Know Your Options–Treating Prostate Cancer with HIFU vs. CyberKnife
Donna Lee:
The Armor Men’s Health Hour is brought to you by Urology Specialists. For questions during the week. Call us at (512) 238-0762 or visit our website at armormenshealth.com. The Armor Men’s Health Hour is a show dedicated to providing information on a variety of medical topics, some of which may include sensitive subject material about penises. All cases discussed have been done with the permission of the people involved and their penises.
Speaker 2:
Welcome to the Armor Men’s Health Hour with Dr. Mistry and Donna Lee.
Dr. Mistry:
Hello and welcome to the Armor Men’s Health Hour. I’m Dr. Mistry, your host here with my cohost Donna Lee.
Donna Lee:
Hi, you sound so radio-y again today.
Dr. Mistry:
I’m trying.
Donna Lee:
You know we had some technical difficulties last week.
Dr. Mistry:
We sure did.
Donna Lee:
I apologize. I didn’t let the listeners know that I’m actually not a producer. But I pretend to be on radio.
Dr. Mistry:
Yes. If anyone is looking for a sound engineer, please do not hire Donna Lee.
Donna Lee:
Daniel makes magic happen on the KLBJ end. And if I can’t make the magic happen on our end, it can’t get to Daniel. So that was my fault. So you guys listened to some replays. I’m sure they were very informative. So we’re back. Here we are in the studio.
Dr. Mistry:
This is a men’s health show. I am a board certified urologist and this show is brought to you by our urology practice called NAU Urology Specialist.
Donna Lee:
And what did NAU stand for?
Dr. Mistry:
It used to sound it used to stand for North Austin urology. I just got some bad advice when it comes to branding and names, but we’re getting better and we are the second largest urology group in this city with four physicians, three mid-level nurse practitioner PAs. We have a nutritionist, a sex therapist, a pelvic floor physical therapist we have in-house sleep counseling and pride ourselves on being an incredibly comprehensive, holistic-type location for you to get your urologic care. A lot of what we do has to do with men’s wellness, preventative care. We love doing intense physical exams that go beyond what you might get at your primary care doctor’s office. We enjoy doing genetic testing and…
Donna Lee:
…food sensitivity.
Dr. Mistry:
…really trying to make sure that your individual needs are met with an individualized treatment plan. We say we put the “you” in urology.
Donna Lee:
…back in urology, that’s right. And you have the world’s best staff.
Dr. Mistry:
We do have the world’s best staff. But if you’re a patient that likes to be treated like a number, we can…
Donna Lee:
Go somewhere else.
Dr. Mistry:
…yeah, go somewhere else. If you want to be treated as an individual person, with care and compassion, I know that we’re going to be able to do that here, right?
Donna Lee:
Mhmm. And we are growing very quickly. So we’re looking for staff. So if you’re out there and you need a job and you’re a medical assistant, call us.
Dr. Mistry:
Oh yes. If you know somebody, let us know.
Donna Lee:
That’s right. Because we could use some staff right now. I know our phones are always a little bit of a delay, but we try to get to them as soon as we can.
Dr. Mistry:
Austin’s 2% unemployment rate is making…
Donna Lee:
It’s making my life hell.
Dr. Mistry:
….really making it very tough. As a men’s health expert and as a urologist, we get a lot of questions from our listeners. We love those questions. It suggests very high degree of engagement from our listenership. Hopefully the information we give you is both pertinent and I feel deeper, than even some of the information you’ll get when you go visit the doctor yourself. Donna, why don’t we go with a question?
Donna Lee:
Well, we have some questions. We also had that complaint, so I’d like to address that. If this show upsets you, just don’t listen. We’re trying to give out the best men’s wellness information we can. And I guess KLBJ was right–after eight months, if we got one complaint, that’s pretty good.
Dr. Mistry:
…not bad, that’s not bad.
Donna Lee:
Okay, well don’t complain. Just send me some emails to armormenshealth@gmail.com. That’s armormenshealth@gmail.com. And the number of patients we’re getting that are then transferring, and I follow up with the email, I answer every email and now there’s so many that are like, “Oh, I’ve been seen by you guys. You are amazing. Thanks.” So that’s great. We’re getting all this engagement.
Dr. Mistry:
Absolutely.
Donna Lee:
Making these appointments, so…
Dr. Mistry:
Urologic type issues can be embarrassing, especially when they deal with intimacy or problems that you don’t know if there really are a problem with your genitals. So just please feel free to send them. We’ll answer those questions anonymously on air and some of them will just answer by email if we can’t get to them on the air.
Donna Lee:
Our first question, you ready?
Dr. Mistry:
Yup.
Donna Lee:
I’m paraphrasing, it’s kind of long, but he was asking, he mentioned his Gleason score. This particular patient wants to know the main differences between HIFU and CyberKnife because where he’s hearing about HIFU from us and other urologists, not necessarily marketing, and then hearing about CyberKnife from all the mass marketing that’s been going on.
Dr. Mistry:
That’s a great question. So to kind of update the listener, prostate cancer is one of the most common solid organ cancers that are diagnosed in men. It’s diagnosed over 350,000 times a year in the United States. Fortunately for most people, it is not a death sentence. So the mortality rate from prostate cancer is lower than many other cancers. And so people get the sense that this is not necessarily it a deadly or fast growing disease, which is true most of the time, but some patients really do have a disease that, that deserves treatment. And so when you have that, when you’re faced with treatment decisions, it is a balance between what is the likelihood of cure with that treatment and what kind of side effects are you expected to endure. As so many things in medicine, oftentimes the most likely to cure your disease is also the one most likely to be associated with side effects. We’re proud in our practice to be able to offer the full array of treatments for prostate cancer. I’ve been doing robotic radical prostatectomies since there were only a handful of robots in United States. And so all the way in 2002. We do quite a few robotic prostatectomies. They take about two hours hospital for a night or two, a catheter for a couple of weeks. But the side effects associated with that can be erectile dysfunction, and the possibility of developing urinary incontinence. So if you’re a 50 year old man and you have a really, really bad disease, and you have little kids at home, we don’t pull any stops, you know, that’s going to be somebody who we’re going to say, okay, we’re going to do the treatment that has the most likely cure and then we’ll deal with complications or side effects later. But fortunately that’s the rarity. Most patients will have a small amount of cancer, or cancer that can be managed over time, or other treatment options want to be given. In this case, the two treatments that the listener is asking about, one is called CyberKnife, which is a form of external beam radiation therapy. The CyberKnife machine looks really cool. It looks like the same kind of laser device you would see in a Bond film. It like moves around on a swivel and it gives the impression of being very exacting in terms of what it does. And because you hear “CyberKnife,” you almost feel like it’s a surgical type precision. And HIFU is High Intensity Focused Ultrasound. It uses ultrasound waves to actually ablate or kill prostate tissue in a non-cutting manner. Both of these use energy externally directed to try to kill prostate tissue. CyberKnife has the benefit over traditional radiation therapy of being shorter, but by no means is it not radiation. So the kind of side effects that you expect from radiation, you’re going to get with CyberKnife. It just happens quicker. So, you know, potential damage to surrounding organs. And then what I tell patients is that side effects of radiation may not become evident for 15 or 20 years after you have it because the tissue changes are lifelong and the genetic changes are evolving. So you could potentially have the development of secondary cancers like bladder cancer. This week alone, I diagnosed an 87 year old man with a pretty bad muscle invasive bladder cancer. After having seeds place for radiation about 15 years ago. He had no other risk factors, and so I have to attribute his risk of bladder cancer to the radiation therapy. And so as an alternative to that, and for men who are trying to keep their erections and continents intact, high intensity focused ultrasound may be a wonderful option. We’ve been offering this treatment for several years. It’s been FDA approved in the United States for about five years. And we have patients that come from all over the country for this noninvasive manner of treating prostate cancer.
Donna Lee:
And you get a free consultation.
Dr. Mistry:
And what you don’t get is you don’t get radiation. It is ultrasound energy. We are visualizing the prostate during the whole treatment. And we’re able to fuse any MRI information you have with the realtime treatment to limit exposure of surrounding structures. It is, it is magic. And I’m so fortunate to be able to offer that to patients. And, you know, I counseled three patients just yesterday on it. They’re coming from Arlington, coming from San Antonio, and one’s coming from Kingsville. So, about 70% of our patients come from outside of Austin. If you’re listening to this on podcast or if you have a diagnosed with prostate cancer, we’ll give them a free telephone consultation to go over their records. It’s just a wonderful opportunity to get a second opinion when you don’t even have to travel or pay.
Donna Lee:
And you spend a lot of time with these guys on the phone answering all their questions, so that’s nice.
Dr. Mistry:
Well, surprisingly a lot of them have had very little information given to them about alternatives that weren’t the first choice of their urologist. And for me, it’s so important for every patient to be very happy with whatever decision they’re going to do for treatment because unlike many other cancers, the urologist is the cancer doctor for prostate cancer. We will take you through your initial diagnosis, your treatment planning, and oftentimes, you know, follow you for many, many years after your treatment, regardless of what treatment you get. So that relationship is super important. If you’ve been diagnosed with prostate cancer or have a loved one that has and want a second opinion, we would love to give you that second opinion. I think that before making a life altering or body altering decision, it is in your best interest to get a second opinion. If you haven’t been given the option of HIFU for your cancer or if you’re doing watchful waiting for something that you thought was maybe not that dangerous, give us a chance to give you some information. You don’t want to be surprised later that something was more aggressive than somebody let on, or somebody you know, predicted your life expectancy shorter than it really ended up. And we’d love to help you. So, Donna, how do people get a hold of us if they want this information?
Donna Lee:
You can reach out to us by email. It’s armormenshealth@gmail.com. That’s armormenshealth@gmail.com. Our phone number during the week is (512) 238-0762. Our website is armormenshealth.com, and we will be right back with a special guest after these messages.
Dr. Mistry:
Be right back.
Speaker 3:
The Armor Men’s Health Hour. We’ll be right back. If you have questions for Dr. Mistry, email him at armormenshealth@gmail.com.