Dec 16, 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!
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Welcome the men's health that went on I'm your host doctor Stephen C on the founder and director of the Sierra deep prostate Centre of Boston that. Greater Boston urology. Join us every week -- at this time for the most advanced and up the big discussion of topics most important to men's health. Join us every week as we discussed topics like prostate cancer or prostate disease. Sexual health. Lifestyle and diet. Weight management. Heart health and hormone will help. Every week -- -- interview and national experts and men's health and empower you with up to date. Scientific progress of 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 on today's show I have a special guest. One of our local patients doctor Todd -- will be joining me you'll be calling into the show. Inexperienced seen. He's issues -- being a patient with that prostate disease he's gonna tell you firsthand. The jury he's been through with the diagnosis and treatment of prostate cancer to this going to be a great show today you're gonna get some real insight. Straight. From a personal experience of someone who's actually in the healthcare field. To remember learn more about prostate cancer prostate diseases go to my website at DR CR TD RSC IO NTI dot com. No we send your questions -- questions write to us here men's health that wrko.com. Slash men's health. Mary can always call our offices at 617. 6961826. Remember go to that website it DR CIT dot com now state -- right back. Bring in my special guest back and we're gonna talk about his journey. Through this whole -- a prostate cancer. Diagnosis and minimally invasive treatment state to those who we were right back. Welcome back I'm doctor Stephen CRT founder and director of the CRT prostate -- Boston had Greater Boston urology and your host of mens health New England today were gonna talk about. The journey. Of a patient through the maze of prostate cancer diagnosis and treatment using some of the advanced technologies my special guest today is doctor Todd -- Todd welcome to men's health knowing when. -- So to god and -- want to tell our listeners just just that just a quick bit about yourself and then we'll go into your your your journey through this whole prostate cancer star. Sure I'm up. And basically -- Or is around a lot. -- Right so and I know the Q -- someone who's in the healthcare field. You know obvious even very focused on your health overall these years. Yes and merely try. You know to learn from people about the kind of thing promote L. A combination of well you know -- the -- physically and also in line up. -- -- -- -- -- Well that's great so you know I know you've been wrestling for a lot of years with the problem and elevated PSA. Yeah I don't want to tell us about that what you know how wonder that started what was your journey through that. Beginning with sort of started from just you go up maybe. Well -- That he would say it was a little elevated like that concern. And they they watched it -- -- and then they well you know -- go up to consult with the hour. So I went there were very. In the -- is. And on the basis. -- -- going up he said well I think we need to do in eagle eye out. So races that are not meet with it is that the procedure where they really take -- section of the -- they edit the bill and eat I had to. For one really shows the normal but they. The second one it was some cells that might be pre cancerous but we're not can't. So it's turning point from me I think that the yes it was it. I. At the thought is anything else I can do you know prevent weight it's right -- -- With the help of my you know it's coming taking a biopsy. So I like and act like that answer I felt like it it's something I can be proactive about it what do. So. I. Do my physician who. -- on the web and found the person -- was doing some of the best research in prevention Betty it's fine. You know which is. That that those when they get than -- So I so it's a New York which was really worked -- open with him -- was so late in years ago. And need work out individual -- program and me included. Vitamin supplement it. -- a drink that was how helpful and he ought to look like that moment out exit and activity and keeping keeping. Com. And it was a very. Wonderful work and basically what he was saying is the things that you can hear that or help with. Preventing. Answers for it would be things like. Taking taking supplements and the drink that things that would allow you to make you that would that would be the -- We're still union is so I. We believe that somebody else up against right on site you. Right you know so. Yeah so yeah so yeah so you really the starred with have an elevated PSA going back over ten years ago. He had a standard prostate biopsy. Right in India -- and for our listeners that's something that most urologists do it's an ultrasound guided biopsy but really it's a random non targeted sampling of the prostate. In so you know -- we -- -- some of that this and the shortcomings of that basic test but it had that done not once but he had that done twice. Is that -- in no cancer was found at that point is that correct. Nine but do it so you went on a preventative program we are taking supplements trying to minimize the risk for developing prostate cancer is that right. -- OK so now the years go by night and finally the PSA I I continue to go up is that right. -- people -- right there amber. And it's basically it's. A jump. In. -- What's the -- here. On. C. Am sick you know what. I think it's time to do a closer but what's going on and he recommend you -- that. -- -- you know. It was a problem not. Re right. It. Right right so you know so that's suggesting -- -- you have a story that's really fairly common today. Men have an elevated PSA they have a prostate biopsy the -- he may be negative. But then you know how sure we that there is not a small cancer developing right. It because of the isn't as we've talked about before Michelle we'll talk a lot more today this a lot of inaccuracies -- standard techniques for biopsy. Right so what so when you greet you came to -- -- at the at that in our in our senator and and I believe one of the first things I'd recommend it was probably an MRI is that right. Yet and you're out. It's an you're. Right and we're in it. MRI. And the MRI. There. Part of that city. So it was probably. We are right right. And it's due to art. Hi. And see you're witness to two guy. It was I had heard. It was a different. Art. The I see you did in terms of both of comfort. During the procedure and secondly. He's. Editor. Sure. Was so what we used we used some fantastic technology. And in it's it's known by the name of armaments. AAR TE MI AS. And so on the MRI and I remember these -- clear on one region one sign in the prostate there is some very definite areas that or abnormal. And the important thing is these areas or abnormal we're sitting in the upper portion of the prostate. An end and the problem isn't with the standard biopsy approached -- used and commonly. That part of the prostate is never ever sampled by the standard biopsy techniques. Right so -- we saw you know I'd. Eight area that looked like a tumor in the top portion of the prostate in using this -- system and allows me to. And create a three dimensional model on the computer screen of your prostate based on the MRI pictures. We crank it -- and then I can use those MRI pictures. Did directly guide. How like take a biopsy and so the -- device allows me to target areas -- very specifically. Aimed right for way air the that the suspected tumors in your case the time we did that and and and unfortunately difference in cancer there. And it is the number or. Some and -- -- -- -- -- -- -- -- -- -- -- -- -- What -- that's right you know honestly I think of that approach for you made a huge difference because. You know this was a higher grade. Aggressive form of prostate cancer seen. In a portion of the prostate that it's really very silent in his never generally found so if that have been allowed to go on over the years. That's a cancer that don't quite sure would have grown through the prostate capsule. And certainly would've you know possibly shorten your life. So this was I think a huge technical advance -- able to do the targeted technique so we did find fortunately the cancer was localized to a region in the prostate right. And I think -- several things at once they've got that one is it just. People listening also as a -- out as a human being emotionally when you hit it. On the court level is partly and sitting and Wear them and -- all kinds of scenarios in your head about what happened. But. Allen ended up very thankful that the that it got detected -- -- states. Secondly thankful that it -- you know region it was. Was one of local area -- and involvement of greens are not where it. Any way we view hearings in different options of techniques and we're interventions. And well was very helpful was. Not only did we talk about the and it is it's -- but also I would think the people listening well at the person. Very warm and also deal with -- particular situation could learn from new. It's it can be very different and that there were back there in in the treatment. You went through the option with me of a possible re -- and remove the prostate and -- -- and you mentioned. Some -- the -- techniques including high school and when I was. Described -- -- I hit it about is high in the vocalize ultrasound technique. Ten years ago it was being -- in Canada and I thought to myself. If I ever did develop. I -- -- -- -- -- at. -- -- -- And the least invasive and also could do for the war in a -- they. Killed issue. So. We'd go ways to do this I will technique of all the different technique the release. Sexual and urinary side it. And the involvement with the rest of the organs in the area. Right so what we'll come back today in just a minute because you know. You know the key hitting point that I wanna make for our listeners here is that. We filed an advanced. You know. Pathway for diagnosis in other words we didn't just shoot needles randomly into the prostate to find the answer we targeted the area. And we created. A map of your prostate in terms of understanding. Where that cancer lived in the prostate. -- fortunately lived in just a very small area and cry so that led. That opened up the possibility. For a targeted treatment were we can -- became -- Paris region and not treat the entire prostate. So yeah awoke when we tickets the next and what we're gonna talk about that experience remarks are really wanna dig into that but. For our listeners you know the key is. Because we took I think and advanced approach that diagnostics and had a excellent understanding about where the cancer was how aggressive was in where the cancer lived in the prostate. We were able to design for you a range of options. Some of which included just targeting that area and that's what we call full or targeted therapy. And you know it one of the things is very clear to me after doing this for over fifteen years. And it's very clear that. When we target -- even to the prostate there's less side effects and if we treat the entire prostate that should be common sense but that's been shown now on the literature in the scientific literature. So that was really a nice. You know not result in terms of giving you more options. And -- a from the patient's point of view I would see your audience that it was very reassuring. Note that it was this. Kind of very specific targeted focus. A testament and sometimes. We need to interventions that you're like. Hey it's really -- it was so connected to that. We sure. All it's not even going like at -- answer about the way it was analyzed in what could be done. We'll -- that that's that's great feedback -- we're gonna take a break here and what we come back. I really wanna talk about then you know. How you made the decision for treatment we'll talk about the treatment itself which I think this is this is revolutionary four for our listeners out there. This doctor Stephens county and the founder and the director of the syrupy prostate -- our boss -- -- Greater Boston urology. Now for more information on prostate cancer prostate is -- -- GRC on -- DR SCI. ON TI dot com. Since please send your questions to us at wrko.com. Slash. Men's health please stay tuned we'll be right back with my special guest of doctor Todd -- talking about his personal journey through prostate cancer. Diagnosis and -- state to will be right back. Welcome back -- doctor Stephens county founder and director this -- prostate Centre of Boston had Greater Boston urology and your host of may and has helped the way when. My special guest today is doctor Todd -- He is a clinical psychologist he's gonna talk to you today more about his experience. As a patient being diagnosed to being treated with prostate cancer. So tied in there and are for opening segment you really talked about the pathway through diagnosis. And we talked about the fact that. You know he had been through Q standard. Really what I call blind prostate biopsies the PSA kept on rising. We get a multi Parametric MRI -- really sharp focused and -- in the prostate. We found a tumor. We have the technology called part of -- target the tumor in in really substantiate the diagnosis. And none of that came eight. Three dimensional map of where that cancer lives in the prostate. So I remember when you and I sat down about this I said okay here's what we have and here's a different ways to treat this. You know and and how did you make the decision about how you wanted to be treated -- Well I feel like. Some of the fact is considered and it was not -- and am. That people get medical people at which it yeah a lot of I. Was number one. What it. It. Cancer. Spreading and how witty and and I'd like -- -- Is a lot in around you and the glee is eating that radiation. Procedures. And -- What should really do but I. We talked with me and what I learn from these six selfless. Line. That -- re. Issue can do anything anymore and that area. Art and it's -- court. And I eat or -- met you talked about the site. What was the actual site CC. Any damage to two urinary system. Any organ in the area and one of the actors was what would be at least. Am effective way. What was the least invasive. And also. Com. What was what was what shall in terms in the effectiveness of different techniques where that kind of cancer that I act. And what really. Your decision most was that worries in one area right. Well reachable by now. And I. Did not want to. Collect the fact that it was -- I'm now. -- have other major health problem. He knew. That it was -- so that was back. Typical practice well. The -- technique is not at the schools in the country. So I. Do in that's. App CT done it could be. What. I like years. And the number of the something like -- country in the world have been doing. I knew it was -- search and literature supporting the effectiveness of the technique and most importantly -- of the way you and options. I -- part kind of treatment and app or. -- -- -- that -- and subsequently going at it that they share a lot of directions. -- -- it can't get -- and certainly that was my first. It's -- approaches -- like it like it's sensible the only problem lies because it. -- I mean I'm sure. Money. It's. Like the oh and against a lot of people. That see me missing in it for the answer. It's -- -- prostate out in. You know. Well last thing -- like O line. Back. But even like it like there. Was right one -- -- Well you know that that's great because it really it I think you really om highlighted. You know for the audience. This. Terrible conundrum that Mandarin when they get the diagnosis. It really is because of the one thing and I think this to go back to the heart signs that the medical data. -- not one published study out there and errant tire literature. It would tell us firm and Hugh Laurie H. That any one treatment was gonna give you any longer survival than any other treatment. In in fact that's one of the biggest punch first we have to name prostate cancer. Is that are you know most urologists favor procedure is surgery that is robotic radical -- attacked me. You know for men who are in their mid to late sixties are certainly in their seventies we can't site one published. Scientific study that that operations gonna prolonged anybody survival. But yet at the same time we know it comes with standard approach has come with a package side effects. And they've really impacts a man's quality of life. You know and you highlighted that beautifully because you know. There's no way to remove the prostate from the body in -- has some impact on sexual function and you ordinary function. There's you know even if it's not a terrible problem or man is just frankly wet or. Currently completely embedded there is certainly a major impact on those two parts a man's life. So -- and that that's a major thing. So. It's. Right so you know I think -- you know as a as a specialist in prostate cancer. I think that the treatment. Needs to be individualized. And other words I don't think the one size fits every man that walks in the door. You know and and I think you're cases -- beautiful illustration of going down a halfway. Through the proper testing studies. Gain a proper understanding. Where the cancers. How much is there. How much of the profit as an occupied. And then sitting down with you insane okay Todd what's important to you. As we treat this prostate cancer. You know what what -- -- idea how do you value. You know. You know these different you know issues such as how important is the ability to maintain. You know urinary and sexual function home or exits variable be different man. You know and then finally you know. Based on. -- the cancer is what techniques are possible it's not we don't ever do surgery. It's not that you know we don't ever be radiation. But in your case you've had unique situation I think very fortunately. That we had less invasive options that it worked great. I -- right. Now support that would -- for our audience you know -- -- -- intensity focused ultrasound. Is a treatment that's a very high tech. In which we can take ultrasound energy. It's -- was to pinpoint. And uses computerized robotic process to direct that energy across the prostate. And we can treat is much. Or as little of the prostate tissue as is necessary to treat. And the beauty of that technique is certainly in your case Todd was that because the Cantu was localized to a region. We can direct the energy to that region. And -- -- in net spared some prostate tissue but it also. Preserve functionally come back we're gonna talk about. I want to talk a little bit about your experience -- and you know we'll talk about what it was like to go to Nassau. What was like to have the treatment in a foreign country and then of course I think our listeners -- -- really wanna know you know how how are you -- So we're gonna take a break here in just a second here. And and it will come back and talk about this but this is doctor -- out in the founder and -- this -- prostate Centre of Boston -- Greater Boston urology. And learn more about prostate disease and prostate you to go to the web site it's DR COT dot com BR SC IO in TI dot com. Learn more about this revolutionary technique called -- to learn more about that targeted by -- technique called. Our -- he always -- opposite 617696. 1826 -- please send your question wrko.com. Slash men's health. We'll be right back with Patrick Todd -- my special guest and prostate cancer patients so stay tuned. Welcome back I'm doctor Stephen -- they found a director this year that they prostate Centre of Boston a Greater Boston urology and your host job. Men's health knowingly and what about my special guest doctor Todd -- were talking about his personal experience group prostate cancer treatment. So Todd. Because we get the proper diagnostics -- -- the cancer was in one region in we talked about a full all targeted treatment called high intensity focused ultrasound. Stunned virtually ever else in the world it's not yet approved by the FDA in the United States although it's been out there for almost twenty years. So Todd when I talk -- about you know the possibility of going to -- you know a foreign country. You know what did that cause a lot of anxiety were we what was what was your thoughts about that. At a mixed reaction I felt like thank god. Is is that we should. They. And I had been normal ceiling. He's not unknown location what would like with the people with the team you're with these people. Whether you know really well trained and people like it. As much of its view is what would be like art in different totally want to remain. York at all. Now so I -- were in the Boston establishment here so we've got great hospitals great -- great and you know senators'. But now we're we're gonna go to Nassau Bahamas what's it like there. Exactly so -- We. -- -- -- -- -- -- -- On the night we actually. Act. Right and by. The mine was very very. Oh. It so. We. That the people that I professionals. They were friendly they were helpful on the questions. Available at your questions like well is. And and you now aren't -- though it -- -- people like Medicaid. And responses. Sure and you say. And I ever built on. All -- Warmly by a power forward and here. -- -- What was going on. One of the things that was particularly helpful. The FCC -- With me and in. And -- like. -- Lot. App. In question. -- Operating room. I felt calmer. And it would -- when something big was about app I felt. In the -- The reason what I was doing itself. -- -- approach me and that that was -- -- And obviously one expected. -- -- really -- comfortable about who what -- Why. I think that that that's that's fantastic. You know we work with an operation hauled. International I feel. In there in Charlotte, North Carolina. And that outfit. It really has got a very seamless program locations like you know Nassau. Bahamas for example this past weekend I just got back from Cancun Mexico and kind of like -- and says will -- that's a great job you have you know and and it's you know it. Boy you go to get to go on vacation well you know. I don't have a very good hand 'cause I never spent any time I -- them always under the fluorescent lights and are -- opera -- likes you know so it's not it's not not this famous world traveler -- had to work and take care of my -- But but the team from international -- you work with our nursing team probably work with one of my nurses Brandon there. And I think what they do it in and they make sure that. I think all the I's are dotted and all the t.s are crossed in other words everything is taken care so that we get there were raided the gal. You well informed and it basically and telling that they -- held your hand through this whole process. The -- it would mean that the answer questions. We should also giving -- information. And the other thing I'm. It was simple men along with each art and it it is the situations that some at different doctors. -- and it's. That what was being done so presentations. They see. Way. All. -- for all -- Arie what he was. Sure no that's right that's right because I know two patients are exactly alike. But dizzy -- we did the procedure make it probably took and our effort to -- to do it. You woke up from the anesthesia how you feel you know a jury covering. Well you know it's brilliant -- And one of the things about prostate cancer I'm. For me anyways -- -- in some and that's so any pain. And and I well and I woke up for. It actually felt like. Find it. Did not hear any pain you know any -- -- we're gonna be different so I'm not saying it's. Going to let the same result I did. -- difference was at a at and that was. -- -- And that's physically I felt like. Why didn't he and into I don't know like something had been met with inside me what is right. Right so the F do you recover from anesthesia mama you know the the driver to give back over to the hotel we're at the Atlantis hotel remember -- and and it it how high did the rest of the day. Arm I actually was okay. I could eat again. Might movement. Normal. Actions that accurate check dealing with tax day. You know so. So well and it was little uncomfortable. But not see. Anything in terrible it's from the -- sure you were connected to a catheter you know. So it took me a little while. And would like to. I mean -- you when I got back. -- I'm lucky at some people -- -- a couple weeks it would. You know we have a longer -- -- considered that -- -- I'm pretty straightforward. Not comfortable at all. That's something that would. And not seen. Compared to getting it can't it's way. -- Now that's that's right. It great so we're gonna take a break title come right back and wanna talk little about -- you've done and you know in the months and your treatment. His doctor Stephen CIT and the founding director of the CI a deep prostate Centre of Boston had Greater Boston urology. Learn more about. Prostate cancer prostate disease as well as -- miss -- if you. Special techniques go to DR CIT dot com -- question the WR Korea wrko.com. Slash -- south. We'll be right back with doctor Todd goes -- gonna learn about. How he's done since the months since his treatment so stay tuned. Welcome back I'm doctor Stephen Shia they found a direct in the CIT prostate and our Boston had Greater Boston urology and my special guest today's doctor Todd -- And he's been telling you his personal experiences they took the journey through prostate cancer diagnosis and treatment he had a focal targeted -- -- treatment. To -- you tell us about the you know the advent of treatment down in the Bahamas Nassau Bahamas. Get back to Boston. Few days later we took the catheter route that was back this summer. Right so so in the last you know. How -- things don't how how is how how are you doing well very very well I'm glad to say the bird. One. -- -- Oh that's great. Normal and I think to myself well I am just so at CC. That everything has come back and -- myself which one I think he's said to me that this offer the best. This can't come back -- I want it and then all respect. I have. So I have -- You know things. And I can't really say it is anything of any support this has happened since changed my life in negative -- I think what are. Just make me feel very thankful. For my health. And continue to proactively going to be very wary. Like I really appreciate it gets it every day and enjoy what you're doing appreciate what around I appreciate. They get that healthy but again. He is a wonderful doctor and in the document you help me I also with me. A very important things that -- listening. Make sure where they used yet and MRI. Is. There. That's what. I -- not talking and saying them saying see they got -- -- see if you're at. On the MRI and it -- what I can see where -- treated the way it was. And I -- the site -- or that is. My understanding is that there are many yeah. It's still early in the MRI around you're -- I think it's something as a agents and I would and sit there and you want it all right. Well you know that is a that really important point I mean so. Regardless of how we treating your prostate cancer. Had I think the most important. Part of yours situation. Was that you know we found a previously undiscovered -- cancer. In the prostate there was a significant cancer. And in in India were in a lot of ways to address that but if we didn't know was there. Right that would have been a real problem and that really would've had a significant impact on I'm near the quality of your life overall. Exactly and I'm very thankful -- -- wade did. So we you know the treatment went you know obviously very smooth and in an obviously would would someone who's got prostate cancer treatment. We're gonna monitor this you know for a long time. Right my understanding is. -- -- regular schools that do MRI it's it's it's it's kind of see how we doing it and act in the I -- with that but I am and I I'd note that it is detection of something. That was very important to -- So I I like you know that I have a good -- that would -- alliance he carried in in random biopsies and -- would. It -- is that again. Knowing that its technology that you have combined with the MRI. And court. Any accusations will tell you what my client but it has. What would have yet to look at that once you have it is always the inside like with this this means does that mean coming back but will come back and Howell like it was a I think so I would be lying if I think -- at the back in my mind what figures and that is my comfort. And reassurance that I apple way of dealing with people that really is in your am who I am what I want. Why -- this very well said because I think is a physician who. Takes care prostate cancer patients. I mean that would that that's how -- messy experience I hope that every man has you know is that that's truly the goal. You know find a reproach that works for that man that individual. And then understand what's important you know what the cancer requires what sort of treatment options there are. But our goal is -- is the balance you know knock on the cancer around in maintaining and guys quality of life. In I think -- -- situation is really really come a very nice demonstration of that. So in the last 22 minutes you here here's two minutes or so here. On what message you want it you know give the guys listening enemy you've been through a lot here. But what what message do you what meant to remember regarding your experience what's important deal. I hit several things one you know. Deal with your emotions about it talk to people it really. Aren't supportive. And talk about -- -- -- -- -- Have. Approach done like you did -- and use their MRI. Really -- -- treatment options in terms what you really want in your life what are the important things you arms there is -- even though might receive it was right in the might not be right for somebody else was quite something very different viewpoint. Different black. I would encourage people not the rate of finding out. It is a part of it once and I am so healthy. Since -- I -- on it. You know well -- And dot you know -- I think that's -- and have a good equipment. I got that they if it's something yet but I'm higher yet I didn't know it and deal with it and we all. Part of it that want to think about what you. Yeah encourage people that when you say -- talk about it you'd feel with it. Many many times the outcomes in the and earlier to the you know. Right no I think that that's that's great advice. You know and and I think for I think the the thing out I would encourage men to do. Is too you know. Take the time to learn about your options researcher options -- And and I think you know the the Internet a powerful tool if you use it correctly you know it is great source of information. Absolutely now but in addition to missing -- What really made. Mean he was you in your ability in a very kind and caring and thoughtful way lay out the options and learn to see my situation. So you also need to fine a doctor like you we -- -- If there. I don't I don't mind I don't think my wife would agree with that. Hot or not. -- that thank you so much of that that tremendous. That turn -- compliment. But you've been great I think this is this is this is great for the guys out here here remains journey through the process we've talked on about these kinds of things on the show. But to hear right from your heart. About which you've been through is fantastic. I think he's so much for coming on and sharing with us on the show. It. Great to guide says this doctor Stephen CIT we're gonna we're gonna be right back and close out the show on the director founder of this county prostate Centre of Boston a Greater Boston urology go to DRC on T dot com. We'll be right back. Well we're just about out of time. For tonight thanks for listening we talked about. Prostate cancer treatment to diagnose and one man's personal journey through this process that tied -- IQ is great and really shared with you from his heart. What that journey has been like. And I think you give your real insight to the approach that I think is really important in terms of advanced diagnostics. And personalized. Treatment pathways. We don't treat any any two men at the same. Prostate cancer diagnosis and communities to be personal need to be fitted to that man it needs to be individualized. And with the proper technology. And and knowledge I think any man can achieve really the optimal result. So for more information about this for prostate cancer prostate disease please go to deal RC on DSC IO NTI dot com. I'm a Greater Boston urology with locations throughout metro Boston. I'm metro west and the South Shore. Please give us a call at 6176961826. War drop me an email. At wrko.com. Slash men's health I'll answer your questions. And be happy to see it to help you with your journey. Through the prostate cancer pathways. -- thanks Phyllis and it's been a great show state to go to the same time next week and will. Talk about new provocative interesting approaches on men's health -- one thanks for listening.