The Future of Prostate Cancer Treatments & Non-Invasive Techniques with Less Side Effects | Dr. Sanjay Mehta

**Dr. Gabrielle Lyon** (0:00)
Do all cancers respond to radiation?

**Dr. Sanjay Mehta** (0:03)
There is no cancer that cannot be destroyed by radiation. The limiting factor is the human being around that cancer.

**Dr. Gabrielle Lyon** (0:10)
One in eight men will get prostate cancer.

**Dr. Sanjay Mehta** (0:13)
That's right.

**Dr. Gabrielle Lyon** (0:13)
That is insane.

**Dr. Sanjay Mehta** (0:14)
What has really revolutionized our field is we're not treating large parts of the body. I can make the radiation go exactly where the problem is. So in the case of a prostate cancer, I'll treat the prostate gland with just a few millimeter margin around it. And when you get just a few millimeters beyond that, the dose is very low. So we don't cause the collateral damage that we used to.

**Dr. Gabrielle Lyon** (0:33)
Gosh, that is unbelievable. What are some of the biggest myths surrounding radiation?

**Dr. Sanjay Mehta** (0:41)
Radiation is part of the electromagnetic spectrum, just essentially light. Doesn't matter how much FM 88.7 you listen to, it's not going to hurt you. Your cell phone is a radio, so those are all non-ionizing radiation. So the old tale about the cell phone giving you a brain tumor, not going to happen.

**Dr. Gabrielle Lyon** (0:58)
What about living next to an electrical tower?

**Dr. Sanjay Mehta** (1:01)
That's EMF again, and so that's electromagnetic frequencies that are not able to damage your DNA. On the other hand, as you mentioned, the lady who's afraid of going through an airport scanner because she might be pregnant, that is ionizing radiation. It's a very low dose to get like an x-ray to security area, but that is an x-ray. X-rays by definition are ionizing, and if I had a chance of being pregnant, I wouldn't go through it either.

**Dr. Gabrielle Lyon** (1:23)
Wait, wait, wait. This is really important. Dr. Sanjay Mehta, welcome to the show.

**Dr. Sanjay Mehta** (1:36)
Thank you, thanks for having me.

**Dr. Gabrielle Lyon** (1:38)
This episode, my goal is really twofold. Number one, to be a guide for men, men that have had prostate cancer, but also individuals that have been athletic or who suffer from any of the ITISs. Osteoarthritis, rheumatoid arthritis, you name it, you can treat it.

**Dr. Sanjay Mehta** (2:01)
Yes, ma'am.

**Dr. Gabrielle Lyon** (2:02)
Tell me a little bit about your treatment and your experience of treatment with prostate cancer, with low-dose radiation therapy.

**Dr. Sanjay Mehta** (2:10)
Sure. So for prostate cancer, it's considered high-dose, relatively speaking, we use higher doses for any kind of cancer. So radiation is a viable alternative to a radical prostatectomy for most prostate cancer patients. So once the urologist does a biopsy and diagnoses the prostate cancer, then they get sent to me. They'll usually get a referral to a urologist who specializes in radical prostatectomy. And then in my case, I'm a radiation oncologist, so I'm trained to treat all different types of cancer, but prostate cancer being the most common thing we see. I've done probably something like 10,000 cases over the years, so it's a very common thing. But external beam radiation in high doses, usually it's about six to eight weeks of treatment. It's Monday through Friday, five days a week, about a 15-minute per day treatment. It's basically just an x-ray, so it's painless. Patients come in, they're happy, they get their treatment. They leave 15 minutes later without any sort of instrumentation or injections or anything. And by giving a small dose of radiation on a daily basis over several weeks, the cumulative dose is actually quite high, enough to kill the cancer cells without dealing with some of the things people deal with with surgeries, for example, incontinence and nerve damage and things like that.
So, you avoid all of that with just a non-invasive treatment, and people can live their life and get treated for prostate cancer simultaneously with no downtime. And depending on the stage and the grade of the disease and whatnot, the cure rates are basically the same as a radical prostatectomy. So, that's a very popular procedure.

**Dr. Gabrielle Lyon** (3:41)
And one in eight men will get prostate cancer.

**Dr. Sanjay Mehta** (3:45)
That's right. That's right. Very, very common.

**Dr. Gabrielle Lyon** (3:47)
That is insane. There is radiation. There is surgery.

**Dr. Sanjay Mehta** (3:51)
Right.

**Dr. Gabrielle Lyon** (3:52)
Is chemo also utilized?

**Dr. Sanjay Mehta** (3:54)
In metastatic disease, if you have bone mets, even then, like when people think of chemo, you think of like your hair falling out and being super sick, like with breast cancer and leukemias and things like that. Typically an anti-cancer drug is still chemo, but usually in the case of prostate cancer, it's an anti-testosterone drug. So like Lupron, which is an LHRH agonist. So you starve the body of testosterone. So you do cause some side effects, but it's not like chemo, chemo, what you traditionally think of where people get sick. It's not that type of drug. So we usually don't have to use that because prostate cancer is usually a local disease. It's not a systemic disease the way other cancers that require chemo are.