Today Louie speaks with a leader within the men's health arena, Dr. Katelaris. He is highly sought after respected Urologist, who is making waves in the industry for the amazing work he does in helping men with their sexual health, prostate, kidney stones, incontinence and some diseases.
Louie and Dr Katelaris take a dive deep into issues that effect men, in particular erectile dysfunction, prostate cancer, and the best ways to address these health concerns in day to day life. Louie also gets the scoop on were the research is heading surrounding urology in the future.
To find out more about Dr Katelaris, his work and accomplishments visit www.katelarisurology.com.au
Jess: Welcome to Flip the Script Podcast, where we flip the narrative on issues that affect men's health.
Louie: Our aim is to talk about the weird, the wonderful, and perhaps the unspoken issues that affect men. So you can feel empowered and back to living your best life.
Jess: Let's get into it.
Louie: Hey everyone. It's Louie here. And welcome to another episode of Flip the Script. Today, we have a special guest joining me. He's a leader in the men's health space. He's a highly sought after respected urologist. He's an expert in erectile dysfunction, prostate cancer, and particularly with men's concerns around their health. He has experience in addressing how these health concerns affect men in their day to day life. And he's no stranger in receiving accolades for his work and research. I would like to introduce Dr. Phillips Katelaris. Hi doctor. Thank you so much for being here with us today.
Dr Katelaris: Hello.
Louie: It's great to have you here, and I'm really looking forward to sharing your knowledge with our listeners.
Dr Katelaris: It's my pleasure. Thank you for asking.
Louie: So doctor, can you tell us a little bit about yourself and how you chose the specialty of urology and why the focus on men's health?
Dr Katelaris: I've been a urologist for nearly 40 years now. It's a fascinating area of surgical medicine and it's a very necessary area because men's health is a major health issue. And there has been in the past a reticent for men to speak about their health, but happily due to podcasts like this and men being willing to come forward and talk about their health, I think barriers have been broken down and communications established, and it does make the whole process a lot easier to navigate when people are open to information. And when they realize that they're not the only ones suffering from erectile dysfunction or prostate cancer, for example.
Louie: Do you find that it's easy to have that conversation with them? Because we do understand that there is a stigma around men's health. A lot of men try not to speak about it, or they are reluctant to seek treatment.
Dr Katelaris: With myself, I'm very comfortable speaking about it and we ask very direct, frank questions in a comfortable environment. Men do open up. So I don't have a problem communicating sensitive issues with men, because after all, that's why they do come to see. And for any health practitioner, the message is just speak calmly and openly about erectile dysfunction, premature ejaculation, prostate cancer. The more comfortable the doctor is, the more the patient relaxes into the conversation.
Louie: So you find that it's much easier to speak to them when you put them in that situation?
Dr Katelaris: Yeah. You just say directly, "I understand you are having trouble getting an erection. This is a very common problem. Let's talk about it. There's a lot we can do about it." If you open the conversation like that, there's no barrier to communication.
Louie: And prior to them having the appointment with you, I guess, what do you feel that the barriers are with them, is it easier for them to maybe communicate it with their partner or somebody that they're close to?
Dr Katelaris: Not necessarily, especially erectile dysfunction, even if a man's been married for 30 or 40 years, he still feels a sense of failure with his wife. And quite often, therefore it's the wife who will eventually said, "Look, there's a problem. I want you to see the doctor. I want you to see what you can do about getting it fixed, because it's affecting our relationship." So, it is very sensitive, and it is good for men to being encouraged to speak up and [inaudible 00:03:58].
Louie: Oh, that's great, doctor. Now, we wanted to touch on the prostate gland. Can you tell us a bit about the prostate and what its role is in the body?
Dr Katelaris: The prostate is a reproductive organ. It produces a sugar, fructose that is necessary for the health of sperm. Therefore, once a man has finished procreating, the prostate gland doesn't have any identifiable useful function. A little bit like the female uterus, it becomes somewhat redundant.
Dr Katelaris: So physiologically it's important for reproduction. Now, the urethra, the water pipe passes right through the middle of the prostate gland, so that as the prostate gland enlarges over the age of 50, it can start causing urinary obstruction, symptoms like a poor flow, getting up at night, frequency and urgency. And these symptoms are due to a process that we call benign prostate enlargement.
Dr Katelaris: The other common pathology's prostate cancer. And it does not have symptoms. And this is a misunderstanding that men have. They think if they have urinary symptoms, they must be developing prostate cancer. In fact, prostate cancer is asymptomatic, even when it's quite advanced. The only way of detecting it is with the PSA blood test or by the digital rectal examination that we do in the doctor's office.
Louie: And what are some things that can cause prostate cancer? And I guess, also, what are some preventative measures that men can do to lower their risk of getting prostate cancer?
Dr Katelaris: So if you, as a man, have a first degree relative with prostate cancer, your chance of getting it yourself is three times greater than a man of similar age in the community who does not have a first degree relative. Therefore, the genetic component's very important. If a man's mother had breast cancer, he has an increased risk of prostate cancer.
Dr Katelaris: So these men, we start to screen for prostate cancer every year from the age of 40. If there's no family history of the disease, we start to screen from the age of 50. Now, in terms of non-genetic risk factors, the main one seems to truncal obesity, say if a man's waist circumference is greater than 90 centimeters, he does have an increase in risk of prostate cancer. Therefore, it's a very good public health measure for a man to try to slim down, to avoid abdominal fat, to eat a high fiber, low fat diet and to exercise for at least half an hour every day.
Dr Katelaris: Now, not only is that good for the prostate, it's good for the heart and the rest of the body as well. It's important to understand with prostate cancer, that there is low grade and high grade cancer. Millions of men have small areas of low grade prostate cancer that does not need treatment, that does not cause any medical harm. And we simply put these men onto an active surveillance program, and the majority of these men go for the rest of their lives without needing medical intervention. On the other hand, if a man as high grade prostate cancer, then certainly either surgery or radiation therapy needs to be discussed.
Louie: Oh, great doctor. That was actually very insightful. Thank you for that. Now, looking into the future, where is research heading and what are medical advancements are you expecting in your area of urology in particular?
Dr Katelaris: With respect to the field of prostate cancer, more and more research is being done to determine which prostate cancers are biologically significant and therefore can be treated versus which can be safely watched. That's an important activity for research. And of course, research is directed towards more and more, less invasive treatments for prostate cancer.
Dr Katelaris: One of the most exciting advances has been what we call theranostics, combining diagnostic PSMA PET scan with radioactive molecules to treat prostate cancer once it has metastasised to other parts of the body. This treatment is becoming more and more popular and does offer hope to men with metastatic or otherwise incurable disease.
Dr Katelaris: In the field of erectile function, there's been talk for many years about stem cell therapy, we're not there yet, despite the fact that certain private clinics are commercialising it, but in terms of the future, and I think the distant future at this stage, stem cell therapy does have some promise, though that's not to be overstated at this point.
Dr Katelaris: We already have very good treatments for erectile dysfunction. The first of course is lifestyle modification. The same as with prostate cancer, slimming down, exercising, controlling diabetes, stopping smoking. All of these lifestyle factors can improve erectile function if they're properly modified. For men with significant erectile dysfunction, PDE5 inhibited drugs, like Cialis and Viagra are quite effective for about 50 to 60% of men.
Dr Katelaris: Then we have penile injection therapy for non-responders to Viagra, and ultimately, we can always use an inflatable penile prosthesis. Penile prosthetic surgery is very, very successful. It restores excellent natural erectile function and has been a great benefit to many men and their partners over the decades.
Louie: Great, thanks doctor. That was actually very interesting, especially the research around the prostate cancer. Can't wait to see what that brings in the future. Dr. Katelaris, thank you so much for taking your time out of your busy schedule to join us and to share your knowledge. We really do appreciate it.
Dr Katelaris: Yeah. You're welcome.
Louie: For everybody listening, please like, share, leave us a review on the episode so we can continue to bring amazing guests onto the podcast and allow them to share their knowledge with you all, like Dr. Katelaris.
Louie: If you want to get in contract with Dr. Katelaris, you can visit his website, www.katelarisurology.com.au. We will have the link and the information under the episode. Doctor, thank you again for joining us and to everyone, thank you for listening.