10 episodes

Prostate cancer is complex. Patients often struggle to find accurate, stage-specific information. Listen as prostate specialist and author, Mark Scholz, MD guides you through the 15 stages of prostate cancer, recent updates, and all possible treatment options. Avoid prostate cancer pitfalls and take control of your diagnosis with the PROSTATE PROS podcast.


    • Health & Fitness
    • 4.8 • 34 Ratings

Prostate cancer is complex. Patients often struggle to find accurate, stage-specific information. Listen as prostate specialist and author, Mark Scholz, MD guides you through the 15 stages of prostate cancer, recent updates, and all possible treatment options. Avoid prostate cancer pitfalls and take control of your diagnosis with the PROSTATE PROS podcast.

    That's a Wrap

    That's a Wrap

    PROSTATE PROS Series Finale

    On the last episode of the PROSTATE PROS podcast, Dr. Scholz and Liz recap important themes and talk about what’s new in prostate cancer, including Lutetium-177 and Orgovyx.

    Dr. Scholz:  [00:03] We’re guiding you to treatment success and avoiding prostate cancer pitfalls.  I'm your host, Dr. Mark Scholz. 

    Liz:  [00:09] And I'm your cohost, Liz Graves. 

    Dr. Scholz:  [00:13] Welcome to the PROSTATE PROS podcast. 

    Liz:  [00:15] We have a bit of a sad announcement to make, as this will be the last episode of the PROSTATE PROS podcast.  Dr. Scholz and I have really enjoyed working on this project and we've covered so many important topics surrounding prostate cancer and men's health.  So for this last episode, we're going to recap some important themes and talk about some promising new therapies.  So Dr. Scholz, on our very first episode, we talked about how important it is to find the right treatment team.  This is something that's come up again and again and again.  What are some tips you have for newly diagnosed men trying to find their doctors? 

    Dr. Scholz:  [00:53] I think what's confusing is how much of the responsibility falls on the shoulders of patients.  The prostate industry is a very powerful multi-billion dollar industry, and there is a lot happening really fast.  When patients are diagnosed, they're not in a thoughtful perspective, they're in an action mode, they're frightened.  It is hard to sort out who to listen to and who to stay away from. This process can be aided by family members, primary care doctors, oncologists, and of course, online resources and books.  I try to provide some of that information in the book, The Key to Prostate Cancer, but the process, if it was easy, we could give you one simple answer.  It is not a simple process. 

    Liz:  [01:46] One thing that we've talked about is to get a quarterback.  So this is a doctor that isn't the treating doctor necessarily, but it’s someone that will oversee the treatment and work with the other teams of doctors.  This is something I hear you doing Dr. Scholz, you're always talking to other doctors about patients and kind of networking with them to make sure that the patient is getting the best care, even when they're not in our office. 

    Dr. Scholz:  [02:12] I think the issue that you're relating to is that many of these physicians have a conflict of interest.  You're asking them, what should I do?  But they're a surgeon or they're a radiation doctor.  And as a medical oncologist, I'm neither of the above.  This is somewhat uncommon, but you can recruit your urologist or your radiation doctor to help you by explaining at the outset that, “you, sir, will not be my treating doctor, but I definitely need your aid and your assistance in picking the right doctor.” 

    Liz:  [02:43] Now you may be thinking that you have cancer and you don't have time to see all these people, but as we've mentioned, prostate cancer is slow growing.  So really taking that time to find the right doctor for you is crucial. 

    Dr. Scholz:  [02:56] Just yesterday, I saw a very sophisticated new patient who was feeling the rush job, the sense that the clock is ticking, and he did have a Gleason 9.  We consider that the High-Risk category of prostate cancer.  But, the idea that you have to make a decision within days or weeks is never substantiated by the literature and the science.  Patients can take several months to sort out what they want to do.  This sort of careful thoughtful process pays off in the long-term with better results. 

    Liz:  [03:29] So patients really need to take it under their control.  One of the things is to educate themselves.  In the past couple of years, there's been a huge shift towards imaging. &nb

    • 15 min
    Friendly Reminder: Replace the Random Biopsies!

    Friendly Reminder: Replace the Random Biopsies!

    For decades the random 12-core biopsy has been the standard of care for diagnosing prostate cancer. What most men don’t know is that random biopsy can be dangerous and its results misleading. Fortunately, there are now better ways to interpret a high PSA that are less invasive, safer, and more accurate. The tragedy is many men don’t know this. One million men continue to get random biopsies each year despite having better options.

    This episode discusses the dangers of random biopsy and the best steps to take when facing an elevated PSA. If you’ve already been diagnosed with prostate cancer, share this episode with your friends and family! There are better, safer ways to interpret high PSA.

    Dr. Scholz:  [00:03] We’re guiding you to treatment success and avoiding prostate cancer pitfalls.  I'm your host, Dr. Mark Scholz.

    Liz:  [00:09] And I'm your cohost, Liz Graves.

    Dr. Scholz:  [00:13] Welcome to the PROSTATE PROS podcast.

    Liz:  [00:16] A lot of our listeners are men who already have prostate cancer.  This episode is for those people's friends who have a high PSA and are wondering what to do.  Do they get a random biopsy?  Is that dangerous?  Are there any alternatives? 

    Dr. Scholz:  [00:32] Yeah, Liz, I come across this all the time after I have a face-to-face meeting with one of our patients and we're helping them with their prostate cancer.  They mention “Oh, by the way, my friend Sam called me up and his PSA is running high, and his urologist wants to do a 12-core biopsy.  Can I run his case by you, Dr. Scholz?”  

    Liz:  [00:52] This episode, Dr. Scholz and I are going to talk through some easy points that you can share with men going through this, and we'll also post a flow chart on our blog, prostateoncology.com/blog.

    Dr. Scholz:  [01:06] One thing that really motivates us is the concern that too many men are getting random 12-core biopsies.  We've talked before about the wonderful advances in imaging for prostate imaging that have been developed over the last few years.  If 12-core biopsies were harmless, they certainly provide accurate, useful information, but they can cause complications.  Imaging is actually more accurate.  Unfortunately, the industry is sort of stuck in the past and 12-core biopsies are still being done with great frequency.  Hopefully we can give you some idea of when this may or may not be indicated. 

    Liz:  [01:47] Yeah, this is one of those things in prostate cancer, where there are better options, but men are really just hearing about random biopsy.  It's the option most people get.  Almost everyone knows someone who has had a random biopsy.  There are about a million of these done each year, so it's kind of public knowledge that when you get a PSA, you'll likely get a random biopsy. 

    Dr. Scholz:  [02:10] It's been this way for historical reasons.  The random biopsy was a big breakthrough in 1987.  It was approved the same year PSA came on the market.  So when the PSA was high, everyone would get a 12-core, round-the-clock, needle sticking in their prostate.  Really there was no other alternative because imaging for so many years, really wasn't adequate to see prostate cancer inside the prostate. 

    Liz:  [02:38] When you're comparing this to a different type of cancer, let's say liver cancer, they're not just taking random samples of the liver.   Are they expecting that there'll be imaging?  And why is the prostate something that's handled so differently? 

    Dr. Scholz:  [02:54] I think it's because historically the cancers that come from the prostate, aren't very malignant, thank God, and they tend to have a similar background appearance to the prostate gland itself.  So, very specialized techniques had to be developed for the cancers to light up to an adequate degr

    • 16 min
    The Brief on PSA

    The Brief on PSA

    PSA (prostate-specific antigen) is essential for prostate cancer screening and monitoring. This episode explores the PSA controversy, explains why annual PSA screening is crucial, and talks about the importance of PSA testing for monitoring prostate cancer treatment. Understand the benefits and drawbacks of PSA, and use this incredible tool to your advantage.

    Dr. Scholz:  [00:03] We’re guiding you to treatment success and avoiding prostate cancer pitfalls.  I'm your host, Dr. Mark Scholz. 

    Liz:  [00:10] And I’m your cohost, Liz Graves.

    Dr. Scholz:  [00:13] Welcome to the PROSTATE PROS podcast.

    Al Roker:  [00:16] I've been feeling great, but my doctor discovered I had an elevated PSA level in my blood work, PSA standing for prostate-specific antigen.  It's the first line of defense when detecting possible prostate cancer.

    Dr. John Torres:  [00:32] Today, an influential medical task force is changing those screening guidelines.  Now, urging all men ages fifty-five to sixty-nine to talk to their doctor about getting a PSA test.  Men ages seventy and older should not get screened.

    Dr. Kirsten Bibbins-Domingo:  [00:46] This should really be a personal choice that a man makes together with his doctor, and the goal of these conversations is really to understand benefits and harms.

    Dr. John Torres:  [00:57] Previously experts… 

    Liz:  [00:58] There's a lot of confusion and hesitation surrounding PSA screening.  What are the proper steps?  What do you do if the PSA test does come back abnormal?  This episode, Dr. Scholz and I are going to talk about the importance of PSA testing, what a high PSA actually means, and what the best steps to take are to further investigate.

    Dr. Scholz:  [01:21] The PSA blood test has been around since 1987, about the time my career started it up.  I can't tell you how revolutionary this blood test has been.  Really, we don't have another blood test like this for other cancers.  In some ways, PSA makes prostate cancer a much easier cancer to treat.  In other ways, like any powerful tool, if it's misused, it can create confusion and problems.  I hope we'll be able to bring some clarity to why this blood test can be controversial. 

    Liz:  [01:57] Everyone knows that PSA tests for prostate cancer.  PSA stands for prostate-specific antigen.  And when this is screened annually in men, it is to look for prostate cancer, but that is not all that PSA does.

    Dr. Scholz:  [02:15] The problem with PSA as a screening tool and PSA is used for other things besides screening.  But, as a screening tool, men still have a prostate gland.  Typically if they have a small tumor in their prostate, the lion's share of the PSA is actually coming from the gland, the benign prostate, not the cancer.  This is where the confusion comes.  Men will have inflammation of their prostates, and the PSA will be high.  Men will have enlarged prostates, and their PSA will be high.  Or, of course, they could have a low-grade, or a more consequential cancer, and their PSA could be high.  One savvy patient once told me, tell your patients to think of the PSA as a check engine light on the dashboard of your car.  Something's going on in the prostate, it could be cancer, and it could be one of these other causes. 

    Liz:  [03:12] When a PSA comes back elevated, taking time to understand what that means is crucial.  PSA can be a great tool to tell people they have prostate cancer, but it also has all of these other possible complications.  In 2011, the US Task Force advised against PSA testing.  Why was this Dr. Scholz?

    Dr. Scholz:  [03:35] Small cancers that don't spread are the root difficulty we have.  There have been active discussions about renaming certain types of prostate cancer as something non-c

    • 11 min
    Do I Have Prostatitis?

    Do I Have Prostatitis?

    Prostatitis is inflammation of the prostate gland that can affect PSA and cause symptoms such as urinary frequency and urgency, fever, and pelvic pain. Prostatitis can be difficult to identify and hard to treat. This episode discusses diagnosing prostatitis, treating prostatitis, and how it can affect prostate cancer treatment decisions.

    Dr. Scholz:  [00:03] We’re guiding you to treatment success and avoiding prostate cancer pitfalls.  I'm your host, Dr. Mark Scholz.

    Liz:  [00:09] And I'm your cohost, Liz Graves. 

    Dr. Scholz:  [00:13] Welcome to the PROSTATE PROS podcast. 

    Liz:  [00:16] Prostatitis is inflammation of the prostate, which can have a huge negative impact on quality of life.  This episode, we're going to talk about diagnosing prostatitis, treating prostatitis, and how it can affect prostate cancer treatment decisions. 

    Dr. Scholz:  [00:31] The real reason this topic comes up is because PSA goes up in men that have inflammation in their prostate, which is what we're calling prostatitis.  There are many causes, we're going to go into that, but the confusing factor is that we're using PSA to diagnose prostate cancer, to monitor prostate cancer for treatment effect, and for relapse.  If inflammation in the prostate intervenes and causes the PSA to go up, everyone gets frightened about the possibility of prostate cancer being out of control.  So this podcast will cover trying to make a distinction between a high PSA from prostatitis and a high PSA from prostate cancer. 

    Liz:  [01:17] So prostatitis is inflammation of the prostate, and there can actually be no known cause of this, or it can be due to bacterial infection and it can also manifest in many different ways. 

    Dr. Scholz:  [01:31] There's so much confusion about what really is prostatitis.  It may be sort of an autoimmune phenomenon, the way people get asthma or eczema on their skin, some sort of over activity of the immune system, but it's quite common and it's often asymptomatic.  So that means that the PSA goes up, but men may not be feeling any urinary irritation.  At the other end of the spectrum, of course you have the people that have real discomfort and pain with urination and are getting up at night a lot.  When men have these symptoms, it doesn't necessarily mean that it is prostatitis, it could be a large prostate, it could be an irritable bladder, it could be a urinary tract infection, but prostatitis certainly is on the list of possibilities. 

    Liz:  [02:19] So you mentioned asymptomatic prostatitis, which still has an effect on PSA.  Can you distinguish a rise in PSA from prostatitis from a rise from prostate cancer? 

    Dr. Scholz:  [02:32] Actually, PSA is very nonspecific.  So when we see a PSA rise, we have to start doing all kinds of tests.  The most popular one in the community of course, is to do a prostate biopsy. Our policy has been to do MRI testing, and there are certain blood tests and urine tests like OPKO 4K and SelectMDx that can help sniff out whether prostate cancer is really the problem.  But many times, we are left with an ambiguous situation; an elevated PSA without a clear cause.  And that's when people start calling it prostatitis. 

    Liz:  [03:12] For people who do have symptoms, there are two or three different types. There's acute bacterial, chronic bacterial, and chronic prostatitis. 

    Dr. Scholz:  [03:23] Years past when this problem was encountered, the reflex reaction was just to give some antibiotics.  If the PSA would drop after a couple of weeks of antibiotics, then it must be prostatitis.  The problem with that is that the antibiotics have potential bad effects.  Secondly, they're not always effective because the many types of prostatitis are not bacterial.  Thirdly, the problem with prostatitis is it

    • 14 min
    Considering Prostate Cancer Clinical Trials

    Considering Prostate Cancer Clinical Trials

    Clinical trials are the basis of modern medicine.  Through a series of phases, clinical trials strive to find more effective treatments with fewer side effects.  For men with limited options, clinical trials can be a great way to access the newest treatments; however, choosing the right clinical trial can be difficult.  This episode discusses pros and cons of participation, how patients can benefit, and addresses some common concerns and misconceptions. 

    Dr. Scholz:      [00:03] We’re guiding you to treatment success and avoiding prostate cancer pitfalls.  I’m your host, Dr. Mark Scholz.   

    Liz:      [00:09] And I'm your cohost, Liz Graves. 

    Dr. Scholz:      [00:13] Welcome to the PROSTATE PROS podcast. 

    Liz:      [00:17] Clinical trials are the root basis for modern medicine and they're vital for the development of new treatments.  This episode, we're going to talk about pros and cons of clinical trials, who can benefit, which clinical trials to be most excited about.  We'll also address some concerns patients might have about participating. 

    Dr. Scholz:      [00:37] Yeah, I mean, clinical trials are how doctors decide what to do for patients.  But today we're going to talk more about how patients can extract a benefit from participating in a clinical trial.  Some medicines are only available on clinical trials, they’re not FDA approved yet and trying to make a determination if you, specifically, would benefit by being in a clinical trial, getting an investigational drug is what this podcast today is about. 

    Liz:      [01:05] So which type of patients in prostate cancer are looking for clinical trials? 

    Dr. Scholz:      [01:11] It's really important as has been emphasized many times in the past, that there are different types of prostate cancer.  We call them stages or five different stages of prostate cancer and clinical trials are usually being performed in people with advanced metastatic prostate cancer, more often the type of cancer that is not responding to traditional medicines. 

    Liz:      [01:34] So these are patients who have limited options left and clinical trials can allow them access to the newest treatments. 

    Dr. Scholz:      [01:42] Exactly.  The problem with doing clinical trials is that there are always disadvantages.  If there are other FDA approved medications that have been already shown to prolong life why wouldn't patients use those first, especially since they are typically covered by most types of insurance? 

    Liz:      [02:05] I think one concern people have is that clinical trials are either not covered by insurance or they're expensive.  Is this true? 

    Dr. Scholz:      [02:12] Actually no, most of the time, clinical trials will provide the medications free of charge.  I think the disadvantages of clinical trials are that they’re somewhat cumbersome, there's a lot of paperwork, and it's very formalized.  So people are treated in a very uniform fashion, there's less room for creativity and adjustment of doses and things like that.  There's a major inconvenience to clinical trials.  Then of course the way that the medicine is used or whether or not there is a potential for getting placebos, these things can also be a disadvantage for patients who are participating in clinical trials. 

    Liz:      [02:50] I think one other thing I was looking at clinicaltrials.gov to find the list of what's happening in prostate cancer.  A lot of the eligibility criteria is really strict, so I think that can be kind of a limiting factor as well. 

    Dr. Scholz:      [03:05] Yeah, that's a very g

    • 17 min
    Prostate Cancer Spotlights in 2020

    Prostate Cancer Spotlights in 2020

    This episode of PROSTATE PROS reviews and summarizes the year’s advancements in prostate cancer as well as looks forward to future updates. Beyond prostate cancer, the episode examines how COVID-19 has impacted the healthcare landscape and discusses news of the vaccine. Catch up on the latest and stay tuned for an exciting announcement.

    Liz:  [00:00] We have an exciting prostate cancer update.  Since recording this episode, the FDA recently approved the PSMA PET scan.  Keep that in mind when listening to the episode.  If you'd like further information, visit fda.gov.

    Dr. Scholz:  [00:18] We’re guiding you to treatment success and avoiding prostate cancer pitfalls.  I'm your host, Dr. Mark Scholz. 

    Liz:  [00:24] And I'm your cohost, Liz Graves.

    Dr. Scholz:  [00:28] Welcome to the PROSTATE PROS podcast.

    Liz:  [00:31] A lot has happened this year and we've covered many topics on the podcast.  This episode we wanted to highlight a couple of exciting advancements and talk about some updates. 

    Dr. Scholz:  [00:44] The elephant in the living room of course, is the COVID situation.  That's impacted the way we do business.  It's impacted our patients.  It's impacted all of you dramatically.  I thought I'd give a little update on what's happened in our over 2000 clients.  As you know, we serve a population of men between fifty and ninety plus our oldest patient just turned one hundred.  This is a high risk group.  Men are at higher risk for COVID complications and as we get older, particularly over 80, the complication rate goes up and the mortality rate goes up.  We've actually lost one patient to COVID in our whole practice in 2020.  It was an unfortunate individual that was traveling in Egypt in the January, February timeframe and when he came back to the United States he was ill.  This was before people were really clear of what was going on, went to the hospital with pneumonia, and unfortunately passed away.  We've had other patients, perhaps a dozen or so that have caught the COVID.  They're sort of evenly divided between men who really report that it wasn't much of anything at all and others, the other half, they got pretty darn sick, a really bad flu.  None of them fortunately had to go to the hospital. They all recovered.  This is rather remarkable considering our vulnerable demographic.  It shows that if people are careful and they isolate, they wash their hands, keep their hands off their face, most people aren't going to catch this.  Of course, when I talk to patients, I'm impressed by how much isolation is going on out there, how much care they are taking.  Many men have come to the office and said that I am the first out of the house experience that they've had in 2020.  So people are being very careful and clearly being careful does work. 

    Liz:  [02:49] Yeah.  I remember early on in the pandemic, our office had way less traffic and was almost empty.  Now it seems like things are picking back up and people are checking back in on their health. 

    Dr. Scholz:  [03:01] We've had a bunch of people come to the office who maybe had some cold symptoms, everyone's on edge, and we've tested them for the COVID antibody to see if they did indeed have previous exposure.  These tests are almost always coming back negative.  We're told by the scientists that these tests are probably 80% to 90% accurate.  They're not 100% accurate when you do the antibody test.  That's the test to determine if you've had previous exposure to COVID.  We believe, and some people disagree, that if you've had previous exposure and your antibody test is positive, that it's as if you've had a vaccination and you can't catch COVID and you can't transmit it.  That of course would be good news.  We've tested several hundred people now and almo

    • 20 min

Customer Reviews

4.8 out of 5
34 Ratings

34 Ratings

Buster83843 ,

A clear and well balanced reporting of prostate cancer care

Rule #1 for men with a new diagnosis of prostate cancer: Don’t panic. Rule #2: Do your homework. This podcast will help.

AE Hutch ,

A Hutchison

Dr Peck’s frank description of his experience with Prostate cancer endured at the same time he was providing medical care to others was very moving - I admire his courage and his willingness to share his vulnerabilities on this Podcast - a reminder to me to appreciate every day. Thank you.

Mr. Sumac ,

Dr. Scholz’s podcasts

This whole series is Excellent, and I’m so glad that the Dr. is branching into new media to spread his expertise. 👍 👍 👍

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