And we do it here really depending on the eyes of the pathologist if you and. You know they're more experienced food diet and more they're going to be apt to. Identifying. Very small forward -- campaign there. Sometimes cancer can be had been -- -- or -- or you know and sometimes that's -- -- -- cancer and may lead to false diagnosis. And you really need that they expect eyes to different she tends to -- it gave -- very academic. Well you know you're you're exactly right. He you know if it's say you know I think sometimes -- patients. I assume that this part really automatic. But is behind the scenes once the biopsies taken. What you're telling us citizens of tremendous amount of work in a tremendous amount of expertise. That's involved here. Exactly you know it's not like a blood test you know reluctant to run through a machine through an infantryman. And then being -- the instrument. Tells you you have high blood sugar apocalyptic. You cholesterol is normal. You know -- you don't have that. Human expert. Right she -- you rely on me and you know on a highly trained physician. You know we have to -- highly trained physician who can study the the the tissue under a microscope and sometimes pick out cancers as small as. As you said a micron are you know or you know certainly less than a millimeter in size. Oh yeah. My you know I would say. 110 of a million need to. Right Communist China. But that's so important -- -- giving her arm and the proper diagnosis but I know what are the what are the front cheers I think in the schools backed I think you're expertise. What are the frontiers in diagnosis is not just. How they cancer looks under the microscope to what's called light my cross to be. But the molecular. Study that is I'm looking at the some of the we call the molecular markers I know that that's open your neck to commute let's talk about that a little bit. Sewer firm so -- once had a diagnosis. Is made and and the patient can be satisfied so. Well let me talk first about I'm just a touch briefly on big -- and I agree -- of the tumor and I know patients can hear that. If they get a diagnosis so confident cancer and is -- -- of this is the -- thing to me. Right so what what is what is -- what is what is cleese and grade what what does that mean. So armed backed and putting an end of why are the pathologist and in 1966. Or so I think he came up -- this genius. -- -- and before it was. Yes I -- the diagnosis was miles be differentiated -- his mother in different shape since then. And so forth. And that's at least -- -- you don't have to look at the new community and how we cook and how difficult it is to look at the architecture of the tumor. And he -- Device this -- from grades one too high grade torn being the -- More. Well different actually because they'd better best needs to learn to be a great time with two things. The worst. Truck not to course looking to work. And later on -- -- are connected to a combined with grief and grieving family to me that two more. Prevalent tumor in a biography and that's because that you know the tumor usually you have to -- So heterogeneous is. That this -- doesn't seem to have the same morphology. Of all over the tumor. So we take quick look at the biopsy and then we decide is this four of them. More prevalent one in. Great three and then it all looks like great -- so we add that the great three plus three equals six and that's called the combined decent grade. So the Gleason grade really is I guess more pattern or shape recognition. Exactly -- And into what you're defining is the most common pattern seen as the first number in the second most common pattern seen as a second numbers are right. Yes okay all right so but that that that's been in use now for. Really about fifty years. Oh yeah yeah I mean it it didn't really pick it even though he. We have come from came up -- -- with sixteen I think it's really picked up probably in. This late seventies and you need to it went all the pathologist had to do it and so it's meant any reporter -- -- forty years of. Right right but but that's basically tells us kind of what a cancer well looks like. Right right okay. But sometimes. -- as a as a clinician as someone taking care of the men with prostate cancer I sometimes wanna know a bit more information. Right. And our job as the -- and to provide as much information. To you and the street to about two hours you can decide would you patients. On the streets when plan. Whether. To do active then. I think with -- focus of cancer and a fifteen -- lo green or -- to be more aggressive and that's something of course let me ask you. So in some cases where he you wanna give the patient more information about the behavior of the -- to -- and what is likely to behave. So even though. Can't -- our mop -- -- thank. It didn't have the same looking cancers and that's the basics in two patients and they might behave differently. Why because Jeanette ticks me these two might have different predisposition. So here that's trying to we developed to attend. One is called people and that's PT ENN. And morning called ER achieve which is. So the that pizza and and really any. It's a pro team. And if the tumor suppressor gene who would does that mean. People and it really is not unique to propagated. -- present in most of the tissue in our body and it acts behind the scene to. Suppress. Any tumor. So. The wind itself but can you -- then who have. Beat them and functioning properly it is oppressive the mutation of the fell and broke. -- The captain -- so in. Some of the patient the -- and -- to. Not functioning. And did -- -- over that the senator mutation. That did not achieve controlled and the family mutates and go on to develop cancer. Inpatient that have distribution. It's proven that -- and they're at higher risk. Then others who don't have suppression of the British. Right so that's so that that's that's that's getting a lot more information -- -- -- -- -- -- and other. Yes it you know what it keeps everything in -- lawful and order. And -- that I think it's that's right when that that -- that gene has been deleted and then there's less police on the street. And you start to see cells behave -- a lot more on rule -- fashion right thank you start to grow you know more aggressively got to control is that is that a good way to think about it. That's a perfect analogy. Right here. So so given given the route is more information. It is incredibly helpful now the -- in the ER GO we can get a break here. We're gonna go back. I mean just to many here -- everything wanna talk more about these markers because I think they're incredibly incredibly important. So what that original and had to come back in just a moment here as a doctor I'm Stephen Giambi. You host a men's health when when the director of -- out of CRP prostate Centre of Boston. On our website at DR CRD DR CI a when TI dot com learn more about prostate cancer prostate disease. Our call our office at 617696. 1826 we right back with doctor -- from strategy DX learn more about. Prostate cancer diagnostics and prostate cancer technology. Stay tuned. For over seven years the staff at Belmont medical -- have listened to their clients can match the right product to be exact needs of their customers hi -- from the -- car show and this month's -- medical is featuring a light therapy during the long cold months -- one hour with less daylight and less activity people confront the feelings of depression you can ease the symptoms of seasonal affective disorder with an incredible LED -- -- -- called Caribbean sunrise this portable light therapy is safe. Doctor recommended and highly effective. It can easily seen on any desktop exposing you to deal looks like you need to stop sign -- Belmont medical supply -- -- Caribbean -- -- can light up Fuhrman -- volunteer with everything from scooters about safety products some medical supply helps people would mobility problems the more comfortable and confident. Find 125 Belmont street in Belmont call 617443888. Or visit -- medical dot com I'm not a matter of supply and you're one shot at home health stops at six point 74843888. Or visit Belmont medical dot com. Hi this is the -- president of American auto transporters we have been an advertiser on WRKO for the last twenty years it has been a great partnership for us as WR -- has been able to continually bring -- new customers even in this difficult economy -- radio spots have been able to help us grow our customer base the production and sales at the WR KOR always helpful and they have always taken the time to learn what makes us different from our competition our dependability and reliability is what makes this different and we would say the same for WRKO. The ability to respond to our customers' needs quickly and to be flexible is a vital benefit that we provide our customers and one of the reasons that we have been so pleased with WRKO. They have produced by stress and they had them on the air and producing results in -- matter of hours which really helps our advertising budget to pull its own -- I would be happy to talk with anyone about our -- actually WRKO and you can reach me at 180825. -- war -- cart dot com. I'm in the country and American auto transporters and can't mess. Welcome back this is doctor Stephenson county founder and director of the CIP prostate Centre of Boston Massacre may urology and your host up. Men's health who would -- Today we're having a great discussion about prostate cancer diagnostics. Can we have pathologist. Doctor taser from strata it DX as our special guest she's right here in the Boston area. And does a lot of work I mean how. Prostate specimens pathology specimens that we harvest from prostate glands and our patients is so this is an important incredibly important done. Addition to necessary part of the whole picture of diagnosing prostate cancer said doctor -- Thank you come back we're talking about molecular markers so let's go right back in this some of these markers. Their -- helping characterize. Prostate cancer behavior. So we talked about the copy can gene which is a tumor suppressor gene. And -- the other hand we have. Another. Gain market -- we've looked at and called earth ERG. Which -- Reading an abbreviation. Of any sort block confirmation. Specific critically thinking. And what -- yeah I mean I didn't I don't think I even knew what that was I can always call and heard. And and I grew -- that. So there aren't as opposed to peak and peak and. The practice of the tumor development when it is it's the policemen and that's really keeps everything gains tax and -- -- -- any. Cells become unlawful -- It acts -- Relief supplies and. Current -- on the other hand news and quantity. So he had the bad guy. It seemed it promotes. The development of mutation in a -- to crumble the. Division the on -- division of the so which leads to cancer. And again in. If the patient that the positive for that. -- fusion. And believe that it treaty is transform its punitive -- -- a mother -- Not technically called template to where I don't think you know anyone needs to remember them. But that's also we are -- confirmed in prostate cancer. And especially. If it's present there it's like -- hit it promotes the division and the mutation of the tumors you know. But also it it was phoned in cancers that are hormones refractive me so been wounded. You know. And engines suppression is used to also treat prostate cancer. And if a patient is positive for a bit gene fusion date they have to crack into that treatment. So it's good it's everything important. Piece of information when we look at these two machines. Number one a guide you treatment if the patient. Choose to choose to be three pin numbers do -- stratified that it couldn't ask for a lot. It can be better for. If the patient is on active surveillance may mean for. Developing more cancel have been confirmed grew even though profit painfully slow to go. Or. Even in three to station game may be at the hiring for accountants -- local because. Right so this is this gives -- critical information -- beyond. What cancer looks like for the Gleason score. This tells us more about the molecular program into the south. And and really you know accuses some ability to predict how this cancer will behave in the future. Right. So it is -- this routinely offer by every laboratory. No I believe would be on an opportunity. People and then Greater Boston area that offers. It didn't content there we look at them -- -- cold fish which stands for. A reference to fight for hybridization. And basically he you leave booed the team and that helped send their eleven with a fluorescent. Commentary and. And then we know and and there are three fluorescent. Colors that we look at. Those schools. Green and breadth. And when we look at BP can. Still remember would look at -- deletions. -- looking -- action keep canned and -- and we live and it would AM goals for our. So we took ourselves but don't ethical for a and the current fusion was looking for fusion between two. Genes. And then and goes one point two genes are if you lose you lose the genes in between them. So would look for. Green and red -- Next to each other not separated by another color. It takes a long time to read reality -- those fish probes. It's it's a very laborious and and very unique and meticulously validation. Because you have when you're doing your validation you look you have to look at a certain level of normal prostate. And -- like I said these. These two EDT. -- the gene fusion and the people of the -- can be seen in normal tissue. But she wanted to see what is their level what's the threshold that beyond this it's abnormal. So. You look at you know certain level of normally establishing. Normal baseline. And then you -- -- -- known cancer and think it's a very laborious. Round. Right but you know because of that I think we get a much better -- understanding. How this cancer is gonna behave so what can we give the audience another analogy -- And so one of the guys listen -- people do Latimer guys and I'm sure some ladies listen Cuban -- music. You know an analogy that might make some sense. You know I think that there's ways. You when you see them you know lot and and a nice red sports car right. You know you think OK it's really pretty NCE get the look concern that that looks like it's going to be really fast car it looks like it's a really sleek. I'm really sexy car. But you don't really know how it's gonna performance he'll put up the -- right in front -- -- horsepower it's got what -- you know. Now what's the kind of transmission what kind of torque its got all the technical issues right. -- so this is this is how I think -- prostate cancer right. You know we get a Gleason score it gives its okay that tells us you know. What does that cancer look like and what's its appearance but what I really wanted to was on -- open up the court that cancer so to speak we'll look inside one understand. How it's programmed to grow was gonna -- slow is gonna grow fast is gonna is it going to be program to develop. Resistance. To you taking away testosterone to call energy and not resistance. Power is gonna isn't it is to sell -- attending Grohl. Not in an unrelated packet because the policeman function is missing and -- and a grown more Iraq. You know outlaw all I know and the like outlaws and just kind of grow crazy. So he -- not getting that information is incredibly important and I think it takes a special chief. Laboratory. And a specialty pathology department done and pathology team to get a say information hesitation shed its its pretty complex stuff. Did you these these different down the measurements on with these what they call the fish assays and so forth. So right it's you know -- I think it's an incredibly important part of how we approach this disease. Right and -- know -- different path thinking I think counseling are the laboratories don't go to step further to. Have any and molecular. Doctor -- we have to you know a top knots. Ph.D. in the -- anything you packed up my experience. And he is the one who work with myself in developing these in these studies. And he came to us from new -- name in news that unbelievable. You know community. Meticulous and and I think put -- me. Very lucky to have you on our team and so it is creating it for a complete team approach and you -- offered the best he can. And do more in a bit more information to that are we live in any in an age of information. So. I don't there are a lot of controversies. And over diagnosed than that of. Prostate cancer in all do we have to read it you know screen all these things. Well we are pleased that these -- the hot topics. Dole is important but I can't get one right have a diagnosis I think the more information we can provide to the document to the patient of that sort. And then they can make an informed. No I I agree I I think that's exactly right to take a quick break we'll come back we'll do another segment and we don't talk about this. We're gonna tell a couple of particular patients. In some of the diagnostics from our strategy DX and operator and how that might help change how we approached a patient is doctor Steven Shapiro the men's health the -- We're gonna take a quick break we'll be right back so stay tuned. Continue to look these vegetables are being contaminated with bacteria that could cause paralysis. Listen. You can't see it either. 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Forcing ETE 70% less food without surgery or ever join Hungary and -- you literally can't eat for five to six hours. See you can lose weight from day one safely and actually and if you call the next fifteen minutes -- little what you try by strict and completely risk free. To either lose weight or you don't pay a dime. But this is a special limited offer saying gotta call now 1805286030. That's 1800 by 286030. 1800 -- 286030. Welcome back this is doctor Steven Segal he's founder and director of the jockey prostate Centre of Boston mass -- urology. And your host a men's health who would win. Today we are very happy to have doctor -- He was the head of molecular pathology at strata DX here in Boston. We're talking about prostate cancer diagnostics. And the importance of having the proper. Diagnostic approach the proper pathology and molecular pathology team so we can give our patients the proper information to doctor isn't welcome back. Think this has been a great discussion because I think you've really helped explained. You know what. Happens you know in that in sort of up by what I said the little -- behind the scenes -- a -- this amount of expertise side that goes on there. Once we give some little vials of prostate tissue to the pathology department. But talk about a particular patient is in India and get your get your input on it. So while the gentleman came to say we recently. He was 63 years old. Is PSA was only four and a half. Now we do a lot of advanced diagnostics we use MRI to help identify where the tumor is. And then we target our biopsies as well as we take some samples throughout the prostate. And we think that I think that really helps me to identify. You know really the worst part of where the cancer in the prostate by using that approach. And then so we we we this -- went through an MRI and we went to a targeted MRI guided what's called an -- mr. biopsy at the NR and in the result the report that I got back from China. Showed that. In two sites on the right side of the prostate right next to each other. There was two very small sites. One millimeter each. Publicly -- six. Prostate cancer. Right so here's a general we think has a very small -- cancer. And from -- coalition standpoint. Meteorologist import the question is does he really need aggressive therapy or can we mentioned with something called active surveillance. So -- as a patient where the molecular diagnostics can help us. I think that's the perfect and I do patient when -- look at -- diagnostic code penalties. You know if you have a small focus of cancer -- Especially if it's less than 10% of the tissue. The patient. In the candidates for active -- him and. And I think. When you get to molecular diagnosis of the patient. It's basically you one way or another. So for example if we do with the American people and step up and me come back. Negative -- lower risk. Then that the patient really and people can have some peace of mind that he has any quote unquote favorable to -- -- you know didn't do wherever you can act wild in a year and eat. We have been he'll feel more comfortable going to active surveillance. However -- The molecular diagnosis comes back at you know -- -- is high risk you have. Pete and deletions and you have -- -- that's expressed on these specials. In the current and that's. Then you know he may think well maybe I I could be more aggressive I came -- don't choose to. Being active surveillance -- -- more prudently and. Actually do have the that demand so. Decisions that. Well maybe my 200 -- More aggressively and sit -- and these these -- extent -- Why don't I think that's exactly right I mean you know so. If I isn't as -- -- the clinical physician who's advising mr. Obama what to do. If the laboratory analysis tells me that that people the and the -- are favorable. That is low risk. I think I would have a lot more confidence advising this man to be on surveillance. And an end in frank you know. Research suggesting he'll do very well on surveillance that the incident that we probably don't need if we if we treated with surgery or anything else we probably over treated him. On the other hand you know if we look at this cancer and you know it's got some molecular features that. Make it more apt to. Or more are possible for it to grow and develop but you know bad characteristics. Then we we may still do surveillance but we're gonna -- they have a lot more carefully. Or perhaps we may talk about minimally invasive therapies as is is really how it is sort of an in between approach yeah. This is where it's incredibly important you know what surprises me frankly. Is that. Not all urologists use these tools. Yeah and I I think. And really it's the fact of -- out of their laboratories that does she use and anything can it's really our responsibility. To. Spread the word if you lose owner cannot teach the clinicians because of the. A lot of them you know may not really no immunity because it's an entirely new -- and you know I'm conditions may not know exactly you know how we use put it can't be their decision making in man. Patients. Follow up until forward so. I think we do the best we can to spread the word. Well I think it's it's incredibly helpful you know. And I think you know part of often free -- part of being a state of the art prostate cancer diagnostic and treatment center. Means that -- you've got these you know you gotta have all the parts of that in I think one of the most critical parts that we have and our senator is. The fact we have expert level pathology. As most molecular diagnostics. So that. The more I understand as a clinician about. That -- cancer in its potential behavior. Better advice I give my patient. About me you know what the most appropriate treatment is because and you know. One of the biggest concerns today. Is that we we tend to over treat prostate cancer. You know in the end and sometimes you know treatment very you know aggressive treatment is warranted. And sometimes it's really not sometime I'm really better to watch but without you know without having this information I think we're essentially flip of the coin. Right exactly you know and I think most most patients don't want their futures decided. By coin flip. Absolutely not I'm not -- -- thing that fell -- to mention you know even if you know if you haven't been too much that he no European. Respective teams can do Judy. -- people you know -- not a small to learn maybe in higher grade. But when you get that information. Of the molecular. Diagnostics. For prostate cancer. It's me. Also and correct me if I'm wrong. To persuade you to word. Doing -- linked militant site section of the spinal surgery or not because if you have a higher risk patient. And you know that there is I hired like to move that can. Cancer has spread out by the -- Right we may modify our operation and do more aggressive operation and consequently will follow that patient much more carefully after surgery because he isn't higher risk for recurrence. Six so again no substitute for information here. This has been a great -- and a great a great segment and I really appreciate your time doctor -- to come on men's health a win win. It helped to teach our audience about this because it's all important. My pleasure thank you so much for being our guest. And again guys you know there's nothing more important getting a proper diagnosis. Dawn to be right back or talk -- more about this whole issue of diagnostics stay tuned this doctor Stephen C at -- he'll host a men's health plan. And vacation much the doctor is from strata DX. 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We treatment regardless of their major medical history including prostate cancer and diabetes. Call now toll free 803331950. If you suffer from erectile dysfunction and the popular appeals have let you down. Don't be fooled by the big drug companies any longer call 803331950. Now for your free book. Or go to pre ged book dot com that's free ED -- dot com or call 803331950. Now. Trying to sell -- old car instead donate your vehicle to heritage for the blind -- is free and your donation is tax deductible just call 1809534036. Heritage for the blindness of -- vans trucks and -- whether they run or not -- right now and receive a free three day vacation -- to over fifty locations call 1809534036. Donate your -- today that's 1809534036. Welcome back this is doctor Stephen seal -- -- Founder and director of young people prostate Sandra -- that massive pay urology your host up. Men's health -- would. Today we have been talking with -- doctor -- from -- DX. She is an expert pathologist molecular pathologists have -- -- Boston. Most of the pathologist. Specimens. Our our senator we talked about the importance of getting -- distant the accurate diagnosis. I would've spent the next couple of minutes just talk about just how important that is. You know all not all prostitutes are created equal. This week as we talk about you know earlier in the show. Some catches it appeared slow growing types may actually have the machinery to be much faster growing. I've been more aggressive cancers. Really important we note that the approach we've taken our summer really starts with you CNET tech. Knology amusing diagnostics. So if a man comes in to me with an elevated PSA. We want to make sure that that's real and it's not simply a laboratory mr. Reid or laboratory miscalculation. So we certainly repeat the PSA blood test but also -- look at a special type of PSA called the free PSA percentage. We use a special urine marker when you're in molecular marker called PC a three. This is a special chemical released into the urine after a prostate exam in which he mused that. That testing help. Who really make some sense combined with the PSA. About what a man's risk for prostate cancer is. So those markers are -- normal. We did take the next step. We move on to taking a picture. And so that for the prostate you've heard me talk about this before you listen to the show but we use in advanced multi Parametric. Prostate MRI study that's taken a very high resolution. In depth picture of the process in which -- characterize the prostate tissue. And grade -- risk that any part of the prostate cancer prostate cancer. Now for example. Say there is an area that looks to be abnormal in a certain part of the -- states in the right side. And in the end it's got the characteristics that make -- highly suspicious. And the PSA is no later and the PC three is abnormal. My suspicion for prostate cancer goes way up. It -- then a biopsy is absolutely. Required. Now we used technology that takes advantage of those MRI pictures. We use a technology called art of miss. Which basically is the goddess of Christina from Greek mythology but -- allows me to take the MRI pictures. And you -- MRI pictures through a process called image fusion. Or basically superimposed. In the MRI pictures on an ultrasound picture. -- allow me to make sure when I do a biopsy. I can direct the -- directly through the heart of where that. Abnormal lesion is that our -- suspicious tumor. They increase the accuracy commit initially what we do you and so -- and -- targeted by a -- is well some samples around the rest of the prostate. Allows me to send these little pieces of prostate tissue over to -- pathology colleagues the experts that we talked about today. And where they will process that prostate tissue -- a look at it under the microscope. They'll tell us something called a Gleason score. Or what the overall shape and pattern of the prostate cancer is. Then they'll do the advanced molecular diagnostics we talked about. You know give me more understated about -- is a slow growing cancer or fast or what's a good guy or bad guy. Then sit down and we'll talk about all this information what does it mean. Some and it means that active surveillance is very appropriate this akin to we -- watch or observe. We'll look at it again within a variety here at some point no the boxing may be required. Other -- very clear that we need to move on to therapy. And we -- therapy we have a whole range of therapy options from minimally invasive. I'm last week show we talked about prostate trial therapy you've heard -- talk about a revolutionary new technology called high intensity. Focused ultrasound. Or -- Those are -- a violation technologies that allow we destroy part of the prostate or all the prostate inside the body without any kind of major surgery. Sometimes the cancer is extensive and out of the capsule area. And really a more dangerous cancer and therapies like radiation therapy you're sure you're going to be far more appropriate. You had value per day if you listen to the shall we had doctor cliff blocked our director of robotic surgery. At the Beth Israel deaconess hospital in Milton. Part of our program I'm Michelle talking about. The robotic surgery program for -- some patience that's very appropriate. But the key here is. The proper diagnosis. And proper understanding of the cancer. Leads to the best treatment and I think that's the philosophy that we've always taken at this -- prostate Centre of Boston because there's -- -- Then I can do more important for my patience and to provide. You guys with the information that you need to understand. Exactly what type of prostate cancer you have. And isn't cancer they truly really requires therapy. If that does require therapy can we treated with a less invasive. Less you know less aggressive type -- -- that preserves your quality of life. So -- just a bit of summary about how we integrate. All this information in the last two months we've talked a lot about each of the parts to this puzzle. As one of the summarize that for you should get a really good sense of what we do. To learn more about prostate cancer prostate disease go to my website at DR CID DR AC all in TI dot com. And you can call our center of mass may Rollins -- COD processor and a Boston en -- they urology. Or 100 highland street Milton Massachusetts. Were part of the Beth Israel Deaconess Medical Center Milton campus. Are number 617. 696. 1826. That's 617. 6961826. Remember the website DR. CR TS EI who in TI dot com. Well we'll be back -- -- -- at the polls out today show today it was exciting we talk about advanced diagnostics would back the -- this thing up in a just a minute so stay tuned. -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- Call what's the best way to transform your next gathering or event. T shirts custom made T shirts that you design online with custom make whether a big game reunion charity fund raiser with custom make any occasion becomes a memorable event. On time delivery is guaranteed and -- even ship your order absolutely free start designing your custom pink T shirts today and CY 99% of our customers say they would order from us again custom ink dot com. Ladies are any of these symptoms familiar hot flashes sleeplessness irritability or weight gain if your woman over forty experiencing these symptoms you probably have hormonal imbalance and printing will be balanced hormones and really -- hot flashes sleeplessness irritability and other symptoms of menopause and now you can finally lose weight yes even that stubborn -- that would amber and -- -- -- -- and ask you to get your free -- -- weight loss of 100 flight 819496. That's -- 800 flight 819496. Well welcome back does not receive 50000 directed facility -- in the Boston. He had an exciting show today we had doctor Acer from strategy DX. The -- of molecular pathology strategy based right here in Boston. -- as our special guest -- talk about the importance of proper diagnosis for prostate cancer. You talked about what goes on behind the scenes -- what's the prostate biopsy goes off to a laboratory. We're so fortunate to have people like doctor ray Cyrus -- partners for patience is that kind of expertise. Helps media give. My patients the best advice the best recommendations if they're diagnosed with the prostate. Cancer. So join us every week is what will continue this discussion we'll talk more about prostate is we'll talk more about issues central to men's health. Remember more information about prostate cancer prostate disease you go to my website. That's DR CIT SEI ON TI. You go to their website at mass they urology that's masks may urology MA SS -- urology dot com. You can certainly -- center at 617. 69618266176961826. -- the -- the final message the final messages. There's nothing more important. They get the proper diagnosis. If you've got prostate cancer there are no shortcuts here. What is the proper technology state of the art diagnostic techniques and expert pathology and molecular pathologists to give you information that you need. To make the right decisions about how to approach prostate cancer. Thanks for listening and will be back next week and talked more about exciting topics in men's health. This is doctor Stephen COT your host of men's health who England and that's all for this week tune in again next week at the same time for more exciting discussion. It took one hour stink up an idea. Three months to get a business long. Two months to find space and who Gruner and find weeks later in the first return customers who. All told it took two years to bring your ideas to life. So why wouldn't you take twenty minutes to make your business better. We're introducing the Comcast business twenty minute advantage. 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