Latest / Becker’s Healthcare Podcast / Ashutosh (Ash) K. Tewari, MD, Urologist and Prostate Cancer Specialist and Chairman of the Milton and Carroll Petrie Department of Urology at the Icahn School of Medicine at Mount Sinai

Transcript

Ashutosh (Ash) K. Tewari, MD, Urologist and Prostate Cancer Specialist and Chairman of the Milton and Carroll Petrie Department of Urology at the Icahn School of Medicine at Mount Sinai · Becker’s Healthcare Podcast

• 0:00
  This is Gracelyn Keller with the Becker's Healthcare
• 0:03
  podcast, and I am thrilled today to be
• 0:05
  joined by doctor Ash Tewari, who is a
• 0:08
  urologist and a prostate cancer specialist
• 0:10
  and a chairman of the department of urology
• 0:13
  at Mount Sinai. So, doctor Tewari, thanks for
• 0:16
  being here today. I'm gonna have you introduce
• 0:19
  yourself and tell us a little bit more
• 0:21
  about your background and what you're doing right
• 0:23
  now as a urologist and prostate cancer specialist.
• 0:28
  Thanks a lot, Grace.
• 0:30
  I am a surgeon scientist who is leading
• 0:33
  the department of urology at Mount Sinai Hospital
• 0:36
  in New York City.
• 0:38
  I also have a additional title that is,
• 0:41
  surgeon in chief for an upcoming
• 0:43
  Tish Cancer Hospital, which is a multi specialty
• 0:46
  hospital being built within the Mount Sinai Health
• 0:49
  System.
• 0:50
  I am
• 0:51
  actually an insurgent
• 0:53
  scientist.
• 0:55
  I started by being a surgeon and early
• 0:58
  on in the journey, I realized that, maybe
• 1:01
  I should learn a little bit more deeper
• 1:03
  part of, the genetics of the prostate cancer
• 1:06
  and molecular imaging part of the prostate cancer.
• 1:09
  So that's where the scientist part comes. So,
• 1:11
  yes, I have an administrative role. I am
• 1:14
  a surgeon who does surgeries almost every day,
• 1:16
  and,
• 1:17
  I am a researcher who
• 1:19
  is funded by NIH and,
• 1:21
  has been funded in past with the other
• 1:25
  funding agencies. So I'm a surgeon scientist.
• 1:29
  Wonderful. Well, thank you for taking the time
• 1:31
  to be here. And I'd love to start
• 1:33
  our conversation today,
• 1:35
  talking about what trends you're currently watching in
• 1:38
  your space of specialty and some of the
• 1:40
  things that you're keeping an eye on right
• 1:42
  now.
• 1:44
  So I think the prostate cancer seems to
• 1:46
  be on an increase.
• 1:49
  What they are predicting that because we are
• 1:51
  doing a great job in managing
• 1:53
  cardiac issues,
• 1:55
  cancer is rising and it may become a
• 1:58
  prominent problem for humanity.
• 2:01
  And prostate happens to be one of the
• 2:03
  commonest cancer. It is impacting about three hundred
• 2:05
  and fifty thousand men every year. And and
• 2:08
  worldwide population, it is couple of million patients.
• 2:11
  So
• 2:13
  managing prostate cancer is the major challenge and
• 2:16
  that's what my focus has been.
• 2:18
  But the key with the prostate cancer is
• 2:20
  not just
• 2:21
  managing it, how to diagnose it, how to
• 2:24
  risk stratify it, how to know which patients
• 2:27
  actually need intervention or not. And when you
• 2:30
  do intervene, what is the best way to
• 2:32
  treat it? And in prostate cancer, there is
• 2:34
  another dimension which, is very important that
• 2:38
  not only that, we have to treat patients
• 2:40
  with prostate cancer, but prostate cancer treatment can
• 2:43
  be very closely tied to sexuality
• 2:45
  discussion.
• 2:46
  So my main focus has been as to
• 2:48
  how to minimize
• 2:50
  deranged sexual function after
• 2:54
  treating a prostate cancer patients, and, it's a
• 2:57
  journey. And, we have made progresses, but, we
• 3:01
  are not at the finish line. So that
• 3:03
  that's been exciting time. That's what I've been
• 3:05
  focusing,
• 3:06
  how to treat,
• 3:07
  how to avoid treatment
• 3:09
  related side effects.
• 3:11
  And
• 3:13
  looking back at what you've been working on
• 3:15
  for the past year or two, what is
• 3:17
  something that you're particularly proud of or that
• 3:19
  has been very fruitful for you?
• 3:23
  The way we have understood the anatomy of
• 3:25
  the prostate
• 3:26
  and how the nerves are intermingling around the
• 3:29
  prostate and what relationship nerves are having with
• 3:32
  the cancer,
• 3:33
  that work itself has been very satisfying.
• 3:36
  Tweaking the surgical
• 3:37
  approach to minimize the damage and then having
• 3:41
  your results in the six weeks after the
• 3:43
  surgery is an important
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  milestone for us.
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  We also have developed a very large pool
• 3:50
  of patients who are being followed
• 3:51
  for long term, what we call active monitoring
• 3:54
  of patients with prostate cancer, and we do
• 3:56
  that
• 3:56
  based on our understanding about the biopsy, the
• 3:59
  Gleason score, the imaging, the genomics,
• 4:02
  and
• 4:03
  some kind of in molecular markers. And we
• 4:05
  can really avoid
• 4:07
  intervention
• 4:08
  in a mean large majority of patients,
• 4:11
  and that itself is in very rewarding field.
• 4:14
  I
• 4:15
  also
• 4:16
  have a calling that,
• 4:18
  you don't have to just treat the prostate
• 4:20
  cancer. You can diagnose the cancer early and
• 4:23
  many times you don't need to intervene.
• 4:25
  With that background in mind, I have an
• 4:28
  initiative what we call a million strong.
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  Basically, what that means is that,
• 4:33
  we want to
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  find out cancer early when it is curable,
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  when it is not creating any symptom
• 4:40
  because that is the time when you cannot
• 4:42
  just cure the cancer but can also result
• 4:45
  in having a better quality of life in
• 4:46
  the patient. So I have created mobile units.
• 4:49
  These mobile units are equipped within best
• 4:52
  imaging modality with the point of care, blood
• 4:55
  testing,
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  and they go to where people live.
• 4:58
  And with that mobile unit mindset, I have
• 5:01
  been able to reach out to over 12,000
• 5:04
  patients in last three years. And we have
• 5:06
  just started a newer version in Emery in
• 5:09
  Atlanta,
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  and we are working on a newer version
• 5:12
  in Long Island area. So
• 5:15
  not only I will treat the patients, but
• 5:16
  I will try to diagnose them early so
• 5:18
  that they can avoid
• 5:21
  more intense side effects if they are found
• 5:23
  a little late in metastasis. So that these
• 5:25
  are the things which I've been excited about,
• 5:27
  and these are the things which I would
• 5:29
  like people to know about.
• 5:33
  That's wonderful.
• 5:35
  And it sounds like you've made quite an
• 5:36
  impact on your patients with these,
• 5:39
  focuses and techniques. And so kind of going
• 5:41
  off of that, you're a leader in your
• 5:43
  field, and I would love to know what
• 5:45
  advice you would give to evolving leaders who
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  hope to to be as advanced in their
• 5:49
  career one day as you and on the
• 5:51
  cutting edge of things in
• 5:53
  the urology and prostate cancer world.
• 5:57
  I think leadership
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  is in very,
• 6:00
  delicate topic. You lead
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  by your actions. You lead by example. You
• 6:05
  lead by your compassion. You lead by
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  showing people
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  how to
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  look at the future.
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  And then as a leader, you have to
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  create an opportunity. You have to create a
• 6:17
  platform. You have to create an chess board
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  in which everyone can kind of navigate through
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  as long as we keep the basic
• 6:24
  vision intact. That in health care,
• 6:28
  we exist
• 6:29
  because we want to take care of the
• 6:31
  patients.
• 6:31
  And if we can do a better job,
• 6:34
  if we can give them a lesser
• 6:36
  anxiety, if we can make their treatment less
• 6:39
  painful,
• 6:40
  and everything we can do in that journey
• 6:42
  with the people who are the doctors,
• 6:44
  who are the nurses, who are the PAs,
• 6:46
  who are
• 6:47
  technologists, who are the administrators.
• 6:49
  And what they do
• 6:51
  is what we call them leadership
• 6:53
  because, ultimately, patient centric approach
• 6:56
  will give them to the next level in
• 6:59
  their journey.
• 7:00
  And it's all about learning. It's all about
• 7:02
  responding. It's all about retraining,
• 7:05
  and it's all about ambitions and mentorship.
• 7:08
  That's what I would call the leadership, and
• 7:10
  I'm personally learning.
• 7:15
  Wonderful. Well, thank you so much for joining
• 7:18
  me today, doctor Tuarey, on the Becker's healthcare
• 7:21
  podcast and sharing these thoughts and insights with
• 7:23
  all of us today.
• 7:25
  You're very welcome, and,
• 7:27
  my greetings to your audience.