Hi everyone! A quantity of you have beensubmitting YouTube comments and a lot of you guys have questions on prostate cancerthat you would like us to ask Dr. Scholz, and today we’re going to answer those questions. What precisely induces so many lovers to die ofprostate cancer each year? It seems that there are both primary and secondary causesof death( so liver omission is secondary to prostate cancer ). They justwould like to know the deterioration. Well, I mean the things that induce prostate cancerdeath are either bone marrow failure because if you think about it prostatecancer spreads to the bones. Bone marrow failure wants progressive anemia wherepeople got to get transfusions all the time, susceptibility to infections because the bonemarrow is where your immune system is drawn, or bleeding questions because that’s where theclotting roles that help your blood to coagulate usually is made.So, you mentioned liver, the liver is very prone. Thankfully, prostate cancer doesn’t frequently spreadto the liver unless it’s very advanced, but if it does that can be a real problem.Obviously, we need our livers to be able to function metabolically in a normal style. Thesoit’s really those two things are the most common thing and the second thing is with oftentimes ondeath certifications beings are put down if they’ve had prostate cancer this is some of the confusionabout the COVID too.If they’ve had a COVID infection and they die, well if you have a heartattack when you had the COVID infection, they call it a fatality from COVID and if you have a heartattack while you have advanced prostate cancer, they’ll call it a prostate cancer death sometimes.So it’s not a super precise, well what actually caused the death, it’s sometimes a combination ofold age, other medical problems, plus the prostate cancer, and oftentimes the decision to call ita death from prostate cancer is quite arbitrary. Okay, our next question is how muchlonger might the average case live after coming the therapy lutetium-1 77? So for the public, they may not know whatlutetium is, can you explain that first? So lutetium is a new targeted radiation that’savailable outside the country right now and pending FDA approval here in the UnitedStates. Novartis Pharmaceuticals purchased this technology for about two billiondollars a duet years ago I see now, and we’re awaiting the results of phase threetrials to confirm that it does utter parties live longer.The survival after lutetium isgoing to depend very much on how aggressive the cancer was going into the treatment soif someone has had every known treatment and gets a poor response to lutetiumbecausenot everyone responds to itsurvival could be less than a year. On the other hand, beings that go into lutetium with relatively small tumor volume and who’ve been doing well, they could live numerous many years after lutetium. Now, you’ve had cases treated withthis; what have the effects been? So, individual patients that we sent over toGermany or to Australia for therapy, cases had to pay out-of-pocket for this, guarantee didn’t cover it, the government has normally had advanced disease which was resistant tochemotherapy, resistant to second-line hormone therapy( Xtandi, Zytiga, Erleada, etc .) andwere in dire straits and its own experience with the medicine is that about one-third of the men thatunderwent this management had spectacular and useful responses, big lowers in PSA and reversal of thedisease that no doubt cleared them live longer, and about two-thirds or one-third things get sidewaysand about one-third it didn’t seem to work at all.So, the one-third that did greeting well, are they in oral remissions currently? The patients thatI can’t recall at the topof my headbut we do have cases that have had continued remissions andthen we’ve had patients that have had remissions for 6, 12, 24 months andthen the cancer started coming back again. So, Dr. Scholz, we’re getting outside of prostate cancer a little bit now and just goinginto prostate with BPH and prostatitis; the first question is regarding BPH, thisperson is thinking of skipping the treat stage and just going straight to Urolift orRezum and they would like to know if that’s okay? Yeah, my answer is it’s your body, it’s okay.Thereason I don’t generally think in that cycle is my preference is to startwith reversible treatments because every treatment has a potential sideeffect and side effects can be categorized as reversible or irreversible and the side effectsfrom most prescriptions are reversible with rare objections whereas the side effects fromprocedures are rarely irreparable and there’s just less threat in starting offwith some of the medication approaches than there is with jumping right into aprocedure, but that’s how someone wants to live their life if they are informed as towhat the pros and cons are, that’s their option. Yeah, I think it’s really interesting becauseI think so often when it comes to health issues like prostate BPH, prostatitis, prostatecancer the quality of life aspect is not something that someone immediately thinks aboutbecause they’re in survival state or wanting to deal with the problem, but these long-term sideeffects and things that people are dealing with and then having to deal with those side effectsand making troubles last-minute down the line it, and I 100% appreciate that you say that because Ithink that it’s the PCRI’s job to really tell people your quality of life truly matters andif you can do something that’s reversible it’s so important and I know I’m proclaim the choirhere, but i crave our gathering to know, you are familiar with, it’s like when you rush to these treatmentslike surgery and radioactivity in prostate cancer and all that stuff when instead of seeing what youreally have, dealing with the problem accordingly, and then dealing with the quality oflife issues.I think it’s detrimental … It’s kind of juggling a few different thingsat the same time and that’s difficult for some people. This is why it’s nice toteam up with someone, have a partner, get second sentiments, make yourtime, and actually make sure that parties understand the pros and cons ofall the different options and then make a decision rather than only making an immediateemotional decision that you may regret later. Our next question goes intoprostatitis and this person is asking is there such a thingas non-bacterial prostatitis? There certainly is. It’s incredibly commonand maybe as many as one out of four lovers are facing non-bacterial prostatitis so they maybe unaware of it.Non-bacterial prostatitis could attest just as some calcium on a check that yousee without ever being is attributable to any symptoms whatsoever. It could be presenting just as ahigh PSA that you can’t ask any other way. So the non-bacterial prostatitis issue is verywidespread and it’s not very well understood. Since it’s asymptomatic a lot of seasons peoplejust ignore it; some soldiers can get non-bacterial prostatitis and it can they have discomfortin the pelvic field, burning with urination, feeling sick, and certainly can represent a huge challenge and entire notebooks havebeen written about non-bacterial prostatitis.Our next question goes into diet and sowe’re kind of going into the nutrition health and wellness lists here. So, doeseating fresh fruit affect prostate cancer? So, I think this person’s reallytalking about the carbohydrate … Yeah, I don’twell first, while sugar controversies arethought to be very important with things like pancreas cancer and lung cancer, they’re notthought to be as big-hearted national priorities with prostate cancer. We fret more about animal flabs, animalproteins than we do about carbohydrate. So I has not been able to prescribed or come out against patients eatingfruit that have prostate cancer. There are some very stringent vegetarian diets that do takethat stance and I’m not a dietary expert, but you’re getting into pretty esoteric and quite limited diets when you getto the level of saying you need to avoid fresh fruit and I think there’s a lot of interesting thing Iwould consider before I went to such an extreme.Are there special meat to avoidwith Gleason 6 prostate cancer? Well, we don’t think of Gleason 6 truly asbeing a cancer. It doesn’t spread; it does sometimes scare beings into pointless treatment.That’s probably the main danger. So, if people got nothing to worry about their own health, they should befollowing a nutrition that they believe will minimize the risk of congestive heart failure. Just because someonehas a harmless prostate cancer doesn’t mean now that you can throw caution to the wind and justignore your health in general, but it’s not fair to tell people with Gleason 6 that they shouldbe afraid of their cancer and they should change their whole lifestyle on the basis of the canceralone because we know it’s a harmless condition.This party invites, when youtalk about the effects of solid in the diet of prostate cancer are youspeaking precisely to animal paunches or are there plant-based paunches including nuts andolive oils and avocados worried about? I think there’s levels of intensity and I belief realistically we’re talking about animal fats.When we talk about gobbling animal protein it’s always desegregated in with animal flabs and the reasonwe make solid gravely is based on a variety of studies that is demonstrating that these prostate tumorson Baby examines pick up these solids really quickly and they’re a real high vigour source so onecould extrapolate and say well shouldn’t you avoided vegetable flabs as well? And I’m not sure anyonereally knows the answer to that.If they do, I don’t, but I frequently sort of draw the line attrying to cut back on animal protein which thus also eliminates animal flabs and tell cases thatif it comes from a weed that it’s probably penalize. Our next question is genuinely are thereany long clinical tribulations demonstrating that switching from a meat-based diet toa vegetarian diet or plant-based diet has any effect on loweringPSA or anything like that? Yeah, Dean Ornish published some wreak. Did you say advanced prostatecancer or only any prostate cancer? Just any prostate cancer…Dean Ornish did some studies in earlier-stageprostate cancer showing that changes in diet and life restrained PSA rise and I’ve observedit also in humanities that have had rising PSAs after surgery who we check PSA’s monthly and show thatonce they flip over to a brand-new diet that the rate of PSA rise is altered almost immediately. So, it’s kind of a seeing as believing thingthis pattern of cases borrowing different lifestylesand observing a big change in their PSA patternsa patternit’s something I’ve seen over andover again it’s a very real phenomenon to me. Going off that question, this person says thatDr. Scholz doesn’t really be divided into the vegan diet and the vegetarian diet. The vegan dieteliminating all products of animal descent and the vegetarian nutrition does include things like milk andeggs, and so where does milk and eggs lie on that? How serious do you want to get about diet? And that’s probably provide a response to how serious is the cancer.We go to the extreme of theGleason 6 kinfolks and there’s no motivation to change your food at all really based on that. Menthat have advanced hormone-refractory disease who are literally fighting for their lives, Iwould definitely eliminate the milk and eggs. Thank you guys so much forcommenting on our youtube videos; we really appreciate your questions andit’s an honor to be able to answer them. If you would like further information about anyof the topics that we talked about today you can visit our website at pcri.org. If you haven’talready subscribed to our canal delight do so; you are eligible to affected the agree button below, and ifyou have more questions go ahead and leave them in all of our youtube observations; our crew will pickit up from there. We hope you have a great week !.