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What To Expect After Prostate Surgery: PSA, Sex & Recovery · Intellectual Medicine

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  Even if you've had your prostate gland removed, there's lots you
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  can do. Strength, energy, mood can all
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  be depleted. Urinary leakage can occur.
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  Well, the first part of doing better is not accepting the
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  compromise to your masculine vitality.
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  Never stop fighting. Never stop fighting.
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  Cancel like a man. Even if you've had your prostate
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  gland removed, there's lots you can do.
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  You need to be prepared for what comes next.
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  What am I talking about? The prostatectomy.
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  Some men choose to have their gland removed.
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  This is the institutional approach to prostate cancer
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  treatment. Take the gland out and you don't
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  worry about cancer. Or do you?
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  Well, it turns out many of you will experience a recurrence.
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  You need to be prepared for the possibility that it may occur.
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  So at least you know you have a framework of engaging your
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  doctor so you could discuss how you want your health to be.
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  Suppose you're suffering. You have the prostate gland
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  removed. Erections aren't working,
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  whether or not what they used to be, ejaculation not so good.
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  Strength, energy, mood can all be depleted.
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  Urinary leakage can occur. Well, the first part of doing
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  better is not accepting the compromise to your masculine
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  vitality. There are ways that these can be
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  addressed safely and effectively.
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  Sometimes you need to find consultative support outside
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  your urologist or your oncologist.
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  Not really there area of focus when it comes to the
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  intellectual medicine approach to revitalization, right
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  protocol approach. So if you're struggling with
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  erections and most men are after the prostatectomy, don't accept
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  that. Now the traditional drugs, the
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  Cialis, Viagra, tadalafil, sildenafil, they don't work as
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  great in this setting. Don't forget these are
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  circumstances men, where it's already been a little bit of a
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  struggle. Now they take out your gland.
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  Entirely different ways to approach that.
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  One of them is to restore erectile function.
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  The oral medicines can be helpful but may not be
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  sufficient. Ask your doctor about Trimix.
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  It's a compounded injectable drug that goes actually into the
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  penis. Sounds hideous but quite
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  tolerable. It is very effective at
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  generating erections. Trimix.
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  TRIMIX, any doctor can order it. It's not available at your local
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  pharmacy. It has to be compounded by a
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  state regulated pharmacy. I met.
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  Every man needs erectile function back to enjoy sexual
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  activity. I had one patient, I asked him
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  how his erections are doing. He said well doc, not that great
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  but I have a mouth and everything's fine.
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  Personal satisfaction is what we're after.
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  Now how about the sex drive? A libido can be negatively
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  affected. This is an amputation of other
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  part of your body was removed. There are ways that could be
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  restored. One of the ways we'll talk about
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  is actually going on testosterone.
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  We'll get to that. But another one is a peptide
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  called PT-141. It can be compounded by your
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  state regulated compound or do not ever, ever, ever go to the
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  black market and get stuff or go to the Gray market is called and
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  get stuff off the Internet. I don't care how much they say
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  it is safe and it is pure, it's neither for research purposes
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  only. All right, So don't be cheap.
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  Get your doctor, go to a state regulated compounding pharmacy.
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  PT141 is fantastic. It stimulates the part of your
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  brain where sex drive, erection and climax all emanate from.
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  Has no effect on hormones, no effect on cancer, none.
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  So ask your doc about its side effects.
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  Can be a little nausea, but not necessarily occurs if your dose
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  is right. So sexual vitality, What else
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  happens? They don't talk about this
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  sometimes when you ejaculate, some men lose control of the
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  urine. Some men lose control of the
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  urine when they become aroused. The sphincter muscle can get
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  weak, right? That's the, the, the valve, if
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  you will, that controls urine flow.
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  Now the prostate gland has been removed, so a major inhibitor of
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  urine flow has been taken out. In addition, don't forget guys,
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  your bladder has been squeezing against a prostate that is
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  likely partially obstructing flow.
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  So what happens? The muscle gets thick, big
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  strong gets if you will, spastic.
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  So you get an urgency. You got to weaken that muscle.
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  That muscle has to be weakened. So that can happen over time.
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  The prescription drugs that can relax the muscle, maybe maybe
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  you don't need them. How about supplements?
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  They can be really helpful, but be careful.
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  There's some ingredients you do not want in your supplement.
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  Three of them come right to my line.
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  Copper, selenium and vitamin E Selenium and vitamin A have been
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  shown in some studies to increase the risk of prostate
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  cancer. Bad play, no value copper in a
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  supplement, potentially neurotoxic.
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  You don't want to survive prostate cancer guys to end up
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  with dementia. So contemplate your supplements,
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  make sure you're getting quality resources and be patient with
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  them. It could take six months to have
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  full effect about the other sexual energy vitality
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  dysfunctions. How about testosterone therapy?
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  Like, why not? There's no strong evidence.
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  I should say, Let me put it this way.
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  The old dogma that testosterone is like pouring gas out of fire,
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  If you've ever had cancer, you can't touch it.
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  You will blow up with cancer. The new research is actually
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  refuting that we owe a debt of gratitude to those doctors
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  who've been pioneers in the space, Doctor Abraham
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  Morgentaler among them. These are guys.
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  These are doctors, guys and gals that have looked at the
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  evidence, found it lacking, have applied testosterone therapy in
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  a very unique manner to selective patients to enhance
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  vitality. You decide how you want to live.
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  Nobody's going to say to you this path is risk free.
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  I can share with you that there's abundant evidence that
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  it will not blow up cancer. It might even be helpful.
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  But we're not going to know in your lifetime or mine.
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  This is generic therapy. This is clinical, intuitive
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  medicine judgment based upon experience and evidence without
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  proof. So you have to decide how you
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  want to live. Fighting cancer like a man.
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  It doesn't mean you ever quit. Hold on your vitality on every
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  level energy. And what does testosterone do?
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  It fuels us, it helps our brain, it helps our muscle, our bone.
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  A powerful anti aging support. Just because you had your
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  prostate gland removed does not mean you need to be deprived of
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  its benefit for the rest of your life.
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  Now suppose you go on testosterone and the cancer
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  comes back. That could happen, but it may be
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  coincidental to the use of testosterone and not the cause
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  of it, and you can always then change therapy.
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  Suppose, on the other hand, you're tired, you're weak, your
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  libido's gone, a little bit sad, maybe a little depressed.
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  All symptoms of testosterone deficiency in some cases.
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  So you don't want testosterone because you're fair fearful
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  about cancer. And then the cancer comes back
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  saying, yeah, that stinks. I suffered and here I am.
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  Let's talk about that cancer coming back, right?
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  It can happen after the prostate gland is removed.
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  Upwards of 50% of men will have a recurrence.
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  Now, what does that mean? There's something the doctors
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  call a biochemical recurrence. I feel great, doc.
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  I feel fine. I'm urinating fine.
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  I have no signs of cancer. Ah, but Mr. Jones, your PSA went
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  from .2 to .4. The cancer's coming back.
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  That's a biochemical occurrence. We have to castrate you.
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  Androgen deprivation therapy. Yikes.
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  Time out. Time out.
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  Think 3 * 4 times. Ask questions.
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  If I go into androgen deprivation therapy, will that
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  lessen my chance of dying of prostate cancer?
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  The honest answer? We don't know.
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  We don't know, we don't know. But it will make you feel crappy
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  and it will make the PSA go down.
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  I don't think that's such a good deal, guys.
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  A maybe about benefit with a certainty about harm.
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  This defies intellectual consideration.
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  Doctors love treating numbers. Your PSA was 2.3, now it's less
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  than .1. Isn't that good?
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  Or maybe not. It may give you psychological
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  comfort guys, but don't hang your hat on the wrong on the
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  wrong post here. The goal is not to make the
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  number low. The goal is to have you live
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  your best life. I mean, death waits for all of
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  us, but blocking your hormones is not going to make you live
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  longer. It's going to make you live more
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  miserable. It might feel longer.
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  I don't think it'll actually be longer.
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  So a biochemical recurrence, the institutional medicine, the
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  standard of care. And remember, standard of care
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  does not mean it's good. It just means all the doctors
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  agree to it or most this doctor doesn't.
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  And other doctors that are trained in my protocol and
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  certified in it are like minded. They're out there, so you're in
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  the box. Your PSA went up.
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  They want to castrate you just say no.
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  Why? The minute you start taking
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  androgen deprivation therapy, the clock is ticking.
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  It's a matter of when, not if, that'll stop working.
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  The cancer cells, we've come resistant to testosterone
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  blockage. Initially, the PSA goes down, it
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  starts coming back up again. That's called castration
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  resistance, gentlemen. That's a prelude to death.
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  At that point, there's nothing great out there to treat you.
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  Therefore, you wait. You wait, you wait.
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  You don't fire this bullet. You don't use this treatment,
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  androgen deprivation, unless symptoms compel you to use it.
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  You're having trouble urinating because now the prostate or
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  prostate's going. In your case, better example,
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  you're having bone pain and now they find that there's prostate
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  cancer in your bone. That's the time to consider it.
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  But wait doc, shouldn't I do it early so I don't get bone
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  metastatic process? No, because it's not strong
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  evidence that it'll prevent metastasis from occurring.
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  Furthermore, you're going to burn up its value at a time you
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  don't really need it, and if and when bone metastasis occurs, it
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  may no longer be effective. Wait until you see the whites of
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  their eyes before you shoot the analogy.
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  Enemies coming at you. He's a mile away.
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  Your M16 shoots 100 yards. You start firing now.
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  By the time the enemy is in range, you got no ammo.
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  So save the ammo, hold your fire.
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  At what level of PSA should you consider it now?
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  Maybe the PSA is not relevant to this discussion.
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  I would suggest to you that you negotiate with your doc at least
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  until the PSA hits 20. Better if you wait until
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  symptoms occur. Gentlemen, my practice PSA hits
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  60. All the docs are having kittens.
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  You got to go into energy deprivation.
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  You called me up, doc. I feel great.
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  What do? What should I do?
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  So don't do it. Let's wait.
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  A couple years later, PSA is now 80.
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  Feels great. A few years later, PSA is 160 at
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  that .4 years after it initially started to climb.
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  Four years of feeling great, four years of no symptoms.
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  He started his therapy. That's four years of preserved
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  benefit of the therapy itself. When you start androgen
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  deprivation, maybe 2 years, maybe 3, it's going to stop
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  working. So go slowly down that path.
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  Vital Energy in Trimix for injections testosterone.
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  Yes, it can be done. You may need to seek out a
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  provider who is sophisticated regarding androgen therapy,
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  regarding its use in the setting of someone who has a history of
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  prostate cancer, who has a history of the gland being
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  removed. Many urologists would not be
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  comfortable with this approach. Some of them would be ask about
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  it. You, my friend, you must be the
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  one that asserts your value. Doctor, I want my full vitality.
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  I may or may not live longer, but I want full vitality.
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  I'm willing to accept the unknown.
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  Whether or not this will actually aggravate the cancer, I
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  don't believe it will. Many doctors that study the same
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  material. I do concur with that opinion,
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  but it's uncertain. You have to make the call.
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  Here's another thing you must do.
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  Get your heart checked thoroughly.
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  Androgen deprivation, if you're going to do it, increases your
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  risk of heart attacks, Cardiac events from the American Heart
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  Association, right? This has been documented.
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  Guys. Get a calcium score.
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  Make sure you're working with a good independent minded
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  functional family practice doctor, preferably a board
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  certified osteopathic like me, a good doc, good nurse
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  practitioner, somebody that is going to be proactive and help
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  protect your heart so that you don't die of a heart attack.
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  That's no way to cure cancer. Things you can do, maintain
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  vitality. You have to decide that you want
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  to pursue that. You have to initiate the
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  conversation. Some of the things you're
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  suffering, some of them you suffer in silence.
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  You may presume nothing can be done.
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  I'm just glad to be alive, right?
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  You can choose that path or you can push back.
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  Look, what can I do? What's the next level?
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  Get some consultative input. If there's a Intellectual
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  Medicine Pedrity Protocol certified doc in your
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  neighborhood, knock on their door.
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  Nurse practitioners or docs, find out what's there for you.
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  If I cancel like a man, hold on your vitality.
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  Hey, we only live once. We might as well keep our boots
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  on, stand upright and feel vital.
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  No matter if the glen's been removed or not, Be prepared for
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  the biochemical recurrence fear factor.
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  Do not let your brain get hooked on chasing Psas.
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  Gentlemen. In my practice PSA is 16, MRI
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  done a year ago, Pyrides of four a year later.
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  His PSA is 16 is MRI, no change a year later.
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  That is success, that is stability.
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  He feels great. You don't knock that number down
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  just because it's uncomfortable. It's a little bit high.
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  You base it on how you feel symptoms.
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  Symptoms drive the train in my book, not the number.
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  So don't number chase. Get your heart checked.
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  There are ways to restore and maintain erectile function.
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  Testosterone makes muscle strong, including the sphincter
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  muscle that controls urine flow. It could in fact help with
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  urinary incontinence as well. Well guys, that's all I got for
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  today. Thanks for being part of this
• 17:11
  podcast. Please leave comments.
• 17:14
  We love your feedback. You can help other men by
• 17:17
  sharing your story. You know you don't have to
• 17:20
  suffer in silence. Some of the things you're
• 17:21
  experiencing don't necessarily come to your mind as a
• 17:26
  consequence of what you've been through.
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  But when shared, we can get collected information.
• 17:32
  Our clinical intuition grows. Well, thanks a lot guys.
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  We'll talk to you next time at this podcast.
• 17:38
  Bye.