The Dr. Geo Prostate Podcast

Most men who undergo a prostate biopsy may not have cancer found at all—and the bigger mistake may be rushing from a single elevated PSA straight to the needle.
Dr. James Wysock, an NYU urologist with deep expertise in prostate cancer diagnostics and image-guided biopsy, explains why the modern biopsy decision is no longer about PSA alone. Repeat testing, prostate MRI, PSA density, blood and urine biomarkers, and expert image targeting can dramatically change who should be biopsied and how that biopsy should be performed.
Just as surprising: transperineal biopsy is not automatically “better” in every case. It clearly lowers infection and antibiotic exposure, but biopsy accuracy still depends heavily on imaging, fusion quality, sampling technique, and operator experience.
In this episode, you’ll learn...
Why one elevated PSA should often be repeated before escalating testing.
Why MRI may be the most important next test when biopsy risk remains concerning.
How transperineal and transrectal biopsies really compare.
How new fusion, needle and tissue-preservation technologies could make future biopsies shorter, more precise and less invasive.

___________________________________
💪 Exclusive Membership
Want 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
___________________________________
⚠️ Disclaimer
This 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.

What if the biggest mistake men make after a prostate cancer diagnosis is not eating the "wrong" food - but becoming so afraid of food that eating itself becomes stressful?
In this solo episode, Dr. Geo draws on more than two decades in holistic and integrative urology to cut through the noise around prostate cancer nutrition. Rather than promoting another rigid diet, he explains how food choices interact with physical activity, stress, metabolic signaling, and long-term sustainability. The goal is not perfection. It is to create a healthier internal environment while still enjoying life, family, and food.
In this episode, you'll learn...
Why no single food causes or cures prostate cancer.
How exercise and stress may change the way your body responds to food.
Why Dr. Geo favors a plant-forward Mediterranean pattern while allowing strategic flexibility.
How to think about protein, fish, red meat, processed foods, saturated fat, and fasting after diagnosis.

If prostate cancer nutrition has left you overwhelmed, this episode offers a simpler framework for deciding what to eat - and what actually matters most.
Chapterts
00:00 Food Myths Intro
00:55 Podcast Disclaimer
01:34 Why Nutrition Confuses
03:34 Principle One No Guilt
04:46 Stress Exercise Absorption
08:57 No Magic Foods
12:55 How Cancer Signals Work
16:40 Processed Foods And Portions
21:02 Best Diet Patterns
25:11 Protein And Muscle
28:38 Meat Poultry Fish
31:23 Carbs And Fats
35:48 Fasting And Overeating
37:17 Thrive After Diagnosis
👉 subscribe to RX3 Thursdays- https://bit.ly/3UyPJ2M
___________________________________
🌱 Partner Offers
ProLon 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/3TVehAx
AG1 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 Membership
Want 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
___________________________________
⚠️ Disclaimer
This 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.

Dr. Geo welcomes Dr. Peter Bajic, Medical Director for Urology at Cleveland Clinic Main Campus and Director of Men's Health at the Glickman Urological Institute, for an evidence-based conversation about erectile dysfunction, testosterone, Peyronie's disease, and the biggest myths in men's sexual medicine.
They explore why erections reflect cardiovascular health, why "venous leak" is often misunderstood, how GLP-1 medications may temporarily influence testosterone during weight loss, and when testosterone replacement therapy is actually appropriate.
The episode also covers Peyronie's disease, treatment options including daily tadalafil and traction therapy, and practical lifestyle changes that can improve both sexual function and long-term health.
If you've ever wondered whether ED is psychological, physical, hormonal—or all three—this episode delivers clear answers backed by today's science.
In this episode you'll learn:

Why erectile dysfunction often predicts cardiovascular disease
The truth about "venous leak"
How erections actually work
Psychological vs. physical causes of ED
GLP-1 medications and testosterone explained
When testosterone replacement is appropriate
The biggest myths about Peyronie's disease
Daily Cialis beyond erectile dysfunction
Lifestyle strategies that improve sexual health
The latest treatments available for men

Timestamps
00:00 Introduction: ED may be your first warning sign
02:45 Why erections are a window into overall health
06:20 Psychological vs. physical erectile dysfunction
13:15 GLP-1 medications, weight loss & testosterone
18:30 Combining GLP-1 therapy with testosterone replacement
28:45 The truth about "venous leak" explained
40:05 Why most men do NOT have true venous leak
43:10 The best approach to treating erectile dysfunction
49:20 Understanding Peyronie's disease
54:20 Can Peyronie's disease be prevented?
58:00 Why daily Cialis may be one of men's most useful medications
1:01:00 Xiaflex, surgery & future Peyronie's treatments

___________________________________
💪 Exclusive Membership
Want 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
___________________________________
⚠️ Disclaimer
This 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.

For decades, men with high-risk prostate cancer have routinely been told they need 18 to 36 months of androgen deprivation therapy (ADT) alongside radiation.
But what if 12 months is enough?
In this episode of the Dr. Geo Prostate Podcast, Dr. Geo Espinosa welcomes internationally recognized radiation oncologist Dr. Dan Spratt, Chair of Radiation Oncology at University Hospitals/Case Western Reserve University, to discuss groundbreaking research that could change how advanced prostate cancer is treated.
Together they explore the latest MARCAP consortium data suggesting many men may receive the same cancer control with significantly less hormone therapy—potentially reducing years of unnecessary side effects while maintaining excellent outcomes. They also discuss how physicians personalize treatment decisions, the growing role of artificial intelligence with Artera AI, and why the future of prostate cancer treatment may involve doing less, not more.
If you or someone you love is facing radiation therapy for prostate cancer, this episode provides one of the most important conversations happening in prostate cancer care today.

What You'll Learn
✔ Why 2-3 years of ADT may not be necessary for many patients
✔ The new evidence supporting approximately 12 months of hormone therapy
✔ Why longer hormone therapy can permanently affect testosterone recovery
✔ How physicians balance cancer control with quality of life
✔ The difference between NCCN guidelines and individualized patient care
✔ Which patients may still benefit from longer hormone therapy
✔ How AI (Artera AI) is helping personalize prostate cancer treatment
✔ Why prostate cancer care is shifting toward treatment de-intensification
✔ The future of precision medicine in radiation oncology

Episode Timestamps
00:00 Introduction
01:30 Meet Dr Dan Spratt
02:22 Why ADT Lasts Years
05:42 How ADT Helps Radiation
08:49 Personalizing ADT Duration
12:39 Guidelines and Real World Use
18:03 Who Needs Long Term ADT
21:13 Artera AI Explained
23:19 Old Data and Modern Outcomes
27:28 De Intensification Future
31:33 Biomarkers for Urologists
33:57 Choosing Artera vs Decipher
37:28 Final Takeaways and Outro

Key Discussion Points
New MARCAP consortium analysis on ADT duration
Radiation sensitivity and androgen deprivation
Why many men never fully recover testosterone after prolonged ADT
Balancing survival outcomes with quality of life
Shared decision-making between physician and patient
Genomic classifiers including Decipher
AI biomarkers and Artera AI
Personalized radiation oncology
Modern imaging and PSMA PET
De-intensifying prostate cancer treatment
Precision medicine in localized prostate cancer
The future of individualized prostate cancer care

Resources Mentioned
• MARCAP Consortium research on androgen deprivation therapy duration
• NCCN Prostate Cancer Guidelines (discussed throughout the episode)
• Artera AI clinical decision support platform (discussion)
• Decipher genomic classifier
• PSMA PET imaging
• MRI-guided prostate cancer staging
___________________________________
💪 Exclusive Membership
Want 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
___________________________________
⚠️ Disclaimer
This 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.

We’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.

⏱️ Chapters
00:00 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 Membership
Want 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
___________________________________
⚠️ Disclaimer
This 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.