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.


    • Medicine
    • 4.7 • 28 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.

    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

    • 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 pro

    • 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 wel

    • 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 vacc

    • 20 min
    PSMA Imaging Detects Prostate Cancer Spread

    PSMA Imaging Detects Prostate Cancer Spread

    Correctly assessing prostate cancer’s spread is essential for staging and treatment options. Until now, scanning technology has lacked both clarity and specificity, leaving treatment recommendations to partial information and guesswork. The new PSMA PET scan changes this. This episode of PROSTATE PROS explores the benefits of the PSMA PET scan and how it can be used to make intelligent treatment decisions. READ MORE ABOUT ON OUR PROS BLOG.

    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] Prostate cancer imaging has improved tremendously over the last decade. Advanced imaging means safer screening, more accurate staging, monitoring, and targeting. 

    Dr. Scholz:      [00:29] Liz, I’m glad we’re going to address this new area of prostate cancer imaging because there’s one scan in particular called PSMA PET scan, which is revolutionizing the field. 

    Liz:      [00:42] So PSMA stands for prostate specific membrane antigen.  This is a scan that I hear you talk about all of the time in the office.  Can you tell us what it does? 

    Dr. Scholz:      [00:55] Whenever we’re talking about scans we’re always trying to answer the $64,000 question: Where is the cancer?  The scary thing about cancer is it can spread and with prostate cancer, of course, ideally we want the cancer to stay confined inside the prostate gland.  Historically, we’ve had a variety of scans to look throughout the body, MRI scans, bone scans.  The problem has been that these scans are nonspecific, they can light up with injuries and other cancers and all kinds of confusing things. And they’re not really that accurate so they can miss cancers outside the prostate, even when they’re there. 

    Liz:      [01:37] PSMA only shows where the prostate cancer is located in the body. 

    Dr. Scholz:      [01:43] That’s right.  And let’s reiterate, of course, that prostate cancer that spreads to a lymph node or to the bones doesn’t become bone or lymph node cancer, it’s still prostate cancer. And the PSMA signature stays intact, even if it gets into another part of the body.  So if a spot lights up on the scan, this new PSMA PET scan that we’re talking about, it means there’s some prostate cancer there. 

    Liz:      [02:09] I’d imagine this is really important for staging.  Right now you are using a lot of different ways to predict if the cancer has spread, but with this PSMA scan, you’ll know for sure. 

    Dr. Scholz:      [02:22] That’s very well stated.  The historical use of Gleason Score was to try and predict the likelihood of something being outside the prostate or how high the PSA is.  High PSAs were statistically more likely.  This scan is so much more accurate than anything we’ve had.  Now, if the scan is negative, it doesn’t entirely prove there’s no cancer outside the prostate, but it gives us a lot more confidence that the cancer is still confined inside the gland.

    Liz:      [02:50] The scan seems pretty revolutionary, is everybody getting this?

    Dr. Scholz:      [02:55] PSMA PET scans are available in a number of research centers, university centers around the country right now.  And they are usually associated with some sort of a financial charge, but the information is so valuable, the money is usually dollars well spent. 


    • 14 min
    Time to Address Testosterone

    Time to Address Testosterone

    Testosterone naturally decreases with age. This can mean loss of libido, fatigue, and decrease in muscle. So why are you waiting for your doctor to talk to you about your low testosterone? What solutions are you missing out on?

    Testosterone replacement therapy can help reverse side effects of low testosterone and improve quality of life. This episode of PROSTATE PROS covers how testosterone replacement therapy can be used for aging men, men with chronically suppressed testosterone after TIP, men with advanced prostate cancer, and even spouses.

    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:  [00:20] Testosterone is the primary male hormone.  As men age testosterone naturally decreases.  Low testosterone can mean loss of libido, fatigue, or muscle loss.  This episode we’re going to talk about testosterone replacement for aging men and men with prostate cancer. 

    Dr. Scholz:  [00:39] So this is a controversial thought.  Men with prostate cancer often are treated with testosterone blockade.  There are situations though to consider giving testosterone.  We’re going to briefly cover three broad categories: aging men, as Liz mentioned, category number two will be men that have had previous TIP or testosterone inactivating pharmaceuticals and their testosterone just isn’t recovering normally, and then the third situation is in very advanced prostate cancer.  There are controversial new treatments to administer high-dose testosterone as a form of therapy to control prostate cancer. 

    Liz:  [01:22] There are a lot of appeals of testosterone replacement.  One being that it can help return your libido, two, it provides energy, three, it assists in muscle gain, and four, it can improve your mood. 

    Dr. Scholz:  [01:35] One of the things to realize about testosterone is that the blood tests give you an accurate number, but they don’t necessarily tell you how you’re going to feel.   Throughout the years I’ve seen how some men have rather low testosterone, but feel perfectly fine.  Other men may have somewhat or mildly diminished testosterone, but really feel poorly.  So, one of the things to know in this whole realm of giving testosterone is that the lab numbers, the amount of testosterone in the blood, is not the most important thing—it’s how men feel—because giving testosterone is designed to restore a better quality of life, provide energy, improve libido.  If men are already feeling well, you really can’t improve on that. 

    Liz:  [02:22] Is testosterone something that’s tested annually or do men have to ask what their testosterone levels are?

    Dr. Scholz:  [02:29] Oftentimes this is something that gets overlooked.  Of course, physicians tend to think that as men get older, their testosterone levels are going to drop and that even if they are somewhat low, that’s just part of life.  So I think it’s a good question to put to your physician is “is my testosterone normal?”  This is particularly relevant for men that are over age 60.  If testosterone levels are running low, there are situations where men are going to feel better if they take some supplemental testosterone. 

    Liz:  [03:00] So Dr. Scholz, if you have an older man who has no known prostate cancer, and he goes to the doctor and asks about testosterone replacement, will the doctor say, “there’s no way, that’s going to cause prostate cancer?” 

    Dr. Scholz:  [03:15] You may get that kind of an answer.  This thinking is rooted in the fact that many people are aware of the fact that whe

    • 20 min

Customer Reviews

4.7 out of 5
28 Ratings

28 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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