Senior Living LIVE! Healthy Aging: Men’s Wellness and Prostate Health

Video Transcription

Hello, everybody, and welcome into Senior Living Live. My name is Melissa. Thank you so much for being with us. Well, recently, we had a wonderful webinar led by Suzanne Pricess.


You see her there. All about women's health and aging. Today is the men's turn. September is prostate cancer awareness month.


We will start there and expand a little later in the webinar on men's overall wellness, cognitive health, and overall better aging. And, of course, we want all of you to be a part of the conversation. To do that, all you have to do is scroll down to the bottom of your screen where you see the q and a button. Feel free to type your questions out there at any time during the webinar, and we will be happy to have our panel answer those questions for you today.


Well, Suzanne is back as our guest host, and she is joined alongside doctor Randy Kronick. Hi, guys. Good to see you. Feel free to introduce yourselves to our audience here today.


Good morning.


Go ahead, doctor Kronick.


You can Okay.


I'm doctor Randy Kronick. I have been in private practice here in Duluth, Georgia since nineteen ninety four.


I'm currently the director of senior care for Ascend Medical Group, which is focused mainly on, cold health for senior citizens and assisted living facilities, and office care.


And as well, I'm the medical director for Capstone Hospice, and I have a private practice still in Duluth, Georgia dealing mostly with internal medicine and geriatric care.


And I am Suzanne Price. I'm a registered nurse. I have been with Arbor since two thousand sixteen.


Prior to working with Arbor, I worked in coronary care in the hospital, in the emergency room, cardiac rehab.


You name it. I've done it.


It's been a lot of years, and I love it.


Senior living is my passion, and I am very happy to be here and have this time with doctor Krennick to really talk about men's health and specifically prostate care.


Okay. Well, let's start there. Prostate care. Let's talk about the prostate.


Why is this, a topic? Why why are we even discussing this? What is, the importance of having this month as prostate, awareness?


Well, the most important thing is that prostate cancer is certainly on the ride. It's the second most common cancer in men, really, in the world, certainly in the United States, and that's secondary to most basic nonmelanoma skin cancers, which are very common. But prostate cancer is diagnosed at least three hundred thousand times a year. So three hundred thousand men are diagnosed a year with prostate cancer.


It's also the second leading cause of death by cancer in men, a high lung cancer.


So the difference is with proper screening and preventative care, prostate cancer can be diagnosed in very early stages. And when it is, the success of treatment is close to a hundred percent, at least ninety eight percent survival after five years.


And the screening tests are fairly easy, you know, simple things to do.


I guess going back to the start, it's so we're all on the same page. The prostate itself is a small, basically, walnut sized gland in the men men's reproductive tract, kind of under the bladder in front of the rectum.


Its purpose in the body is basically to make fluid and nourishments, you know, in the in semen, for sexual function.


Most problems with the prostate start coming around around age forty five, fifty.


Most of the time, and most of us men will start having some symptoms related to usually a benign enlargement of the prostate, which generally will come as more frequent urination, sometimes getting up to bite more to urinate, trouble starting the urination stream, sometimes the throat stream.


So most of those symptoms are not related to cancer, and that's what sometimes we get a little bit misled. We think, well, I don't have symptoms of of cancer, so I'm okay. But that's not true. Prostate cancer, until it's usually advanced, will not have any symptoms.


And, unfortunately, the biggest symptom usually is back pain, and that's because it's already spread to the spot.


So we want to educate men that this needs to be screened on a regular basis and not wait for symptoms, and unlike other cancer symptoms come, unfortunately, very late, you know, in the pacificance.


So we won't, you know, we want people to be aware of that. And I think, you know, that will help out tremendously on you know, our treatment success.


Suzanne, I'll let you follow-up with, how what what we should be doing or what our seniors should be doing in terms of, maybe these screenings or how, companies like the Arbor company can sort of push that so that in case it's kind of forgotten or not top of mind that people can get these proper screenings and be tested correctly.


Yeah. So as doctor Purnick said, you know, you don't want to wait until you have significant symptoms.


Prostate cancer is a very treatable cancer, and it is really, just a shame to have someone in the later stages when it could have been prevented had they gone in for their regular screenings. So as many things in in health and taking care of ourselves is we need to make sure that we are going in for our regular checkups.


There are different screening tests that can be done.


The diagnosis is made with a urine flow test, ultrasounds, and the PSA blood test, which you go into your doctor's office to get in. And doctor Kronick, how often would you recommend having men go in for their PSA?


Well, what the general consensus now is starting at age fifty and men that are considered normal or average risk, men that are high risk, which kinda fall into three categories, black males, males that have family history of prostate cancer, and, and usually then men that already have face on symptom.


We would start around age forty five, and we normally recommend that men come in once a year.


And, generally, the screening's done with a PSA, which is a simple blood test. We usually do it if you're here for a physical, but we check your cholesterol, your blood sugar. It's just part of the panel.


And in my thirty one years of practice, I diagnosed several men a month still. No symptom, come for the physical, and the PSA is high or it's higher. We really go by trends, and that's why it's important to do it every year because the PSA still may be almost normal, but say it's gone up by two or three times since the year before.


That's very important as what there's some men that have cancer that still have normal PSA, but they're normally going up a lot over one year to the next. So we're able to, you know, identify that, you know, much early.


And so, yeah, generally, you wanna do it once a year.


Most experts recommend doing it to age seventy, but, personally, I base it on the math the person's health, their general health. Some men now are ninety. They're very healthy. I would still do a screening.


They can be cured easily if we find something early, whereas there might, you know, be a problem if if not. So, normally, once a year at either twenty five or fifty year old.


And let's point out again, you said something so important. Those yearly physicals, because we are all different.


And what is a a normal baseline for me would not be for somebody else.


And so we can't do a hit or miss or wait for symptoms. We have got to take care of our health and start early so that we have that healthy baseline for doctors to go on and compare as we age.


Can I ask you let's talk about the difference between benign prostate hypertrophy and prostate cancer because I think sometimes people get it mixed up or think that one causes the other?


Yeah. There's really no obvious relationship between the two.


Like I say, the benign enlargement of the prostate is close to the universal for most men.


Symptoms may vary from very mild symptoms to very severe symptoms.


Most men will see and I'm sixty one, so, obviously, I used to not get up at night. I do now. So I'm usually the one having to stop to the rest areas when we travel and not my wife. So that's a normal, usually thing we start seeing in people.


Now when we get more severe symptoms where it's very difficult to start the screening, the screen is very weak, sometimes even to the point of urinary retention, which means that it's very difficult to start urination.


Now those symptoms are certainly to the point where there are treatment options for just the benign you know, enlargement of the prostate, which certainly, even though it's a benign condition, can still cause some pretty significant problems for some reason.


So those are things, certainly, we need to get neurologists involved and, you know, take it from there.


Again, prostate cancer, on the other hand, is, you know, very treatable early on, but can be deadly if not treated.


Fortunately, the hospice medical director, the men every month that are at that state, unfortunately.


So when we see that, most men, we see the PSA going up. We refer them to urologist.


Nowadays, sometimes they'll do an MRI of the prostates if there's an obvious tumor they can see.


If so or if the PSA is very high, they know exactly where to do a biopsy.


You have to see, well, is this a malignant cell or not?


And the biggest advances now is not only you can tell if there's cancer there, you can tell how aggressive the cancer is. Some prostate cancers are extremely nonaggressive and may not ever even affect the person. So they might not ever be treated. They might just need to be followed over the year versus somebody that has a very aggressive tumor, which is determined by the genetic makeup once there's a biopsy done.


Those people are certainly amenable to to treatment and need treatment, or that's gonna be somebody that would probably have significant problems, you know, in a short period of time. So that's kinda how the, you know, how it goes once you do the test, you know, if there is an after amount. And then you can get in later to based on what you have. What are the treatment options?


There's multiple. Usually, the doctors will, you know, discuss those options with the patient based on what they find and then give you these are your options. You know?


This is something you can research. It's not the same for everybody. Some people, you know, now that hopefully take more, you know, care of their help will decide for themselves or sometimes we need a different another opinion, you know, and see because there's lots of different treatments that predict problems.


And what are the different treatments for BPH?


Well, if it's mild, we always try the safest and easiest things for her. So sometimes we'll just have men, you know, not drink so much after six PM.


Maybe try some supplements like saw palmetto or, you know, lots of over the counter kind of prostate supplements.


And a lot of times, those work very well.


Second step, there are some prescription drugs. There's a couple that we use. There's one that helps kind of the flow of urine. There's another one that really helps getting shrink the actual size of the prostate.


It's very slow, but over time, that can help.


So that's usually the next step.


Third steps, usually, you're getting then into some kind of procedure.


Now the most common one's done.


If they're surgery recommended, it's usually done with our with robotic, prostate surgeries that, preserves the nerve function and the vascular function. So the side effects from the older surgeries usually are not there now, which being nearly where incontinence


And, you know, there's trouble urinating and erectile problems. So we've kinda gone away from that with the new surgical procedure.


The other two things that are done now, there's a high flow water treatment that actually is forced up through the prostate to kinda enlarge the opening, you know, of the urethra.


So there's less pressure on the, you know, on the urethral opening.


Then there's what's called the urolift where that's a less invasive type of procedure where they go in and put clips to hold up kind of the prostate. And, again, that kinda opens the urethra so the urine flows better.


And then the fourth one is a little newer that may become the most popular.


Is called a prostate artery, embolization.


So that's done by the interventional radiologist. They go they go in and put small beads in to reduce the blood flow to certain parts of the prostate, so the prostate actually decreases in size.


That procedure was first done in females for fibroids. They were using a peruterine artery of, like, embolizations to reduce the size of fibroids.


So they started doing that for men now.


It's still kinda new, but it is certainly being done. And the recovery from that is so much better and less invasive than any of the other procedure. So I think down the road, we may be seeing that you get more and more, you know, for men with more advanced cases of prostate enlargement, you know, that haven't responded, you know, to the less invasive type of procedure.


Would you say the success rate so far with that is as high as the other patients?


As high as the others so far. Yes.


With much faster recovery, let's put it that way. So yeah. Okay.


But we'll see how that goes down the road.


Doctor, can you give some, initial symptoms that maybe people can be on the lookout for? You know, we have sort of that age range where it's kinda like you should be going in for your yearly screenings, but what are some of the earlier symptoms that might lead someone to head to the doctor?


Well, related to the prostate, you know, mainly the symptoms are gonna be you know, if if you notice there's a change for you, basically. If you've never gotten up at night till you're late, now you're starting to get up once or twice or you notice even during the day. Well, I feel like I'm going to the you know, I'm urinating a lot more than I used to.


When you feel like you have to empty the bladder, if you're having to stand there a little while, you know, to get the strain started, even though it feels like the bladder is full, that's certainly a sign that there's some obstruction of urine flow already.


A lot of times, the stream of urine is much slower.


Now, you know, fifty year old man is not gonna be like a twenty year old man.


But if you notice for yourself, there's been a significant decrease in the strain. It takes you much longer to get through your bladder.


It feels like after you didn't get your bladder, you're having to go back and then do your bladder again, you know, but sooner than you normally would.


Those are the most common things you're gonna see early on. And and and, certainly, you you can see that in in ages earlier than fifty, just based on the person.


But those are definitely things that you'd wanna talk to the your physician about.


Because over time, even though it's a benign condition, it does lead to pressure that's pushed up toward the kidney.


And the urinary tract is a closed system. So if there is pressure coming in the lower urinary tract, over the years, it's putting more pressure up through the bladder and ureters that go to the kidneys and even the kidneys. So you can see in there with long term, we call BPH, you know, prostate, hypertrophy, hyperplasia, that you can start getting some natural damage to your kidney just from back pressure that's going on for many, many years.


So it is important to discuss that with your physician, you know, if you start seeing some certain people then.


So walk us through maybe somebody's never done this before. They've never had a screening. They've never gotten checked for this.


What does that first step look like? What does the process look like? Obviously, the first step is contacting somebody like yourself, but what does the process look like? What does it look like?


Right. Right. Main thing that I would recommend is, you know, if you have a family physician or a, you know, regular doctor you can have a relationship with. Or if you don't, it's fine. You know? And mostly most family physician or internal medicine physicians are very adept at, you know, doing kind of physical screenings of wellness exams on patients, men or women.


And then based on your age, you would wanna just you know, have a yearly wellness visit or yearly exam, clinical exam. We have a lot of names for them now, but it's basically that, okay. I don't really have any problems per se. Maybe I have a few old symptoms of things here and there I'm not so sure about. So I wanna make a list of things I may wanna talk to them about, what screening test I may need for my age, what vaccines I may need for my age.


Just kind of a list of things, that you might wanna ask them about if they don't bring it up.


Normally, there's an exam done, you know, check your blood pressure, pulse rate, heart, Sometimes an EKG if you have never had one just to have a baseline kinda, you know, to check the heart rhythm and everything. And then, you know, after that, most of it, the tests are done with blood. So there could be a blood test taken. And with the blood test, we always wanna look at the blood sugar. You know, are you diabetic, prediabetic?


Are are the lipids in good range? Because we're really trying to screen for risk factors as well for heart disease, which by far the number one killer, men and women. So we wanna know your blood pressure, your weight, BMI, your lipids, your blood sugar, all pertain to risk for heart disease. They'll ask questions about your history, when you smoke, like alcohol.


Are there other things, you know, family history of various things, cancer, heart disease. So we kinda put all this together, and we try to get for this individual, what's their risk for various things that are common or important. Right? So at the end, like I said, there's full blood test done. Part of it would be at PSA level.


So usually the test come back. We've looked at that.


Either different people do it differently. Some people would call. Some people now with electronic medical record. We can send copies of all the tests and write their you know, from the doctor what we think, what we see, what we recommend. And then based on that, some guidance of, you know, a more healthy, you know, lifestyle things that you might can do or look at, and then when to follow-up. If everything's perfectly normal, normally, once a year or so, you know, perfectly fine unless something else comes up, symptom wise, with the person.


Then, you know, every year, it's good to relook it. We looked at Gillette.


And if you're on medication or say you are diabetic or there's some other, you know, circumstances there, then some of those people are on more of a three to four month, you know, kind of follow-up as well.


If the PSA, say it's normal, but maybe it's a little higher than it had been. We might have you come back in three months, six months to relook at it and see, well, is that a trend? Is it going up more? Or was that just a little blip? You know, and now it's kinda back down to where it had been.


So that's what I would recommend people. And I think as long as you're proactive and you, you know, and you wanna kinda fight for yourself now, It's a big medical system. It's not easy to navigate things.


But to make sure you have your questions, and a lot of times it's better to write them down. A lot of times once you're there, it's hard to, you know, think of everything you may wanna have. But that tends to be the, I think, the best we can probably get.


We can look for that.


And speaking of those questions, Suzanne, as we talk we're talking about aging, you know, healthy aging, for our seniors. What maybe are some of those questions that our, senior gentlemen should be taking to the doctor? What are some of the, maybe, higher, risk factors as we age, that that can be problematic? Cardiovascular, maybe it's cognitive health. What are kind of the host of issues that we start to see as we as we age that we we wanna be monitoring?


That's a great question. And I love, doctor Kronick, that you said write it down. And when we were speaking about women's health, we said the same thing. You have to advocate for yourself.


And if you're not comfortable doing that on your own, brings a trusted friend, a spouse, someone with you to kind of hear the same discussion you're hearing so that you understand the conversation. And if you feel rushed or that your answers, the questions weren't answered, find somebody else find a practitioner that you're comfortable with and you feel like you're being listened to.


So there are some basic, lifestyle pieces to this too. And as doctor Kronick said, the the blood panels, your cholesterol levels, your heart, heart healthy people do better in all areas. We are now understanding more about inflammation and the effect it has on the body, and that is a a direct impact on the prostate health as well.


If you're not sleeping well, which is a common, I think, complaint for men and women as they age, Part of it has to do with changes in the urinary habits and other things going on in their life, perhaps stressors.


But if you're getting up to void, what, you know, three, four times a night, which some of the seniors that I talked to, they are getting up all night long to go to the bathroom and and try and urinate. That is a huge impact on healthy living and, a REM sleep cycle.


So if you are struggling with that, you need to talk about that in terms of your sleep and, what's going on with that, which is another really great reason to go and talk about this. I think there's a stigma with, you know, men and women when it comes to reproductive and urinary, anything to do with that, especially with our seniors who are in that, age category, the eighties and nineties, because when they were growing up, it was not talked about at all. So we have to really encourage them to talk about it and write down their questions and really be honest about what they are dealing with and not be embarrassed. It's part of a healthy body.


If you're having anything that's out of your baseline whatsoever, that's something to talk about with your doctor. So if you started out healthy and then, you're having stomach troubles or you're having urinary troubles or, heart palpitations, you're out of breath a lot, swelling, any kind of difference, that is something to talk about because it can directly relate many systems of the body, and, doctors have so many different choices now to help treat these things. It it's it's up to you to make that choice, but they can present to you so many different options that there really is no reason not to go and address these things.


I think one issue that, is kind of hard to detect that doesn't just kinda crop up or or is is, quote, quote, noticeable, and that's hormonal changes. And I think on the women's side, it tends to be talked about more, maybe less so on the men's side unless it's referring to, you know, the erectile dysfunction portion of the hormonal changes. And, you know, the quick fixes, so to speak, on that end. But it's so much more than just that, isn't it, doctor Kronick? And can you please, kind of lead us into the discussion on men and hormones and maybe when it might be time to go get looked at or, maybe to give them something else to think about instead of blaming the fact that they're tired in their job or they're tired because of this x y z. It it could just be something related to their hormones.


Right. Yeah. We, you know, we've known for many years that after about age forty, forty five, and and the main hormone in the male is the testosterone.


You know, there's a normal sort of gradual decline in testosterone after, like I said, about age forty, forty five.


A lot of times, it's very slow, and it's not a problem for most people.


The symptoms, as we get older, may gradually get worse, and we just think, well, I'm just getting older. That's how I'm supposed to feel.


But now we're seeing a lot of symptoms regarding the cognitive health of people, the mood of people, as far as if you look at the list of symptoms for low testosterone and the list of symptoms for depression, they're the same pretty much. So you have that aspect of it. You have certainly a slowing of cognition, which we always say, oh, my memory is just bad because I'm getting older, but that's not always true. The physical aspects of it, we see mainly definitely is erectile dysfunction, but it's also loss of muscle mass, strength, and recovery from exercise.


So one of the best things we can do is we age, and it doesn't matter if you're ninety years old, is exercise.


Well, if we're not able to, we can get even weaker. So that leads to problems with balance. That leads to problems falling, which is one of the most common things that happen to to people over eighty or eighty five years old.


There's about a fifty percent mortality in nine in ninety days after a fall, especially if there's a fracture involved. It's not because you fell. It's just because of the complications from what happened after you did fall.


So we are very serious things that we might then do something about. So when men have a lot of symptoms of low testosterone, and you can you know, anybody can Google that symptoms, and they'll have checklists, you know, that you can go through and say, okay. I've got, you know, this, this, this, this, and this. That's something you certainly wanna write down and discuss with your your doctor.


Those, again, levels can be measured through the blood, and, you know, we know now that testosterone replacement can be very important, for these symptoms, for well-being, for strength, for cognition, for mood, you know, in men.


And there is some evidence now maybe for progressive heart disease and some other things. So that's also important, you know, thing to look at. Now not every man with low testosterone needs to be on testosterone.


There might be a reason that they're that can be picked up as well. We can work on the underlying reason, and the testosterone will go up without taking testosterone.


So not everybody needs testosterone because they're a little low.


The side effects from testosterone really don't come into play when you're replacing somebody from blood and normal.


The side effects we always hear about and see in the media and things. It's usually people that are using testosterone, that are not low, but Using it for enhancement of something. Right? So it we've been very safe when it's monitored, you know, and used in the, you know, in the medical form.


So that's also something I'd like to be aware of, you know, for me.


Can we talk about, for both of you, it we talk about testosterone. Right? And you seem to we we seem to think, or it it just seems in the media or what have you, whether it's online, that it's kind of for the certain subset of this age group. Right? Maybe men who are, in their thirties and they're start starting to see a decline, forties, fifties. But then after that, it's kind of like, oh, well, I'm just I've just hit this certain age, you know, and and people even see people who are practicing medicine that are even offering that as, something for somebody in their seventies, their eighties, and their nineties.


What about that subset, that group of individuals? Is that even something that is that is commonplace in in the medical field to be even offering testosterone to somebody in that age range?


Well, it Should we be doing that?


Should that be something that should be Yeah. Should be pushed?


It should be as a but more as a one on one thing with your physician in your situation, looking at your risk, your benefit, not going up online to a website, you know, that sells stuff. Right? And they'll show you anything you'll buy. They're certainly marketing toward young peep younger people.


And so those, I think, you certainly have to be careful with that topic. But in situations where individually you're discussing your issues, symptoms with your physician, and he or she is looking at your situation with your test results, with the medicines you're already taking, with your other medical conditions, and individualizing, you know, your treatment and what's, like I say, benefits you versus the risk to you, then it may be something that, is worthwhile.


And then it again, it's monitored.


When monitored appropriately, there's not usually any problems. Right?


That's that's really good to know. And you mentioned something, and and maybe, Suzanne, you can touch on this too, when it relates to nutrition and things that maybe can help without the need for testosterone replacement. What are some of those things nutritionally or, as you mentioned, working out? Things that people can do to naturally sort of give themselves that boost that maybe they're they've been missing.


Well, you mentioned, doctor Kronig, and, I thought it was very interesting. There are some supplements that are encouraged for prostate health. You touched on one of them. Are there any others that you might recommend?


You know, there's there's several that are just considered, like, for healthy prostate.


Some of them will have different supplements in them. Usually, saw palmetto is usually the main one. There's some with selenium.


You know, there's some other, vitamins and, you know, things that are in some of those supplements for the prostate that are certainly safe and worth trying at least early on.


Because I've had some patients with mild symptoms that have been on these now for several years, and they haven't gotten any worse.


So what you know, we just don't have a lot of normal pharmaceutical studies, you know, double blinded studies on most supplements, and and we don't have a lot of knowledge on the exact dosing or how much you need or but if you get a legitimate supplement, you'll do a legitimate supplement something. Most of those do their own, at least studies enough to know the dosing of it and the safety of their products.


So these are things as long as you're getting from a trusted, you know, supplement supplier, you should be fine. You know, with that type of thing.


Right. And, of course, the heart healthy diet is across the board. Right. The Mediterranean diet kind of thought process. What is healthy for one part of the body is healthy for all of it, and that is a a big area that we need to look at for all of us with our well-being is those things that we can do that will prevent disease processes initially or prevent them from getting more serious. Can we talk for a minute about stress? Because that's one thing I feel we all have more of these days, and stress does have an effect on, the prostate health and, of course, our health overall.


Everything. Yeah. And and it's a this whole process is all intertwined.


Right? So when there's a problem with stress, there's more cortisol in the body, which is a steroid. Right?


There's typically then more visceral fat, which is the fat most men most of us store in our abdominal area. So the more visceral fat you have, the less well your insulin works. So then you get into a problem where now you're insulin resistant. Your pancreas makes more and more insulin to try to beat the blood sugar norm. Well, this does a lot of things.


One thing insulin does, it blocks the effect of a stimulating hormone from your brain that causes you to make testosterone.


So in a roundabout way, that lowers your testosterone.


So one of the ways you can increase testosterone is by lowering carbohydrates, sugars in the diet, and losing weight, especially in the abdominal area. Then the insulin goes down, your blood sugar stabilized, and your testosterone goes up. So, again, when you get to the stress reaction, there's a lot more cortisol in the body. Well, cortisol causes weight gain. It causes bad weight gain. It increases inflammation in the body, which leads to pretty much every disease we have.


Brutus diabetes, cancer, arthritis, name it. More inflammation we have, more disease we have. And that's a direct effect in a stress usually. And stress comes in forms of external stress, emotional stress, things we have to deal with every day that we didn't used to have to deal with, and not sleeping well. Also, does the same exact thing. So lack of quality sleep, lack of good nutrition, lack of exercise, and more stress, all of those things play into about every disease which we have.


It certainly makes it more fun.


Right.


Yeah.


There's very much a causation between all of those things. Exercise is a great way to lower your stress and also perhaps cut down on your weight and just an overall healthy, daily habit. What would you recommend if someone came into your office and just said, I I really don't know what to do in my life to to have the tools to go towards a healthier lifestyle. What would be the basic things you would recommend?


Well, usually, what I like to do is sort of a full, you know, full cylindrical panel that fits in something here. You know, that's obvious. You know? I usually come across somebody that's got a barrier under active fire away or somebody that's got something that if you don't correct that, nothing's gonna get better. So I'll assume we look at that first. We look at the lifestyle they have right now.


How much are they working? How much are they sleeping? How much are they exercising?


What are they eating? When are they eating? You know, all that has a lot of food.


And are they drinking a lot of alcohol? Because that's another problem.


Another problem. Yeah. It's worse than others. So, obviously, that's you know, you wanna minimize or not drink alcohol.


Smoking is another question. I mean, I think for now fifty, sixty years, we've known that. So we're gonna look at those things. We wanna see, like, again, what can we do with the diet?


We wanna reduce most of the time the easy things are soft drinks and fast food. You can get rid of soft drinks that have high fructose corn syrup, fast foods which are loaded with same thing, high high fructose corn syrup, which is the worst chemical that's ever been made, probably, cytisinicotene.


If If you get rid of those sweet things in most people's diet, that's gonna make a huge difference.


And then increasing healthy things, increasing vegetables, different colored vegetables, lean meats, good fats, which would include avocado, nuts, you know, things that, are good for us. It's not like just getting rid of things that are bad and increasing things that are good.


Bring your water. Hydration is extremely important.


And then we wanna look at the exercise, and we wanna see where are you know, are you doing nothing? Well, if you're doing nothing, doing something is better.


So if you get up and walk around your house twice, three days a week, that's better than nothing. Next week, go three times. Next week, four times. You know, start doing something.


And then we try to keep building on that. You You know? Then are we are you getting enough of a road that that's fine? Well, when you are, let's start looking at some resistance training.


Then you, you know, you don't have a gym, there's plenty of things you can do with bands, with light dumbbells, with things that you can do at home, to increase your strength, which also increases your balance, prevents falling.


Now you're burning calories more because resistance training continues to burn calories not just while you're exercising versus aerobic exercise, which you only burn calories while you're exercising. So we wanna incorporate both of those things.


So we kinda looked at where you are and what are we gonna do, you know, to get to where we wanna be. Then we try to you know, you wanna follow-up. You wanna follow these people up three or four months, see where we're at, what do we need to change, what's not working, what is working.


And then we get into more details, you know, specific things we might can improve on. And then if we need to, sometimes, if we're dealing with somebody that's diabetic, we may need to incorporate a diabetic nutritionist to work with them, you know, very specifically on diets, how to read labels. Some of them will even go shopping with the patient, just, you know, go their details of what we should be eating, how to, you know, how to look at at least, and how to convert, you know, what sugars to eat, how much.


So we just have to go by each person, you know, and and try to figure out for them. So but you have to start somewhere, and it's never a good lesson.


You know, there's there's studies now they're doing on people eighty five and older. And if they can get people to exercise, it increases their lifespan even after that age and their overall well-being after that age, less fall and less injuries and fracture even in people over eighty five years old.


So there's you know, I'd say it's never too late to, you know, do something.


Yep.


And I love that you mentioned that because we we I think we preach that almost every single webinar with Alright.


We don't wanna take well, we don't wanna retire when we're sixty five and say, okay. That's it. I'm sitting here.


Right.


Towards in three days. Right.


Well, I mean, we could we could literally go, hours on this topic. Unfortunately, we're whittled down to the one hour. We've got a little less than ten minutes left, and we do want to, open this up for questions for our audience if they have any. It's a great opportunity, to ask your question to Suzanne and to, doctor Randy Kronick.


We do have one question that I will, throw out to both of you. It's from anonymous. If PSA this is going back to prostate health. If PSA is high and no focal mass is detected on MRI, what type of follow-up is required?


Okay. In my opinion, now all medical opinions are not exactly the same. You might get ten opinions if you talk to ten doctors. Right? My opinion would be a couple of things. One is the patient's age, the previous PSA levels, basically. Is this you know, is it a little high, but is it about what it has been, or is it three times higher than what it was?


I would normally, at that point, either repeat the test in three months. And there are some advanced PSA testing that will show you what the free PSA percentage is. It's just a little more detailed test.


That's typically done when the PSA is between four and ten, which four is the upper limits of normal. So if somebody has got four to ten, when I usually repeat the test, I would do a free PSA. That gives you not only again is the trend still going up and is the free PSA lower than what it should be, And that tells you then the person's risk of having cancer. Do they have a five percent risk or a seventy percent risk?


So that would be a person. So say if we get a note in three months and it was twice as high again as it was then, even if something's not seen on the MRI, those are patients that probably should still have biopsy done. And the way those are done, usually, the prostate's kind of sectioned off into twelve zones, and they take a biopsy of twelve spots. So you kinda don't miss any areas, you know, of the prostate. If there's not a specific, you know, anatomical site we have seen, you know, that looks like it could be a treat.


So that's usually how that would be approached, because even in aggressive prostate tumors, they still don't grow very fast. So if the prostate's just a little higher than it had been, usually, first thing is to reject it. Sometimes you can get a very low grade prostatitis, which is a little bit of infection in the prostate. And I have seen a lot of urologists, especially if somebody's prostate has been normal and it comes back really high, a lot of pro a lot of urologists will treat them with antibiotics and then repeat it just to see. Because if you have some infection in the prostate, it can really increase the PSA, you know, like, really high. And so that would tell you right away once it's treated, if it just goes right back down, then we're not dealing with it, you know, profit.


It's a great answer. I hope that that answers your question anonymous. And I I think we had an audience member, Reginald, that was raising his hand. Reginald, if you wanna get a question in for the doctors, here today, go to your q and a button down at the bottom of your screen and type your questions out there.


All, video and audio has been muted for our guests. So, that is the way that we can interact with each other here today. One more thing is we're kinda winding down with the webinar here, and you hear it all the time. I'm not a man, but, Randy, I know you can answer this.


It seems it's it's pretty difficult to get most men to go to the doctor unless there's a little prodding or pushing from a spouse or family members. What Or threatening.


What is the what is the advice, Because you we can't we can't help you if you show up.


Right? So what is the advice that you give to your male patients in order to get them to come in on a somewhat regular basis to catch some of these issues early?


Well, I'm kinda laughing because I am a male, and I have a wife. So And I am a wife, and I know what I have to do.


I'm not yeah. You know, now we're trying to make it a little bit easier for people. You know, it it it it it once a year you know, it may be an hour of time. It's not that much to it.


Ninety eight percent of the information we get is basically from your history and the blood test we get. You know, that way we can tell what something might be going on here or or it looks like you're fine. If you're not having any symptoms of any problems, your history's pretty clean, your labs look good. It's not a big, there's not a lot of poking and prodding and and pain involved other than getting the blood drawn, you know, with the needle. So that's about it.


Can I ask a quick question? Because I know there was, a digital exam involved. Is there still or is that kind of gone by the way, Simon?


It that's still in the official recommendations from fifty years ago.


That in you know, that was was really before there was PSA testing. You're you were trying to tell if there's a tumor. Well, you're not if you find something that's a tumor, that's not a good time to find it. BSAs are gonna find things that are microscopic.


I now, you know, again, ten doctors, ten different reasons. I don't usually do them routinely unless there's symptoms or a problem for screening.


Because I don't see the advantage. I did probably hundreds of thousands in the last thirty one years.


I never felt the nodule that where there was no symptoms.


So I can't say that that's accurate enough to, put somebody through.


You know, if there's a reason or, like, to say symptom or there's a, you know, increase in PSA or, you know, reason to do that. And usually, when most tests are needed or MRI, you know, I always have people go to a urologist. That's their specialty.


And they generally, you know, take care of that. And, like, saying in the MRI, you're gonna detect tumor within the prostate that you couldn't feel any, what, external.


So that's my opinion. That certainly would be debated by many doctors.


I I think that's the trend now, and I say this because I think a lot of men are hesitant to come in because they have that lumenoid. Yeah.


I do not you're right. Last thing I wanted a man not to come in, but don't be worried about that. So I wouldn't worry about it.


Yeah. See, this is why we have these webinars so that we can do things like this.


And we've had They've got their own thing today.


Yeah. Harvey said that's a good question, and, we wanna get to Reginald's question before we wrap up here today. I know he's been trying to get this in. So, Reginald says, I'm sixty five, in great health, a plant based eater. I walk and work out. Good job, Reginald.


Good.


I get my prostate checked annually. Yay. Wow. Reginald. Herbal tea, diuretics, burdock, chamomile, dandelion. So I, urinate a lot. Should I be worried?


Probably not if you're getting your yearly, you know, BSA and exams.


If they're not seeing any, you know, problems there.


If it's frequent urination, but the screen is still, you know, strong. There's no, what we call, hesitancy, which means that, oh, my bladder is full, but I'm standing here, you know, twenty seconds before I can start the stream.


That hesitancy and then the slow strain, I would be much more worried about than just the frequency of urination, especially if you're drinking a lot. I mean, which is good, you know, and you're on if you're on a diuretic, obviously, too. That might have an effect.


The other thing that as long as you're not losing significant sleep at night, getting up every hour or two, That would be an issue that would be more important as well. Just during the day, I, you know, I wouldn't learn that one.


Yep.


Reginald, we hope that that answers your question. It was a great question, and we really, really appreciate you gentlemen being a part of our conversation for this webinar today. It was all for you.


So we thank you for being here. We thank you for watching, and, and we certainly thank, you, Suzanne Price, and you, doctor Randy Kronick, for being a part of the conversation for our audience here today and and sort of a beacon for those who who may have questions and maybe were too afraid to ask. And, we hope that everybody was able to take a little bit of something away from this webinar, as we enter and are crystal currently in this September prostate cancer awareness. So thank you both so much for being here today and for sharing all of your knowledge with our guests.


Thank you.


Oh, you're welcome. Thank you very much.


Yeah.


And and like I said, we could have gone on for hours about this week.


Lot to do.


But we barely even touched mental health, so we hope that both of you come back so that we can have that back. Discussion.


Right. Very cool.


Thank you.


Alright. Well understand.


Yes. We could like I said, we could go on forever, but, we do have our shortened time. However, for those of you who enjoyed this webinar and you're looking for more information about senior living, you can head on over to our website. It is w w w dot senior living live dot com. There, you can find videos all about senior living geared just for you. And the best part, they are available twenty four seven, and they are all free and on demand.


We thank you all so much every day, for being a part of Senior Living LIVE in some way, shape, or form. We hope you have a great day, everybody.