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so everyone wants to try and squeeze PSA into something it is and it's a very nonspecific test and they've looked at rates of rise and all kinds of different algorithms which really don't add much more than just knowing the number we've learned that PSA is useful if it's from 1 to 10 10 to 20 or 20 and above that's pretty crude I mean so these numbers where it goes from 6 to 7 and 5 to 3 unfortunately don't translate into useful information the only thing that's been shown useful is to compare it to the size of the prostate called the PSA density and that's what marks talking about you can't compare it to the size of the prostate if you don't know the size of the prostate so we see patients that largest prostate in might the winner in my practice right now is 350 CCS all right I've got about five guys over 200 and it's that's big because the average is 30 to 40 all right so you're looking at almost 10 times bigger than normal yeah cuz the average size is a walnut and that's a watermelon it's it's not really a watermelon but it's you so only a grapefruit I know this is so the point is these gentlemen most of them have come to the office they've been biopsied like 5 to 10 to 15 times because everyone's so terrified that they have cancer over and over and over the biopsies are clear they just have a giant prostate because their PSA is running 10 to 15 to 20 and they don't have cancer mark so you say they could have been spared all those biopsies if someone had just measured the size of the gland and put the PSA into context you damn right because the number one reason a PSA goes up in American around the world today is because the prostate gets bigger not because of cancer so you have to differentiate what's going on and by knowing the size you can level the playing field the other way you level the playing field and I know I sound like a broken record year after year is that if you don't take care of yourself then they're gonna think the rising PSA must be due to cancer I can't emphasize that enough so when someone is gaining weight in their blood sugars going up so is their blood pressure all these things are happening it can actually make the prostate bigger the prostate doesn't like to be heart unhealthy if you are heart unhealthy the prostate responds in many men by getting bigger so it's a cruel joke that God plays on men as you age the only thing that really gets bigger on your body our bellies and prostate but you've got to go against that so what happens is when you take care of yourself it's the ultimate truth serum as to what is really going on here so what happens all the time I see because I'm subject to this but I wish this was standard is a guy starts taking care of himself with the rising PSA and they can't tell them it's B pH or not and then the PSA starts to plummet as he loses weight so what was happening was this prostate was getting bigger and bigger and it didn't relaxed or started to shrink a little bit and they still can't find a tumor than the PSA stabilizes and he's okay so I wonder about these guys who never get the opportunity to make that lifestyle change you know we talk about prevention but it's so amazing if I stood up to you and I said when diet and exercise doesn't work there's lipitor you would go oh yeah I know that that's true there's lipitor that's a statin but let me tell you this for the rest of your life I want you to remember this when diet and exercise doesn't work there's proscar when dye and exercise doesn't work there's my Angra when diet and exercise doesn't work there's meza care it's true of everything when dye and exercise doesn't work there's Fosamax for your bones it's true for everything it's not just when dye and exercise doesn't work we have a drug for you so we have to find out what diet and exercise is gonna do whether it's for your hot flashes whether it's for your bone loss whether it's for your rising PSA because your prostates getting too big so this is a really critical point I mean how many guys do you know can tell you the exact size of their prostate and of course I'm surrounded by a lot of savvy patients but I'm gonna guess less than 10% [Music] [Music]