Joey Wahler (Host): One on One with Regional One Health is your inside look at how we're building healthier tomorrows for our patients and our community. Join us for expert insight that empowers you to achieve a lifetime of better health.

Today, we're talking to Dr. Ava Saidian, a urologic oncologist at Regional One Health. She's joining us to share what patients need to know about their risk factors, symptoms, and treatment options for urologic cancers. Hi there, Dr. Saidian. Thanks for joining us.

Dr. Ava Saidian: Hi. Thanks for having me.

Host: Great to have you aboard. So first, tell us a little bit about your professional background and what drew you to this particular career.

Dr. Ava Saidian: Sure. I did my medical school at the University of Kansas, and I did my urological training at the University of Alabama in Birmingham. And then, I did a Society of Urologic Oncology two-year fellowship at UC San Diego. So, I am trained in urologic oncology, which is a surgical specialty that treats cancers of the GU tract. So, your kidney, bladder, prostate, testicles, penis, and the adrenal gland.

Host: So, that obviously covers a lot of ground. What's it like having to be familiar with so many key parts of the body?

Dr. Ava Saidian: It can feel overwhelming when you're first starting out, having to learn about all of this stuff, but it becomes part of my routine to just keep up on the latest treatments and literature and all these different organ systems. And it's just a natural part of what we do.

Host: And one great thing about the care offered by you and yours is that you'll follow a patient post treatment, post surgery, so that If anything comes back, or even if it doesn't, if there's good news, one way or the other, you're there for them, right?

Dr. Ava Saidian: That's right. That's one of the things that drew me to this field in particular is that I will operate on you, but then I will follow you for five, 10, 15 years afterwards to keep an eye on everything, make sure you're not only doing well from a surgical perspective, but also keeping an eye on the cancer and making sure that it does not come back. And if it does, making sure that we're the first ones to know so we can get it taken care of as soon as possible.

Host: Gotcha. So, what services do you actually offer cancer patients?

Dr. Ava Saidian: We are a surgical specialty. So, we will take care of patients from the very beginning in terms of doing a biopsy or getting tissue samples in order to diagnose a cancer, all the way towards minimally invasive or larger open surgeries to actually treat and remove the cancer.

Host: Obviously, cancer and surgery can be very scary for patients. So, give us an idea, please, how you walk them through those early conversations about their diagnosis and their treatment options.

Dr. Ava Saidian: So when a patient comes to me, I like to first figure out what their understanding is of their disease. If I'm diagnosing them versus they already have a diagnosis, I try to understand, you know, where are we at? Do you know anything about this disease? Do we need to start from the beginning? Do you have family members with it so you have some background in it? And then, I like to understand what your support system is because if you're someone who is going to need a little extra support throughout it, I want to make sure that we have all of those things set up for you.

Then, I like to go over the big picture for the patients. So that if down the road something comes up or something happens, I don't want it to be a surprise for you. I want for us to have at least talked about it. And then, from there, we kind of focus on our next steps. So, what are we going to do next? What do you need to do next? Is it get labs? Is it going to get scans? Is it setting you up from surgery? And then, most importantly, I let patients ask me a lot of questions. There's no small questions or silly questions. I like to spend the majority of our visit answering your questions, because if you don't have an understanding of what is going on, then you will not have a good outcome in my opinion.

Host: Understood. You mentioned earlier the different organs that you treat, so generally speaking, what are the different treatment options for urologic cancers?

Dr. Ava Saidian: Because there are so many different organs, the treatment options vary, it can vary from removing part of the organ to removing just the tumor in the organ, all the way to removing the entire organ, like removing your entire prostate, your entire kidney, your entire bladder, et cetera. It really varies depending on the cancer type.

Host: And so what, again, generally speaking, would be some of the risk factors that people need to consider when getting that cancer treatment?

Dr. Ava Saidian: So, general things would be just surgery overall, there's always a risk with surgery, things like bleeding, infection, damage to other organs nearby. Again, it really depends on what organ we're focused on. And we go over that in a lot of detail, the specifics of what you can expect before, during, and after your surgery.

Host: So when someone comes to you with symptoms making them think that perhaps or making their general practitioner, let's say, think that there may be cancer present. What are the steps you take to make a diagnosis?

Dr. Ava Saidian: Let's say, for example, we're talking about bladder cancers, the most common sign of bladder cancer is blood in your urine. So usually, someone will go see their primary care physician and then they will get sent to us. So, we will get a good history of when it started, what's going on, if there are other things that could be causing blood in your urine. And then specifically for that, we'll do two things. We'll get a scan of your abdomen and your pelvis. And then, we'll also look inside your bladder with a very small camera, and we can actually do that in the office, and it takes less than five minutes.

Host: And so, you mentioned blood in the urine as one symptom for that particular cancer. Anything else that people should be aware of in the way of potential symptoms that may mean there's a urologic cancer present that might not be as obvious as that?

Dr. Ava Saidian: Sure. So, that brings up a great point, which is actually prostate cancer, which is one of the most common urologic cancers and one of the most common cancers in men. It actually does not have symptoms early on. So, the way that we find that is by doing a blood test called a PSA. And that blood test is usually done by primary care physicians. And for most men, they'll get their first PSA checked around age 50.

Host: And that is the gold standard, if you will, for screening for that, yes?

Dr. Ava Saidian: Yes. Currently, right now, that is the cheapest, easiest, and most simple way we can help detect prostate cancer.

Host: And it's really crucial that that be done on a regular basis starting at that age, isn't it doctor? Because prostate cancer, if caught early, is very treatable. But if caught later, not necessarily the case, right?

Dr. Ava Saidian: Yes, absolutely. So, if we're able to diagnose your prostate cancer early, it is curable, and we can make sure it's something that does not affect your life and how long you live. So If you are a male with an average risk for prostate cancer, you know, no strong family history of it, then we usually check your first PSA between age 50 and 55.

Now if you're someone who's at a higher risk for prostate cancer, so that would be you've had multiple close family members with prostate cancer, such as your father, brothers, uncles, or you're African-American or Black, then you're at a higher risk for developing prostate cancer at a younger age. So for those men, we might even check their PSA for the first time between ages 40 and 45.

Host: A couple of other things. When we're dealing with, when you're dealing with, the parts of the body we've been discussing, there are potential side effects after surgery that deal with sexual performance, that deal with urinary issues, when you're dealing with sensitive subjects like that, how do you walk patients through weighing what's best for them considering not just what's needed to address the cancer, but what might result in doing that on the other side

Dr. Ava Saidian: As an oncologist, it might seem like the thing that matters most to me is dealing with the cancer, but I don't find any benefit in curing cancer if your quality of life is ruined afterwards. So, things like your sexual health, your urinary health are very important to me as they are to our patients. So, I like to get an understanding of what their sexual function is before surgery. We have very candid conversations about patients' erectile functions, if they are using any medications, if they are sexually active, and then whether there are things we can do during surgery to help preserve that sexual function. And then, there are things that we can do afterwards to make sure the patient's have the quality of life and sexual health that they want. Sometimes that takes a lot of work, but it's something that we will work on together.

Host: And so if caught early enough, after surgery, what type of experience and outcomes can patients usually expect? Again, we give the disclaimer, if you will, that we're speaking in generalities to cover a lot of different areas here.

Dr. Ava Saidian: So, let's say for prostate cancer, if caught early enough and we're able to get the prostate gland out and it's. If you have good surgery and we got all the cancer, then from a cancer perspective, we're checking your PSA every few months for the first year or two and then annually and making sure that that PSA stays undetectable. So, there is no evidence of prostate cells making PSA, i.e. no cancer left in your body. And then, that's what we do from a cancer perspective. But afterwards, we'll also be focused on your urinary and sexual health. So, for example, with the prostate, when we take it out, it's not uncommon for men to have urinary leakage, after surgery. There are different exercises we can do to help improve that urinary function and to keep you as dry as possible, so that's one of the big things we work on. The other thing we work on, If patients are interested, is there a rectal function? So, there are lots of different medications we can use to help with that. And then, the worst case scenario is we can actually perform another surgery if patients are interested where we put in inflatable prosthesis to help give them erections.

Host: And so, having said all of the above, in summary here, doctor, if diagnosed with a urologic cancer, why is it so important to see someone like yourself and your colleagues that specialize in this?

Dr. Ava Saidian: I think we have tools that can help you succeed, not only from a cancer perspective, but a lifestyle perspective. We are trained in treating these specific types of cancers. And we know and have experience with all the different outcomes associated with treating these cancers that affect your lifestyle as well. We're also very well-versed in what to look for to make sure the cancer doesn't come back and we are keeping up to date on the most current guidelines and treatment options. So, we can give you a complete comprehensive care, not only from your cancer, but the things that come along with cancer survival.

Host: Well, folks, we trust you're now more familiar with urologic cancers and their treatment. Dr. Ava Saidian, a pleasure. Thanks so much again.

Dr. Ava Saidian: Thank you so much for having me.

Host: And a reminder that Dr. Saidian sees patients at Regional One Health's Outpatient Center at 880 Madison Avenue. For appointments, please call 901-545-7486. Again, 901-545-7486. If you found this podcast helpful, please share it on your social media. I'm Joey Wahler. And thanks for making one on one with Regional One Health part of your journey to better health. Join us next time as we cover another topic to keep you on the path to a healthier tomorrow.