our next guest dr. Joseph marques
urologist to the polyclinic we're
talking about men's health prostate
awareness dr. Marquez welcome to health
talk good morning how are you I'm doing
great hey you're all just tell our
listeners about your practice your
training yeah you know give us the day
in the life I always like to do that the
day in the life of dr. Marquez how's
that sound
oh that's awesome yeah I mean I didn't
even know what a urologist was going
into med school we're surgeons and we're
clinicians and we specialize in the
genital urinary tract so if there's a
problem the kidneys bladder prostate the
genitals especially if it's a surgical
problem that's something we deal with
but we also deal with medical issues
like infections and things like that
I think the common list one would say
urology I mean that's a male thing but
it's also yeah I mean male and female
patients you see them all oh yeah
definitely so kidney stones happen in
men and women equally infections bladder
cancers so sure you know we're in
November here in November is Men's
Health Awareness Month I mean no-shave
November I'm gonna participate my little
gray right now but that's okay but let's
talk about the prostate a big deal for
men tell our listeners let's do some
anatomy and physiology why do we have a
prostate what is it and you know why
does it become a problem all that neat
stuff yeah why do we have it that's a
great question yeah it has an answer but
well it's a reproductive organ so it
supports basically fertility that's it's
only function you don't need to have it
for any other reason so it creates the
fluid that's needed to support the sperm
in fertility but it can become
problematic in tell us about that who
gets it and what is prostate cancer and
signs and symptoms and we're going to
talk about some treatment yeah so it's a
gland so it's any gland makes secretions
and that's what it's primarily its
function is it's where it's located that
often causes the problems that we see so
it's located between the bladder and the
urethra in the in the male of course so
if it gets enlarged it can obstruct the
urinary flow it can make it difficult to
pee if it has inflammation you can have
blood in the urine
if it gets infected it can be painful
and then lastly is it can develop
cancers and in fact prostate cancer is
one of the most common cancers to affect
men let's visualize this I know on the
radio but let's let our listeners really
understand so the prostate it doesn't
surround the aretha it just sits close
to it and in or does it even golf theory
theory Thea is the tube that goes from
your bladder that allows you to pee
that's right and that goes right through
the prostate and in fact we'll call that
the prostatic urethra okay so the
prostate it's almost like a doughnut
shape okay wreaths are going right
through the middle thank you so if it
gets inflamed and and becomes enlarged
it puts pressure or compression on the
Reetha that's why you have difficulty
peeing or urinating and the blood it can
actually cause that reason become
inflamed and irritated then yeah exactly
so those are things you need to kind of
look for then I mean difficulty
urinating blood in your urine any
there's no pain with it is there it
depends on what the problem is yeah
we're talking about prostate cancer in
fact what's remarkable about the modern
era as most men with prostate cancer are
diagnosed without symptoms they're
diagnosed by blood tests or maybe a
physical exam finding but actually in my
practice it's rare that someone sees me
with a symptom and that that symptom is
the first time they're found to have
prostate cancer
well is it is it is it fair to say that
if you have symptoms like pain or
discomfort the prostate cancer is
probably advanced I mean is this this is
one of these cancers that it's so
important to get early detection yeah
absolutely
I mean exactly if the symptoms that
someone is experiencing like blood in
the urine or obstruction is due to
prostate cancer unfortunately that
probably means it's further along which
is less fortunate than if it got picked
up let's say much earlier in the process
it is fair to say again you know just
from a medical standpoint the blood
tests that they're doing now what is
that called again is that like something
with an eighth or something isn't it
there's the most common test is called
PSA which stands for prostate specific
antigen and that's what I think most
people are aware of but there are other
tests out there the PSA test is pretty
accurate I mean in most family
physicians now I guess I want to
listeners
understand that back in the day you were
probably going to get a digital exam at
50 as a male right today they're just
doing blood tests for the most part or
how do you feel about those do well as a
urologist I really think both are quite
important yeah so I think a PSA blood
test and the physical exam in the
appropriate candidate the appropriate
patient is a very good idea that's dr.
Joseph Marquez we'll have more of our
conversation with him coming up next on
come on dr. Marquez thank you again for
joining us you're all just at the
polyclinic I mean you're doing a great
job describing this prostate situation
so I have symptoms or no symptoms but
let's say I go to my doctor and I get
picked up on my blood screen that I have
potential prostate cancer what's gonna
happen then
well then typically you'll get referred
to a urologist like myself and hopefully
that urologist is pretty familiar with
how to manage a situation like that
because you know one of the issues with
the PSA test for example is that it's
not really telling you if you have
cancer or not it's just telling you if
you have a risk for prostate cancer and
a good urologist who's familiar with how
to manage PSA and and just prostate
cancer detection will be able to put
that into context for you how serious is
this risk what's the likelihood this is
cancer and what's the likelihood it's
serious cancer and then what are other
things we can do to sort that out what
are the treatment options I mean I know
Cancer Care and cancer research and
survival rates have increased
significantly you know I think back 15
years ago they talked about these proton
bullets or what are they where they put
in there now you're doing some neat neat
stuff and some advanced stuff because
you want to preserve the prostate as
much as possible and eliminate any post
surgical consequences my understanding
is yeah I mean as we talked about
earlier the location of the prostate
down by the bladder is what puts it in
harm's way for things like surgery
radiation etc and so a lot of the
complications you see from treating
prostate cancer come from the fact that
the bladder can get involved the urethra
the sphincter the rectum etc so whatever
treatment you can do the least sort of
collateral damage is what the goals are
you have some techniques or you're using
some robotic assistive devices that
pretty fascinating stuff
yeah so something I'm really excited
about is called the Artemis MRI fusion
biopsy robot and that happens in the
stage where we're trying to either
detect a man with having prostate cancer
for the first time or if he has prostate
cancer but we don't think that those
risks we just talked about with surgery
and radiation are going outweigh that
that the Bennet the risks are
outweighing the benefits there and so in
those cases we'll see if men are good
candidates for active surveillance where
we're not actually treating this cancer
but to do that safely we want to know
exactly at least as much as possible how
serious the cancer is and using this
artemis biopsy robot is one way to do
that we can really look at the prostate
we use an MRI we take biopsies we can
follow this over time and so a lot of
men these days especially in my practice
don't necessarily need to suffer the
consequences of surgery or radiation
that that's really interesting I mean so
what you're actually saying is that
sometimes you know you're weighing the
risk of intervention versus the risk of
just watching it and protecting the
patient yeah so I like to think of
prostate cancer as five different types
of cancer and some are serious and some
aren't and the ones that aren't super
serious maybe our best followed over
time and not treated any advice for men
who are notorious for not seeking out
health care and following up on annual
physicals I mean just get it checked
just go get a PSA if anything get a
check you know urologists are human we
don't want to hurt anyone don't be
afraid of pain or anything like that
well you've made me really comfortable I
wrote I feel really comfortable talking
to you and if the earth like this with
your patients you're a phenomenal
urologist thank you for joining us it's
my pleasure thanks for having me here