Advertise on podcast: The Dr. Geo Prostate Podcast

Before prostate surgery, there are 3 questions you should ask your surgeon—and “How many surgeries have you done?” isn’t enough. In this episode of The Dr. Geo Prostate Podcast, Dr. Geo sits down with renowned prostate cancer surgeon Dr. Jim Hu, Ronald P. Lynch Professor of Urologic Oncology at Weill Cornell Medicine, Vice Chair of Clinical Research, and Director of the LeFrak Center for Robotic Surgery. The conversation starts where many prostate cancer journeys begin: an elevated PSA. Do you really need a biopsy? Should you get an MRI first? What about PSA density, the 4Kscore, or newer urine tests? And if a biopsy is necessary, should you choose transperineal instead of transrectal biopsy? Dr. Hu explains why he now favors the transperineal approach and discusses findings from the PREVENT and UK TRANSLATE trials, including infection risk, antibiotic use, cancer detection, pain, and the learning curve physicians face when adopting the procedure. Then the conversation turns to one of the biggest decisions a man with prostate cancer may ever make: Surgery or radiation? And if you choose surgery, how do you know whether your surgeon is actually good? Dr. Hu explains why simply asking how many prostatectomies a surgeon has performed may not tell you what you really need to know. Instead, patients should be asking whether their surgeon actually tracks urinary continence and erectile-function outcomes. Because two surgeons can perform the same “robotic prostatectomy” very differently—and those differences may matter to your quality of life. In this episode, you’ll learn: • What an elevated PSA really means—and what may come before biopsy • How MRI, PSA density, 4Kscore, and urine biomarkers can help guide decisions • Why Dr. Hu favors transperineal prostate biopsy • What the PREVENT and TRANSLATE trials tell us about prostate biopsy • Why avoiding antibiotics may be another advantage of transperineal biopsy • The learning curve patients should consider when choosing who performs their biopsy • How to think about prostate surgery vs. radiation • Why robotic technology doesn’t automatically mean better surgical outcomes • Why surgical volume alone may not predict continence or erectile-function recovery • The questions to ask before choosing a prostate cancer surgeon • Why surgeons should track their own patient-reported outcomes • How surgical technique, nerve handling, and cautery may affect recovery • Where active surveillance and focal therapy may—or may not—fit • Why treatment choice matters if prostate cancer eventually returns • What patients should understand about salvage prostatectomy after radiation or focal therapy If you’ve recently been diagnosed with prostate cancer—or you’re trying to decide whether to have a biopsy, surgery, radiation, focal therapy, or active surveillance—watch this conversation before making a decision you can’t easily take back. Chapters ⏱️ KEY TIMESTAMPS 00:00 – The prostate cancer decisions you can’t easily take back 08:00 – Elevated PSA: Do you really need a biopsy? 12:00 – How MRI can help some men avoid biopsy 16:00 – PSA density, MRI & deciding whether to biopsy 17:00 – Transperineal vs. transrectal prostate biopsy 19:00 – PREVENT & TRANSLATE studies: infection and cancer detection 22:00 – The learning curve for transperineal biopsy 26:00 – Why transperineal biopsy may avoid antibiotics 36:00 – Prostate surgery vs. radiation: How do you choose? 42:00 – Does doing more prostatectomies make a better surgeon? 43:00 – The #1 question to ask your prostate surgeon 51:00 – What are good erectile-function outcomes after surgery? 55:00 – Nerve sparing: the surgical details that may affect erections 59:00 – The 3 questions to ask BEFORE prostate surgery 1:03:00 – Active surveillance for Gleason 6 / Grade Group 1 1:06:00 – Focal therapy: Where does it fit? 1:10:00 – Erectile dysfunction & incontinence after prostate surgery 1:11:00 – Prostate surgery after radiation or focal therapy 1:12:00 – PSMA PET scans, recurrence & salvage treatment 🔗 RESOURCES & RESEARCH Dr. Jim Hu — Weill Cornell Medicine https://weillcornell.org/jimhu Follow Dr. Hu on X: @jimhumd PREVENT Trial — JAMA Oncology https://jamanetwork.com/journals/jamaoncology/fullarticle/2823969 Memorial Sloan Kettering Prostate Cancer Nomogram https://www.mskcc.org/nomograms/prostate UK TRANSLATE Prostate Biopsy Study — The Lancet Oncology https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(25)00100-7/fulltext Michigan Urological Surgery Improvement Collaborative (MUSIC) https://musicurology.com/programs/prostate/ MUSIC brings together academic and community urology practices across Michigan with the shared goal of improving prostate cancer care and patient outcomes. ___________________________________💪 Exclusive MembershipWant deeper insights? Join The Dr. Geo Prostate Podcast Exclusive Membership for curated transcripts, detailed show notes, expert resources, and member perks. → https://drgeo.com/membership ___________________________________ 📌 Follow and Connect📺 YouTube → Dr. Geo Prostate Podcast — https://www.youtube.com/@DrGeoProstatePodcast 🎧 All Episodes → Captivate.fm Archive — https://dr-geo-prostate-podcast.captivate.fm 📸 Instagram → https://bit.ly/DRGEO-INSTA-YT 📘 Facebook → https://bit.ly/POD-FB-DrGeo 💼 LinkedIn → https://bit.ly/DRGEO-LINKEDIN-YT 🛒 Supplements → XY Wellness https://bit.ly/3uJPC7Z | Mr. Happy https://bit.ly/3TE7tWE 🌐 DrGeo.com Website → https://bit.ly/43khht0 ___________________________________ 📣 Hashtags#DrGeoProstatePodcast #ProstateHealth #ProstateCancer #MensHealth #IntegrativeUrology #Urology ___________________________________⚠️ DisclaimerThis podcast is for educational purposes only and not medical advice. The views expressed are Dr. Geo’s and not those of his employer(s) or affiliated organizations. Use of this content is at your own risk. Geovanni Espinosa, N.D., assumes no liability for direct or indirect consequences, including economic loss, injury, illness, or death.

What if one of the hardest parts of androgen deprivation therapy is not simply low testosterone—but the loss of estradiol that comes with it? Dr. Richard Wassersug brings a rare dual perspective to that question. He is a PhD evolutionary biologist, former professor of anatomy and neurobiology, prostate cancer quality-of-life researcher, co-developer of an androgen deprivation education program, and a patient who has used transdermal estradiol for more than two decades. His experience helped drive a deeper investigation into whether estrogen delivered through the skin could suppress testosterone while avoiding some of the burdens associated with standard LHRH-based ADT. In this episode, you’ll learn: 🟠 Why men need estradiol for **brain, bone, sexual, and overall health.** 🟠 What the **PATCH research** suggests about transdermal estradiol, cancer control, and quality of life. 🟠 Why **hot flashes, poor sleep, fatigue, and cognitive symptoms** may reflect more than testosterone loss. 🟠 What men should know about **gynecomastia, monitoring, exercise, and shared decision-making** before considering this emerging strategy. decision-making before considering this emerging strategy. Chapters 00:00 ADT Side Effects Question 00:54 Podcast Disclaimers 01:33 Meet Dr Wassersug 03:59 Diagnosis And Early Treatment 04:58 Finding Estradiol Research 07:29 Lupron Side Effects And Sleep 08:48 Why Men Need Estradiol 11:00 Switching To Estradiol 15:13 NEJM Patch Trial Breakdown 20:53 Gynecomastia And Management 24:07 Real World Patient Stories 25:20 Sponsor Message Break 27:51 Access Barriers And Limits 29:03 ADT Protocols and Sleep 31:32 Estradiol Targets and Ratios 37:23 Patch vs Gel Dosing 39:10 Combining ADT With Estradiol 42:52 Who Benefits Most 44:18 PATCH Study Scope and Add-Ons 47:33 Getting Estradiol Prescribed 50:23 Suffering Mindset and Sexual Health 54:48 Active Surveillance Trial Ideas ___________________________________ 💪 Exclusive MembershipWant deeper insights? Join The Dr. Geo Prostate Podcast Exclusive Membership for curated transcripts, detailed show notes, expert resources, and member perks. → https://drgeo.com/membership ___________________________________ 📌 Follow and Connect📺 YouTube → Dr. Geo Prostate Podcast — https://www.youtube.com/@DrGeoProstatePodcast 🎧 All Episodes → Captivate.fm Archive — https://dr-geo-prostate-podcast.captivate.fm 📸 Instagram → https://bit.ly/DRGEO-INSTA-YT 📘 Facebook → https://bit.ly/POD-FB-DrGeo 💼 LinkedIn → https://bit.ly/DRGEO-LINKEDIN-YT 🛒 Supplements → XY Wellness https://bit.ly/3uJPC7Z | Mr. Happy https://bit.ly/3TE7tWE 🌐 DrGeo.com Website → https://bit.ly/43khht0 ___________________________________ 📣 Hashtags#DrGeoProstatePodcast #ProstateHealth #ProstateCancer #MensHealth #IntegrativeUrology #Urology ___________________________________⚠️ DisclaimerThis podcast is for educational purposes only and not medical advice. The views expressed are Dr. Geo’s and not those of his employer(s) or affiliated organizations. Use of this content is at your own risk. Geovanni Espinosa, N.D., assumes no liability for direct or indirect consequences, including economic loss, injury, illness, or death.

Most men who undergo a prostate biopsy may not have cancer found at all—and the bigger mistake may be rushing from a single elevated PSA straight to the needle. Dr. James Wysock, an NYU urologist with deep expertise in prostate cancer diagnostics and image-guided biopsy, explains why the modern biopsy decision is no longer about PSA alone. Repeat testing, prostate MRI, PSA density, blood and urine biomarkers, and expert image targeting can dramatically change who should be biopsied and how that biopsy should be performed. Just as surprising: transperineal biopsy is not automatically “better” in every case. It clearly lowers infection and antibiotic exposure, but biopsy accuracy still depends heavily on imaging, fusion quality, sampling technique, and operator experience. In this episode, you’ll learn... Why one elevated PSA should often be repeated before escalating testing.Why MRI may be the most important next test when biopsy risk remains concerning.How transperineal and transrectal biopsies really compare.How new fusion, needle and tissue-preservation technologies could make future biopsies shorter, more precise and less invasive. ___________________________________ 💪 Exclusive MembershipWant deeper insights? Join The Dr. Geo Prostate Podcast Exclusive Membership for curated transcripts, detailed show notes, expert resources, and member perks. → https://drgeo.com/membership ___________________________________ 📌 Follow and Connect📺 YouTube → Dr. Geo Prostate Podcast — https://www.youtube.com/@DrGeoProstatePodcast 🎧 All Episodes → Captivate.fm Archive — https://dr-geo-prostate-podcast.captivate.fm 📸 Instagram → https://bit.ly/DRGEO-INSTA-YT 📘 Facebook → https://bit.ly/POD-FB-DrGeo 💼 LinkedIn → https://bit.ly/DRGEO-LINKEDIN-YT 🛒 Supplements → XY Wellness https://bit.ly/3uJPC7Z | Mr. Happy https://bit.ly/3TE7tWE 🌐 DrGeo.com Website → https://bit.ly/43khht0 ___________________________________ 📣 Hashtags#DrGeoProstatePodcast #ProstateHealth #ProstateCancer #MensHealth #IntegrativeUrology #Urology ___________________________________⚠️ DisclaimerThis podcast is for educational purposes only and not medical advice. The views expressed are Dr. Geo’s and not those of his employer(s) or affiliated organizations. Use of this content is at your own risk. Geovanni Espinosa, N.D., assumes no liability for direct or indirect consequences, including economic loss, injury, illness, or death.

What if the biggest mistake men make after a prostate cancer diagnosis is not eating the "wrong" food - but becoming so afraid of food that eating itself becomes stressful? In this solo episode, Dr. Geo draws on more than two decades in holistic and integrative urology to cut through the noise around prostate cancer nutrition. Rather than promoting another rigid diet, he explains how food choices interact with physical activity, stress, metabolic signaling, and long-term sustainability. The goal is not perfection. It is to create a healthier internal environment while still enjoying life, family, and food. In this episode, you'll learn... Why no single food causes or cures prostate cancer.How exercise and stress may change the way your body responds to food.Why Dr. Geo favors a plant-forward Mediterranean pattern while allowing strategic flexibility.How to think about protein, fish, red meat, processed foods, saturated fat, and fasting after diagnosis. If prostate cancer nutrition has left you overwhelmed, this episode offers a simpler framework for deciding what to eat - and what actually matters most. Chapterts 00:00 Food Myths Intro 00:55 Podcast Disclaimer 01:34 Why Nutrition Confuses 03:34 Principle One No Guilt 04:46 Stress Exercise Absorption 08:57 No Magic Foods 12:55 How Cancer Signals Work 16:40 Processed Foods And Portions 21:02 Best Diet Patterns 25:11 Protein And Muscle 28:38 Meat Poultry Fish 31:23 Carbs And Fats 35:48 Fasting And Overeating 37:17 Thrive After Diagnosis 👉 subscribe to RX3 Thursdays- https://bit.ly/3UyPJ2M ___________________________________ 🌱 Partner OffersProLon 5-Day Fasting Mimicking Diet — Enjoy fasting benefits with food. Supports cellular renewal, metabolic health, and fat loss. Special offer for our listeners: Get the ProLon kit for $148 → https://bit.ly/3TVehAx AG1 by Athletic Greens — 75 high-quality vitamins, minerals, probiotics, and adaptogens in one daily scoop. Supports gut health, immunity, energy, and focus. Try it here → https://bit.ly/3mA2tVV ___________________________________ 💪 Exclusive MembershipWant deeper insights? Join The Dr. Geo Prostate Podcast Exclusive Membership for curated transcripts, detailed show notes, expert resources, and member perks. → https://drgeo.com/membership ___________________________________ 📌 Follow and Connect📺 YouTube → Dr. Geo Prostate Podcast — https://www.youtube.com/@DrGeoProstatePodcast 🎧 All Episodes → Captivate.fm Archive — https://dr-geo-prostate-podcast.captivate.fm 📸 Instagram → https://bit.ly/DRGEO-INSTA-YT 📘 Facebook → https://bit.ly/POD-FB-DrGeo 💼 LinkedIn → https://bit.ly/DRGEO-LINKEDIN-YT 🛒 Supplements → XY Wellness https://bit.ly/3uJPC7Z | Mr. Happy https://bit.ly/3TE7tWE 🌐 DrGeo.com Website → https://bit.ly/43khht0 ___________________________________ 📣 Hashtags#DrGeoProstatePodcast #ProstateHealth #ProstateCancer #MensHealth #IntegrativeUrology #Urology ___________________________________⚠️ DisclaimerThis podcast is for educational purposes only and not medical advice. The views expressed are Dr. Geo’s and not those of his employer(s) or affiliated organizations. Use of this content is at your own risk. Geovanni Espinosa, N.D., assumes no liability for direct or indirect consequences, including economic loss, injury, illness, or death.

Dr. Geo welcomes Dr. Peter Bajic, Medical Director for Urology at Cleveland Clinic Main Campus and Director of Men's Health at the Glickman Urological Institute, for an evidence-based conversation about erectile dysfunction, testosterone, Peyronie's disease, and the biggest myths in men's sexual medicine. They explore why erections reflect cardiovascular health, why "venous leak" is often misunderstood, how GLP-1 medications may temporarily influence testosterone during weight loss, and when testosterone replacement therapy is actually appropriate. The episode also covers Peyronie's disease, treatment options including daily tadalafil and traction therapy, and practical lifestyle changes that can improve both sexual function and long-term health. If you've ever wondered whether ED is psychological, physical, hormonal—or all three—this episode delivers clear answers backed by today's science. In this episode you'll learn: Why erectile dysfunction often predicts cardiovascular diseaseThe truth about "venous leak"How erections actually workPsychological vs. physical causes of EDGLP-1 medications and testosterone explainedWhen testosterone replacement is appropriateThe biggest myths about Peyronie's diseaseDaily Cialis beyond erectile dysfunctionLifestyle strategies that improve sexual healthThe latest treatments available for men Timestamps00:00 Introduction: ED may be your first warning sign 02:45 Why erections are a window into overall health 06:20 Psychological vs. physical erectile dysfunction 13:15 GLP-1 medications, weight loss & testosterone 18:30 Combining GLP-1 therapy with testosterone replacement 28:45 The truth about "venous leak" explained 40:05 Why most men do NOT have true venous leak 43:10 The best approach to treating erectile dysfunction 49:20 Understanding Peyronie's disease 54:20 Can Peyronie's disease be prevented? 58:00 Why daily Cialis may be one of men's most useful medications 1:01:00 Xiaflex, surgery & future Peyronie's treatments ___________________________________ 💪 Exclusive MembershipWant deeper insights? Join The Dr. Geo Prostate Podcast Exclusive Membership for curated transcripts, detailed show notes, expert resources, and member perks. → https://drgeo.com/membership ___________________________________ 📌 Follow and Connect📺 YouTube → Dr. Geo Prostate Podcast — https://www.youtube.com/@DrGeoProstatePodcast 🎧 All Episodes → Captivate.fm Archive — https://dr-geo-prostate-podcast.captivate.fm 📸 Instagram → https://bit.ly/DRGEO-INSTA-YT 📘 Facebook → https://bit.ly/POD-FB-DrGeo 💼 LinkedIn → https://bit.ly/DRGEO-LINKEDIN-YT 🛒 Supplements → XY Wellness https://bit.ly/3uJPC7Z | Mr. Happy https://bit.ly/3TE7tWE 🌐 DrGeo.com Website → https://bit.ly/43khht0 ___________________________________ 📣 Hashtags#DrGeoProstatePodcast #ProstateHealth #ProstateCancer #MensHealth #IntegrativeUrology #Urology ___________________________________⚠️ DisclaimerThis podcast is for educational purposes only and not medical advice. The views expressed are Dr. Geo’s and not those of his employer(s) or affiliated organizations. Use of this content is at your own risk. Geovanni Espinosa, N.D., assumes no liability for direct or indirect consequences, including economic loss, injury, illness, or death.

For decades, men with high-risk prostate cancer have routinely been told they need 18 to 36 months of androgen deprivation therapy (ADT) alongside radiation. But what if 12 months is enough? In this episode of the Dr. Geo Prostate Podcast, Dr. Geo Espinosa welcomes internationally recognized radiation oncologist Dr. Dan Spratt, Chair of Radiation Oncology at University Hospitals/Case Western Reserve University, to discuss groundbreaking research that could change how advanced prostate cancer is treated. Together they explore the latest MARCAP consortium data suggesting many men may receive the same cancer control with significantly less hormone therapy—potentially reducing years of unnecessary side effects while maintaining excellent outcomes. They also discuss how physicians personalize treatment decisions, the growing role of artificial intelligence with Artera AI, and why the future of prostate cancer treatment may involve doing less, not more. If you or someone you love is facing radiation therapy for prostate cancer, this episode provides one of the most important conversations happening in prostate cancer care today. What You'll Learn✔ Why 2-3 years of ADT may not be necessary for many patients ✔ The new evidence supporting approximately 12 months of hormone therapy ✔ Why longer hormone therapy can permanently affect testosterone recovery ✔ How physicians balance cancer control with quality of life ✔ The difference between NCCN guidelines and individualized patient care ✔ Which patients may still benefit from longer hormone therapy ✔ How AI (Artera AI) is helping personalize prostate cancer treatment ✔ Why prostate cancer care is shifting toward treatment de-intensification ✔ The future of precision medicine in radiation oncology Episode Timestamps00:00 Introduction 01:30 Meet Dr Dan Spratt 02:22 Why ADT Lasts Years 05:42 How ADT Helps Radiation 08:49 Personalizing ADT Duration 12:39 Guidelines and Real World Use 18:03 Who Needs Long Term ADT 21:13 Artera AI Explained 23:19 Old Data and Modern Outcomes 27:28 De Intensification Future 31:33 Biomarkers for Urologists 33:57 Choosing Artera vs Decipher 37:28 Final Takeaways and Outro Key Discussion PointsNew MARCAP consortium analysis on ADT durationRadiation sensitivity and androgen deprivationWhy many men never fully recover testosterone after prolonged ADTBalancing survival outcomes with quality of lifeShared decision-making between physician and patientGenomic classifiers including DecipherAI biomarkers and Artera AIPersonalized radiation oncologyModern imaging and PSMA PETDe-intensifying prostate cancer treatmentPrecision medicine in localized prostate cancerThe future of individualized prostate cancer care Resources Mentioned• MARCAP Consortium research on androgen deprivation therapy duration • NCCN Prostate Cancer Guidelines (discussed throughout the episode) • Artera AI clinical decision support platform (discussion) • Decipher genomic classifier • PSMA PET imaging • MRI-guided prostate cancer staging ___________________________________ 💪 Exclusive MembershipWant deeper insights? Join The Dr. Geo Prostate Podcast Exclusive Membership for curated transcripts, detailed show notes, expert resources, and member perks. → https://drgeo.com/membership ___________________________________ 📌 Follow and Connect📺 YouTube → Dr. Geo Prostate Podcast — https://www.youtube.com/@DrGeoProstatePodcast 🎧 All Episodes → Captivate.fm Archive — https://dr-geo-prostate-podcast.captivate.fm 📸 Instagram → https://bit.ly/DRGEO-INSTA-YT 📘 Facebook → https://bit.ly/POD-FB-DrGeo 💼 LinkedIn → https://bit.ly/DRGEO-LINKEDIN-YT 🛒 Supplements → XY Wellness https://bit.ly/3uJPC7Z | Mr. Happy https://bit.ly/3TE7tWE 🌐 DrGeo.com Website → https://bit.ly/43khht0 ___________________________________ 📣 Hashtags#DrGeoProstatePodcast #ProstateHealth #ProstateCancer #MensHealth #IntegrativeUrology #Urology ___________________________________⚠️ DisclaimerThis podcast is for educational purposes only and not medical advice. The views expressed are Dr. Geo’s and not those of his employer(s) or affiliated organizations. Use of this content is at your own risk. Geovanni Espinosa, N.D., assumes no liability for direct or indirect consequences, including economic loss, injury, illness, or death.

We’ve been told for decades that giving testosterone to a man with prostate cancer is like throwing gasoline on a fire. But what if, in the right context, it actually acts as the extinguisher?” It sounds like medical heresy, yet this is the foundation of Bipolar Androgen Therapy (BAT). Imagine a treatment that intentionally cycles your hormones from extreme highs to extreme lows to "overload" cancer cells and reset their sensitivity to medicine. In this episode, we sit down with a true pioneer of this paradigm shift: Dr. Michael Schweizer. An Associate Professor at the Fred Hutchinson Cancer Center and a key architect behind the original BAT trials at Johns Hopkins, Dr. Schweizer is the scientist moving the bar for men with advanced, castrate-resistant disease. We’re moving past the fear-based dogma to look at the clinical data that proves supraphysiologic testosterone isn't just a quality-of-life booster—it’s a sophisticated weapon against resistant tumors. In this episode, you’ll learn: The "Hormone Shock" Mechanism: How flooding the body with 1,500+ ng/dL of testosterone causes "mitotic catastrophe" in cancer cells adapted to low-androgen environments.The Resensitization Secret: Why cycling BAT can actually "reset" your cancer, making drugs like Enzalutamide work again after they’ve failed.Precision Selection: Which specific genetic mutations (like TP53) might predict who becomes an "exceptional responder" to high-dose testosterone.The Sequential Strategy: Why the order of your treatments—BAT first, then RPIs—could potentially extend survival by nearly 10 months. ⏱️ Chapters00:00 Introduction: Can Testosterone Treat Prostate Cancer? 02:00 The surprising origin of Bipolar Androgen Therapy (BAT) 04:10 ⭐ Stop & Watch: Why Charles Huggins hinted at this decades ago 07:10 Why ordinary testosterone therapy failed—and BAT didn't 08:20 ⭐ Stop & Watch: The BAT protocol explained (400 mg every 28 days) 10:00 Why BAT is only used in castration-resistant prostate cancer 14:05 ⭐ Stop & Watch: The TRANSFORMER trial—did BAT actually work? 16:20 ⭐ Stop & Watch: How BAT may make failed treatments work again 20:30 ⭐ Stop & Watch: If testosterone isn't the enemy...why do we suppress it? 22:10 ⭐ Must Watch: The biology that completely changes how we think about testosterone 24:10 How BAT damages cancer DNA 26:30 BAT, quality of life, and survival—what the evidence really shows 30:00 ⭐ Stop & Watch: The sequencing strategy that could add months of cancer control 31:30 Which patients may respond best to BAT? 33:20 ⭐ Must Watch: Why every advanced prostate cancer patient should consider genetic testing 36:00 Can someone on ADT simply start testosterone? 40:00 Where BAT fits among today's prostate cancer treatments 43:00 ⭐ Stop & Watch: BAT + Lutetium PSMA—the next frontier 45:00 How to find BAT clinical trials 47:00 Should hormone therapy ever be stopped? 53:00 Final thoughts____________________________________ 💪 Exclusive MembershipWant deeper insights? Join The Dr. Geo Prostate Podcast Exclusive Membership for curated transcripts, detailed show notes, expert resources, and member perks. → https://drgeo.com/membership ___________________________________ 📌 Follow and Connect📺 YouTube → Dr. Geo Prostate Podcast — https://www.youtube.com/@DrGeoProstatePodcast 🎧 All Episodes → Captivate.fm Archive — https://dr-geo-prostate-podcast.captivate.fm 📸 Instagram → https://bit.ly/DRGEO-INSTA-YT 📘 Facebook → https://bit.ly/POD-FB-DrGeo 💼 LinkedIn → https://bit.ly/DRGEO-LINKEDIN-YT 🛒 Supplements → XY Wellness https://bit.ly/3uJPC7Z | Mr. Happy https://bit.ly/3TE7tWE 🌐 DrGeo.com Website → https://bit.ly/43khht0 ___________________________________ 📣 Hashtags#DrGeoProstatePodcast #ProstateHealth #ProstateCancer #MensHealth #IntegrativeUrology #Urology ___________________________________⚠️ DisclaimerThis podcast is for educational purposes only and not medical advice. The views expressed are Dr. Geo’s and not those of his employer(s) or affiliated organizations. Use of this content is at your own risk. Geovanni Espinosa, N.D., assumes no liability for direct or indirect consequences, including economic loss, injury, illness, or death.

Artificial intelligence is transforming prostate cancer care faster than ever before but could it one day replace the traditional biopsy? In this episode, Dr. Geo sits down with Dr. Wayne Brisbane, Assistant Professor of Urology and urologic oncologist whose research is helping redefine how prostate cancer is detected and treated. After earning his medical degree from Loma Linda University School of Medicine, completing his urology residency at the University of Washington, and a fellowship in Urologic Oncology at UCLA, Dr. Brisbane has become one of the leading voices in AI-driven prostate cancer diagnosis. His clinical practice and research focus on image-guided biopsy, MRI, PSMA PET imaging, micro-ultrasound, and focal therapy—helping patients receive more precise treatment while minimizing unnecessary side effects. UCLA remains one of the few centers in the world advancing all of these technologies under one program. Together, Dr. Geo and Dr. Brisbane explore how artificial intelligence is improving MRI interpretation, helping physicians better map prostate tumors, identify the best candidates for focal therapy, and potentially reduce the need for invasive biopsies in the future. If you're navigating a prostate cancer diagnosis or simply want to understand where prostate cancer care is headed this conversation offers a fascinating look at the next generation of precision medicine. Episode Chapters00:00 Introduction 03:00 AI Is Changing Prostate Cancer Diagnosis 07:00 Unfold AI: Mapping Tumors with Greater Precision 10:00 Who Is the Right Candidate for Focal Therapy? 13:00 Life After Focal Therapy: MRI, PSMA & Monitoring 15:00 Focal Therapy vs. Surgery: What the Latest Research Shows 21:00 Can AI Eventually Replace the Prostate Biopsy? 25:00 Dr. Brisbane's Vision for the Future of Diagnosis 29:00 Cribriform Disease: Identifying High-Risk Cancer 32:00 Beyond DNA: How Proteomics May Transform Cancer Care Key Takeaways✅ How AI is making prostate cancer diagnosis more accurate ✅ Why MRI can still miss clinically significant prostate cancer ✅ The technology behind Unfold AI and personalized tumor mapping ✅ Who is—and isn't—a good candidate for focal therapy ✅ Why tumor size plays a critical role in treatment decisions ✅ Can AI eventually replace the prostate biopsy? ✅ The latest research comparing focal therapy and surgery ✅ Why prospective clinical trials matter when evaluating new treatments ✅ How MRI, PSMA PET, genomics, and AI are shaping the future of prostate cancer care ✅ Dr. Wayne Brisbane's vision for the next generation of precision prostate cancer diagnosis Resources MentionedUnfold AI (Avenda Health)MRI for prostate cancerPSMA PET imagingFocal TherapyActive SurveillanceUCLA Prostate Cancer ResearchStanford validation studiesCAPTAIN TrialFARP TrialHIFU clinical studies ___________________________________ 🌱 Partner Offers ProLon 5-Day Fasting Mimicking Diet — Enjoy fasting benefits with food. Supports cellular renewal, metabolic health, and fat loss. Special offer for our listeners: Get the ProLon kit for $148 → https://bit.ly/3TVehAx AG1 by Athletic Greens — 75 high-quality vitamins, minerals, probiotics, and adaptogens in one daily scoop. Supports gut health, immunity, energy, and focus. Try it here → https://bit.ly/3mA2tVV ___________________________________ 💪 Exclusive Membership Want deeper insights? Join The Dr. Geo Prostate Podcast Exclusive Membership for curated transcripts, detailed show notes, expert resources, and member perks. → https://drgeo.com/membership ___________________________________ 📌 Follow and Connect 📺 YouTube → Dr. Geo Prostate Podcast — https://www.youtube.com/@DrGeoProstatePodcast 🎧 All Episodes → Captivate.fm Archive — https://dr-geo-prostate-podcast.captivate.fm 📸 Instagram → https://bit.ly/DRGEO-INSTA-YT 📘 Facebook → https://bit.ly/POD-FB-DrGeo 💼 LinkedIn → https://bit.ly/DRGEO-LINKEDIN-YT 🛒 Supplements → XY Wellness https://bit.ly/3uJPC7Z | Mr. Happy https://bit.ly/3TE7tWE 🌐 DrGeo.com Website → https://bit.ly/43khht0 ___________________________________ 📣 Hashtags #DrGeoProstatePodcast #ProstateHealth #ProstateCancer #MensHealth #IntegrativeUrology #Urology ___________________________________ ⚠️ Disclaimer This podcast is for educational purposes only and not medical advice. The views expressed are Dr. Geo’s and not those of his employer(s) or affiliated organizations. Use of this content is at your own risk. Geovanni Espinosa, N.D., assumes no liability for direct or indirect consequences, including economic loss, injury, illness, or death.

In this compelling episode of the Dr. Geo Prostate Podcast, Dr. Geo sits down with internationally renowned exercise oncology pioneer Professor Robert Newton to explore the groundbreaking science behind exercise as medicine for cancer. Inspired by his father's battle with prostate cancer, Professor Newton has spent decades researching how targeted exercise can improve treatment outcomes, preserve muscle mass, strengthen immune function, reduce treatment side effects, and potentially slow cancer progression. Together, Dr. Geo and Professor Newton discuss why muscle is far more than a movement organ—it functions as a powerful endocrine organ that releases cancer-fighting compounds known as myokines. The conversation dives deep into exercise intensity, resistance training, chemotherapy and radiation timing, wearable technology, exercise "dosing," and the landmark Phase III clinical trial that demonstrated exercise can significantly improve survival outcomes in cancer patients. They also discuss practical strategies for overcoming fear of the gym, maintaining muscle during androgen deprivation therapy (ADT), and why sitting all day may undermine your health even if you exercise regularly. Whether you're living with prostate cancer, supporting a loved one, or simply interested in maximizing your healthspan, this episode provides actionable, science-backed strategies to help you move from surviving to thriving Episode Timestamps00:00 Introduction & Guest Welcome 03:00 Rob Newton's Father & Origin Story 09:30 Exercise as the #1 Anti-Cancer Tool 17:00 Landmark Exercise Oncology Trial 20:00 Exercise as Medicine 26:00 Resistance Training Intensity Explained 35:30 Exercise Before Radiation & Chemotherapy 40:00 Exercise Timing Around Treatment 47:00 Myokines: Muscle as Medicine 52:00 NEAT & Daily Movement 58:00 Final Takeaways & Closing Thoughts Resources MentionedMy Exercise Medicine for Cancer by Professor Robert NewtonExercise Medicine Research InstituteNew England Journal of Medicine Exercise Oncology TrialAmerican Society of Clinical Oncology (ASCO) Researc ___________________________________ 🌱 Partner OffersProLon 5-Day Fasting Mimicking Diet — Enjoy fasting benefits with food. Supports cellular renewal, metabolic health, and fat loss. Special offer for our listeners: Get the ProLon kit for $148 → https://bit.ly/3TVehAx AG1 by Athletic Greens — 75 high-quality vitamins, minerals, probiotics, and adaptogens in one daily scoop. Supports gut health, immunity, energy, and focus. Try it here → https://bit.ly/3mA2tVV ___________________________________ 💪 Exclusive MembershipWant deeper insights? Join The Dr. Geo Prostate Podcast Exclusive Membership for curated transcripts, detailed show notes, expert resources, and member perks. → https://drgeo.com/membership ___________________________________ 📌 Follow and Connect📺 YouTube → Dr. Geo Prostate Podcast — https://www.youtube.com/@DrGeoProstatePodcast 🎧 All Episodes → Captivate.fm Archive — https://dr-geo-prostate-podcast.captivate.fm 📸 Instagram → https://bit.ly/DRGEO-INSTA-YT 📘 Facebook → https://bit.ly/POD-FB-DrGeo 💼 LinkedIn → https://bit.ly/DRGEO-LINKEDIN-YT 🛒 Supplements → XY Wellness https://bit.ly/3uJPC7Z | Mr. Happy https://bit.ly/3TE7tWE 🌐 DrGeo.com Website → https://bit.ly/43khht0 ___________________________________ 📣 Hashtags#DrGeoProstatePodcast #ProstateHealth #ProstateCancer #MensHealth #IntegrativeUrology #Urology ___________________________________⚠️ DisclaimerThis podcast is for educational purposes only and not medical advice. The views expressed are Dr. Geo’s and not those of his employer(s) or affiliated organizations. Use of this content is at your own risk. Geovanni Espinosa, N.D., assumes no liability for direct or indirect consequences, including economic loss, injury, illness, or death.

Can AI help you understand your PSA, improve prostate cancer detection, and help doctors make better decisions? In this episode, Dr. Geo sits down with Dr. Jennifer Miles-Thomas, urologist, healthcare executive, Treasurer of the American Urological Association, and Vice Chair of Integration and Innovation at Northwestern Medicine to break down how AI is changing prostate care. We cover ChatGPT, PSA interpretation, privacy concerns, prostate MRI, digital pathology, ambient AI, and the future of prostate cancer diagnosis. Can AI explain an elevated PSA? Which tools are best? Is your medical data private? And how are physicians using AI to improve care while keeping human judgment at the center? Dr. Miles-Thomas explains how tools like ChatGPT, Perplexity, Claude, Gemini, and Grok can help men ask smarter questions, better understand risk, and prepare for doctor visits—but why AI should never replace medical expertise. TIMESTAMPS 06:00 — Can AI Help You Understand Your PSA? 08:00 — Privacy & AI Health Searches 10:00 — Best AI Tools for Medical Questions 13:00 — AI for Doctors & Smarter Decisions 14:00 — Ambient AI & The Future of Doctor Visits 21:00 — AI, MRI & Prostate Cancer Detection 26:00 — The Biggest Risks of AI in Medicine KEY TAKEAWAYS • AI can help explain an elevated PSA—but context matters • Better prompts lead to better answers • Use AI to ask smarter questions, not self-diagnose • AI may improve MRI, pathology, and cancer detection • Human oversight still matters AI is changing prostate care fast but what does it actually mean for you? Dr. Jennifer Miles-Thomas breaks it all down. Let’s get into it. ___________________________________ 🌱 Partner OffersProLon 5-Day Fasting Mimicking Diet — Enjoy fasting benefits with food. Supports cellular renewal, metabolic health, and fat loss. Special offer for our listeners: Get the ProLon kit for $148 → https://bit.ly/3TVehAx AG1 by Athletic Greens — 75 high-quality vitamins, minerals, probiotics, and adaptogens in one daily scoop. Supports gut health, immunity, energy, and focus. Try it here → https://bit.ly/3mA2tVV ___________________________________ 💪 Exclusive MembershipWant deeper insights? Join The Dr. Geo Prostate Podcast Exclusive Membership for curated transcripts, detailed show notes, expert resources, and member perks. → https://drgeo.com/membership ___________________________________ 📌 Follow and Connect📺 YouTube → Dr. Geo Prostate Podcast — https://www.youtube.com/@DrGeoProstatePodcast 🎧 All Episodes → Captivate.fm Archive — https://dr-geo-prostate-podcast.captivate.fm 📸 Instagram → https://bit.ly/DRGEO-INSTA-YT 📘 Facebook → https://bit.ly/POD-FB-DrGeo 💼 LinkedIn → https://bit.ly/DRGEO-LINKEDIN-YT 🛒 Supplements → XY Wellness https://bit.ly/3uJPC7Z | Mr. Happy https://bit.ly/3TE7tWE 🌐 DrGeo.com Website → https://bit.ly/43khht0 ___________________________________ 📣 Hashtags#DrGeoProstatePodcast #ProstateHealth #ProstateCancer #MensHealth #IntegrativeUrology #Urology ___________________________________⚠️ DisclaimerThis podcast is for educational purposes only and not medical advice. The views expressed are Dr. Geo’s and not those of his employer(s) or affiliated organizations. Use of this content is at your own risk. Geovanni Espinosa, N.D., assumes no liability for direct or indirect consequences, including economic loss, injury, illness, or death.

What if the persistent pelvic pain, the performance issues in the bedroom, or that nagging brain fog isn't just a physical "glitch," but a physical manifestation of an underlying mental struggle? Most men are trained to wear a mask in the clinic, but the body always keeps the score. When a man avoids reality, his physiology pays the price. Today, we’re peeling back that mask with Dr. Daniel Margolis. Dr. Margolis is an Associate Professor of Radiology at Weill Cornell Medicine in New York City and a world-renowned diagnostic radiologist. A graduate of UC Berkeley and USC, he completed advanced fellowships at Stanford and UCLA, specializing in using MRI to detect and characterize prostate cancer. With over 90 publications to his name, Dr. Margolis serves on the ACR PI-RADS Committee and Co-Chairs the Society of Abdominal Radiology Prostate Cancer Panel. He isn't just someone who looks at screens; he’s the "driver" of the most advanced imaging "cars" in the world. If you’ve been worried about Gadolinium brain deposits or simply want to know if you can skip the needle during your next scan, this is the masterclass you’ve been waiting for. In this episode, you’ll learn: The Biparametric Breakthrough: Why most men can now skip MRI contrast without missing significant cancer.1.5T vs. 3T: Why a "stronger" magnet isn't always better, especially if you have a hip replacement.The Biopsy-Free Future: How AI and blood tests are converging to eventually eliminate the needle.Expert Vetting: How to tell if your radiologist is a "pro" or just a "tech" by looking for ACR certification. Chapters00:00 – Intro & Why MRI Matters in Prostate Cancer 02:45 – How Many MRIs Does a Radiologist Read a Day? 06:20 – Will AI Replace Radiologists? 11:20 – The PRIME Trial: Can We Skip MRI Contrast Dye? 14:15 – 1.5 Tesla vs 3 Tesla MRI: Does It Matter? 22:45 – How to Know if You’re Getting a Good Prostate MRI 24:00 – Multiparametric vs Biparametric MRI Explained 35:00 – PRIME Trial Results: Did Contrast Actually Matter? 38:15 – Is Gadolinium Contrast Safe? 44:20 – Why the PRIME Trial Worked: Quality Control Matters 48:00 – Who Still Needs Contrast on Their MRI? 56:00 – Will Prostate Biopsies Disappear? 59:00 – How AI is Changing Prostate MRI ___________________________________ 🌱 Partner OffersProLon 5-Day Fasting Mimicking Diet — Enjoy fasting benefits with food. Supports cellular renewal, metabolic health, and fat loss. Special offer for our listeners: Get the ProLon kit for $148 → https://bit.ly/3TVehAx AG1 by Athletic Greens — 75 high-quality vitamins, minerals, probiotics, and adaptogens in one daily scoop. Supports gut health, immunity, energy, and focus. Try it here → https://bit.ly/3mA2tVV ___________________________________ 💪 Exclusive MembershipWant deeper insights? Join The Dr. Geo Prostate Podcast Exclusive Membership for curated transcripts, detailed show notes, expert resources, and member perks. → https://drgeo.com/membership ___________________________________ 📌 Follow and Connect📺 YouTube → Dr. Geo Prostate Podcast — https://www.youtube.com/@DrGeoProstatePodcast 🎧 All Episodes → Captivate.fm Archive — https://dr-geo-prostate-podcast.captivate.fm 📸 Instagram → https://bit.ly/DRGEO-INSTA-YT 📘 Facebook → https://bit.ly/POD-FB-DrGeo 💼 LinkedIn → https://bit.ly/DRGEO-LINKEDIN-YT 🛒 Supplements → XY Wellness https://bit.ly/3uJPC7Z | Mr. Happy https://bit.ly/3TE7tWE 🌐 DrGeo.com Website → https://bit.ly/43khht0 ___________________________________ 📣 Hashtags#DrGeoProstatePodcast #ProstateHealth #ProstateCancer #MensHealth #IntegrativeUrology #Urology ___________________________________⚠️ DisclaimerThis podcast is for educational purposes only and not medical advice. The views expressed are Dr. Geo’s and not those of his employer(s) or affiliated organizations. Use of this content is at your own risk. Geovanni Espinosa, N.D., assumes no liability for direct or indirect consequences, including economic loss, injury, illness, or death.

What if I told you that after focal therapy, a normal PSA and a clean MRI can still mean prostate cancer is hiding in plain sight? That’s the moment in this conversation that makes you stop—and rethink everything you’ve been told about “success” after focal therapy. In this episode, we’re joined by Abhinav Sidana, MD, MPH, Associate Professor of Urology and Director of Prostate Cancer at University of Chicago Medicine, a nationally recognized urologic oncologist, clinical trial leader, and one of the architects shaping the future of focal therapy. Dr. Sidana has trained at AIIMS, Johns Hopkins, NIH, and now leads one of the most rigorous focal therapy programs in the country—backed by over 100 peer-reviewed publications and multiple active clinical trials. This is not a sales pitch for focal therapy. It’s a clear-eyed look at what works, what doesn’t, and what we still get wrong. In this episode, you’ll learn: ✅ Why MRI made focal therapy possible—and why it can still miss clinically significant disease ✅ How biopsy strategy—fusion, mapping, or transperineal—directly affects recurrence risk ✅ Why PSA is an unreliable signal after focal therapy—and what actually predicts failure ✅ How short-term ADT may expand focal therapy to larger or higher-risk tumorsIf you’re a patient, clinician, or researcher navigating prostate cancer decisions, this episode will fundamentally sharpen how you think about focal therapy—and its limits. 00:00 Can MRI and PSA Miss Significant Cancer After Focal Therapy? 04:00 Who Is a Good Candidate for Focal Therapy? 06:30 Mapping Biopsies vs MRI Fusion Biopsies 09:30 Transperineal vs Transrectal Biopsies 11:00 What Is IRE (NanoKnife)? 14:30 Who Is NOT a Candidate for Focal Therapy? 18:00 Vapor Therapy & TULSA Pro 23:00 Should Doctors Use Multiple Focal Therapy Technologies? 25:30 Can Higher-Risk Prostate Cancer Be Treated with Focal Therapy? 34:00 Does the Type of Energy Matter? 37:00 Combining ADT with Focal Therapy 40:30 How Tumor Size Impacts Eligibility 45:30 Why MRI and PSA Are Imperfect After Treatment 49:30 What Is PSA Recurrence After Focal Therapy? 53:30 The Future of MRI, AI, and Surveillance 57:30 Do Patients Need Repeat Biopsies Forever? ___________________________________ 🌱 Partner OffersProLon 5-Day Fasting Mimicking Diet — Enjoy fasting benefits with food. Supports cellular renewal, metabolic health, and fat loss. Special offer for our listeners: Get the ProLon kit for $148 → https://bit.ly/3TVehAx AG1 by Athletic Greens — 75 high-quality vitamins, minerals, probiotics, and adaptogens in one daily scoop. Supports gut health, immunity, energy, and focus. Try it here → https://bit.ly/3mA2tVV ___________________________________ 💪 Exclusive MembershipWant deeper insights? Join The Dr. Geo Prostate Podcast Exclusive Membership for curated transcripts, detailed show notes, expert resources, and member perks. → https://drgeo.com/membership ___________________________________ 📌 Follow and Connect📺 YouTube → Dr. Geo Prostate Podcast — https://www.youtube.com/@DrGeoProstatePodcast 🎧 All Episodes → Captivate.fm Archive — https://dr-geo-prostate-podcast.captivate.fm 📸 Instagram → https://bit.ly/DRGEO-INSTA-YT 📘 Facebook → https://bit.ly/POD-FB-DrGeo 💼 LinkedIn → https://bit.ly/DRGEO-LINKEDIN-YT 🛒 Supplements → XY Wellness https://bit.ly/3uJPC7Z | Mr. Happy https://bit.ly/3TE7tWE 🌐 DrGeo.com Website → https://bit.ly/43khht0 ___________________________________ 📣 Hashtags#DrGeoProstatePodcast #ProstateHealth #ProstateCancer #MensHealth #IntegrativeUrology #Urology ___________________________________⚠️ DisclaimerThis podcast is for educational purposes only and not medical advice. The views expressed are Dr. Geo’s and not those of his employer(s) or affiliated organizations. Use of this content is at your own risk. Geovanni Espinosa, N.D., assumes no liability for direct or indirect consequences, including economic loss, injury, illness, or death.

What if the most common diagnostic tool in men’s health for the last 30 years was actually failing millions of patients?” For decades, the "blind" prostate biopsy was the gold standard a primitive 'hit or miss' approach that often missed aggressive tumors while over-treating harmless ones. But then came the PRECISION trial, a research earthquake that proved we’ve been doing it wrong. In this episode, we are joined by the architect of that revolution: Professor Veeru Kasivisvanathan. A Professor of Urology at University College London and a consultant at Cleveland Clinic London, Prof. Veeru is the elite surgeon-scientist who convinced a global medical community to stop stabbing in the dark. He led the landmark trials that made MRI the mandatory gatekeeper for prostate cancer, saving countless men from unnecessary invasive procedures. If you’ve ever wondered why your doctor is ordering an MRI before a needle, or why "contrast dye" might be a thing of the past, this conversation is your roadmap. In this episode, you’ll learn: The Precision Paradigm: Why a third of men can safely avoid a biopsy altogether if their MRI is clear.The Prime Trial Breakthrough: Why high-quality "biparametric" scans mean you can likely skip the Gadolinium contrast without losing accuracy.The Focal Therapy Landscape: How "male lumpectomies" using HIFU and Cryotherapy are preserving potency and continence.The Future of "Robotic Nerve-Sparing": How pre-operative mapping is allowing surgeons to operate with a level of visibility once thought impossible. Timestamps:00:00 – Introduction: Is the "Blind" Biopsy Failing Men?01:30 – Meet Prof. Veeru Kasivisvanathan: The Surgeon-Scientist.04:15 – What Inspired the PRECISION Trial?08:45 – The Problem with the 30-Year "Standard of Care."12:20 – MRI as the Gatekeeper: Avoiding Unnecessary Biopsies.15:45 – The UK vs. US Healthcare Systems: Why Cost and Ethics Matter.21:00 – The PRIME Trial: Biparametric vs. Multiparametric MRI.28:30 – Is Gadolinium Contrast "Toxic"? Understanding the Risks.34:15 – MRI Quality Control: Why the Radiologist Matters More Than the Machine.40:30 – Genomic Biomarkers vs. Imaging: Do We Need Both?44:45 – Treatment Paradigms: Focal Therapy (HIFU/Cryo) explained.49:15 – When to Choose a Robotic Prostatectomy Over Focal Therapy.53:00 – How to Find Prof. Veeru and Closing Thoughts. Key Resources Mentioned:Prof. Veeru’s Profile: University College London (UCL) & Cleveland Clinic London.The PRECISION Trial: Published in the New England Journal of Medicine.The BURST Research Collaborative: A global network of 30,000+ patients. ___________________________________ 🌱 Partner OffersProLon 5-Day Fasting Mimicking Diet — Enjoy fasting benefits with food. Supports cellular renewal, metabolic health, and fat loss. Special offer for our listeners: Get the ProLon kit for $148 → https://bit.ly/3TVehAx AG1 by Athletic Greens — 75 high-quality vitamins, minerals, probiotics, and adaptogens in one daily scoop. Supports gut health, immunity, energy, and focus. Try it here → https://bit.ly/3mA2tVV ___________________________________ 💪 Exclusive MembershipWant deeper insights? Join The Dr. Geo Prostate Podcast Exclusive Membership for curated transcripts, detailed show notes, expert resources, and member perks. → https://drgeo.com/membership ___________________________________ 📌 Follow and Connect📺 YouTube → Dr. Geo Prostate Podcast — https://www.youtube.com/@DrGeoProstatePodcast 🎧 All Episodes → Captivate.fm Archive — https://dr-geo-prostate-podcast.captivate.fm 📸 Instagram → https://bit.ly/DRGEO-INSTA-YT 📘 Facebook → https://bit.ly/POD-FB-DrGeo 💼 LinkedIn → https://bit.ly/DRGEO-LINKEDIN-YT 🛒 Supplements → XY Wellness https://bit.ly/3uJPC7Z | Mr. Happy https://bit.ly/3TE7tWE 🌐 DrGeo.com Website → https://bit.ly/43khht0 ___________________________________ 📣 Hashtags#DrGeoProstatePodcast #ProstateHealth #ProstateCancer #MensHealth #IntegrativeUrology #Urology ___________________________________⚠️ DisclaimerThis podcast is for educational purposes only and not medical advice. The views expressed are Dr. Geo’s and not those of his employer(s) or affiliated organizations. Use of this content is at your own risk. Geovanni Espinosa, N.D., assumes no liability for direct or indirect consequences, including economic loss, injury, illness, or death.

What if your prostate biopsy is missing the most important detail? In this powerful episode, Dr. Geo sits down with Dr. Jonathan Epstein, one of the most influential urologic pathologists in the world, to break down what’s really happening behind your diagnosis. From Gleason scores to hidden aggressive patterns, this conversation reveals why pathology is the foundation of every prostate cancer decision — and why getting it right is critical. If you’ve had a biopsy, elevated PSA, or are considering treatment vs. surveillance… this episode is essential listening. ⏱️ Timestamps 00:00 – The Hidden Problem With Prostate Biopsies Why your diagnosis may not tell the full story 02:00 – Meet Dr. Jonathan Epstein A leader who helped define modern prostate cancer pathology 04:30 – What Pathologists Actually Look For Understanding normal vs. abnormal prostate tissue 06:30 – Gleason Scores Explained Simply What 3+3, 3+4, and 4+3 really mean 09:00 – Why Gleason 6 Is So Controversial Should it even be called cancer? 11:00 – The Real Risk Isn’t Gleason 6 What doctors worry about more 13:00 – Active Surveillance: Who Is It For? Why more men are safely avoiding treatment 14:30 – Pathology vs. Biology How research connects what we see to outcomes 15:30 – The Most Important Details in Your Report Cribriform patterns, intraductal cancer, and why they matter 17:00 – Understanding Gleason 7 (Grade Group 2 & 3) Low-risk vs. high-risk within the same score 19:00 – When Cancer Becomes Dangerous What defines aggressive disease 21:00 – Gleason 9: Is It Already Spread? The truth about micro-metastasis 23:00 – Why MRI and PSMA Scans Aren’t Perfect What imaging can miss 25:00 – Why Biopsies Still Matter Even in the era of advanced imaging 26:00 – What Makes a “Good” Biopsy Why technique matters more than you think 29:00 – MRI-Guided vs. Random Biopsies Why both are still necessary 30:00 – How to Read Your Pathology Report What actually matters vs. what doesn’t 34:00 – Biopsy vs. Prostatectomy Findings Why results can change after surgery 36:00 – How Often Pathology Is Wrong Why second opinions are critical 38:00 – The Problem Patients Don’t See You don’t know who’s reading your biopsy 41:00 – The Future: AI in Pathology Will machines replace doctors? 45:00 – What Patients Should Do Next How to advocate for yourself 52:00 – Managing Anxiety Around PSA & Biopsies A real conversation about fear 56:00 – What to Do When You Get Your Results How to approach your doctor and next steps 01:03:00 – Final Advice: Take Control of Your Health 🧠 Key Takeaways Pathology is the foundation of your diagnosis — everything else depends on it Up to 20–30% of biopsy readings may change with expert review Not all prostate cancer is dangerous — but some “low-risk” cases hide more aggressive disease MRI and advanced imaging are powerful, but they can still miss cancer A second opinion on your biopsy can completely change your treatment plan 📌 What to Ask Your Doctor What is my Grade Group (not just Gleason score)? Is there any cribriform or intraductal cancer present? How many cores were positive and how much cancer was found? Should I get a second pathology opinion? Am I a candidate for active surveillance or treatment? 👤 About the Guest Dr. Jonathan Epstein is a world-renowned urologic pathologist whose work has shaped how prostate cancer is diagnosed globally. Formerly at Johns Hopkins, he has trained over 90 specialists and continues to influence the field through clinical work and research. Advanced Uropathology of New York (a division of Integrated Medical Professionals) in Garden City, NY, ___________________________________🌱 Partner OffersProLon 5-Day Fasting Mimicking Diet — Enjoy fasting benefits with food. Supports cellular renewal, metabolic health, and fat loss. Special offer for our listeners: Get the ProLon kit for $148 → https://bit.ly/3TVehAx AG1 by Athletic Greens — 75 high-quality vitamins, minerals, probiotics, and adaptogens in one daily scoop. Supports gut health, immunity, energy, and focus. Try it here → https://bit.ly/3mA2tVV ___________________________________ 💪 Exclusive MembershipWant deeper insights? Join The Dr. Geo Prostate Podcast Exclusive Membership for curated transcripts, detailed show notes, expert resources, and member perks. → https://drgeo.com/membership ___________________________________ 📌 Follow and Connect📺 YouTube → Dr. Geo Prostate Podcast — https://www.youtube.com/@DrGeoProstatePodcast 🎧 All Episodes → Captivate.fm Archive — https://dr-geo-prostate-podcast.captivate.fm 📸 Instagram → https://bit.ly/DRGEO-INSTA-YT 📘 Facebook → https://bit.ly/POD-FB-DrGeo 💼 LinkedIn → https://bit.ly/DRGEO-LINKEDIN-YT 🛒 Supplements → XY Wellness https://bit.ly/3uJPC7Z | Mr. Happy https://bit.ly/3TE7tWE 🌐 DrGeo.com Website → https://bit.ly/43khht0 ___________________________________ 📣 Hashtags#DrGeoProstatePodcast #ProstateHealth #ProstateCancer #MensHealth #IntegrativeUrology #Urology _______________________________⚠️ DisclaimerThis podcast is for educational purposes only and not medical advice. The views expressed are Dr. Geo’s and not those of his employer(s) or affiliated organizations. Use of this content is at your own risk. Geovanni Espinosa, N.D., assumes no liability for direct or indirect consequences, including economic loss, injury, illness, or death.

What if your prostate symptoms aren’t actually being treated—just managed? In this episode, Dr. Geo sits down with Dr. Brian Helfand, Clinical Professor at the University of Chicago and a leading expert in prostate care, to break down aqua ablation, a water-powered, precision therapy that’s changing how we treat BPH (benign prostate enlargement)—and potentially even prostate cancer. What You’ll Learn 1. Why Medications May Not Be the Best First Step Most prostate medications manage symptoms—but don’t fix the problemLong-term use may come with side effects and limited improvementMany men stay on meds for years without real resolution 2. The Shift Toward Personalized Prostate Care Not all urinary symptoms come from the prostateKey contributors include:DiabetesSleep apneaAnxietyTreating the whole patient, not just the prostate, leads to better outcomes 3. What is Aqua Ablation? A minimally invasive procedure that uses a high-pressure water jet to remove excess prostate tissue. Key Features: Robotically controlled for precisionGuided by real-time ultrasound imagingNo heat (unlike lasers or steam)Customized treatment plan for each patient 4. Why Aqua Ablation is a Game Changer Compared to traditional procedures: ✅ Lower risk of sexual side effects ✅ Minimal risk of incontinence ✅ Faster recovery ✅ Highly durable results Results: Significant improvement in urinary symptoms (~15-point IPSS improvement)Very low retreatment rate (~0.4% per year) 5. The “Money Shot” Conversation (Yes, It Matters) Preservation of ejaculation is a top priority for many menAqua ablation preserves it in 90%+ of casesMany other procedures result in permanent dry orgasm 6. Who is a Candidate for Treatment? There is no single number or test. Dr. Helfand looks at the full picture (“gestalt”): Symptom severity (IPSS)Patient bother levelUrinary flow strengthPost-void residual (PVR)Overall health 👉 Bottom line: If symptoms are bothering your life, you’re a candidate for discussion. 7. What About the Bladder? Not all urinary issues are prostate-relatedBladder function must be consideredUrodynamics are only used in complex cases, not routine ones 8. The Future: Prostate Cancer Applications Early data suggests aqua ablation may: Improve urinary symptoms Potentially reduce cancer burden in some patients Could evolve into a whole-gland treatment approach ⚠️ Still emerging—but very promising 💡 Key Takeaways Medications are not always the best long-term solution Treat the patient, not just the prostate Aqua ablation offers a precision, low-side-effect alternative Sexual function preservation is a major differentiator The future may include dual treatment for BPH + prostate cancer 👨‍⚕️ About the Guest Dr. Brian Helfand Clinical Professor, University of Chicago MD, PhD Author of 270+ peer-reviewed studies Expert in prostate cancer and precision medicine 📞 Phone: 847-503-3000 🌐 Website: Endeavor Health (under development) This conversation goes beyond procedures. It challenges the traditional “medication-first” approach and explores how personalized, data-driven care can transform outcomes for men.👉 View complete episode show notes, resources, and transcript at DrGeo.com___________________________________ 🌱 Partner OffersProLon 5-Day Fasting Mimicking Diet — Enjoy fasting benefits with food. Supports cellular renewal, metabolic health, and fat loss. Special offer for our listeners: Get the ProLon kit for $148 → https://bit.ly/3TVehAx AG1 by Athletic Greens — 75 high-quality vitamins, minerals, probiotics, and adaptogens in one daily scoop. Supports gut health, immunity, energy, and focus. Try it here → https://bit.ly/3mA2tVV ___________________________________ 💪 Exclusive MembershipWant deeper insights? Join The Dr. Geo Prostate Podcast Exclusive Membership for curated transcripts, detailed show notes, expert resources, and member perks. → https://drgeo.com/membership ___________________________________ 📌 Follow and Connect📺 YouTube → Dr. Geo Prostate Podcast — https://www.youtube.com/@DrGeoProstatePodcast 🎧 All Episodes → Captivate.fm Archive — https://dr-geo-prostate-podcast.captivate.fm 📸 Instagram → https://bit.ly/DRGEO-INSTA-YT 📘 Facebook → https://bit.ly/POD-FB-DrGeo 💼 LinkedIn → https://bit.ly/DRGEO-LINKEDIN-YT 🛒 Supplements → XY Wellness https://bit.ly/3uJPC7Z | Mr. Happy https://bit.ly/3TE7tWE 🌐 DrGeo.com Website → https://bit.ly/43khht0 ___________________________________ 📣 Hashtags#DrGeoProstatePodcast #ProstateHealth #ProstateCancer #MensHealth #IntegrativeUrology #Urology ___________________________________⚠️ DisclaimerThis podcast is for educational purposes only and not medical advice. The views expressed are Dr. Geo’s and not those of his employer(s) or affiliated organizations. Use of this content is at your own risk. Geovanni Espinosa, N.D., assumes no liability for direct or indirect consequences, including economic loss, injury, illness, or death.