Jeff Elton:

Welcome to the ConcertAI podcast. I have a really special session today and I'm super pleased that we have Steve Osunsami with us. Steve has a career that's a bit different than sometimes some of the folks we have on the podcast, which is he has been a broadcaster and a senior broadcaster for a number of years with ABC, also is kind of part of World News with David Muir and appears in a variety of special research assignments, et cetera, which I've seen many of them, so I was super pleased to be able to have this moment. The reason why we're here is, we've been talking about the nature of how we can actually do surveillance of patients that may actually be at higher risk for different diseases, in particular prostate cancer. What really got Steve and me into the conversation was new guidelines actually were released a few weeks back.

That was the result of curating hundreds of underlying publications that actually indicated that different subpopulations in particular black men in the United States actually were at higher risk of prostate cancer. It wasn't part of the guidelines, in fact, it wasn't part of how people were treated in a primary care or specialist setting. In fact, there was the view that came from the group of clinicians that did this and that actually recommended pretty significant changes to the guidelines was that it has had a cost.

It's had a cost to a number of men who actually did encounter and understood that they had prostate cancer much later when treatment options were fewer. Steve, one of the things we kind of normally do, I'd love for you just to give an introduction of yourself, but also you pick up a variety of topics for your own investigative reporting, which oftentimes are around whether or not there's bias or whether or not decisions are made in ways that didn't fully accommodate the interests of different groups in the United States. So maybe you can take us into a little bit of how you came to that area as well. Please.

Steve Osunsami:

Yes, so thank you for having me. It's a pleasure to be here because I feel that the work that you do here is hugely important and truly changes and saves lives, and so for that reason, I'm glad to be a part of this. A brief note about my career. I've been in the news business as we'd say for over 30 years. I've been with ABC now for 27 of those years, and I've been based in Atlanta that entire time. I'm a senior national correspondent at ABC News as you shared. For a very long time, the majority of what I did was running to breaking news events, so I was in New Orleans for Hurricane Katrina. I was in St. Louis for Ferguson. I was in North Carolina for the church shooting that killed a number of people. Over the years, I've done the breaking news. I've been to Cuba a number of times, when Castro died, but I've always done some of this other reporting that you mentioned, but in the last, since 2020, especially, as we all know, what happened in 2020.

Two big things, one was of course COVID and then secondly the street protests. Since then, the bulk of my work has now shifted to more investigative work, to more health reported work, and the area that I am perhaps well most known for over the entirety of my career is social justice and we're doing long form pieces that air primarily on either primetime or our streaming services. It's been a joy for me because a lot of that has been dipping into the well of my own personal experience, which that's a wonderful transition to what we're talking about today. I'm an open book, so don't hesitate to [inaudible 00:04:05], yeah, feel free to... I'm an open book about this. I'm actually thinking about writing a book about this subject. I am currently 53 years old. When I was 40 years old, I got my physicals around my birthday, which is in February.

For year 40 I was younger and was probably busy with work and I didn't get my physical that year. 41, I go in for my physical and my doctor at the time was a Hispanic woman, and I've always been very big about having a woman as a doctor, that's my own personal reference. But Hispanic woman. I remember her asking me, she's like, do you know if you have a history of prostate cancer in your family? I said, no, I don't think so. My father didn't have prostate cancer. I knew that my parents are from Nigeria and I've never met my grandparents and my grandfather on my dad's side, I knew he died young, but I was always told it was a heart attack. My great-grandfather on my dad's side died young when my dad was young and I told that to her, I said, no, at the time one of my other grandparents had died, but they'd lived a long life, but my grandfather, my paternal grandfather died young, I told her that.

She said, you know what? Of course we do the finger test that didn't find anything. She said, well, let's give you a PSA test. So my phone at the time, I was just so, so busy with work, I was constantly being called to different things and my phone's ringing while I'm in her office and I leave the office without going down the hall to do the PSA test. Luckily it was a day trip where I was gone and back the next day, I come back to her office, I do the PSA test, I go home.

The next day, she calls in a panic. She says, I need you to come back up and take this test again. I was 41 years old. For people who are aware of prostate cancer, anything above a four, you really start to worry about cancer. So the PSA test for people who don't know measures, its prostate-specific antigen, and so it's sort of evidence of activity in the blood and you can still have a high PSA and not have cancer, but in my case, anything above four, you have to sort of investigate. My number was a 21. I was 41.

Jeff Elton:

You had a baseline before this?

Steve Osunsami:

No, because I'd never taken a PSA test before and I'm glad you mentioned the word baseline because that's what I encourage all my friends who say, oh, I don't need it, or It's not recommended or whatever, take the test, know what your baseline is. So then if you're 55 and you go from a baseline of a 3.5 to a four, you don't freak out. Anyway, I had a 21, come back, take the test again. It's a 21. She's trying to calm me down, but I call my sister who's a nurse who's like, oh, okay. It could be something she knew then. Anyway, long story short, we go to the biopsy and my cancer journey begins. It is indeed cancer.

Not only did I have a high PSA which is not the greatest news. I also had based on the test, high volume cancer, 60%, based on the tests, I also had fairly aggressive cancer. PSA, the other thing that matters in addition to volume and your PSA is also something called a Gleason score and a Gleason score gives you essentially the aggressiveness of a cancer. Mildly aggressive cancer is a six or a seven, and it's two numbers that are put together. The first number matters more. So for example, a three four is not as bad as a four three. I had a five four, so I had a nine. So I had aggressive high volume, high PSA cancer at 41 years old. All these sort of recommendations that you wait till 50, I would've been dead. There was no if, ands, or buts about it. I would not be here today if I waited till 50 years old to get a PSA test.

Jeff Elton:

You commented that she had done the normal rectal physical inspection, but wasn't suspicious of anything at that particular point.

Steve Osunsami:

So in my case, the reason why the physical inspection showed nothing, she didn't find it is because all of my cancer was on the other side.

Jeff Elton:

So nothing didn't show up as an enlargement or anything else-

Steve Osunsami:

That she could tell. My cancer was on the bladder side.

Jeff Elton:

Okay.

Steve Osunsami:

So it was on the bladder side, and even though it was 60% because it wasn't obvious to her. I personally don't. I think the physical tests are junk. That's just my personal opinion. I think the PSA test is your best gauge because you're seeing evidence in the bloodstream and it's why the baseline that you mentioned is so important. I personally wish that every man in America got a PSA test at 35, got a baseline, and then they have something to compare it to later on in life if the number is big. That's what I wish. I think the clinical argument against that is people could get numbers that say 3.5 and eight and it leads down to unnecessary testing and so on and so forth. But I wish that in their thirties, every man in America got a baseline. Because this is affecting so many of us.

The other thing that I wish clinically, okay, let's just say you don't want to do every man in America, then do your at-risk groups, every African-American man in America get a baseline at 35. Someone will have to correct me on this. My memory is black men are more at risk, and then a real small section of European men, I think in the Dutch, are more at risk. It's not just black men in America. It's men of African descent across the world. So going back to the testing story, when I had surgery in 2012 to remove my prostate, I ended up having cancer in my margins. So I was stage three. When you test for prostate cancer, they do a lot of assessments in terms of your volume, your aggressiveness, and all of those things. Then when they removed the organ, they test it again to see what the real situation was.

In my case, it was still 60%. It was still aggressive. Everything, the tests were accurate. I had surgery in 2012. I recovered from the surgery very well because I was young. So then the process is to do PSA tests from then on, and I should have an undetectable PSA. My PSA was, I had surgery in August and by January I was undetectable. Three years later, I [inaudible 00:11:22] do a PSA test and it's detectable again. So that meant that there was some little cancer cells that were running around that we missed. I also had a number of lymph nodes removed during surgery. I had a portion of my bladder removed during surgery, and so I had radiation in 2015. So three months of radiation.

I did the traditional regular radiation at the time, there was a photon radiation, which is a little more targeted and less harmful to some of the other organs. We did not have that in Atlanta. Surprisingly. Closest at the time was either Charlotte or Houston and I elected to stay in town and do the regular radiation because it's every day for three months. After I did radiation. Radiation started in October of 2015. I ended in December, and by January again, I was back to an undetectable PSA. I had been undetectable since January of 2016. It is now 2024.

Jeff Elton:

Wow. Congratulations and that's wonderful news.

Steve Osunsami:

Thank you. Thank you. There are absolutely side effects to both of the treatments. I'm very open about discussing all of that. For me, the biggest side effect is stress incontinence, where if I sneeze or if I laugh or if I'm sitting in the uncomfortable positions or whatever, I might have an accident, but I'm told by my female friends of my same age, especially those who've had children, what are you talking about? What are you complaining about? This is, welcome to our world. So one issue I'm going to lean into that I know stops a lot of men from discussing this and dealing with this is sexual function. I talk to anybody who talks to me about prostate cancer that any man who you're dealing with who is afraid of getting tested, afraid of learning what their PSA is, it's not because they're worried about incontinence, it's because they're worried about sexual function.

It is the one part of this disease. Its connection to it that I think is so limiting for the fragile male ego that men in this world have. If this was a disease that wasn't tied to such a famous male organ, men would be better about dealing with it and talking about it and treating it. But this is where we're at. I did a lot of interviews on this with our defense secretary and his inability to tell his boss that he was going in for a surgery and he was going to be down for a little bit. I guarantee you that if he was going in to get his foot worked on or his arm worked on or something like that, he would've been very forthcoming.

Jeff Elton:

He would've straightforward about that one.

Steve Osunsami:

Right. But because it was prostate cancer and because this is a disease that is very much connected to a man's junk, he was embarrassed and weird about it.

Jeff Elton:

Maybe he's equating virility to leadership strength.

Steve Osunsami:

Oh my goodness.

Jeff Elton:

I have to tell you, Steve, as I'm listening to this just to reflect, you arrive at this with such personal strength and resolve. In fact, the way you're even beginning. I can tell the education you put yourself through just to make sure that you actually knew what you were going into and you have such an intellectual openness about everything there. Then this ability to bring it back to yourself, which allowed you, even as you described the trade-offs you were making that involved life trade-offs, as well as your own personal physical status trade-offs. You have a very unusual ability to articulate this [inaudible 00:15:34]. I think that's just tremendous. I think two, I'm hoping it benefits others as they think about their own reserve in how to think through these processes.

Steve Osunsami:

I think some of it has to do with what I do for a living. I'm a storyteller and I consider myself a student of the human spirit. I've always felt that the power in my work especially comes from my relating to the stories. I like to be intellectually and emotionally invested in the story to tell it. So I find I also do believe that as a journalist, it's one of my jobs is to inform. It's to report. There's also I feel a slight responsibility or a significant responsibility. In doing that, that you are, one of the public services of journalism is to save lives. We warn when the hurricane is coming.

Jeff Elton:

Absolutely.

Steve Osunsami:

We send alarms and I feel like it is my duty to send the alarm on prostate cancer and other diseases, especially those that affect the group that I am in as an African-American. So I'm also an open book. A lot of people aren't like that. A lot of people aren't comfortable talking about this so personally. It's so much easier to talk about certain other diseases. But this one, anything related to sex or sexual function is hard. So at work, everyone knows about my situation at work and my company's fairly large. Disney owns ABC and I've been there a long time. So people know that if they have a relative who has been diagnosed with prostate cancer, they can call me and they can ask me any question and I'll answer it. I tend to get more calls from women, from the daughters and the wives.

Jeff Elton:

Wow, interesting.

Steve Osunsami:

That's who I tend to get the calls from. One of the things I tell them, I said, I don't care what he's telling you, in his mind, he is panicked about sexual function. He may not admit it to you, but I'm telling you.

Jeff Elton:

No, I believe that, and I'm probably projecting a little bit here, being [inaudible 00:17:49]. I was saying there's something liberating if your significant other or daughter or somebody who's kind close to your life, grants a recognition to this. It almost allows you to then say, yeah, that scares the crap out of me.

Steve Osunsami:

I've said to women, it doesn't matter how little he uses it- There's something in the mind that, oh no, this could take that away. It's so defining. So I always say, you have to keep that in mind and in check. The guy is not going to like hearing, and I say this to all the clinicians out there who might be listening to this, the man is not going to hearing well, there are things you can do. There are implants, there are tools. No, even though that's the truth, that's not going to make him feel any better. I know when I was hearing that, it was like, what? I just firmly believe that a lot of men who end up dying from this preventable deaths, I believe that a lot of them were struggling with that notion. Why else wouldn't you go see a doctor and get tested for this.

Jeff Elton:

When you were 40, 41, what was the reason why your primary care thought it made sense to?

Steve Osunsami:

Excellent question. So she since retired in January after my surgery, when my PSA went down was undetectable. I sent her three bouquets of flowers. When she retired, we had a long conversation, it was so sad. We got into a deeper conversation about this. So she's a Hispanic woman. Her family is from Honduras, I think. That population also has an elevated, not as elevated as African Americans, but elevated chance of a risk of prostate cancer. She told me that when I told her that my grandfather died of a heart attack, she was suspicious.

Jeff Elton:

Oh, interesting.

Steve Osunsami:

Yes, she was suspicious. She said that I didn't have any other details other than he died of a heart attack, and I didn't have any markers of high cholesterol or anything like that. My father wasn't taking a statin. She said none of that stuff was sort of making sense. She said, it didn't seem like she said, I just didn't trust your information. This is coming from-

Jeff Elton:

This is almost back to the cultural, the attribution of no one even wants to be, no one is having died of that as well. Maybe the cardiovascular, a cardiovascular death is a more acceptable.

Steve Osunsami:

Yes.

Jeff Elton:

Of explanation.

Steve Osunsami:

Yes. So she told me she was suspicious, and she said that she thought as a Hispanic woman, she said that she had seen that in her family where someone who had had prostate cancer, they called it something else just like you said. She said That was the reason why she ordered the test. I'm like, oh, goodness. Thank God. Because she had personal experience with the lie. So now after that conversation, this was January of 2013, in the spring, I call my dad and we have an intense conversation. I'm like, okay, I need to know what happened with your dad and I need to know everything. He was young. So the other thing is his father was about my age when he died, and it was at the time, and my dad then started telling me he was sick for a long time. He had trouble using the bathroom at one point.

I'm like, wait, that's not heart disease. Heart disease is quick. You have a heart attack, you suddenly die. It's not drawn out. Cancer is drawn out. It was then that I realized that it was very likely that my grandfather had prostate cancer. Now, fast-forward a year or two, my uncle is diagnosed with prostate cancer and it's now where I'm like, this is absolutely prostate cancer. They just didn't tell them the truth or want to admit it or whatever. I now firmly believe that my grandfather died of prostate cancer and given how young, my dad was young and he was in his forties. My grandfather was in his forties when he died.

Jeff Elton:

So you clearly just even as you went through your own treatment, elected to say, I want to understand this disease. I don't want to understand it in an absolute sense, but I also want to understand what it means in me. You clearly understood ranges of treatment options, even the way you even related this, you had a sense of what outcomes you were targeting to come from the round of surgical, then the round of radiation therapy from doing this. As you came through this and you've commented about wives and daughters and others, how important was a supportive network of individuals around you in reinforcing some of the decisions that you were making? Or was this a process that you took yourself through as you went through that a bit?

Steve Osunsami:

I'm a weird case, so I'm a journalist. So for me-

Jeff Elton:

You have the conversation with yourself as well.

Steve Osunsami:

Yeah, it was the story of my life.

Jeff Elton:

Okay. I saw where you were going with that one.

Steve Osunsami:

Yeah, so it was just sort of like, because I'm also sort of a producer as well, a news producer where you're used to juggling a lot of different things.

Jeff Elton:

I'm looking at your bylines [inaudible 00:23:38].

Steve Osunsami:

Right. So it was like, I had my notebook. I was on it. I was interviewing doctors, even though I knew I was going to go laparoscopic for surgery, I still interviewed a doctor at Emory University, which is down the road from my home about doing it the old way. For me, it was more of I needed as much information as I can. In my mind, I was trying to, and the doctor's telling me to hurry up because I'm at 21, don't spend too much time before we sort of figure out how we're going to start treating this. But the importance of family is real and friends, my work, family, it's work. I work for these people, but there are also people who I really care about. Their support was big. Once I made a decision to take the stress off and the anxiety off my spouse, I'm gay.

I have a husband. He was super helpful. He went with me to the appointments. We have a daughter. She's a nurse now. She wasn't at the time, she was super supportive. It's funny, the things I remember most from my support, I remember, it was funny because I had a different relationship with work at the time. I was very mad at work because I felt overworked. I'll never forget, I was in the hospital and the phone rings and Joe is next to me. It was the day of surgery. Joe answers the phone and it's Diane Sawyer. She's talking to my husband, because I worked for her show and I have a good relationship with her, and she's just checking in on me. She didn't talk to me. She's just talking to Joe. Then when we were home, she sent us food every day. It was just-

Jeff Elton:

Well, that's called community.

Steve Osunsami:

You know what I'm saying? It was just sort of like, wow. So she of course is someone who I'm super close to, to this day. I tell this story often that just having that person who did that thing, helped me in my healing. I felt supported, and it definitely made a difference. At the time, I chose a doctor who was out of network and I didn't care. Yeah, sexual function, it didn't matter how big that check was, I was going to write it. He was the best doctor, I knew I was, my best chances. I didn't care.

Jeff Elton:

Right there with you. Yep.

Steve Osunsami:

Right, right. People flew in from around the country to see him, and he did a good job. I can say that, you follow me and his office called a couple months later. I don't know who did it, but somehow they said, we have a check for you, so look like Disney has covered part of this. I'm like, oh. Yeah. It was just sort of, okay, yes, these people will work you to death. But when the crap hits the fan-

Jeff Elton:

There's a deep personal respect obviously that was there and kind of backstop you as you kind of hit the stuff that you shouldn't be hitting.

Steve Osunsami:

Exactly. That was definitely something that I saw.

Jeff Elton:

Yeah, no, that's tremendous.

Steve Osunsami:

It made a difference. My friends were great, my family was great, but my work was also really good. Now, I only took a month off the first time and I should have taken longer, but that's that. But my workplace was very supportive and I've watched them be supportive of other people as well. That's part of our culture. They'll work you, but when you need help or when you're down, they will do what they can to bring you back up.

Jeff Elton:

I think we understand that we are a bit of the same, because we have so many also people with clinical background that when families get something, hit them or we have tornadoes coming through the Memphis area, Nashville area where also some people and everybody stepped in and kind of took care of everybody else, and it's a work relationship. But at the end of the day, it's another version of community.

Steve Osunsami:

It is. It is.

Jeff Elton:

So Steve, when I listened to you and I'm so happy we're having this conversation, and I think you know that one of the catalyst was the Prostate Cancer Foundation, the research there, and Dr. William Oh. Mount Sinai was one of the people that led that. But what struck me both about what you're saying and that work, which we thought was significant and could be lifesaving for people, but it was hundreds of published research pieces had already existed. This was going back years in curating that, which is known but hadn't become part of standard practice. Standard practice was things tend to be thought of sometimes at a bell curve. Standard practice may have determined who is in the main portion of that bell curve.

Here, I mean an American or Americans that participate in research bell curve because clearly this was of significance to so many, but hadn't been put into standards of practice where we didn't have somebody like your primary care physician who had a cultural and a familial background that would've at least allowed her to suspect something. It was trying to bring that all together. What I was really struck by what you said is there was just, you had the fortune of picking the right person to be your personal care provider, and then you obviously had the instincts and self-discovery intent to make sure you got data and got information about something when even something just even slightly looked like it was going the wrong direction. But unfortunately, that's probably not what most people experience at the end of the day.

Steve Osunsami:

No, it's not. I love your example about the bell curve because that's really it. So our former chief medical editor was Dr. Richard Besser, which some of your people may know. He was one of the top scientists and leaders at the CDC for a long time. He came to us and was our medical editor for a number of years. After I was diagnosed and the standards had not yet changed at that point in terms of testing. I was prostate cancer. I had a colleague, she was an anchor at Good Morning America, Amy Robach, she had breast cancer and she was also in her early forties when she was diagnosed with breast cancer.

Both of us were at ages where we were on the edge of the bell curve. I remember both of us went to Besser and had a very big conversation with him about discussing with public health officials and public policy, public health policy directors, for lack of a better word, about the sense and sort of developing policy only for the height and center of the bell curve. Both of us made the argument to him that unless there are changes, there are going to be more people in our exact same situation who will needlessly, needlessly die, that we would encourage public health to put more financial and sort of value and just in general on the edges of the bell curve than we currently do. It was a very interesting debate because from a public health perspective, he kept arguing that there would be needless testing, there would be needless scares, there would be needless expense overall.

What we kept hearing is, well, that means you're sacrificing people like us for this sort of greater good of efficiency. My sort of feeling is, let's be inefficient here a little. A little inefficiency in the system could save more lives, and there's value to that. So I think that some of what you are doing and what God bless the podcast, social media, so on and so forth, is increasing the awareness, not just prostate cancer, but diabetes and other, increasing the awareness to people who might be on the edges of that bell curve. This is helping somewhat. It's helping in terms of alerting healthcare providers, researchers, that there is significant value and loss that happens on the edges of the bell curves as we decide what public health policy and encourage it early testing should be.

That we can still find ways to reach out to those populations and encourage people to get tested, encourage people in diseases and where you can make the lifestyle adjustments to prevent those diseases because you're more at risk. Encourage people to get, as you mentioned earlier in this conversation, a very important word, a baseline. A baseline. My younger brother is five years younger than me, so he's 49 years old, and thank God, immediately after I was diagnosed, he went and got tested and his PSA was like a 0.7 or something low, right? He's five years younger than me. He has since crossed the age that I crossed and that my grandfather was when we both were sick. But he has that number now. So if he gets a four, three years from now, he knows that's serious. Because his baseline is less than a one, so he went three up.

So that's where the baseline becomes important. I encourage every man, I don't care who you are, don't get that PSA test, get that baseline because like what? One in four of us will get this at some point in our lives. Get the baseline, know what your baseline is now. So you know whether or not to freak out or to take corrective action or to be moved towards further testing, if you have a number that is close to four.

Jeff Elton:

We're not even talking about something that's a major personal or health system investment to do the first, the baseline PSA testing, to your point.

Steve Osunsami:

Let's call at least with prostate cancer. What a blessing, right?

Jeff Elton:

Yes.

Steve Osunsami:

What a blessing that there is a blood test. Imagine if there was such a thing for breast cancer. There's no blood test for breast cancer that you can give a woman that gives her a sense, a good sense of whether or not she has cancer, has breast cancer or not. Prostate cancer, there's a blood test you can take. It doesn't hurt any more than any other prick in your arm, and it gives you a very good baseline or sense of whether or not you have prostate cancer. That's the part that is just amazing to me. Guys, it's easy, and I don't think that it's a terribly expensive test, even if you had to pay for it outright, get the baseline, find out what it is, and then save that piece of paper, keep it in your records. So then later on in life, if you do have a high number, you can know how to react.

Jeff Elton:

I kind of feel like your last comments and messages, which are really empowering of the individual and I think encouraging, if you will, of the medical community to move that to one, to act on their own behalf. The second is to perhaps act in a more flexible way, recognizing that there's going to be groups of individuals that have different needs and requirements at different times, and the system needs to understand that those are just super important messages, and I feel like that's really a major take away for folks from the conversation.

I'll say that my point of optimism is that some of what we can now do, whether it's next generation circulating tumor cell tests that can start doing surveillance, which is still very early, and we're still trying to make sure we fully understand interpretation. Even things such as AI, augmented decision support tools that don't treat everybody by placing them on the center of the bell curve, but allows you to see characteristics of an individual and understand that maybe I need to do diagnostic activity, surveillance activities and treatment selection, response monitoring in different ways. Those are things that actually can enhance and can reduce biases and make sure that people can be a beneficiary of some of information. But maybe that's a conversation that we'll pick up at another time because that's an area that's beginning to change quite a bit across healthcare.

Steve Osunsami:

When I was treated, robotic surgery was young. There were still people doing the perniums, can't remember what it's called, the regular old prostate surgery. That was 12 years ago. Now that's standard operating procedure.

Jeff Elton:

It is.

Steve Osunsami:

So the different methods that you are speaking of, using AI to assist in treatment, for all we know 12 years from now, that may be standard. Things you're improving and changing, we're using computers in particular to improve outcomes for people in surgeries. We're reducing the amount of time people need to be hospitalized. We're improving recovery. I have dime-shaped scars around my abdomen from the surgery that I had. There's no doubt in my mind that the way that they're doing it today, I would guess that those wounds are smaller. We're using technology, of course, overall to improve outcomes, and I don't see why the newest technologies that are available today can't continue that process. I'm all, let's go. Let's do it. I would like to see, of course, I'd love to see a cure for cancer as we all would.

In the meanwhile, more awareness on testing because early testing saved my life. So there's that. The other thing that I say to people, especially when, this is any cancer, not just prostate cancer, but any cancer. So remember I told you earlier that I skipped my physical at 40. Had I gotten that physical at 40, had I not skipped that physical, we probably--, and she had, my doctor had said, let's run this PSA then, if she had said that then, we would have caught this because my PSA was a 21. So you know a year earlier it was high.

Jeff Elton:

You were still going to be very high.

Steve Osunsami:

It was still going to be very high. We would've caught it, and my outcomes likely would've been better because I would've caught it a year earlier. I might not have needed radiation had I gone to that physical at 40. The other thing is I am very lucky in some respects that I was young, and so that meant that my side effects were also going to be lower. Had I caught it at 40, maybe I might have zero side effects. So my point to people listening and providers and listening is that the earlier you get it, the better. They're just on so many different levels. So I really just really preach the early detection as an early surveillance because everything improves in terms of outcomes when you find it.

Jeff Elton:

Well, I think one, it's its own inspiring story. I think that you have multiple lessons actually, that you're relating and that certainly I'm taking personally. There's just so many different ways you're encouraging people to advocate for themselves and ask the right questions. They have to take the right actions, which when you're in that relationship with your clinician, oftentimes you can get them to do if it's not an automatic part of how they're actually delivering care. So until we can catch up and get it into the standardized processes, we can have individuals advocate for themselves, and that's kind how we can make progress.

Steve Osunsami:

Absolutely. Absolutely. No, I totally agree with that.

Jeff Elton:

Well, Steve, thank you so much. It was such a pleasure, and I've just always enjoyed your reporting and things of that nature. So it's a true pleasure to have you here today. So thanks again.

Steve Osunsami:

Thank you. Thanks for having me.