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-- just in America.
A doctor aren't just going to out dance morning done thanks for having me I don't tests of by federal marshals.
I'm -- national overall just moved on to great dark on the bottom.
General yeah and -- and Wyoming somewhere fly fishing I think -- June.
Our doctor Cassell sale was in neurology department at Columbia climate right yes I was for about twenty years and then about a year and a half move over.
To Winthrop university hospital and what did you -- on aggression and as to why you play well I think it was time for me to leave I want to run an apartment and I think that -- it's a terrific place and you know they gave me great opportunity that run the department -- be the chairman and I'm extremely pleased with the facility the hospital and so forth.
Now she can sometimes when you change positions.
And you go to -- players and it's -- When they're trying to recruit terrorists that are obviously digital -- tell -- of -- -- integrating all started a group of yeah.
You know you get a contract in and you don't know.
By the start out that way all -- so far beyond what -- it foreign beyond -- passed a facility that doctors are wonderful actually some of the doctors.
From Columbia actually moved over to Winthrop.
And help -- you have on our part governor there mark yes -- -- -- not -- -- I'll be seeing you today.
The president bring your glove over could have done an error well we could've you know speculated that -- Eric type of thing you know when I was initially diagnosed with my numbers and their world -- All.
-- -- bottom.
-- is not English barked you know.
Now that you recommended radiation.
There was some concern about whether -- -- to endure an operation.
Yeah but after flying all over the country talking about it and -- -- I decided to Rwanda to help missiles Imus and fabulous.
Decided to pursue all solicitor -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- Warrior -- my question I asked us was an office.
Richardson and -- so far sort of.
Fantastic any -- don't terrific on the diet supplements -- PSA numbers and you know your overall health it's not just about the prostate.
You know in my program active holistic surveillance it's about improving your general -- you cardiac health your bone health.
Keeping your blood flow to vital organs like your heart your penis.
You know and allowing your prostate cancer to enter a very good remission and be stable and that's basically what we've -- way over the last 45 years -- -- care why or why don't lost -- of that was well actually they aren't -- and -- of things -- want to talk about this morning one of the signing things that came out of this year is a UA American neurological association meeting in San Diego two weeks ago.
Was that we now know that there's a large number of men that get diagnosed with prostate cancer in this country that are excellent candidates for active surveillance.
And you know that's because that that the cancers that are diagnosed by PSA and I hope we can talk about the new guidelines for PSA.
Many of these cancers are very small and slow growing.
So we can use an active surveillance approach and my approach has been not just watch and wait but to incorporate.
Diet nutritional supplements exercise and of course I think that the PSA should be here.
In terms of monitoring you as well as an MRI probably once a year as well just to monitor the growth.
One of them their -- this -- so here's the new guidelines and I I came back I think it was 2009 anyway said we should start screening everybody at the age of forty.
Over the last few years we've had some new research in new studies have come out and now the -- UA's panel has recommended that under forty no screening.
There's no screaming except for high risk men high risks being a family history.
Or men that are African American and now if you between 55.
That's when we're recommending screening that's we found the most benefit that's kind of like the sweet spot for PSA.
In 55 and 69 and if you're -- -- with -- -- seventy and above.
We now are now recommending screening but we are saying we should have a decision making with the patient because a lot of guys that are seventy still have.
1520 years to live so we should still discuss the role of PSA because if -- get a PSA and he comes back high.
Well then you may need to have the next step which should be a biopsy there are some risks although small but there are some risks of a biopsy.
So -- dot -- again so so the difference now is not a routine screening starting from forty probably from 55 to 69 and not necessarily yearly.
It can be done actually every other year but still that PSA.
I think although it's not a perfect screening test on it is the best screening test it's cheap and I think.
The the issue is not the screening test itself.
But when we get the information -- we act on it and not every man needs radical surgery or radiation -- And my stance is that where I think that I don't wanna go back to the pre PSA error when I was a resident and -- -- that would come into the hospital with bone metastasis.
If we don't have PSA.
We're gonna wind up with a lot of men in this country that are under 55.
I -- -- -- guys in my office.
That are in their forties that if I didn't to a PSA screening we would have known about the prostate cancer so.
That's the panel's guidelines will most urologists do that probably not -- most men in this country do that.
I don't know I still think that PSA is here to -- Most madam.
Simply wanted to to cancer on their -- and -- an adult.
A lot of them do or a lot of their -- to.
-- -- a lot of them say you know honey -- he should have it out but you know having it out.
Although we've made great advances with robotic surgery and trying to -- nerves and allow men to have surgery to urinary control.
I do cry -- surgery I do a lot of them I did four yesterday to freezing technique where we can just freeze the cancer in place.
So like four guys yesterday that I treated -- had small little cancers on one side of the prostate.
Rather than going through the major surgery in taking -- the whole process it'll radiating hope prostate.
Just focus -- into a targeted therapy.
But we're not learning is -- -- deals that are.
Cash deals and are on notice and I take all insurance is no -- -- This is covered by Medicare -- very well Brussels -- -- wondered -- my my wife tells whoever is -- -- during World Bank while I'm very happy and you know I'm very happy with the hospital happy with my position.
Also happy with the patients and every day patients to come into me.
And are very happy with with the care they've -- in with the other things that we're learning a lot more about genomics about more about the DNA so now we have.
Like a biopsy that you had.
That may have been considered a Gleason six at least -- seven media low risk is it really low risk and so -- now ways of looking at the genomic DNA.
We can take your biopsy send -- for a DNA analysis.
And then determine whether or not you really are a low risk and can go on to active holistic surveillance let's say or you need to have definitive treatment may be right away I would point out total.
Well program and -- on -- requires.
Some commitment and tremendous discipline because -- just does not exist there and and -- go -- to our bruised battered.
Now and only you know doing you know the Dunkin' Donuts within the eggs and -- and there but a lot of this is information that will be presenting.
On the June 15 men's health seminar is gonna ask you yeah we have a wonderful seminar on June 15 you can have to register -- men's health seminar dot com that's men's health seminar dot com.
A full day not only on the prostate but what about sleeping issues for -- what about bone health all these issues will be addressed testosterone -- -- An explosion in this country in the number of men that are taking testosterone replacement therapy which tripled in the last few years line.
Because men feel that they want a quick fix because all the sudden feeling fatigued -- bottled -- to maybe -- libido is in his good parent and they don't even and actually the studies that have been just been a political term but it'll -- her prime.
I have to check that want to remind me com.
But the thing is just on that a lot of men are taking these testosterone replacement therapies without even having -- testosterone level.
You know and I don't know whether -- are they don't know where they are.
Testosterone replacement therapy can can be very beneficial for guys with low testosterone can improve their libido can -- their energy.
But if you don't have a testosterone level and you just want to take it because you're feeling tired.
It's dangerous and it's dangerous even for young guys taken because -- can -- -- always sperm count it can cause.
In your blood to thicken they can be a lot of it it's it's hormone therapy it's this stuff that that -- rods and take our news conference.
You know men's health -- our -- and tests -- much rather.
-- this woman is of the same moment -- -- Columbus that's not to -- Machida and she just joined me she's actually a medical correspondent here on fox shows she is and she's also a variety of things.
Assumptions are fairly snapped an -- dark very well issues this is a wonderful Dr.
-- co host the men's health -- with me to be at the garden city hotel on.
On June 15 Father's Day weekend in the big theme -- par at men's health -- seminar men's health seminar dot com so you are -- alive.
And done I want to thank you so much from me on today car market losses -- -- o'clock we'll see it now get to -- -- -- I had after I.
I'll -- out.
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