 It's Sri Ram Surya, this is Feebo 104. Dr. Ajay Asshetty, he's lead consultant with Manipal Hospital. Urologist, how many years have you been a doctor now? Yeah, so I think I became a doctor in 1999. Yeah, so it's nearly 22, 23 years that I've been a doctor, but I've been a urologist for the last 12 years. For the last 12 years now, Dr. Ajay Asshetty, he's answering a whole lot of our questions. And Dr, as in terms of taking a break and just unwinding, what do you end up doing most of the time? If my wife permits me, I end up going to the golf course and hang out with my golf buddies. And we have a diverse bunch of golfers, as you know, out there. It's not necessarily doctors, but people from all streams of life. So that's the excitement, meeting people from other disciplines, too. But golf is my passion. Yes, that's what I do in my free time. So you have all the guys come in and lots of conversations, plenty of them from different fields as well. And it's always good quality time. Bangalore's weather is just perfect for golf in a way, isn't it? Yeah, all my buddies outside of Bangalore are extremely jealous. I have a twin brother in the US who's also an avid golfer and he plays only six months because of the weather and we play 12 months a year. So Dr. Ajay Asshetty, of course, is lead consultant, urologist with Manipal Hospitals. Today we are going to be talking about urological cancers. Doctor, it sounds dangerous. Anything with cancer just seems to cause worry to a lot of people. What cancers do you see in your domain and which one is the most commonest? In the domain of urology, there are at least three to four cancers that we can talk about, but the commonest cancer is what is called prostate cancer. The second common, I think kidney and bladder cancers are really close by. Penile and testicular cancers are not so common, but prostate cancer is by far the commonest. OK, and how do you diagnose prostate cancer? Is there a particular diagnosis to it? Yeah, so I think that's something that is very important here simply because even now, in our country, at least six out of 10 patients that I see in my clinic with prostate cancer have already come to me in an advanced stage. It's simply because of lack of awareness about this condition. The only way that one can pick up prostate cancer early is if you're aware that there is a blood test called PSA, Prostate Specific Antigen. This is a blood test that every adult, once he crosses 50, must do as a part of his annual health checkup, and this is the only way to catch prostate cancer early. So if you find that your PSA reading is a little above normal, which would be the value cutoff is four, then that's the time that mandates a visit to your urologist to evaluate the prostate. I'm not saying it means cancer, I'm just saying it means you need to get yourself evaluated. Wow, so it's such a silent killer, and regular checkups make so much of a difference, and it needs to be stressed upon so very much. What is treatment towards this cancer, doctor? So once the PSA is high, and a diagnosis of cancer has to be made, typically a urologist would ask for an MRI and do a biopsy from the prostate, which would mean take a little bit of a tissue from the prostate and send it for testing. And that's the only way to confirm that there is cancer. Once the cancer is confirmed, then there are many lines of treatment available, and the common ones are surgery, radiation, or in advanced stages, some hormonal treatment. But one glove does not fit all. We decide on what treatments we offer to the patients based on multiple factors, like for example, the age of the patient, what are his medical conditions, does he have heart disease, what is his fitness level like? And more importantly for me, what is the patient's choice? Because every patient having understood the pros and cons will make an informed choice about whether they want to go for surgery, whether they want to avoid surgery. So I tailor make my treatment based on patient's wishes too. Lovely. Is this preventable, can prostate cancer be avoided? Prostate cancer, the only thing that we can do is actually have a healthy diet and a healthy lifestyle, but I really don't think it's preventable in that sense. Which is why again the concept of early detection, do that blood test PSA as a part of your annual health checkup and meet your urologist whenever the value is abnormal. There you have it. Dr. Ajay Shetty, he is lead consultant urologist with Manipal hospitals, Yashranpur as well as Hebal. Thank you for shedding light because this is not spoken about that often. We do hear that Bangalore is a hub for breast cancer. However, prostate cancer is not spoken about much and until someone is affected in the family, you don't really know the magnitude and what needs to be done. Just some basics are also something that I feel is missing. Do you feel that knowledge or communication needs to be stressed upon a whole lot? No, absolutely. I think we are still suffering from lack of awareness and that is simply because we don't spend enough time educating the public and creating awareness on how to prevent disease. And that's something that actually is a very, very important part of our day-to-day medical practice. It's not just enough treating an illness. I think creating an awareness is a bigger responsibility that I think often we fail to fulfill. Well, thank you. You, of course, are involved with saving a whole lot of lives but that apart, propagating the right message and being here and doing your part means a whole lot. When we come back, we will be talking about the stages of advancement in treatment, robotic surgery, laparoscopic surgery, all of this and a whole lot more with Dr. Ajay Shetty in the studios of FIBO 104.