Low T, High P.C.: Dr. Mistry Explains the Link Between Low Testosterone and Prostate Cancer
Speaker 1:
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:
Hello, everybody.
Dr. Mistry:
Welcome to our show.
Donna Lee:
We’re so bubbly.
Dr. Mistry:
I know. This is a men’s health show. I’m a board certified urologist, and this show is brought to you by our urology practice, NAU Urology Specialists.
Donna Lee:
What did NAU stand for, Dr. Mistry?
Dr. Mistry:
It used to stand for North Austin Urology. And as a result of the fact that we opened up a Dripping Springs and a South Austin office, we had to change our name into some mutated name, but I assure you that urologic care stays the same.
Donna Lee:
So, you know, in Dripping Springs, there’s a sign in the downtown. It’s like half a block long, and it says, “We love Dripping!” And I’m like, “Oh, we don’t want to love dripping. That would be awful for our patients.” But anyway, we do love Dripping Springs.
Dr. Mistry:
Dear Dripping Springs, let us help your drip.
Donna Lee:
T-shirt!
Dr. Mistry:
This is a men’s health show. We talk a lot about issues that affect men. As a urologist, of course, we talk a lot about erectile dysfunction, low testosterone, kidney stones, those kinds of things that affect men’s health. A big shout out to all of our great and committed listeners, both on the radio, as well as the podcast that you can get anywhere you get your podcast. It’s been a super fulfilling to deliver the show for the last year. Even my wife says that we do a good job.
Donna Lee:
Really?! Well that’s impressive.
Dr. Mistry:
That’s right. Any kind of compliment is like a one that I’m really happy to get.
Donna Lee:
What about all these podcasts? This is kind of crazy. We’re podcastable everywhere. You know what? I just signed us up for Alexa. No, you signed us up for Alexa. Amazon. Amazon has podcasts now.
Dr. Mistry:
That’s right. And I think that if you find a topic about men’s health that you want to learn more about, please search on the podcast. I’m sure we’ve touched on it. Especially if it comes to Peyronie’s Disease.
Donna Lee:
Holy Moly, with the Peyronie’s! Holy moly, with the Peyronie’s!
Dr. Mistry:
What really drives the show is your questions. We encourage you to send in your questions. It really helps us understand those topics that are most relevant to our listeners. We try to talk about those services that we’re really proud of in our practice and how they relate to your health. And we’d love to see you in the office. We are seeing patients all the time. People are worried that perhaps we’re not capable of seeing. Over the last couple of weeks, as we try to redo some administrative and marketing things in our practice, really has coalesced the important things that we want to do it. We call it the three A’s: availability, affability, and ability. So we really take those three kind of aspects of our practice to heart. And availability is a big one. So if you have a urologic condition and you need to be seen, it’s something that we would love to see you for. We offer telemedicine appointments, we offer inpatient appointments. With some of our favorite things, of course, are second opinions.
Donna Lee:
Oh, you love the second opinion. I’m going to change your name.
Dr. Mistry:
Sometimes the second opinions are easier because the whole workups done or, you know, have tried 10 things that didn’t work. And so it’s for us to go about finding ways to help your urologic conditions out.
Donna Lee:
“Dr. Worldwide” is now “Dr. Second Opinion.” We joke worldwide because so many podcasts listeners are in Europe and other countries.
Dr. Mistry:
That’s good. I think we’re going to have to subtitle our podcast. Maybe.
Donna Lee:
Maybe not. If you want to find the podcast, you can actually Google “Armor Men’s Health Hour” or “Armor Men’s Health” and the actual topic like Dr. Mistry said: Peyronie’s or testosterone or anything you can think of…ball pain, anything that you can probably come across. And the little podcast will pop right up and you can listen to us in the car.
Dr. Mistry:
So if people want to come visit us, how do they find us, Donna Lee?
Donna Lee:
You can call our office during the week at (512) 238-0762. You can visit our website armormenshealth.com or northaustinurology.com. We’re going to streamline all this for everybody. You can send us a question and we’ll answer anonymously on the radio show, and I’ll respond to your question by email, to armormenshealth@gmail.com. We have a one shout out that’s very important.
Dr. Mistry:
Go ahead.
Donna Lee:
Shelly in Tennessee. You know we’re in Austin, but Shelly in Tennessee citizen said she listens quite often and she was looking for a urologist much like you in Tennessee.
Dr. Mistry:
Well, she [inaudible] buy her an airplane ticket.
Donna Lee:
There we go, Shelly. You want a plane ticket and a t-shirt, come on over.
Dr. Mistry:
So speaking of questions from our audience, Donna Lee, do you have one for us?
Donna Lee:
I do. I have fairly recent one. This patient has gone through prostate cancer, radiation–my bad, radiation for prostate cancer about six months ago. He’s wondering about whether he should start testosterone. Is it safe for him now?
Dr. Mistry:
That’s a great question. I think that in many doctors’ and patients’ minds, there’s an association between testosterone supplementation and increased prostate cancer risk. So we get a lot of patients who either were diagnosed with prostate cancer or are actively going through treatment wondering about their appropriateness for testosterone therapy. I will tell you that the data does not at all bear out any association between testosterone replacement therapy and prostate cancer. What is strong, however, is the data that shows that if you have a low testosterone, you are at higher risk for developing prostate cancer.
Donna Lee:
Great. Repeat that
Dr. Mistry:
If you have a low testosterone, you are at a higher risk of developing prostate cancer, and those prostate cancers are actually more aggressive than what you would see in the normal population. So treating your low testosterone in many people’s minds and more progressive urologic oncologist is actually protective against prostate cancer. Then you bear in the fact that if you have a low testosterone and you are feeling fatigued, you have poor libido, you have poor energy, poor sleep–all the things that are associated with low testosterone, and then you try to undergo treatment with, for your prostate cancer, you may fare worse. You may have more incontinence, you may have more erectile dysfunction, you may have more fatigue. Really normalizing your testosterone levels during treatment is something that we think is important, and I don’t think is out of the standard of care for a urologist. There is there’s no data that shows that testosterone replacement will affect your prostate cancer recurrence.
Donna Lee:
Why do you think that people think that? Because that’s not the first question we’ve gotten like that.
Dr. Mistry:
Years ago, there was a Nobel Prize, in fact, awarded for this finding, which was that if you had a man with metastatic prostate cancer and you took away all their testosterone, that the cancer grew slower–but it wasn’t a cure. Many people derived this, they concluded that if taking away all your testosterone slows prostate cancer down, maybe if you give testosterone, you help cancer grow, kind of like taking away oxygen from a fire. But just like a fire, if the fire is going to burn, giving it more and more and more and more and more oxygen, more oxygen than it can consume it doesn’t make the fire any worse. So now we have new theories on prostate cancer in which there has to be a certain amount of testosterone in the body and that level is 50, if you’ve ever gotten your level done.
Donna Lee:
50?
Dr. Mistry:
50. So if you have less than 50, cancer will grow slower, but you’ll feel terrible. If your…Normal testosterone is between 350 and 1000. So in a way, just like if you give a hungry person a buffet, it doesn’t mean they’re just going to eat, eat, eat, eat, eat. It means they’re going to eat until they’re full, and the rest of the food can go to something else.
Donna Lee:
I’ll just eat, eat, eat, eat…
Dr. Mistry:
Donna Lee’s on the seafood diet here.
Donna Lee:
I am.
Dr. Mistry:
And so for us, we believe that a normalized testosterone level is protective of cancer. That’s the data that we have seen more recently and agree with more feverously, and we think that making sure that you feel good and are getting good erections and good energy and feeling virile is very important during this time and not a reason to think that it’s going to increase the recurrence rate of cancer. So this patient already got their cancer treated–radiation therapy. Radiation therapy is associated with erectile dysfunction in about 50% of cases.
Donna Lee:
Oh, I thought that it was higher than that.
Dr. Mistry:
Well, if they have great erections to start with, half of them will start getting worse erections from radiation therapy. And so, making sure that you tolerate your therapy well, making sure that you regain function like sexual function as quickly as possible, I think is really important. Some other kind of late effects of radiation therapy for prostate cancer can include urinary problems, bowel problems, they can include even bleeding in the bladder, urethral damage from the radiation–so those are all things that we kind of look out for, but for this particular caller, normalizing your testosterone level and making sure you’re feeling your best should not lead to any decreased outcome when it comes to your prostate cancer.
Donna Lee:
Okay. Well that was good to know.
Dr. Mistry:
And I think it really focused on another thing–one of the services we offer here is high intensity focused ultrasound. It’s a incredibly precise way of treating your prostate cancer and leaving the remainder of the prostate, the nerves, the sphincter that controls your urinary continence intact. And we have one of the busiest and most experienced HIFU practice in the country. We treat many men even from all over the country that will travel for treatment of their prostate cancer with high intensity focused ultrasound. So if you’re out there and you’ve been diagnosed with prostate cancer and you’re searching for a treatment that can retain your lifestyle, retain your function, we would highly encourage you to reach out to us for a second opinion.
Donna Lee:
Right. And you can Google the Armor Men’s Health Hour and HIFU, H-I-F-U, and the first podcast that pops up is the patient that we had that gave such a wonderful testimonial about his experience.
Dr. Mistry:
That’s right. Mark’s experience has been an incredible part of our…
Donna Lee:
It’s on our website.
Dr. Mistry:
Yeah. So that’s on our website. So, we encourage you…So if you have been diagnosed with prostate cancer anywhere in the country, please reach out. We would love to hear from you, give you our opinion on what treatment options have been given to you. If you’ve been told to do watchful waiting, but want to think about doing something perhaps a little more aggressive, but still maintain your function, it’s a great opportunity to get a second opinion.
Donna Lee:
That’s called watchful un-waiting. Get something done.
Dr. Mistry:
How do people get a hold of us, Donna Lee?
Donna Lee:
You can call us for that free consultation for HIFU at (512) 238-0762. You can also send us an email to armormenshealth@gmail.com. Check out our podcasts wherever you listen to podcasts. We are so podcastable and now on Amazon. Thanks so much!
Speaker 2:
Dr. Mistry wants to hear from you! Email questions to armormenshealth@gmail.com. We’ll be right back with the Armor Men’s Health Hour.