Podcast
The Dr. Geo Prostate Podcast
Hosted by Dr. Geo Espinosa · EN
The Dr. Geo Prostate Podcast is a show that takes an integrative approach to men's health, prostate, and functional urology to optimize their health and help them live better with age.
Visit https://drgeo.com/ today to learn how to live better with age.
32episodes
Episodes
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High-Dose Testosterone (BAT) for Prostate Cancer with Dr. Michael Schweizer
2d ago00:55:21Tap to summarizeWe’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.
Transcribe →Can AI Replace the Prostate Biopsy? The Future of Prostate Cancer Diagnosis with Dr. Wayne Brisbane
2w ago00:35:13Tap to summarizeArtificial 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 Introduction03:00 AI Is Changing Prostate Cancer Diagnosis07:00 Unfold AI: Mapping Tumors with Greater Precision10:00 Who Is the Right Candidate for Focal Therapy?13:00 Life After Focal Therapy: MRI, PSMA & Monitoring15:00 Focal Therapy vs. Surgery: What the Latest Research Shows21:00 Can AI Eventually Replace the Prostate Biopsy?25:00 Dr. Brisbane's Vision for the Future of Diagnosis29:00 Cribriform Disease: Identifying High-Risk Cancer32:00 Beyond DNA: How Proteomics May Transform Cancer CareKey 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 diagnosisResources MentionedUnfold AI (Avenda Health)MRI for prostate cancerPSMA PET imagingFocal TherapyActive SurveillanceUCLA Prostate Cancer ResearchStanford validation studiesCAPTAIN TrialFARP TrialHIFU clinical studies___________________________________🌱 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/3TVehAxAG1 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.
Transcribe →Can exercise be one of the most powerful anti-cancer therapies available today? with Robert Newton
Jun 2201:01:50Tap to summarizeIn 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 thrivingEpisode 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 ThoughtsResources 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/3TVehAxAG1 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.
Transcribe →AI, PSA, and the Future of Prostate Care with Dr. Jennifer Miles-Thomas
May 3100:29:01Tap to summarizeCan 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.TIMESTAMPS06:00 — Can AI Help You Understand Your PSA?08:00 — Privacy & AI Health Searches10:00 — Best AI Tools for Medical Questions13:00 — AI for Doctors & Smarter Decisions14:00 — Ambient AI & The Future of Doctor Visits21:00 — AI, MRI & Prostate Cancer Detection26:00 — The Biggest Risks of AI in MedicineKEY 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 mattersAI 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/3TVehAxAG1 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.
Transcribe →Prostate MRI: When Is Contrast Essential with Dr. Dan Margolis
May 2601:07:47Tap to summarizeWhat 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 Cancer02:45 – 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 MRI24:00 – Multiparametric vs Biparametric MRI Explained35:00 – PRIME Trial Results: Did Contrast Actually Matter?38:15 – Is Gadolinium Contrast Safe?44:20 – Why the PRIME Trial Worked: Quality Control Matters48:00 – 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/3TVehAxAG1 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.
Transcribe →Benefits & Challenges with Focal Options for Prostate Cancer with Dr. Abhinav Sidana
May 1801:04:15Tap to summarizeWhat 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 Biopsies09:30 Transperineal vs Transrectal Biopsies11:00 What Is IRE (NanoKnife)?14:30 Who Is NOT a Candidate for Focal Therapy?18:00 Vapor Therapy & TULSA Pro23:00 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 Therapy40:30 How Tumor Size Impacts Eligibility45:30 Why MRI and PSA Are Imperfect After Treatment49:30 What Is PSA Recurrence After Focal Therapy?53:30 The Future of MRI, AI, and Surveillance57:30 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/3TVehAxAG1 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.
Transcribe →Skip MRI contrast Gadolinium, Precision Biopsy, UK vs. US Care, Dr. Veeru Kasivisvanathan –179
May 900:54:49Tap to summarizeWhat 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/3TVehAxAG1 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.
Transcribe →From Blind Biopsy to Precision: How MRI Changes Everything with Dr. Veeru Kasivisvanathan
May 800:54:51Tap to summarizeWhat 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/3TVehAxAG1 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.
Transcribe →How a Pathologist for Prostate Cancer Reads a biopsy & Cribriform with Dr. Jonathan Epstein – 178
Apr 3001:05:38Tap to summarizeWhat 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.⏱️ Timestamps00:00 – The Hidden Problem With Prostate BiopsiesWhy your diagnosis may not tell the full story02:00 – Meet Dr. Jonathan EpsteinA leader who helped define modern prostate cancer pathology04:30 – What Pathologists Actually Look ForUnderstanding normal vs. abnormal prostate tissue06:30 – Gleason Scores Explained SimplyWhat 3+3, 3+4, and 4+3 really mean09:00 – Why Gleason 6 Is So ControversialShould it even be called cancer?11:00 – The Real Risk Isn’t Gleason 6What doctors worry about more13:00 – Active Surveillance: Who Is It For?Why more men are safely avoiding treatment14:30 – Pathology vs. BiologyHow research connects what we see to outcomes15:30 – The Most Important Details in Your ReportCribriform patterns, intraductal cancer, and why they matter17:00 – Understanding Gleason 7 (Grade Group 2 & 3)Low-risk vs. high-risk within the same score19:00 – When Cancer Becomes DangerousWhat defines aggressive disease21:00 – Gleason 9: Is It Already Spread?The truth about micro-metastasis23:00 – Why MRI and PSMA Scans Aren’t PerfectWhat imaging can miss25:00 – Why Biopsies Still MatterEven in the era of advanced imaging26:00 – What Makes a “Good” BiopsyWhy technique matters more than you think29:00 – MRI-Guided vs. Random BiopsiesWhy both are still necessary30:00 – How to Read Your Pathology ReportWhat actually matters vs. what doesn’t34:00 – Biopsy vs. Prostatectomy FindingsWhy results can change after surgery36:00 – How Often Pathology Is WrongWhy second opinions are critical38:00 – The Problem Patients Don’t SeeYou don’t know who’s reading your biopsy41:00 – The Future: AI in PathologyWill machines replace doctors?45:00 – What Patients Should Do NextHow to advocate for yourself52:00 – Managing Anxiety Around PSA & BiopsiesA real conversation about fear56:00 – What to Do When You Get Your ResultsHow to approach your doctor and next steps01:03:00 – Final Advice: Take Control of Your Health🧠 Key TakeawaysPathology is the foundation of your diagnosis — everything else depends on itUp to 20–30% of biopsy readings may change with expert reviewNot all prostate cancer is dangerous — but some “low-risk” cases hide more aggressive diseaseMRI and advanced imaging are powerful, but they can still miss cancerA second opinion on your biopsy can completely change your treatment plan📌 What to Ask Your DoctorWhat 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 GuestDr. 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/3TVehAxAG1 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.
Transcribe →Prostate Cancer Future: Can Water Jets Replace Surgery & Radiation? with Dr. Brian Helfand
Apr 1301:03:49Tap to summarizeWhat 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 Learn1. Why Medications May Not Be the Best First StepMost 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 resolution2. The Shift Toward Personalized Prostate CareNot all urinary symptoms come from the prostateKey contributors include:DiabetesSleep apneaAnxietyTreating the whole patient, not just the prostate, leads to better outcomes3. 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 patient4. Why Aqua Ablation is a Game ChangerCompared to traditional procedures:✅ Lower risk of sexual side effects✅ Minimal risk of incontinence✅ Faster recovery✅ Highly durable resultsResults: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 orgasm6. 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 ones8. The Future: Prostate Cancer ApplicationsEarly data suggests aqua ablation may:Improve urinary symptomsPotentially reduce cancer burden in some patientsCould evolve into a whole-gland treatment approach⚠️ Still emerging—but very promising💡 Key TakeawaysMedications are not always the best long-term solutionTreat the patient, not just the prostateAqua ablation offers a precision, low-side-effect alternativeSexual function preservation is a major differentiatorThe future may include dual treatment for BPH + prostate cancer👨⚕️ About the GuestDr. Brian HelfandClinical Professor, University of ChicagoMD, PhDAuthor of 270+ peer-reviewed studiesExpert 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/3TVehAxAG1 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.
Transcribe →