Prostate Cancer & Hydrocephalus

the start of your summer vacation. But also keep in mind what Memorial Day is all about, all of the men and women over the years that sacrificed their life for our freedom. We sometimes get a little bit wrapped up in the fun and the parties and the get togethers, but really we have to be very thankful for those that sacrifice to the families that sacrifice for those that lost a loved one in the defense of the United States, the greatest country in the world, and certainly this is

a health and wellness program. I would also say the greatest scientific minds in the world with regard to innovation, medical and scientific discovery, and patient care right here in the United States of America. So again, many thanks for tuning in on this weekend, and we're gonna have a lot of fun this upcoming hour with regard to health and wellness. And as I always like to say, we want to raise your health i Q. We want to make you better consumers, make you really understand the reason

to be proactive with your own health and wellness. We don't want to start thinking about our health when it's too late, when too many problems have developed and the reality is it's just too hard to recover after too much damage has been done. It is early intervention. But to intervene early you have to have the knowledge and understanding and appreciation. So to set the table. Here our website Doctor Joegalotti dot com d R J O E G A L A t I dot com is our

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out and be part of it. The big story in the news this past we has to do with President Biden and his newly discovered prostate cancer diagnosis, and all of the talking heads are rendering their opinion ranging from it is a government conspiracy that they knew yet prostate cancer and didn't say anything all the way through. This was medical negligence for the most important, the most well known, the most famous gentleman, the most famous person in the

world is not getting adequate medical care. And so, depending on what camp you want to follow or believe, you have a whole set of things to think about. But let me let me sort of back up and give you my spin. Now, as many of you know, I am a hepatologist. I am a liver doctor taking care of patients to livid disease. But you're involved in the care of patients, and I have some opinion on this.

So the whole topic of discussion with regard to prostate cancer over the past fifteen to twenty years has gone through a number of different iterations, and there are different opinions that have been put forward by the various medical societies based on what I would say is rigorous thoughtfulness and scientific explanation. So these are not just a bunch of people that are sitting in a smoke filled room to say let's do this or that with regard to screening.

And you could apply this to that, go for mammograms or screening for colon cancer, which I'll comment in a second. But anyway, so if you look at the American Cancer Society, we're just going to start there, and I'd like to think that the American Cancer Society is right down the middle. They're not too controversial on either side there. It's going

to be a good reference point. So first and foremost, they talk about when you start screening for prostate cancer, you have to understand that you have to make an informed decision about whether you even want to be screened for prostate cancer. But then once you get the information, you have to look at the usual it's the benefit, the risk, and uncertainties of prostate cancer screening. It is

not perfect. And to back up just a little bit, one of the issues with pross cancer screening was that there were a number of situations where too many prostate biopsies were being done which were then ultimately found to be negative, that there was no cancer. So men were going for digital rectro exams. You'd feel a little nodule on your prostate and that would trigger a biopsy of

your prostate, which is uncomfortable. There's a cost involved and potential complications with any procedure, so they found that biopsying everything that you saw was probably not the best idea. The other is with the PSA test, a prostate specific antigen test. There is some variability in the PSA test, and again a rise in the PSA may not necessarily have to result in getting a buy. It may not mean you have prostate cancer, and so this is the uncertainty.

It is not a water tight plan of attack for preventing or limiting the number of cases of prostate cancer. So inherently the testing is not perfect. So with that said, the guidelines are you should think about getting tested at age fifty for men who are at average risk for prostate cancer and are expected to live at least ten

years or more. Okay, Number two for men forty five at high risk for developing prostate So this would include African American male, African American men, and men who have a first degree relatives that would be a father or a brother diagnosed with prostate cancer at an early age, typically younger than sixty five. The third category would be men age forty at even higher risk, those with one or more first degree relatives who had prostate cancer at an early age. So you have to see where do

you fit in? So where did Joe Biden fit in? Well, he probably not knowing his whole history, let's just say age fifty, who's at average risk. I don't know if his brother or father had prostate cancer. So at this point they then say, if your PSA is normal, then you need to be retested maybe every two years. Now, of course, if new symptoms come up, new complaints, urinary symptoms, you should get tested moro offin or should be looked

at a little bit more. Now, why they were saying that, I think his last PSA was in twenty fourteen, so that was over ten years ago, so he was in his seventies at that point. You would have thought he would live at seventy seventy two years old. He would live to eighty two, so I don't know why he was not tested more frequently. Now. What they're also saying is that this was an advanced case of prostate cancer

that had spread to the bones. So one could theorize that maybe he had prostate for three years, five years, eight years. I really don't know. Of course, there are certain malignancies that do not follow the normal natural history of a slow growing malignancy, and you could you could say this for any kind of cancer or disease. It just bed genes, bad biology. This tumor is just going to take off like wildfire. That is always a possibility.

But why he was not screened? Now to something that I do colon cancer screening, most would say, most authorities would say after the age of eighty, you don't need a screening colonoscopy for colon cancer. But yet I have patients that are seventy five, eight eighty two years old. They are still working, very active, running companies, traveling, exercising. Why would I not want to screen that person and maybe find an early lesion that could be removed. It's

relatively easy to do a colonoscopy. There is a cost, there is certain precautions that need to be taken. So along those lines, I feel very comfortable on a case by case basis doing these screening tests, even though the guidelines for colon cancer totally different here say after eighty you should sort of hang it up and not screen anymore. Same thing for prostate cancer. This man has access to

the world's greatest medical care, one would think. But yet nobody decided to say, let's just get a PSA on the president and see how he's doing early intervention, whether he's going to remain in office or not go in office.

screening like crazy. Throw the guidelines out the door. He is not your usual patient. And so that's all I could really say is PSA probably was elevated years ago. Now, whether or not they knew it and they said let's watch it, and then they watched it to the point that it just spread and broke loose. That may be a possibility, but to think that this is something new

is a little hard to believe. And why again, why they were not screening him with a PSA, checking all kinds of other lab tests on him or imaging studies is a little, a little beyond me. So that is my take on President Biden's prostate cancer. It's a very unfortunate situation. I hope he does well. It'll be interesting to see what therapies are going to be offered to him and how public this all becomes in the week

months to come. All Right, we're gonna take a quick break on this Memorial Day weekend of doctor Joe Galotti. Don't forget doctor Joegalotti dot com is our website. Stay tuned more health and wellness when we get back. Welcome back everybody, doctor Joe Galotti. This is your health First. Every Sunday between seven and eight pm, we're here. Don't forget our website, Doctor Joeglotti dot com. And you know, while we're talking about Memorial Day planning, a little patriotic

music for your summer plans. If I could advise you, I would definitely say, if you're looking for a relatively close road trip and you like American history or World War two history, and maybe you want to take your school age kids, or your high school kids, or even your college kids on a really worthwhile outing. The World War Two Museum in New Orleans is absolutely outstanding. I've been there twice and I am thoroughly blown away as

to the scale and scope of the museum. It is on par or better than anything you could see in Washington and the Smithsonian. The history is Originally it was going to be a D Day museum, but then in a short period of time they realized that this museum was so much more than just D Day that they turned it into a full scale World War Two museum. So I would definitely allot two full days to see all of the museum and you will leave really enriched

with the history of World War Two. Highly recommended World War Two Museum in New Orleans. Whether you're here in Texas or anywhere in the country and you're looking for a summer idea with your family, definitely look up the World War two museum. All right, so last segment, we were talking about prostate cancer and the dilemma of what happened to President Biden. Again, I believe that this is going to be discussed, argued, litigated for years, and we're

all living it in real time here. But as we are speaking of cancer, I'm posting on our Facebook page, which is at doctor Joe Galotti on the Facebook page, but you can get their Facebook page by going to our website, doctor Joegalotti dot com. Through the American Cancer Society, they have a one page screening recommendations and I would certainly this is one of those things that you would want to take to your doctor when you visit them for you or annual visitor, bi annual visit, whatever it is.

And it goes through the screening recommendations for people that are at average risk for certain different types of cancer. And so if you just break it off into three big categories, if you're twenty five to thirty nine years old, this is going to be predominantly women with cervical cancer

screening typically starting at about age twenty five. Then when you get to the forty to forty nine year old range, breast cancer screening starts at forty five, with the option to begin at age forty again, cervical cancer screening continues. Collo rectal cancer is going to start at age forty five, and also at forty five. African American individuals should discuss

prostate cancer screening with a doctor. If you know, forty five a little bit younger, then fifty and above can breast cancer screening, cervical cancer screening, colding cancer screening continues, and then people who currently smoke are used to smoke, should discuss lung cancer screening. There are a number of strategies using low dose radiation imaging of the lungs to screen for colding cancer that has certainly been shown to

be effective in picking up early lung cancers. And then, of course fifty and older, the ongoing discussion about about prostate cancer screening as recommended by your doctor. So this will be posted on the Facebook.

was diagnosed with normal pressure hydrocephalis. And you're probably saying, what on earth is that man? And it's interesting to note that a few months ago there was a video clip of Billy Joel on concert and sort of moving around that I don't know if he was going up steps on the stage, but he fell over and it looked like an innocent enough kind of a fall, though you never like to see this. Bruce Springsteen fell about two weeks ago on stage and that made the headlines.

But it turns out that he has normal pressure hydrocephalis. Whether or not this was all part of the disease, you know, we don't know at this point. But here again, this is one of those conditions that when celebrities develop it, all of a sudden people start talking about it. And I would say that's a good thing. It's horrible for Billy Joel. I've seen Billy Joel a number of times in concert. Yes, he did grow up about ten minutes

from where I grew up. He is many years older than me, but there is a certain connection with him with Long Island and all the work that he's done in the greater New York area. He is just iconic and legendary to those of us that are from New York loving his music. But again, it's a great excuse in a sense to talk about normal pressure hydrocephalus and for all of you to have an idea of what

on earth this is. Now the symptoms or the signs of normal pressure hydrocephalis are are rather curious, and I'm going to go over that in a minute, but it makes us pause to say, hey, do I have any of these symptoms or somebody that you're close with, a coworker, a family member, a friend, Bob, the neighbor next door, could it be that there's normal pressure hydrocephalis going on?

And again, the key thing here is there are surgical and therapeutic remedies for this, but if you come too late in the disease, you are not able to recover and reverse from it. So, first of all, what is normal pressure hydrocephalis? So, in the most very basic description, of this. This is a plumbing problem in your brain. So within the brain there is cerebral spinal fluid. This is the fluid that's in and around your brain, the

ventricles and the different chambers of your brain. And what happens is there is an accumulation or build up because the flow of this cerebral spinal fluid. I like to call it the Champagne of body fluids. The cerebral spinal fluid is not circulating properly. There is a blockage of some kind. And as a result of this increased pressure on the brain, you have difficulty walking, trouble controlling your bladder,

and memory problems. Now, the triad of those three bladder, walking, and memory problems really in a sense, can cinch to diagnosis. But there are many other diseases, conditions, syndromes that can just cause difficulty walking, or difficulty controlling ones bladder or your memory problems. And so what happens is you may have this constellation of these three major symptoms or complaints. But you may say the bladder control, okay, oh I'm

getting older. All of my friends and girlfriends and relatives, they all get up in the middle of the night and you're in an aid and they're up tinkling three times a Night's that's pretty normal. Why should I raise a red flag and go marching into the doctor. The other is memory problems here again, as the population is getting older, everybody just thinks, oh, you know, to see in your moment, I'm sixty, I'm seventy, I'm eighty, and

of course I forget. Everybody has memory problems. You watch TV at night and there were all these wacky supplements that you should be taking to sharpen your memory and make you function at a higher level. Again, this is at the wholesale level. Everybody has memory problems. Come on, I'm seventy five years old. I'm going to forget the name of my grandkid's school, or who is you know, baseball buddy is? But really, and of course the walking problems. People say, oh, I've got a bed knee, I have

a bed hip. I slept on my side and it am a little little cock eyed when I walk around. But really, this may be the early warning signs of normal pressure hydrocephalis. Now it really does not affect that many people, probably less than one percent of the population age sixty five to eighty, okay, but if you're over eighty, it represents about five percent of the population. So this is one of those diseases that as we get older, more things come up, and so we have to stay

on guard. So you know the problem is a condition like this, because some of the symptoms are so vague and everybody has them, it's likely underdiagnosed because people will simply say and really dismiss it. It's part of the normal aging process. Come on, Joe, if you're seventy five, you're going to have a little loss of memory. But I think that this is where we have to be better consumers. We have to understand really what the hell

is going on here, so you know, to make the diagnosis. Yes, you could first see the increased pressure in the brain, your ventricles. Now you have ventricles in your heart, but ventricles are just simply a term for a chamber you'll have. The ventricles in your brain will be swollen, they'll be

enlarged due to the increased pressure. So you could see this on a cat scan or an MRI, and then of course the diagnostic test is typically going to be a spinal tap where they can measure this increase in pressure, and also by taking a little bit of the fluid out, some of the symptoms may temporarily be alleviated. So the treatment of this sounds a little archaic, but this is what has been around for a good number of decades.

You develop, you have a surgical procedure where they are going to insert a shunt or a tube that is going to go from the ventricle in your brain and tunnel this out of your brain, typically along your chest into your abdomen. So it's a bypass in a sense where the excess fluid is going to drain directly into your abdomen. And these these tubes have valves on them, so if the pressure increases to a point, it pops open and the fluid will drain into your abdomen and

you normalize the fluid and people will be better. But the key thing is that you want to catch this early.

So if a patient shows up having had incontinence or urinary problem for months to years, they've had memory problems progressive for months to year, they have gate abnomalities to the point where you take your loved one into the neurologist, let's say, and they can't walk their wheelchair bound, I would say, and experts would say, it's very unlikely that you're going to be able to reverse the neurologic damage.

All right, So here again, you want to not put your head in the sand and think that we're all going to live to one hundred and have no complications. Now, you know, the issue is we have to be aware not only in identifying these problems, identifying these conditions, but for things other than normal pressure hydrocephalis. What can I do with my lifestyle, my diet, certain other interventions to

prevent this. So factors that affect the outcome of normal pressure hydrocephalus early diagnosis and treatment, okay, cognitive symptoms that develop after gate issues and or urinary problems. You have to address these. Okay, positive outcome are going to be

less likely. So bad outcome, delay in diagnosis and treatment, cognitive symptoms that start earlier before the gate issues, So it's bad if the neurologic mental part starts early, or if you have severe cognitive symptoms, you're going to have a much poorer outcome. So again, normal pressure hydrocephalus. Again,

we'll have to see how Billy Joel does. And you know with diseases like this, having a celebrity that sheds light on it, and certainly what I think we're doing here is to talk about it and get early intervention. Typically patients are going to be seen by a neurologist. You may be seen by a neurosurgeon who's going to put in the drain, but it's going to start off with a neurologic evaluation, thinking could this be normal pressure hydrocephalus?

All right, Final segment coming up, Doctor Jogolotti. I'm also going to post a little bit of information on normal pressure hydrocephalis on the Facebook page which is at doctor show Galatti if you go directly to Facebook. But of course our website doctor Jogolotti dot com is where you can get all these links. Stay tuned. Final segment coming up.

We are conducting a wide range of research studies within the liver realm. Let's say, we certainly are concentrating on fatty liver something called metabolic syndrome obesity diabetes now. So if you want to reach outreach out and find out more, certainly go through a website Doctor Joglotti dot com and signing off for our newsletter is probably the best way

to stay in touch with us. It comes out every weekend and you'll get updates on the goings on as I like to say, of me and my team and all of your health first, so doctor Joglotti dot com, I want to give a dear shout out to my wife, Geraldine, who for twenty two twenty three years now has allowed me every Sunday to do this radio program. And she is a die hard, die hard Rod Stewart fan, So

this is for her, all right. You know, I think if there's one area that has controversy surrounding it, not only in our medical practice office, but in the research realm, but also on social media. It is food and obesity and how we address obesity and what is the root cause of obesity. Where do we point the finger or do we point multiple fingers. Now, a few years ago I wrote a book Eating Yourself Sick, which by the way,

is available on the website. And the premise of that is from my perspective, and it's a very personal perspective, is that we have strayed away from not only eating properly, but understanding food. How to analyze commercially made food, how to read labels, how to know which foods really are high in fiber, high in macronutrients, high in various substances that are going to promote a healthy microbiome, and which

foods are the absolute opposite. Okay, there is a lot of political dancing going on out there with regard to food labeling, market pressure, basically somebody else. Now if you want to say it is big food, it is Campbell's soup. It is the people that make chef Boyer d be Ferroni,

the government. I don't know who really is behind all this, but we're basically being told what is healthy for us, what we should eat, and we are not doing all that well because if you look at the amount of chronic disease, and this is a broken record for me and my colleagues that really live in this space of obesity related medicine or obesity related surgery, diabetes, cardiovascular disease, cancer, kidney disease. Of course course all of the fatty liver

that we see. Now it's really pretty sick when you think that we have a condition and the root cause is obesity. Okay, obesity leads to fatty liver. In a subset of people with fatty liver, you're going to develop cerosis. Once you develop cerosis, you're going to probably progress to end stage liver disease, and you're going to go into

liver failure. What is the rescue a liver transplant. So a problem that we know about that takes years to decades to form, we neglect and then the solution is, let's pay for a multi million dollar solution to fix something that could have been remedied years or decades earlier. Now, again, the remedy to that is going to be public education on food and nutrition. Had a meal prep how to select food for our children, getting the consumerism out of food.

It's it's a it's a billion, billion, billion dollar market, and there's going to be a lot of people that that don't want to lose their their their steak in this Uh, it is the availability of food. We don't want people to eat cheap, crappy food that has no nutrition. But why is it that there are neighborhoods that don't have decent or safe supermarkets or pharmers' markets things like that.

So anyway, so it's a big complicated problem. But the reason I'm getting to this and we just have a few minutes left, there was an article in the New York Times talking about how American breakfast cereal is becoming more unhealthy. We always knew it was crap. It was

a mouthful of sugar. But a study published in the Journal of the American Medical Association this past week shows that, based on an analysis of twelve hundred new or reformulated cereal products in the United States between twenty ten and twenty twenty three, they are adding to childhood obesity and the rise in chronic disease. And what they found is the fat content per serving of newly launched breakfast cereals increased by thirty four percent, sodium content thirty two percent,

and sugar content increased by nearly eleven percent. So these ready to eat cereals, which is basically, you know, your typical cold breakfast cereal that you throw a little milk into, is not getting any healthier. And most of the people that are consuming this are kids between five to twelve years old, and we are seeing rises in childhood obesity, fatty,

liver dia, BET this cardiovascular disease. And the truth is that the children of this generation are not going to live as long as their parents, and so you have to be a better consumer. Understand that a steady diet and I'm talking about a steady diet. You know, do you want fruit loops? You know, once every couple of weeks. That's not going to kill you. But it is the steady dose where kids are not getting foods that are high in fiber, unprocessed foods instead of this ultra processed diet.

So anyway, this is sort of a rant right now, but I think be where there's a lot of research going on and as consumers, and I say this at the beginning of the program, we want to raise your health IQ make you better consumers of healthcare and realizing that the alleged claims that these foods are healthy they're high in iron, ail protein or low in sugar is sort of a farce. And I take game with the American Heart Association on a lot of these crappy series.

There's a little heart that says the American Heart Association has approved this food. Well that's the wrong message. But anyway, beware, I'll try to continue to talk about this and maybe get some experts to talk about it in the weeks to come. All right, we're going to wrap up here. Hope you all have a great rest of your Memorial Day weekend. I'm doctor Joe Golotti. Don't forget doctor Joeglotti dot com is our website. Take care, be blessed, take

care of your body. We'll see you next Sunday night.