Dec 2, 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!
Transcript - Not for consumer use. Robot overlords only. Will not be accurate.
Welcome an immense help the way when I'm your host doctor Stephen C ninety directly this healthy prostate Centre of Boston mass bay urology in Milton Massachusetts. Join us every week and at this time for the most advanced and up to date discussion of topics most important to men's health. Join us ever week as we discussed topics like prostate cancer or prostate disease. Sexual health. Lifestyle and diet weight management. Heart health and hormone -- health. Every week we will interview national experts in men's health in empower you with up to date. Scientific number aggressive 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. We're going to be talking about a couple of different topics. Number one I wanna talk about a recent book that I read called we belly. Isn't tremendous but the talks about how weak is make him a second how it's making us fat. That we're gonna go right back after that and talk about prostate. Cancer diagnostics will talk live about the PSA dilemma some of the problems we face. With diagnosing prostate cancer. So join us every week here cigarette your questions to -- dubbed wrko.com. Slash immense help I'll answer them -- directly or. On the air. And -- who call our office at 617. 6961826. That's 6176961826. Not learn more about prostate cancer prostate disease go to our website at. The DRC. Conte and it's DR SE oh and TI dot com doctors see on T dot com. Thank you go back that set for more updates as we continually. Updated. Stay jewelry right back we'll come right back and talked about we -- stay tuned welcome back. Doctor Stephen CRT founder and director of the -- -- -- prostate Centre of Boston located that massive bay urology in Milton Massachusetts. Today we're going to be talking about. Something called weak to belly so what does that what does that wheat belly. Let -- take the background on this. Always been very interested in the relationship. Between diet and that. The a condition called metabolic syndrome. And this book we to belly and that's a W each WH ENT week to belly as in the green. Talks about some of the fascinating. Aspects of -- in what it's doing to -- basically. It's making us. Mrs. booklet -- highly recommend to my wife got me to read this book and she thinks that I have a week that he can you imagine that that. It's written by a doctor William Davis. He's a cardiologist. You can find this book online and also if you Google it -- you can learn more about it. But just look at the cover of the book some of the the very interesting factoid -- in this tour I think really get too interested. For example. Did you know that eating two slices of whole wheat bread. Can increase blood sugar more than two tablespoons. A pure sugar -- so just Tutu peace that we -- raise your blood sugar more than two tablespoons of pure sugar. Can imagine that I thought we were supposed to be good for. So we always have provocative look at how eliminated week even that so called healthy whole grain wheat. From our diets. Is the key to permanent weight loss and can offer really relieved to a broad spectrum of diseases. Now doctor Davis talks in this book about clinical studies and experience over. Many years in makes very compelling cases against. These ubiquitous up product in our diet that is a week. Really let's talk a little bit today about what this does. Because I found this really fascinating how can. A green product. That is central to our diet. You make him a sick. And particularly happy to be making us fat. So guys you know -- -- -- -- There's expend extra weight that sits right around your -- you know as the years go by. The -- keeps on. Getting let out an extra notch every year. And pretty soon before you know your -- is 4042. May be 44 inches. Well that you you've got to wheat belly. And the case is made by this book. Is that our diet expert typically the carbohydrates. And particularly weak. Is what's really contributed to this so. That's pretty hard to accept but let's talk to them about the you know the mechanisms of this. You've heard -- talk about a condition called. Metabolic syndrome. Over the the last several shows no amount syndrome. Is a real disease in it's really defined by having high blood pressure. By having me waste. Greater than forty inches. And by having abnormal cholesterol abnormal what kids. This combination. I'm having a big belly right around the middle it's called central obesity. And having. Abnormal. Triglycerides cholesterol and so forth really is a tremendous health risk -- who have this condition. -- much higher risk for heart disease. Much higher risk for diabetes. In overall. We find tremendous health problems that go along with this. This syndrome. What causes this. So if you look around earlier bodies out there. You find it is guys aged they tend to -- on the -- and that's pretty normal. But at some point it becomes abnormal in fact. If you ticker tape measure. You put that tape measure right around the middle. Down where you look we are your pants but right around your belly button the widest part of your abdomen. And measure that circumference with the tape measure. If the measures. More than 35. Inches. And that's too big. You're at increased risk for heart disease and diabetes. So what causes that. Well it's not any one thing but the premise of this book wheat belly is that our diets high in week. Kind grains. High in carbohydrates. High in processed foods. Really -- blood sugars. In is we get older. Our body can't respond very well to that spike in blood sugar it really it releases very high doses of insulin. In pretty soon. The cells in our body get resistant or immune to the effects of insulin insulin the hormone that looks is supposed to lower blood sugar in allow. That. Sugar. Which is released from eating wheat in other carbohydrates. And allows that to be burned as -- Well. When this mechanism is altered. All of the glucose all the sugar in your blood. Again it comes from eating carbohydrates. Starches and particularly -- A pleasure only can do one thing. It's stored. As fat. In so that carbohydrate meal. Particularly. Processed foods most particularly weak our body can only do one thing with that. And that's the turn than the fat and worst start. It stores the fat right around her middle. So one of the ways to break the cycle. Of continual weight -- Is to cut up the carbohydrates. And particularly. Take the week in the grains. Idea diet. Now it sounds crazy but it's really pretty easy to do pretty easy to deal. You know how many did notice that. You know if you get up in the morning and you have their bowl of cereal or what cereal it's grain. Most cereals have. -- -- You have breakfast in the morning. In bed and Howard to later. You're really hungry again. It's ego when you have a snack maybe don't grab a donut. And then the lunchtime comes in -- grab a sandwich. Or worse yet to you know something fast food you know cheeseburger. Something like that. -- to a clock again you're really hungry but then you get really really tired. This is related to blood sugar levels that are really going up and down up and down all through the day. So the -- you have wreckage of that bowl of cereal blood sugar spikes up the body releases a lot of insolent. Like sugar gives absorbed into the system. Blood sugar levels go way down when they go down you feel tired you get hungry again because low blood sugar released the emulate your appetite. So now I don't had a snack. -- shoots up again the same cycle repeats itself throughout the day. So you constantly hungry I bend there and know exactly what the feeling this. Now what's happening all the sugar that our bodies absorbing from the cereals the breads the -- which the snack foods throughout the day. We'll guess Schwarz store and it's torn right around your middle. Right -- that fat. -- on your mid line that's not healthy. That's what leads to higher risks of heart disease. Vascular disease stroke. At least all sorts of problems like diabetes. And believe it or not you guys again affect hormone levels. Men who have this metabolic syndrome. Tend to have much lower levels of the male hormone testosterone. They have diminished sex drive diminished libido. If that's not enough they really have increasing levels of erect tile dysfunction. So how do you break this cycle. Well it's all comes back to -- You know you may not you might not want to just live in the gym all day but certainly exercise is important but really died is really really important so. The first thing you really wanna do we you wanna get familiar with the concept. Called the blue eyes seem Mick index that YC make index. So the good -- great scenic index. Is basically a table that gives a number. Associated with different foods. In it tells you how much that particular food or affect your blood sugar and insulin levels. For example. If you look at some of the common foods twice in the index's arbitrarily set and a level of hundreds. -- cry. And if things that are either. Below or above that either high glee -- index foods are lower twice in the index foods but for example. If we look at. A typical. A typical food that we mining. -- will pick something here. Let's -- snack foods right. How about fruit roll ups that just caught my mind that's got a very high voice in the index. That by -- indexes that 99. Into what that tells you is that that's just that's like -- pure sheer. Right. And if you look up the place in the index on the Internet right and you look at a media a baguette a white plane -- Right so what is what is a baguette was made of wheat wheat flour right. And that that roll that back again hasn't pricing index of 95 extremely high. Hamburger Hamburg a -- 61 at Kaiser roll 73. A white wheat flour bread white -- white bread made with wheat flour 71 index. It's a Wonder Bread 73 index. He's a pita bread 6068. Index so these things. These foods all have tremendous ability to spike your blood sugar. That blood sugar produces a significant release of insulin. And insulin release. Will. -- the what you're gonna decrease. It will make you hungry again but what's happening -- a -- it's getting stored. As fat. Does a cycle that we're all in so what I want it to you today is that. The way to break this cycle. Is to get on a low life seem like index diet in get the week in grains audio system audio guy. If you do that. You'll see a weight loss of twenty or thirty pounds over two to three months just by doing that very simply. Now you blend in some exercise the proper levels of exercise you've heard us talk about this on the show. And you combine that with the low life scenic index diet. It's like guaranteed weight loss of ten to 20% of your body weight over three to four months without feeling hungry. This book wheat belly wheat rally by William Davis MD. Get the book and read it. We Billy WH. The AT wheat belly because I've never read a book in which it explained so well. The interaction. Of foods like -- Like grains. What the effect was on our blood sugar and how it produced. This. That lives right around the middle. So guys the good news is that you can fix this to -- -- got this problem. You can fix this it's really quite easy to do. You're not hungry why you do this it's really not correct to say this is a diet. Learning how to eat the foods that are healthy for your body. Healthy for me your metabolism. Foods that it will take away some of the fatigue the daytime tired news. Those balance of just ravenous hunger which you sort of eat everything you can find. And really what it comes down to is improving your health is -- what it's all about this a strategy that will lower your risk for heart disease. Lower your need for cholesterol medications. Decrease your risk for vascular disease. Improve hormone levels improved sexual health improves sexual functioning now I hope I got your attention again diet. So important what you week the type of food to eat at this book we belly rated. I'll make this bet with anyone out there if you read this book. It'll take a couple of hours to go through it. And you follow some of the recipes you follow the recommendations. Made. I probably issue. That the wait would just literally peel off. To anyone out there wanted to do this. Tried for two months. And then sent me an email telling how worked. And I probably issue there's no way people all this the way it won't fall off. To take a break here I hope is been helpful -- about we pal but take a break as doctors Stephen CIT. The founder and director of the C on the prostate center at mass bay urology Milton Massachusetts. Our specialty is prostate disease and prostate cancer diagnosis. And see -- their phone number 617. 6961826. You always go to my website learn more about prostate disease and prostate health at. DR CIT dot com it's DR SCI ON TI dot com and -- sink your questions to. Wrko.com. Slash men's health. I'll answer the questions directly of war only answer them for you on the air. So state to a -- apple learn more about. Prostate disease in our next segment will be right back welcome back this is doctor Steven CIA founder and director of the -- on the prostate Centre of Boston. And your host of mens -- New England. Now narrow segment we talked about metabolic syndrome. And a book called wheat belly that really gives you a very sensible way to -- take off that way around the middle and overall improve your health. And I challenge in my readers as I said -- get this book find it find it on the Internet invited any bookstore we belly. You follow this. I promise you you'll lose twenty to thirty pounds over three months to take me up on this -- how it goes but let's switch gears a little bit. We're gonna talk about prostate disease. Now. How many of you men out there heard about something called the PSA test. PSA prostate specific. Antigen. PSA -- virtually every guys heard this because our doctors talk about this all the time in fact. If I go back to the 1980s. When I was a resident in training. Learning how to be urologist in those days. We can have the PSA blood test came along in 1988. -- back in those days. The only way to diagnose prostate cancer was to put a finger into a man's rectum. Do a rectal exam that he did dreaded digital rectal exam. And fuel and a big hard lump. -- by the time we felt that big hard lump. There was already a very significant prostate cancer but many times and -- had already spread beyond the body. Another words but a time Lincoln feel with the finger there's a lot of cancer present it was 1980s. 1990s. Come along and now there's a blood test called the PSA. When a blood test was elevated to a level higher than before. That would prompt. A prostate biopsy. -- the biopsy that was developed in the early 1990s. Was done it with what's called ultrasound guidance. So I'll -- probe was placed into the rectal canal. Any needle was then directed into the prostate in different locations. To sample the prostate. In samples of prostate tissue were taken. It first only six samples but as the years went by we learned that the more samples we take. The more chance to raises a finding prostate cancer. And currently. Most -- we'll take twelve quarters or twelve samples. Of prostate tissue through needle under ultrasound guidance when they do a prostate biopsy. But this technique of using the PSA. And doing an ultrasound guided biopsy of the prostate. Really took foothold in the 1990s. And changed tremendously. The way we diagnose prostate cancer because the number of men. By 1995. And we diagnosed with prostate cancer more than doubled compared to 1985. And we are finding men with a much smaller. Earlier prostate cancer and other words. Prostate cancers that were now curable. They were early they were contained. In cancers in which men were having -- response to treatment. So what happened. Well as the ninety's went on we get better and better at doing -- percent owns we've lowered the PSA number down to about 2.5. We also learned that in African American men. Started at age forty that PSA should be no higher than about two. We -- aggressive with doing PSA blood testing and prostate biopsies. So by the time. The new century gets here -- into 200200220032004. Prostate cancer. Is being diagnosed just like the measles and man -- I'm sure any guy out there knows someone. Who's had prostate cancer. It's either supporting your family so when you work with what are your body's. And if you're in that age group of over 65 years old. Certainly you know people at this. Well that's created an epidemic of prostate cancer. And what we've learned now in the last five years. Is that these prostate cancers that were finding many times very early. And out all the same. Some of these prostate cancers. And really very few of -- fortunately. Are very fast growing. Very aggressive cancers. And really dangerous prostate cancers. Their prostate cancers that have the potential to kill someone just like any -- cancer. Now fortunately. That's the minority. -- prostate cancers most are not like that. Most prostate cancers are small. They're very slow growing. They have a very limited ability to grow and spread outside of the prostate. And they're not a major risk. To a man's health. So here's the problem we have today. We've gotten very good. It diagnosed in men with prostate cancer. In because. We haven't really always been able to tell. Which cancers are gonna behave. In a very slow growing way in which -- will behave very aggressively or fast growing. We've -- -- everybody. In so most men have had. Surgery to remove the prostate. War they've had radiation therapy. The problem is that. Many times. The men who have undergone these treatments. Would not have died from their prostate cancer anyway even if they'd left it alone. Now as urologists are problems we have we've always had a hard time knowing. Which can't just could be left alone so not knowing that we can't treat everybody. Well now the federal government got involved and you can obviously. See what the government's concerned about it. They're the largest payers of the health care dollar in America today through the Medicare program. It would this epidemic of men being diagnosed with prostate cancer. In now with the baby boomers now gate and into their sixties into into that age where. Certainly prostate cancers become much more common. If we diagnose every man out there with prostate cancer and treated a man that walks in the door. From a financial standpoint we will bankrupt the system. But even I think more importantly. Its -- a lot of -- unnecessary. Or overly aggressive treatment. So guys if you happen to have a cancer that slow growing small. Contained in one that probably doesn't present much risk. And you go and see your friendly your route -- to takes your prostate now using a robotic crossed the tech to be procedure. Or you go through two months of radiation therapy. In many cases. You've gone ahead and you -- use an old saying. You shot a mouse with -- open -- Another words. That was probably overly aggressive treatment. Is that what I mean my aggressive well. Treatment that causes side effects. So the most common. Issues that men will deal with after prostate cancer treatment. Far. Erect tile dysfunction that is poor quality erections. They lose their sexuality you lose their ability to function. And that happens in a very high percentage of men after treatment. And secondly. They deal with urinary leakage problems there requirement to Wear protective pads. When their physically active. Urinary incontinence that's called. Now I've always said that men weren't destined to Wear pants. Is so now we have a treatment we've gotten very good at diagnosing very good -- -- in fact surgery radiation of work very well over the years. But because we've cheated all Manuel walked in the door with a diagnosis. We've inflicted an awful lot of harm in terms of men's -- to them so that's the debate today. Is there a way to better understand. What type of cancer some enhanced. And really begin to understand who needs to be treated aggressively. In which meant to be treated. With less invasive. Less aggressive treatments or in fact which -- even be watched a concept called active surveillance. Wanna take a break -- to come right back -- talked about. Some of these changes today in how we diagnose. In how we treat prostate cancer with these concepts in mind. Stay -- -- doctors Steven C to your host of men's health -- when I'm the founder and director of the CP prostate Centre of Boston and mass may your reality my website at. DRC. OT dot com that's the RS CI -- in TI dot com. So your question the wrko.com. Slash men's health state to it will be right. Welcome back this is doctor Steven -- founder and director of the CI a deep prostate Centre of Boston in your host of men's -- the England. Today we're talking about. Prostate cancer. Talking about PSA and some of the changes have occurred historically over the last twenty years. Their lesson when I told you about the introduction -- the invention of the PSA test. In 1988. In the explosion in the diagnosis of prostate cancer. As well as prostate cancer treatment which occurred over the last 20/20 five years. It's on the problems that created with a real sense that a lot of men are being over treated. So here's the question. Is there -- new technology available. In other ways to better understand. How to more accurately diagnose a man's prostate cancer. And how to decide. Determine who really needs active were aggressive treatment. And who can be treated less invasive we less aggressively. Or even watched or surveyed for their prostate cancer. So that's where we are today. At this prostate Centre of Boston a lot of techniques that we use I didn't invent it wasn't that Smart. But I tell you what I did do I -- very very interest in the research. Very interested in new technology that's what I wanna tell you about today. Let's start off with. Your PSA is elevated what do we do. Well typically if -- referred to the neurologist. You'll be told that you need to have a prostate biopsy. That my -- will be done the way we've done for the last thirty at 35 years as an ultrasound probe its place in the rectum any random. Non targeted sampling of the prostate is performed taking six samples from the right side of the prostate. And six samples from the left side of the prostate. Now the approach is a little different first of all we know the PSA can be very inaccurate test there's a lot of false positives. So and our first visit we're gonna repeat that PSA. We're gonna measure -- more accurate version called the free PSA percentage. In some cases that may measure a special marker. Or chemical in the -- called PC a three. Now of these markers and these tests all come back and suggest. There there are abnormal. Now where suspected visiting creased risk of prostate cancer. Now there's now been great published researcher ID Europe. Out of the national cancer institute at the NIH down to Bethesda. On a major universities like NYU New York City where I'm still on the faculty by the way I'm still professor of urology there. And senators like UCLA. Who have showed -- state using. Advanced high resolution. MRI imaging of the prostate that is taken and am I picture of the prostate. Can help us to understand. If there's a significant cancer in the prostate. How large it is and where it lives in the prostate. That's a non invasive test. Get in the prostate MRI study takes about 20/20 five minutes. It -- gives us these beautiful high resolution pictures. And based on the degree of abnormality of the picture. The radiologist -- predict how likely. That abnormality is to represent a prostate cancer. And now the my patient was back -- scene we've got some markers we've repeated some blood tests and urine tests and now we got a picture. Of the -- take my MRI. In for the first time that could really. Go beyond. The PSA. Another words the PSA is a warning light and you dash board it says there may be a problem. Let's look a little further into this problem let's look at different markers let's look at the MRI image of the prostate. Now if all these tests. Suggest. That there is a risk of prostate cancer event in fact the biopsy is going to be necessary. The difference here in our -- we employ a technology called artists. A RT EMI AS artists so what does that. That is a really cool technology. That allows me take the pictures from the MRI. And use the MRI that chills. To guide exactly. How and where we do a biopsy of your prostate. So armaments is a robot who lives in my office. We called RD his name is RD. And we load the -- pictures and -- brain. -- -- you -- percent of the prostate increase -- ultrasound model of the prostate. And the software inside -- party will overlaid these pictures. It'll give me a glide path. It was showing the way the pass a biopsy needle. Biopsy exactly where the abnormalities are. What are my patients say you know hey that's like one runway lights and -- plane at night you wanna lay in and use the runway lights the guy did. -- the guy the airplane down on the runway I -- that's exactly right. So I'm an advocate a blind bonds I think that's ridiculous. When you can get a accurate picture. And direct a biopsy needle to exactly where the abnormalities live in the prostate. Why would anybody. Blindly put needles into the prostate. -- fishing expedition to see what they can find. It just makes no sense to me at all. -- our senator we use RT we use the anonymous technology. We've lined up the biopsies based on worthy abnormalities of the prostate. Are seen on the MRI. Additionally I'll take some other samples. In order to create a -- This map we'll tell me once we get the results back from a biopsy. Exactly where the prostate cancer lives. Well now how large the prostate cancer is. It really what what do. Will know that the biopsy. Went through. The most significant. Area of cancer in the prostate. In now we have them more. Accurate understanding. Of exactly. How much tumors present. How abnormal what is. -- -- And is we'll talk about a minute all of these factors lead into. A better understanding. Other man's prostate cancer. In now a better ability. To predict. Who -- that aggressive treatment. And who can be fouled. Less aggressively. So. Here's what it's about it's about using technology. And using technology to get a better diagnosis. Now your interest in this website. DRC RT DR SCI. ON TI doctors CIT dot com. In on the homepage. You're gonna see party sit right there on the homepage. I get several articles there. That talked about. The importance of the proper diagnosis. Imports and here's an MRI directed by sees. The importance of targeted by sees the importance of getting a good understanding about. If you've got prostate cancer. Exactly. What type of prostate cancer you have. So go to that website learn more about it -- take a break will be right back this doctor Stephen CIT. Your host of men's health the win and we're going to be right back and talk more about. Prostate cancer diagnostics and treatment stay tuned welcome back this is doctor Stephen -- deep. Founded directed this county prostate center Abbas that it masks they are our Jim -- the Massachusetts. And your -- domains -- and today we're talking to you about. Some of the new technology for the diagnosis. And ultimately the treatment of prostate cancer. Several -- we talked about. RD part of -- new technology allows a direct prostate I was exactly based on MRI abnormality is a better understand where. Cancer is where the worst parts of the cancerous BC if we do prostate biopsies blindly. We're subjected to -- called sampling error. Another where is the needle may go along side the two were or might hit the edge of it and thus the reading on the biopsy. May. Really underestimate that you -- cancer presents. And likewise. The -- may miss the cancer altogether. In fact in a study from the national cancer institute of men who previously had a negative prostate biopsy. When those -- underwent an MRI. And a biopsy that was targeted. Using the technology like armaments. 39% of those men were found their prostate cancer despite. Previously had been ahead a negative prostate biopsy done sort of the old fashioned way the blind way. So our approach to the shut their prostate Centre of Boston is the use target a biopsy technology. Advanced imaging advanced bio markers and other words let's understand what's present now and what a preview shows we had a guest on. Who is a research sites -- told us that we can use genetic testing. If there's a cancer present to determine whether it's a good cancer or bad cancer. Is a test that we talked about in the shell called the pro aleris test so says the biopsy comes back positive. If that Gleason score under the microscope. Looks like it may will be a slow growing cancer. There's some advanced testing we can do look into the genetics and neck cancer. Did document that in fact it really is behaving as a slow growing cancer. You see if you're if you're. Certainly in your seventies and maybe even in your sixties today. And you got a very small. Cancer. And we know it's extremely slow growing. Researchers telling us that you'll probably live exactly. Just as long if we do something called active surveillance. Compared to -- surgery to remove your prostate but here's the key. We have to know that that's safe to observe. Or watch your cancer we -- eat the proper diagnostics. Now for men that really do we need some type of treatment. But yet the cancer is still fairly small. Still contained in the prostate. There are alternatives today two of the traditional treatments like surgery. Or radiation therapy. Industry which you've heard we talked about. So using any minimally invasive technique like cry a -- -- crowd surgery in which we can use ice to freeze. Parts or sometimes the entire prostate. That's certainly less invasive. Then proceeded in which we take the -- prostate out of the body. Or which we go through prolonged course of radiation to the pelvis. And the newest kid on the block for treatment. You've heard me talk about this as well. Is a non invasive technology. It's call high intensity focused ultrasound. High intensity focused ultrasound or -- to HIF. You. I have an interest in this for the last ten years. In fact. Given perform this procedure for the last eight years. I've treated over a thousand men with this particular technology. They send non invasive treatment which we can focus ultrasound. Directly into the prostate. And destroying. Prostate. Tissue. In a very precise very targeted manner in -- we've done the proper diagnostics we understand where the cancer lives and three dimensional space in the prostate. We can use that information to direct energy in kill that area now why -- we wanna do that. The reason that were looking to do treatments like this is because there's less side effects. Studies out of the United Kingdom out of England show that we do a targeted. Therapy using the hi fi technology. 95%. Of men maintained. Their same degree of sexual erectile function. Now guys there's nothing else we do in prostate cancer that's anywhere even. Close to that not even close. In this study out of the UK published a year ago in the lancet oncology. By my colleague doctor mark -- can. There were zero instances. Zero risk. Of incontinence. No leak. So. There's technology out there guys today that -- we have the proper diagnosis. And were fortunate enough to have cancer -- early contained. And it still requires treatment. We have ways of treating prostate cancer today that are less invasive than the traditional approaches. Now -- virtually. If the diagnostic test -- and a large more aggressive cancer sure that's the situation where we may well recommend. Traditional robotic surgery remove the prostate or radiation therapy procedures. But I'll tell you guys it's wrong to treat every guy that walks in the door. With either surgery or radiation somebody can have active surveillance. Some men can have a targeted partial treatment. Some men are well treated with a sub -- technology idea of freezing. Or high intensity focused ultrasound. -- -- Prostate cancer treatments need to be personalized. They need to be adapted to the patient. To the man did a guy that's got a hold of what that prostate cancer. And the point is there is technology out there today that allows us to make the right diagnosis. It allows is determine which treatment options. Our most suited to that particular guy because men. You're gonna live with that treatment decision. The rest your life. Sometimes we need to be aggressive. And sometimes. We don't. But here's the key. In our senator. What we stand for. And what we teach. That we talked to our patients about every single day. Is getting to the proper diagnosis. How much. How valuable. Is the right diagnosis. What's it worth. I think it's worth a lot because that's it allows to determine what's gonna -- you the patient if you dealing with this disease prostate cancer. To hope -- helped him understand a little bit about the PSA dilemma some of the new technologies -- that would go to my website. DR CIT that's the RS EI ON TI DRC -- dot com. All the CIT prostate Centre of Boston mass may urology were in Milton Massachusetts. That's 617. 6961826. That's 6176961826. You all to yourself to get the proper diagnosis. Get a big it made by somebody's got the right technology. And so who's an expert in the field. Give us a call we're right back the calls up the show. Combat is doctor Stephen C onto the founder of this -- -- prostate Centre of Boston were just about out of time today thanks for listen and today we talked about. This condition called the metabolic syndrome. And I told you about this revolutionary book I read called wheat belly WH EAT wheat belly by doctor. William Davis. And I challenge you to go ahead get the book. Well this way of living this way of beating. And let me know of two to three months -- you haven't lost 2030 pounds improve your help lower your risk for heart disease that we talked about. Get wheat belly read it tried out. We were right back we summarize some of them changes in the prostate cancer world the diagnostic world we talked about the art of its technology. The changing PSA environment the landscape about the ever PSA testing. We talk -- new technology. We talk about advance ways to treat prostate cancer with less side effects. That's what it's all about guys -- -- week we smarter about what we do how can we use technology to our advantage. That we stand for and our senator. Bill I hope it's been helpful for you thanks for listen this is doctor Steven C on the again and the founder of the director of the CI a -- prostate Centre of Boston or at mass may urology where a division of Greater Boston urology -- on the web -- DRC. On DD RSC IO NTI dot com or call our offices at. 6176961826. That's 617. 69618262. To get the same time in next week for a men's health that we wouldn't and again. Thanks for -- and have a great week.