Movember: Getting Honest About Prostate Cancer (EP 140)

[0:15] Hello, everyone, and welcome to another episode of my own, the High Unhealthy Podcast.

[0:21] I'm Uncle Marv, and today we are continuing our talk around Movember, where the mustaches get the attention, but men's health is the real conversation. And fellas, today we're going to be diving into a lot of these check engine light topics and stop talking about it's probably nothing and we're going to stop putting, the stuff off that we need to talk about. So today I've got a gentleman with me that is probably somebody who is, well-versed in the topic that we're going to talk about today and that is prostate cancer and we're going to focus on a, on an angle of the questions men need to ask. So, Michael, welcome to the show. Thank you, Marvin. I should probably let listeners know that if you have been following the podcast, Michael has been on the show before, and we talked about his journey a little bit. We're not going to dig too much into that, so I'll have a link to that previous episode if you want to hear more. And we are certainly going to be spending a good amount of time on his website.

[1:41] Theprostateeducationproject.org. And, uh, Michael, I guess some of the first questions are is, you know, for people that, well, specifically men, uh, this is a subject where we probably need to figure out how to turn fear and uncertainty into a more useful conversation. Uh, how have you kind of dealt with that when it comes to men talking about this?

[2:06] Well, as we talked before, I think the biggest problem we have in discussing prostate cancer is when you hear those words, you have prostate cancer. I think most people, including myself, you go blank when you hear that and you hear that diagnosis. And all sorts of things start entering your mind.

[2:32] What stage is it at how bad is it and generally I have found in my experience in doing this project that unfortunately I'm not, most men just clam up and they don't want to talk about it. They're either embarrassed about it. They think their sexuality is, you know, disappearing. And just so many factors enter into what they're thinking and feeling when you, again, when you are initially diagnosed and you hear those four words. So I think the biggest problem I have found, unlike women who are more open generally about dealing and talking about their particular problems and especially breast cancer, which is, you know, we just talked about every single day, prostate cancer is not talked about. I mean, it's one of these things that, oh, it's never going to happen. You know, I don't think it's going to happen to me.

[3:30] At some point in time as we age, most men are going to have some kind of a cross-state problem, not necessarily cancer. But unfortunately, in today's world, with the lack of testing, too many men are becoming diagnosed with cross-state cancer. But again, going back to your question, I think the biggest problem is when you are initially diagnosed with, There's so many questions that come up, and being able to find information, there is a lot out there, but unless you are willing to spend time and go digging.

[4:08] You're not going to probably find the answers that are going to be meaningful to your particular situation. Right as i say and the other thing i found is they say if there's a family involved a spouse involved, uh so many men just are embarrassed they don't want to talk about it uh for whatever reason that may be and i just maybe that's just a male psyche right i know that the, the research that I ve done and you know most men probably don't start asking questions until they're already sitting in the doctor's office. And even still, they may not know what to ask.

[4:46] So let me start with a question from your point of view. You've gone through this. You're now educating people about this. Is there a question that looking back now, you wish you would have known to ask at the time? Well, like in my episode, as we talked earlier.

[5:08] I was originally diagnosed 23 years ago and had a radical prostatectomy and was cancer-free, if you will, or in remission, call it whatever you wish, for 20 years. And then, unfortunately, it decided to raise the second headache again. And I think, in retrospect, the second time around was probably worse than the first time because the prostate had already been removed. And I knew from my own research, and I had done a lot of studies on this thing, and certainly no expert by any means.

[5:45] That knowing if it did come back, that oftentimes it will come back with a vengeance. And so when I was re-diagnosed, that was more of a shock to me. And to answer the direct question, what did I wish I knew then?

[6:08] I wish I had an answer as to why and how after so many years that there's a lot of discussion about COVID vaccines, et cetera. We'll never know. It did come back. And how then was, okay, the biggest question was, okay, how am I going to deal with this? What is the severity of my particular cancer? Where is the cancer? And once I was able to get those answers, then it became an easier road to travel. Gotcha. I don't know if that helps at all, but, you know, no, it does.

[6:46] Um, now you created the, you know, prostate education project, uh, mainly, you know, out of your experience and realizing that, you know, there needs to be, you know, one, a conversation and two, better understanding of, you know, diagnosis, treatment options, uh, PSA monitoring, which we talked a little bit about in your last show and stuff. When you started creating the project, what did you find was missing most in normal conversation that men were having or normal education that men were getting? What I found to be the most critical factor, Marvin, is the fact that most, too many men, not most, too many men.

[7:38] At ages 40, 50, 60, still have not gotten a PSA test. And there's so many arguments about the pros and cons of PSA testing, meaning that there's too many maybe false positives. But there is still a lack of continuity, in my opinion, amongst the medical profession about testing, at what point men start testing, whether it be Caucasian community, especially in the black community, as you probably are aware of, that has a higher percentage of prostate cancer than the Caucasian community. So the fact that.

[8:19] I just, in my research, the lack of education, I'm sorry, the lack of prostate cancer testing was probably the biggest awareness. And I go to support groups and there are men in these support groups and they're 60s and 70s who had not in their lifetime had a PSA test until something else happened, and they then ended up with a PSA test and found that their PSA levels were through the roof.

[8:51] So, again, I come back to testing, testing, testing, and that, to me, is the critical factor in this whole thing. And quite frankly, that's what saved me the second time around because I did continuously do testing. After 20 years, there were some clinicians that said, you know, in the 15, I think I may have told you before, at the 15-year mark, a current urologist said, if I had been a patient all along, you wouldn't stop doing testing. And my answer to him was, yeah, I'd probably be dead because he wouldn't have known I had prostate cancer again. And so, again, there's no uniformity. There's a lack of uniformity, a lack of continuity on protocols on how to do it. And I'll take it a step further. In the Affordable Care Act that was passed a number of years ago, as an example, mammograms are included in the Affordable Care Act. If state testing is not.

[9:49] So there's another avenue, if you will, of why are men, so to say, left behind in the respect, again, is it because of the testing involved? It's a blood test. Yes, there may be false positives. But we're also finding that younger and younger men are being diagnosed with severe metastatic cancers, lack of testing, lack of awareness. So that's the biggest number for me. is just get those PSA tests regularly regarding, I don't care what a healthcare professional says, if you have to pay it on your own, get it done.

[10:26] So let's dive into that just a little bit because I was going to have you describe the PSA test, but when you talk about the fact that it's not covered, most men are still under the, I don't want to say illusion, but under the idea, that the basic way to test for prostate cancer is to go into, a physical facility, the doctor puts on the latex gloves, stick your finger in the rectum, and that's pretty much it. The PSA test is completely different, right? PSA is a simple blood test. And then, I mean, then if an indication is, again, I'm not practicing medicine here, if there's an indication that the PSA is elevated, and when we talk about elevated, the normal numbers, if you have a prostate, that are the accepted numbers is 0 to 4 in PSA testing. Prostate-specific androgen is what it is. And in numbers 0 to 4, generally speaking, you're pretty good. But people have had prostate cancer with numbers in the three. That all said.

[11:38] If the number is higher, then your clinician certainly may want to do a digital exam, as we call it, and which may give him another indication that there is a problem than perhaps if there is and he feels something or she feels something that is out of the ordinary, then take it to the next step and either going in for a PET scan, MRI, whatever the protocols.

[12:10] Whatever it may be in that particular setup. Again, generally speaking, now my understanding, the way the medical insurances, again, insurances are going, it's an MRI first, and then potentially the PET scan. I chose a PET scan immediately, and I was able to do that versus having to go through another extra step.

[12:32] But PSA, bottom line, is a blood test. Yeah, pretty simple.

[12:38] Going back to your website, theprostateeducationproject.org, so there is a full education library there that gives you guides with, you know, diagnostics, diagnostic basics, treatment options, treatment journal. We'll get into a couple of things down the road. but a lot of printable, downloadable tools. So for somebody that, you know, maybe is, let's say they're in their 30s and they haven't gotten yet to the magical age where we're told to get checked out and stuff, would you recommend this be a place to at least go start to look at information and get an understanding ahead of time?

[13:21] That's a very interesting comment. And I would absolutely agree with what you just said, yes. And my whole argument is the more education you have about this and understand, the potentials of what prostate cancer can and does do, the better off you are in the event that you have the unfortunate experience of being diagnosed with it. So, yes, if men are interested enough in understanding what happens to the body as they age, and also genetics, as you know, plays a huge role in it. And if there's been any history of prostate cancer in a family, a father, or a sibling, by all means, you try to get started as early as possible. Because genetically speaking, you might have the potential of having a higher.

[14:19] Probability of prostate cancer. It happened to me. My father died from prostate cancer. So there you go.

[14:27] So for people that either don't know their, you know, family history or genetics, and they're, you know, kind of going through life blase and stuff, let's talk about prostate cancer in terms of what it is. The one thing I do know, and the reason that we have to encourage testing is, in a lot of cases, early prostate cancer shows no symptoms, right? That is correct. Absolutely correct. But when it does start to show symptoms or when it does manifest itself, what are some things that we can expect? These things that I have heard, a potential blood in the urine, pain in the abdomen. And interestingly enough, very often people will have a pain in their shoulder.

[15:21] Strange as it may be meaning that the cancer has progressed it has metastasized and it's now in the bones, so a shoulder for whatever reason again this is you know like again all of this information is out there uh that area and obviously you're going to the doctor with something else and bingo, So a PSA test is done, blood work is done, and this shows up. So it's, but it is, you know, essentially it's almost like blood pressure. It can be a silent killer. So this is something, folks, where, listen, as men, do not accept the fact that, hey, just because we're getting older and urinating more at night, that may not be normal.

[16:10] Obviously, blood in the urine, serious. And any pain or burning during urination, serious. Right. And I didn't even think about a pain in the shoulder. That's interesting. It is. Because it's quite interesting when you start talking with people and you do some research, which I've done a lot of. And again, I don't profess to be an expert. I just talk about things from a lived experience and try to help as many people now as we can because of the lack of education. And again, there is information out there. Unfortunately, a lot of it is politically motivated, I should say. And the people that are out there doing a lot of these things are also in the fundraising business. So that's not our goal.

[17:00] Uh, one last question about somebody that say they go to the website, they start to get information. Uh, obviously they will take this to the doctor if they're getting regular exams and maybe they haven't been diagnosed or not. Uh, or if they just got diagnosed, uh, is there a way to have this education, and not challenge the doctor? You know, if a doctor says you're fine, but you're like, I feel these things, I think I need to be checked again. How do we how do we deal with this without challenging?

[17:38] My quick answer is get a new doctor. But.

[17:43] You know, I that's it's a tough one because, yes, you don't want to you don't want to be practicing medicine when your clinician is trying to tell you that you're OK. And my answer to that is I am an absolute believer that one has to be proactive, in their own health care. And if you think there's a problem, again, I come back, if a clinician isn't willing to do a PSA test, for whatever reason, go to a lab, make an appointment with a lab, whether it be Quest, a LabCorp, any quality laboratory. Generally speaking, a PSA test out-of-pocket is anywhere from $70 to $100, depending on the lab. It's a simple test. And get your asses. Get that benchmark. That's the key. You know, I, I, again, I, I'm not, I'm not at all embarrassed to tell a doctor, Hey, this is what we're doing and why we're doing it. Uh, you know, that's, that's why you're my doctor. Well, and of all the things in life, all the people we need to know in life, our doctors should be the one person that we can talk candidly and openly to, uh, about our health. It's our life. So, uh, I've been there twice, Marvin, you know, we process a cancer and open heart surgery. So yeah, I, I hold nothing back anymore.

[19:12] All right, folks, just so that you know, I have asked Michael to join me for a second episode, because even though we've talked about this from the, I guess, the front side of prostate cancer, we're going to come back and talk about, you know, what happens after the diagnosis and the fact that, you know, a diagnosis for a man affects a lot more than just themselves when it comes to family and friends. But Michael, thank you very much for doing this and I look forward to talking to you in part two of our discussion. Thank you, Marvin. All right, folks, that is going to wrap up this episode. Movember may get our attention with mustaches, but the conversation needs to last longer than a month. So whether it's your prostate, your mental health or something you've been putting off. You don't have to have all the answers to start asking questions. So be listening to our episodes all month. Check in on a friend and have it be more than just how's it going. Give them a minute to tell you how it really is.

[20:17] I'm Uncle Marv. Thanks for listening. Thanks for hanging out. And remember that you don't have to get healthy all at once. Take it one step at a time. And until next time, live healthy and be happy.