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Welcome to the Why Urology podcast with Dr. Todd Brandt.

This podcast is my personal attempt to teach you about your genito-urinary tract, what can go wrong, and how your urologist may just become your superhero.

The name of the podcast comes from my ongoing need to answer the question that I get so often from patients, friends, and family, “Why Urology? Why did you choose to become a urologist?”

Nov 17, 2019

In this episode we are going to compare betting on horse races to a man choosing a prostate cancer treatment path when first diagnosed with prostate cancer.

When a man is diagnosed with prostate cancer he is faced with many choices. He has to weigh the odds and he has to step up, lay his money down, and try to pick a winner.

A trifecta is a bet in which the person betting forecasts the first three finishers in a race in the correct order.

The term trifecta came up in our last episode when Dr. Joseph Mahon introduced the idea of a trifecta for prostate cancer treatment as 1. the cancer is cured, 2.  after treatment the man has good urinary control, and 3. is able to be sexually active.

For most men, the priorities are clear. First is cancer cure, then is continence, after those two things then sexual function. It is not always that pure and simple but I think for most men it’s a good way to frame the discussion. A trifecta is when a man is cancer free, dry, and potent and in that order.

I really like this concept of a trifecta of treatment goals for men facing a choice of how they should be treating prostate cancer. Men facing prostate cancer treatments want to try to hit the trifecta of cancer control, urinary control and sexual function. This is a tough ideal to meet for some men–some cancers will simply require more extensive treatment with a higher risk of side effects–but it should be the ideal when we, as urologists, are talking to men about their prostate cancer treatment options.

Men want to be cancer-free, potent, and dry. We should help them choose treatments that can increase their chances of hitting that trifecta.