Interviewer: We get this question from people that watch some of these videos is, what should be the first couple things that a person does when they get that diagnosis? I mean panic and fear often set in but what would you recommend that people do?
Dr. Phranq Tamburri: Well the first thing is, I would always read The Hitchhiker's Guide to the Galaxy and don't panic. Seriously. Bad geek reference I know but there's not a reason to panic. I see patients sometimes that have really high numbers who've not been monitored at all. Men come in with a PSA of 3000. And that's a different story. But if a man's PSA is under ten. Which most men are when they get this. Don't panic. Just quick. PSA under two in most cases is not cancer. A PSA over ten most cases is cancer but not always. Between two and ten now unofficially is no man's land. Doesn't mean anything. It just means we need more information and usually something comes up in the story. That's what I've found over and over. You got a Harley Davidson you didn't tell me about and that's usually. You bought the Harley and the PSA went up. I see this all the time. So you need to have a doctor to take time to get under the hood to work this through. Second, many men will take antibiotics. Now I don't like the pressure with antibiotics but some way of reducing an inflammation or an infection and then we test the PSA over time. That could help show whether or not the PSA really is up for the right or wrong reasons. If you're asking if someone was diagnosed with cancer specifically on a biopsy, still same thing. Would not be panicking because as I said we have cancer in us all the time or at least we suspect that. And so a cancer may not be an issue. Let me give you one little quick case study that I mention to physicians. It might answer this question about not panicking. I gave a speech at the Mayo and there was a woman there who was there who heard me and she decided to bring her husband in. Her husband thought it would be a waste of time because he was diagnosed with prostate cancer and he had a PSA of 15. He said, what's there to talk about? I'm going to waste money. He sounds like a nice doctor but I'm going to waste the money. So she dragged him in anyway. He was Polish, I'm Polish so at least we talked galumpkies and pierogies and had something to talk about but he came in and I said, OK let's talk about this. I said, how do you know you have cancer? Well, my PSA I got a biopsy, why? My PSA was 15. How'd you know it was 15? Well doctor pulled it at the ER. I said, the ER why are you in the ER? And he said, well because I couldn't urinate. I said, why couldn't you urinate? He said, well...he said, I bought my first Harley Davidson when I turned 50 in a mid life crisis a little late he said as a rich dentist and he decided when he got his Harley to do a Dennis Hopper from Easy Rider and he wanted to go cross country from California to Maine. Well he made it as far as Chicago at which point his prostate seized up. It's like a Charlie horse of his gland, one of these. He couldn't urinate. So in the emergency room now he's got a seized up prostate. Now imagine a sponge that has water in it and you squeeze. Imagine all the water it shoots out. That's the PSA. Getting squeezed out into the body. But it gets better. The ER nurse took a catheter and shoved a catheter up his penis through the prostate and to shove into [?]. That increases the PSA. So at this point all we looked at was one number. One number again making a judgment call. No one asked him how he got there, they didn't ask what he did, none of that. And that triggered the biopsy. They did the biopsy, they found cancer. I said, let me see the biopsy report. They normally take 12 cores. They found cancer in only one of the 12 cores and of that core they found it in less than 1% of the one core. And of that they found a Gleason six which is the weakest cancer you can have. So a Gleason six of less than one core. That's not cancer that's a joke is how I would see that. But they I simply asked the one last question. I said, do you happen to know what your PSA was before the trip? He said, matter of fact my wife because we almost divorced over the motorcycle made him get a life insurance policy before the trip. Smart lady. Turns out one week before the trip his PSA was 1.4. So 1.4 to 15 in a week. That's not cancer that's called a hog is what that is. And that is an example of don't panic. You never know. But I've seen too many of these stories. Once you get used to the...you get more comfortable with these lower PSAs under 10, under 20. And cancer doesn't really mean cancer with a capital C. In most cases it's a lower case C.