Al Roker has Prostate Cancer! Dr. Ahdoot Explains Treatment and Early Diagnosis.

Al Roker has Prostate Cancer! Dr. Ahdoot Explains Treatment and Early Diagnosis.
Dr. Michael Ahdoot MD talks about what this diagnosis means, how to screen for prostate cancer and what you can do to screen yourself. Al Roker was recently diagnosed with prostate cancer. We will discuss his diagnosis, what it means and what you can learn from it.
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Our goal at Cancer Better is to provide people with the best possible information to help them make the right health decisions. When it comes to big decisions like cancer treatment, you should know the facts so you can be in control of your health.
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To learn more about Dr. Ahdoot go to: www.michaelahdootmd.com/
Dr. Michael Ahdoot is a urologic oncologist specializing in the care of prostate, bladder, and kidney cancers.
Disclaimer: The topics discussed in this video are for educational purposes only and should not be used to make medical decisions. Every individual has unique circumstances which will influence their medical care and the application of scientific literature should be interpreted within the context of your general health. Please consult a physician before making any clinical decisions.

[@sherylrobinson-collins484]

Dr Adhoot performed surgery on my husband after Jim was diagnosed with prostate cancer and he did a phenomenal job both technically, and from a patient care perspective. Jim had three malignant tumors in his prostate and together with Dr. Ahdoot decided on the prostectomy and one week after surgery Jim had full sexual function. Highly recommend Dr. Ahdoot - fantastic surgeon.

[@cancerbetter]

Very kind of you! Thank you for the comment. Nothing makes me happier than seeing my patients do well. - Michael Ahdoot MD

[@cancerbetter]

I’ll make a video soon about the new prostatectomy surgical techniques that result in superior outcomes

[@user-bk2xm2nx6t]

Thanks again for all of the helpful information in an understandable format. It was most appreciated.

[@jimjohngirard]

I just had my prostate biopsy. The MRI found an area of concern as a PIRADS4, "Clinically Significant Disease Likely". The Urologist performed the biopsy using the MRI data and fusing with the Ultrasound probe with the Phillips UroNav System. He took 3 targeted cores from the lesion site and 12 systematic cores. 5 days later, I was told I had cancer....but not where the MRI saw the PIRADS 4, but in the right apex where the MRI missed it all together but picked up by the systematic sampling. The Gleason score is 3+4=7, with a PSA of 3.3 and the nodule is very small, 3mm x 6mm. The Urologist didn't offer surgery, but recommended external beam therapy. I'll meet with the Radiologist to discuss next steps. To me, this stuff is like alchemy....imprecise and a myriad of scenarios. I'm 72 yrs old and asked the Urologist if this was a death sentence and he said absolutely not. Anyway, what this told me is that it is vitally important in the biopsy to use the MRI Data, but the 12 core systematic sampling is still relevant and efficacious. I hope he's right it not effecting my life span....in my family, the shelf life is around 90-95 years old.... hope I make it. I love your videos and thank you so much for your knowledge, wisdom and experience.

[@chrisconnors5911]

Doctor, a big thank you to you for taking the time to produce this content. I’m based in the UK starting my journey of high PSA levels, biopsies etc so your well informed videos are very much appreciated. Chris

[@raymonddavis5271]

Great job!!!

[@georgefitzhugh6455]

Thank you for your information. Subbed! I’be just been diagnosed with prostate cancer through a biopsy. Just starting to research my options.

[@georgerios7491]

Thanks 😊 doc u Rock God bless keep up the great 😊 work

[@berg6964]

Love your Videos ! Thank you

[@cancerbetter]

It's a passion project. I'm glad I can share my knowledge to help people find high quality medical care.

[@wilson4328]

I just got symptoms at age 59. My Gleason score is 6 and 7. The cancer is contained in the prostate so my chances at curing it are pretty damn good doc.

[@cancerbetter]

Absolutely

[@CaptAdam500]

As a PC patient, this is well described and explained.

[@curiousk9603]

Dr. Ahdoot may have improved this video if he knew that the FDA would approve the PSMA PET-CT scan 12-1-2020. I had the scan on 11-13-2020, which led to 3 high dose (800 cgrays) treatments of 1" diameter tumor on left pelvic bone in 1/2021. Future PSA tests may reveal that I have gone from stage 4 to stage 0 prostate cancer. A PSMA PET-CT scan early, may lead a man to avoid a biopsy and prostate surgery and choose Brachytherapy instead. The future availability of PSMA PET-CT scans should cause major cancer organizations to push for widespread PSA testing.

[@cancerbetter]

@@curiousk9603 @CuriousK The approval of PSMA pet scans is really exciting and something many of us have been anticipating for years. There is no doubt when it comes to looking for evidence of metastasis PSMA PET way out performs the traditional tests of CT scan plus bone scan. PSMA PET + MRI is an exciting possibly for the future to improve imaging even more. @CuriousK, congrats on the great outcome!

[@toppie5700]

welcome to the club

[@craftsmanctfl3493]

I don’t know what the accepted protocol is, but I was under general anesthesia for a 14-core prostate biopsy and it was, of course, painless. I didn’t have any pain in the days after the biopsy, but it took 3-4 days for my urine to be free of some small amount of blood. I believe the antibiotic I was on (cipro) contributed to some constipation for a few days.

[@cancerbetter]

Typically biopsies are performed in clinic with local anesthesia. For a transrectal biopsy blood in the urine, stool, and ejaculate are common and usually resolve within 2 weeks. For transperineal biopsy there is no risk of rectal bleeding.

[@b8kersfield]

Thank you Dr. Ahdoot. All your videos have been a huge help towards my final decision, whenever that will be. I am turning 69 in July and four months ago was diagnosed with prostate cancer. My Gleason is 3+4, PSA 11, cancer contained in 1 (out of 12) core, with no perineural invasion (they hope-the biopsy was performed with an ultrasound only). - I am wondering why my PSA is 11 when only 1 out of 12 cores contains the cancer. Could it be that other cores have cancer, but were not detected because I had an ultrasound ONLY biopsy? - Being 69 I am leaning towards radiotherapy, but I am in good physical health, so am wonder if I should go the surgical route. Any comment? - Also, and would you recommend a PET scan along with an MRI before any final decision? Oh, I tried to donate on your website but it had a hiccup. Though I am old I am computer savvy. I think it is on your end. You might need to update some plug-ins on the site. Again, thank you so much for your work.

[@cancerbetter]

Interesting situation. You sound like you might be a potentially good candidate for focal therapy. This is where the doctor burns the segment of your prostate with the cancer in it. The segment with cancer can be burned using focused ultrasound, such as HIFU, a laser, etc. The risks of erection loss with these treatments are lower than surgery or radiation but the risk of cancer recurrence in the prostate is higher at about 30% on average. There are a lot of reputable people doing this treatment but also some less reputable people. In order to be a good candidate the area of cancer found on biopsy would have to correlate with an abnormality on the MRI to allow for targeting. I am not sure where you are located but her are a few doctors who do reputable work in this space beside my self. Mark Emberton - London England Bruno Nahar - University of Miami Art Rastinehad - Lenox Hill, NY Myself - Michael Ahdoot or my college Tim Daskovich - Cedars Sinai Arvin George - University of Michigan This is by no means a complete list but I know these individuals have extensive experience with the technology. I hope this helps. As always I can not comment about the specifics of a person's care without a complete history. The goal is to help people get access to modern care bc unfortunately that does not always happen. (I'll get the website donate function fixed. Thanks for the heads up)

[@b8kersfield]

Thank you for responding Dr. Ahdoot. I thought you and your followers might be interested in my appointment on Friday April 8th, 2022 with Dr Sukin at Texas Urology in Houston. He has done over 600 robotical prostindectomies and over 1000 robotic surgeries total. He said I needed to get an MRI before he could advise the best way to go. What he did say about my biopsy report was that a Tulsa Procedure might be the best way to go. I asked him how many he has done. He said "None, but the first will be today"-the first in Houston. What is your thoughts and cautions (outside of the fast that it only three years new) on the Tulsa Procedure? Will Cedars-Sinai be offering it soon? I have an appointment at the end of the month with MD Anderson-they do not perform the procedure yet. Also, do you have any Urologist or Radiotherapist in the Houston area you can recommend? I retired to Houston from California 2.5 years ago to be near two daughters and 7 of 10 grandkids. If I cannot find someone I am comfortable with here I just might come back to California and bug you!

[@b8kersfield]

@@cancerbetter Yes, I forgot to mention that I live in Houston. For a second opinion I met with a Dr Sukin with Texas Urology last Friday, April 8th. He was in a rush to perform the first Tulsa Procedure in Houston, and he was pretty hyped-up for me to consider it. At over 1000 robotic surgeries under his belt and 600 of them Prostindectomies I feel that I would be in good hands if I go that route. But what are your about the advent of the Tulsa Procedure? Has any of you on this blog got one? As always, and input is helpful.

[@cancerbetter]

​@@b8kersfield Focal TULSA is rather new and there is limited data on its use so its unknown how successful the treatment would be to cure the cancer and the side effect profile. As of now, focal prostate ablation with TULSA should be done as part of a clinical trail in my opinion. In general focal therapy risks incomplete cancer treatment in about 15-40% of people across many studies. In general if there is a large cash cost associated with a given treatment this may incentivized its use before there is substantial data supporting it. Try to make sure you understand the possible risk and benefits of TULSA before you go down that path. While there is limited data looking at focal TULSA, there are numerous studies looking at whole gland TULSA which can provide information about safety and side effects. I wrote the first clinical trial on focal TULSA at the NIH before I left (clinicaltrials.gov/ct2/show/NCT04808427) but it does seem to be recruiting yet. TULSA seems promising but the data just is not adequate to say yet.

[@b8kersfield]

@@cancerbetter Thanks for your input. I meet with MD Anderson next week. I am leaning toward SBRT, Proton therapy or Brachytherapy-in that order. Oh, and I have tried three times to donate on your website with no success. I will get my wife involved next time. She is the online payment guru.

[@josephblack9779]

Dr. Ahdoot, thank you for your information - it is very helpful. My biopsy, which results I just received yesterday, has detected 7 areas of concern ranging from grades 1- 4 (the majority being 1s and 3s, and one 4). My next step per may urologist is a CTscan and bone scan. Can you speak generally to the need for "urgency" relative to treatment based readings of this nature?

[@cancerbetter]

Generally, prostate cancer is slow to spread. Often cancers detected by the use of PSA are found years before they spread so delaying surgery for a several months does not significantly increase the risk of metastasis before surgery. This has been found in clinical trials even in men with the highest risk prostate cancers. Here is a reference if you wanted to read the study abstract: pubmed-ncbi-nlm-nih-gov.ezproxy.nihlibrary.nih.gov/33289846/ So in summary, unlike some other cancers its ok to take a few months of time in the treatment of prostate cancer. Get those 2nd opinions if you feel you need one and make sure you are getting the treatment that is right for you. The fact that you found my little channel makes me feel you are already on the way to finding quality info. (We both know there is a lot of non-evidence based junk out there!) Hope this helps. - Michael Ahdoot MD

[@josephblack9779]

@@cancerbetter THANK YOU!!

[@WW-bf8sz]

How does ExoDx score relate to Gleason Score?

[@cancerbetter]

ExoDx is a urine test that attempts to predict the presence of dangerous prostate cancer. It’s a complicated topic but the short version is an MRI is better for prostate cancer risk assessment, diagnosis and biopsy.

[@richbrown6747]

I have noticed that in the videos viewed you do not refernce men over 80 yrs of age. Could you advise if MRI shows a lesion should it be biopsied?

[@cancerbetter]

Usually if a person has a life expectancy of less than 5 years biopsy is not warranted. If 5-10 years it’s worth a discussion with your urologist.

[@cactusstudiossouth]

My PSA Level went from 4.5 to 5.7 in the last year! My doctor immediately felt a nodual upon the rectal exam and scheduled the Prostate biopsy which was the most painful thing I've ever been through my life! Prostate biopsy showed 6 out of 12 points Cancers so push that rectal exam, tough it out through that biopsy and then go get a Radical Robotical Prostindectomy! Then you finally be able to pee again!

[@jimjohngirard]

I just had a TRUS / MRI fusion biopsy and it was totally painless. The nurse applied lidocaine gel to my rectum and then the urologist gently inserted the probe and injected numbing lidocaine. I had 12 cores systematic and 3 core samples in a MRI identified lesion. Painless....I'd fire your Urologist as this procedure can be done humanly and quickly. Sorry for your experience.

[@cancerbetter]

This is the typical experience for my patients as well. Most people have no pain to mild pain after local anesthesia is used.

[@lindamastropietro4429]

Would you say Gleason score of 3+4 = 7 that surgery should be done?

[@cancerbetter]

All depends on life expectancy. I have a whole video about what happens if you don’t treat prostate cancer. I’d recommend you check that out

[@mauriciobantuspirit3629]

PLEASE TALK ABOUT THE EFFECTS OF TAKING (ABIRATERONE 1000MG) I DID NOT ENDORSE RADIATION OR SURGERY VERY INVASIVE. SO FAR MY PSA LEVELS ARE UNDER CONTROL. YES IT DOES HAVE SIDE EFFECTS, SUCH AS BLOATING, AND ERECTILE DYSFUNCTION HOWEVER THE PSA LEVELS ARE UNDER CONTROL AND IAM DOING FINE.

[@cancerbetter]

A video about abiraterone and all the second generation anti-androgens would be a great idea. I likely will do a video on these. Abiraterone as a primary treatment for cancer that has not spread is a uncommon treatment choice as it requires ongoing treatment for life or until it stops working. Surgery, however, if successful offers an opportunity to be one and done. This is why treatments like surgery and radiation are chosen as primary treatments for prostate cancer.

[@treemands]

So a physical and I had a high psa. I then had a biopsy. I then had my prostate removed. I just wondered wouldn't the doctor let you know that "yes we found a very cancerous organ" or "it was not quite as bad as thought and maybe in retrospect radiation treatments would have worked".? I am 72, had the operation 2 1/2 months ago and the incontinence is very impacting on my life as is likely the inability to ever have sex with my wife again.

[@wilson4328]

Hang in their brother, I know this sucks but you can satisfy her other ways.

[@treemands]

@@wilson4328 I do Wilson.

[@cancerbetter]

Give it time. Continence can improve for months after surgery and erections can take up to 18 months to return. If the incontinence don't return you been get an artificial urinary sphincter or if you loose erections you can try penile injections or implants. Speak with your urologist to learn what is out there. It might take intervention but your function CAN be restored.

[@pg9144]

PLEASE! Slow down. Ypu know your stuff and are excited about it, but the rest of us NEED TO KNOW. I almost feel like I'm listening to a car salesman.

[@mikeahdoot]

Will definitely slow it down!!! More videos to come. Just getting settled after accepting a new position in Los Angeles.

[@johnmcauliffe9281]

Geez, when I was diagnosed with prostate cancer nobody announced it to the world ! Wtf

[@terrellwilliams5829]

I wish my brothers would have shared their diagnosis with me. Hell, I didn't know until Insaw one ringing a bell on FB. I would have got screened sooner, but its almost 21 year age difference between us.