The Dr. Geo Prostate Podcast

A new curve in the penis is rarely just a cosmetic change. In this episode, Dr. Geo revisits his conversation with Dr. Petar Bajic, Medical Director for Urology at Cleveland Clinic Main Campus and Director of Men’s Health at the Glickman Urological Institute, to unpack what Peyronie’s disease actually is — and what can be done about it.

Peyronie’s affects roughly one in ten men, yet more than 80% of them can’t recall the injury that triggered it. Dr. Bajic explains why the condition is better understood as a genetic predisposition to over-exuberant scarring than as the result of a single traumatic event, how that scar tissue interferes with the valve mechanism that holds an erection, and why curvature is only one of several possible changes — lost length, lost girth, and hourglass indentation are just as common.

The conversation then turns practical: what Dr. Bajic puts every newly diagnosed patient on, where traction therapy genuinely helps and where it doesn’t, the difference between Xiaflex injections and actual surgery, and the one red flag that should send you looking for a second opinion. If you’ve noticed a change in shape, firmness, or length, this one is worth your time.

Key Points

🟠 Peyronie’s disease affects approximately 1 in 10 men, most commonly in their 50s and 60s.

🟠 Abnormal scar tissue can cause penile curvature, shortening, narrowing, and erectile dysfunction.

🟠 Over 80% of men don’t recall a specific injury, suggesting repeated microtrauma may play a role.

🟠 Early treatment matters. Peyronie’s typically progresses for 6–18 months before stabilizing.

🟠 Penile traction therapy may help restore lost length. Xiaflex injections combined with traction can improve curvature in eligible patients.

🟠 There is no conclusive evidence that supplements effectively treat Peyronie’s disease.

🟠 Surgery may help in severe cases, but the goal is a functional erection, not necessarily a perfectly straight penis.

🟠 If your provider offers only one treatment option, consider getting a second opinion.

⏱️ CHAPTERS

00:00 — What a sudden curve can really mean

01:00 — Disclaimer and introducing Dr. Petar Bajic

01:50 — Dr. Geo’s question: do firmer erections protect against Peyronie’s?

03:20 — What Peyronie’s disease actually is — and who gets it

04:20 — Why scar tissue makes the penis bend

05:00 — Beyond curvature: length, girth, indentation, and erection hardness

05:40 — The 80% who don’t remember an injury

06:40 — “Erectile insufficiency” as a possible trigger

07:00 — Why low-dose daily Cialis is the first thing he prescribes

07:45 — Centuries of failed remedies and the supplement question

08:30 — Sponsor: RestoreX traction therapy

09:05 — The newly diagnosed protocol, and the one-option red flag

09:50 — How hard does an erection actually need to be?

11:00 — The broader case for 5 mg daily tadalafil

11:50 — What tadalafil doesn’t replace

12:30 — Why measuring Peyronie’s improvement is so difficult

13:40 — Xiaflex vs. traction: what gives the most bang for the buck

15:00 — When surgery is the right answer

15:50 — What’s still left to cover: shockwave, implants, GLP-1s, TRT

16:20 — How to reach Dr. Bajic

17:00 — Why Dr. Geo keeps doing this

📕 Get Dr. Geo’s Free Ebook- A Guide to Improve Prostate Problems Naturally https://bit.ly/DRGEOFreeEbook

🎯Subscribe to the Dr. Geo Prostate Podcast and visit https://drgeo.com for evidence-informed prostate health education and the Rx3 Thursdays newsletter.

📌Thank You To Our Sponsors

RestoreX® is designed to address penile curvature, indentation, and lost length associated with Peyronie's disease. https://bit.ly/4i8niC0

Consult your healthcare provider and review the applicable Instructions for Use before beginning treatment. Individual results may vary.

📌 Dr. Geo’s Social Media and Websites

Instagram: https://bit.ly/DRGEO-INSTA-YT

Facebook: https://bit.ly/POD-FB-DrGeo LinkedIn: https://bit.ly/

DRGEO-LINKEDIN-YT Website: https://bit.ly/43khht0

💊 Prostate & Male Health Supplements XY Wellness-

Prostate Health Supplements - https://bit.ly/3uJPC7Z

Mr. Happy- Supplements for Men- https://bit.ly/3RJMX6O ________________________________________________

DISCLAIMER: This audio is educational and does not constitute medical advice. This audio's content is my opinion, not that of my employer(s) or any affiliated company. Use of this information is at your own risk. Geovanni Espinosa, N.D., will not assume any liability for any direct or indirect losses or damages resulting from using the information in this video, including but not limited to economic loss, injury, illness, or death.

The most dangerous thing about peptides may not be the peptide itself—it may be what's actually inside the vial.

Peptides are everywhere. From BPC-157 for injury recovery to anti-aging treatments, hormone optimization, and the growing popularity of GLP-1 medications, these compounds are generating enormous excitement. But which peptides are backed by science, which are still experimental, and what happens when people buy injectable products online without medical supervision?

Dr. James LaValle, clinical pharmacist, board-certified clinical nutritionist, and longtime educator in precision health and longevity medicine, joins Dr. Geo to separate the science from the hype. Drawing on more than four decades in pharmacy and his involvement in FDA advisory discussions, LaValle explains how peptides work, why compounding regulations matter, and what patients should understand before considering these treatments.

The conversation takes an especially important turn for men with prostate cancer, as Dr. Geo raises concerns about BPC-157, blood vessel formation, and the unanswered questions surrounding peptide use in patients with cancer.

In this episode, you’ll learn...

🟠 What peptides actually are, how they work in the body, and why not all peptides are created equal.

🟠 Why BPC-157 is generating excitement for injury recovery and gut health—and the unanswered safety questions for men with prostate cancer.

🟠 What the FDA's peptide regulations and compounding discussions mean for patients, and why an advisory committee recommendation is not the same as FDA approval.

🟠 How to recognize potentially unsafe peptides sold online, understand the risks of unregulated injections, and avoid the dangers of peptide overuse.

📚 Chapters

00:00 Are Peptides Really Safe?

03:00 What Are Peptides?

08:00 FDA-Approved vs. Experimental Peptides

10:00 Compounding Pharmacies Explained

13:00 The Dangers of Online Peptides

16:00 FDA Regulations and Peptide Access

19:00 GLP-1 Medications and Proper Dosing

24:00 BPC-157 for Injury Recovery

27:00 BPC-157 and Prostate Cancer Concerns

30:00 TB-500 and Immune Health

35:00 MOTS-c and Mitochondrial Aging

38:00 Epitalon, Sleep, and Growth Hormone

43:00 DSIP, Semax, and Brain Health

47:00 Oral vs. Injectable Peptides

51:00 How to Identify Unsafe Peptides

55:00 Long-Term Risks and Peptide Overuse

59:00 Dr. LaValle's Work and Resources

Peptides may hold exciting possibilities for the future of medicine. But promising science is not the same as proven safety—and knowing the difference could protect your health.

📕 Get Dr. Geo’s Free Ebook- A Guide to Improve Prostate Problems Naturally https://bit.ly/DRGEOFreeEbook

🎯Subscribe to the Dr. Geo Prostate Podcast and visithttps://drgeo.com for evidence-informed prostate health education and the Rx3 Thursdays newsletter.

🎙️ GUEST – Links related to the podcast:

Dr. James LaValle

Website:https://jimlavalle.com/https://jimlavalle.com/

Instagram: @therealjimlavalle

📌 Thank You To Our Sponsors

Sponsored by PathRight Medical. RestoreXL® provides a focused option for restoring lost penile length or limiting loss of erectile function following prostatectomy.

For more information on RestoreXL:https://bit.ly/3VWiC9Lhttps://bit.ly/3VWiC9L.

📌 Dr. Geo’s Social Media and Websites

Instagram:https://bit.ly/DRGEO-INSTA-YThttps://bit.ly/DRGEO-INSTA-YT

Facebook:https://bit.ly/POD-FB-DrGeohttps://bit.ly/POD-FB-DrGeo

LinkedIn:https://bit.ly/DRGEO-LINKEDIN-YThttps://bit.ly/DRGEO-LINKEDIN-YT

Website:https://bit.ly/43khht0https://bit.ly/43khht0

XY Wellness – Prostate Health Supplements:https://bit.ly/3uJPC7Zhttps://bit.ly/3uJPC7Z

Mr. Happy – Supplements for Men:https://bit.ly/3RJMX6Ohttps://bit.ly/3RJMX6O

📣 Hashtags

#DrGeoProstatePodcast #Peptides #BPC157 #AntiAging #Longevity #ProstateHealth #MensHealth #FDA #IntegrativeMedicine

⚠️ 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.

The biggest mistake after prostate cancer treatment may be waiting for erections to “come back” on their own.

Dr. John Mulhall of Memorial Sloan Kettering has spent three decades in sexual medicine, sees roughly 600 prostatectomy patients a year, and served as a senior author on sexual-medicine guidelines. His central message: recovery is a race to protect erectile tissue while nerves heal. After prostatectomy, erection nerves can remain functionally “asleep” for months. During that window, reduced blood flow, oxygenation and stretch can allow penile smooth muscle to deteriorate and be replaced by collagen-rich scar tissue. Radiation follows a different pattern: function may look preserved at first, then decline over two to three years as vascular injury develops.

In this episode, you’ll learn...

• Why penile rehabilitation is about preserving tissue, not simply taking a daily pill.
• How surgery, radiation, and ADT disrupt erections through different biological pathways.
• Why sleep apnea, diabetes, and very low testosterone can reduce recovery.
• How reducing performance pressure can rebuild sexual confidence.

📚 Chapters

00:00 Sex Recovery Starts Early

05:28 Why Erections Fail

07:36 Radiation And ADT Effects

11:07 Collagenization Explained

12:39 Modern Penile Rehab Plan

16:14 Choosing A Prostate Surgeon

19:49 Orgasms After Prostatectomy

21:38 Erection Recovery Timeline

24:19 Confidence And Intimacy

34:34 Injection Safety Standards

40:48 Testosterone Before Treatment

45:24 ADT Risks and PSA Monitoring

56:32 When to Consider Implants

59:37 Choosing the Right PDE5 Pill

01:01:23 Trials and Where to Find John

This is the conversation men need before treatment—not months after sexual function has already changed.

Dr. Mulhall X handle@saveyoursexlife

Website: Dr. John Mulhall - MSKCC

📕 Get Dr. Geo’s Free Ebook- A Guide to Improve Prostate Problems Naturally https://bit.ly/DRGEOFreeEbook

📌Thank You To Our Sponsors

Sponsored by PathRight Medical. This episode's guest, Dr. Landon Trost, is the majority owner of PathRight Medical, manufacturer of RestoreX® and RestoreXL®. Dr. Geo Media retains editorial control over the interview and its independent clinical content.

Find the Right Device for You linked tohttps://bit.ly/3VnIsU0.

___________________________________

💪 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

___________________________________

📌 Dr. Geo’s Social Media and Websites

📺 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 Wellnesshttps://bit.ly/3uJPC7Z | Mr. Happyhttps://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.

What causes Peyronie’s disease? Can penile curvature be reversed without surgery? And what actually works to restore lost penile length?

In this episode of the Dr. Geo Prostate Podcast, Dr. Geo Espinosa welcomes Dr. Landon Trost, former Chief of Andrology at Mayo Clinic and a leading researcher in Peyronie’s disease and men's sexual health.

Together, they separate science from misinformation and explore the latest research on Peyronie’s disease, Xiaflex injections, RestoreX penile traction therapy, and why early intervention may make a significant difference.

Dr. Trost also shares the research behind combining Xiaflex with RestoreX, why some commonly recommended treatments lack convincing evidence, and what men should understand before considering surgery.

Whether you've recently noticed penile curvature, are experiencing lost length, or are exploring treatment options, this conversation offers valuable insights to help you make more informed decisions about your sexual health.

IN THIS EPISODE, YOU'LL LEARN:

• What causes Peyronie’s disease and how genetics may contribute.
• The connection between Peyronie’s disease and Dupuytren’s contracture.
• Why popular remedies like pentoxifylline, castor oil, and manual stretching may not deliver the results men expect.
• When penile curvature requires treatment and why early intervention matters.
• How erectile quality and penile trauma may influence risk.
• How Peyronie’s disease is diagnosed.
• The science behind Xiaflex injections and RestoreX traction therapy.
• What clinical trials reveal about restoring lost penile length.
• How often RestoreX was used in clinical studies and how long improvements may last.
• The potential side effects of Xiaflex and when surgery may be considered.
• The psychological impact of Peyronie’s disease and the future of treatment.

📚 Chapters

00:00 Introduction: Can Peyronie’s Disease Be Reversed?

01:40 Meet Dr. Landon Trost

06:30 What Causes Peyronie’s Disease?

07:50 Genetics and Dupuytren’s Contracture 09:15 Common Myths and Ineffective Treatments

15:20 When Does Penile Curvature Need Treatment?

16:50 Why Early Treatment Matters

20:00 Can You Prevent Peyronie’s Disease?

25:30 How Peyronie’s Disease Is Diagnosed

28:00 Early Treatment Options

31:00 Traction Therapy and Restoring Lost Length

32:30 Why Xiaflex + RestoreX Work Better Together

38:15 The Science Behind RestoreX

41:15 How Often Should You Use RestoreX?

🎙️ GUEST

Dr. Landon Trost Clinic - https://malefertilityandpeyroniesclinic.com/about/

http://peyronies.com - https://malefertilityandpeyroniesclinic.com/peyronies/

Goniometer - https://en.wikipedia.org/wiki/Goniometer

📕 Get Dr. Geo’s Free Ebook- A Guide to Improve Prostate Problems Naturally https://bit.ly/DRGEOFreeEbook

📌Thank You To Our Sponsors

Sponsored by PathRight Medical. This episode's guest, Dr. Landon Trost, is the majority owner of PathRight Medical, manufacturer of RestoreX® and RestoreXL®. Dr. Geo Media retains editorial control over the interview and its independent clinical content.

Find the Right Device for You linked tohttps://bit.ly/3VnIsU0.

📌 Dr. Geo’s Social Media and Websites

Instagram: https://bit.ly/DRGEO-INSTA-YT

Facebook: https://bit.ly/POD-FB-DrGeo

LinkedIn: https://bit.ly/DRGEO-LINKEDIN-YT

Website: https://bit.ly/43khht0

XY Wellness- Prostate Health Supplements - https://bit.ly/3uJPC7Z

Mr. Happy- Supplements for Men- https://bit.ly/3RJMX6O

___________________________________

💪 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 Wellnesshttps://bit.ly/3uJPC7Z | Mr. Happyhttps://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.

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 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 Wellnesshttps://bit.ly/3uJPC7Z | Mr. Happyhttps://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.

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 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 Wellnesshttps://bit.ly/3uJPC7Z | Mr. Happyhttps://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.

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 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 Wellnesshttps://bit.ly/3uJPC7Z | Mr. Happyhttps://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.

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

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___________________________________

📣 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.

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 disease
• The truth about "venous leak"
• How erections actually work
• Psychological vs. physical causes of ED
• GLP-1 medications and testosterone explained
• When testosterone replacement is appropriate
• The biggest myths about Peyronie's disease
• Daily Cialis beyond erectile dysfunction
• Lifestyle strategies that improve sexual health
• The latest treatments available for men

Timestamps

00:00 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

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#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.

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 Timestamps

00:00 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 Points

• New MARCAP consortium analysis on ADT duration
• Radiation sensitivity and androgen deprivation
• Why many men never fully recover testosterone after prolonged ADT
• Balancing survival outcomes with quality of life
• Shared decision-making between physician and patient
• Genomic classifiers including Decipher
• AI biomarkers and Artera AI
• Personalized radiation oncology
• Modern imaging and PSMA PET
• De-intensifying prostate cancer treatment
• Precision medicine in localized prostate cancer
• The 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

___________________________________

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___________________________________

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___________________________________

📣 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.

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.

⏱️ Chapters

00:00 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 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

___________________________________

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___________________________________

📣 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.

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 Chapters

00:00 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 Mentioned

• Unfold AI (Avenda Health)
• MRI for prostate cancer
• PSMA PET imaging
• Focal Therapy
• Active Surveillance
• UCLA Prostate Cancer Research
• Stanford validation studies
• CAPTAIN Trial
• FARP Trial
• HIFU clinical studies

___________________________________

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___________________________________

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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

___________________________________

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📺 YouTube → Dr. Geo Prostate Podcast — https://www.youtube.com/@DrGeoProstatePodcast

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___________________________________

📣 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 Timestamps

00:00 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 Mentioned

• My Exercise Medicine for Cancer by Professor Robert Newton
• Exercise Medicine Research Institute
• New England Journal of Medicine Exercise Oncology Trial
• American Society of Clinical Oncology (ASCO) Researc

___________________________________

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___________________________________

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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

___________________________________

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___________________________________

📣 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.

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.

___________________________________

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___________________________________

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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

___________________________________

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___________________________________

📣 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.

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.

Chapters

00:00 – 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 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

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___________________________________

💪 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/

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🛒 Supplements → XY Wellnesshttps://bit.ly/3uJPC7Z | Mr. Happyhttps://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.

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?

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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

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📣 Hashtags

#DrGeoProstatePodcast #ProstateHealth #ProstateCancer #MensHealth #IntegrativeUrology #Urology

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⚠️ 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.

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.

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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

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___________________________________

📣 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.

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,

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___________________________________

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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

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🌐 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.

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 problem
• Long-term use may come with side effects and limited improvement
• Many men stay on meds for years without real resolution

2. The Shift Toward Personalized Prostate Care

• Not all urinary symptoms come from the prostate
• Key contributors include:
• Diabetes
• Sleep apnea
• Anxiety
• Treating 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 precision
• Guided by real-time ultrasound imaging
• No 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 men
• Aqua ablation preserves it in 90%+ of cases
• Many 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 level
• Urinary flow strength
• Post-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-related
• Bladder function must be considered
• Urodynamics 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

___________________________________

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___________________________________

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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

___________________________________

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📺 YouTube → Dr. Geo Prostate Podcast —https://www.youtube.com/@DrGeoProstatePodcast

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___________________________________

📣 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.

Most men haven’t seen a doctor in 10 years. They wait until a crisis hits, a "zero birthday" looms, or an addiction begins to tear their family apart. Dr. Ray Zakari is changing that by stripping away the sterile clinical walls and treating the mind, body, and soul where life actually happens: at home.

As a Doctor of Nursing Practice specialized in Family Psychiatry and Primary Care, Dr. Ray offers a unique "one-stop shop" for high-performing men and families navigating the complexities of modern life.

What You’ll Discover Here:

• Men’s Mental Health: From Gen Z to Gen X, we’re diving into the unique pressures men face today.
• The Truth About Addiction: Real talk on everything from "ubiquitous" marijuana and alcohol to the hidden drains of workaholism and digital dependency.
• Parenting with Purpose: How to stop being your child’s "friend" and start being their parent—breaking the cycle of enabling and teaching self-efficacy.
• The Mind-Body Connection: Understanding how stress and anxiety manifest as physical symptoms (like pelvic pain, ED, and chronic fatigue).
• Radical Accountability: Why "victimhood mentality" is a dead end and how to build the resilience to do hard things.

Timestamps 🕒

00:00 – Introduction and the "Geo" Philosophy of Aging Better

01:45 – Dr. Ray Zakari: Men’s Mental Health from Gen Z to Gen X

03:45 – Why House Calls? Escaping the 10-Minute Insurance Treadmill

05:40 – The "Zero Birthday" Crisis: Why 30, 40, and 50 are Danger Zones

07:45 – Stop the Victimhood: Why You Can’t Medicate the Past

11:00 – The Parent’s Nightmare: When Your Child is Spiraling

13:45 – Illegitimate Means: Why Your Kids Use Addiction to Cope

16:30 – The Friendship Trap: Why Being Your Kid’s "Buddy" is Failing Them

18:30 – Hard Truths: How Parents Accidentally Fund the Addiction

21:00 – Digital Junkies: Reclaiming Control Over Phones and Gaming

25:30 – The 10:15 PM Rebellion: Allowing Age-Appropriate Pushback

27:45 – Red Flags: The 3 Signs Your Teen is Losing Their Way

30:30 – The Marijuana Myth: How Today’s Weed Destroys Motivation

34:30 – Defining Addiction: When the Habit Starts Taking Your Life

38:15 – The 30-Year-Old at Home: Ending the "Gravy Train"

41:30 – When Love Becomes Dangerous: Dealing with Domestic Violence

44:00 – Narcan 101: The Life-Saving Tool Every Parent Needs

46:30 – Hidden Addictions: Porn, Workaholism, and "Liquid Courage"

51:30 – Cooking as Therapy: Building Brain Function in the Kitchen

53:45 – The Goal of Therapy: Building the Capacity to Do Hard Things

Whether you are a professional struggling to balance high-stakes work with mental peace, or a parent trying to save a child from the brink of addiction, this channel provides the clinical expertise and "straight-talk" strategies you won't find in a 10-minute insurance-treadmill appointment.

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🌱 Partner Offers

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___________________________________

💪 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

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🛒 Supplements → XY Wellnesshttps://bit.ly/3uJPC7Z | Mr. Happyhttps://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.