Andrea Miyahira: Hi, I'm Andrea Miyahira at the Prostate Cancer Foundation. Today, I'm interviewing Dr. Stacy Loeb, a professor and urologist at NYU and the Manhattan VA. She also runs the Men's Health Show at SiriusXM. Thank you for joining me, Dr. Loeb, for a wonderful interview on your career path.

Stacy Loeb: Thank you so much for having me.

Andrea Miyahira: So you wear a lot of hats as a urologist, as a researcher, and now you're double boarded in lifestyle medicine and also with your Men's Health Show. So tell us how you came to this, your career path.

Stacy Loeb: Thank you. Yes, well, I first became interested in prostate cancer during medical school because of my grandfather who died of prostate cancer and was very fortunate to have wonderful mentorship all the way through to help me start getting involved in research on prostate cancer. I just really wanted to help other families going through this experience. And I came to discover that I really enjoyed both the clinical and the research side of things. And actually, it was really what I call the circle of life.

I loved hearing questions from patients in the clinic, and often, we don't know the answer. And that is the most important thing to research, to find out the answers to what our patients really want to know. So actually, my very first NIH grant, my K award, was on the intensity of surveillance for active surveillance, and it was inspired by questions from patients.

Do I really need another biopsy this year? And the truth is, we didn't really know what is the optimal frequency of doing all these tests or how much that matters. And so it was wonderful to take those patient questions, craft a research project, and then take the answers back to the clinic. So I really enjoyed that.

As for the radio show, this was actually never something that I had anticipated doing or was one of my goals per se, but I was offered this opportunity to host the Men's Health Show on SiriusXM, and I really came to see how powerful it can be to participate in public media.

Actually, I started in the show in 2011, and as I'm sure you and many of the listeners recall, it was around that time that the US Preventive Services Task Force recommended against prostate cancer screening and there were huge controversies going on, so much public confusion. And it was at that time that I realized how powerful it was to actually have a radio show with—SiriusXM has 32 million subscribers across the US and Canada. So it was amazing to have this opportunity to share important information about, really, the importance of PSA screening and how I think it really is important for people to discuss the pros and cons with their physician and the dangers of a blanket statement against screening. So I think that was my first realization of how much it matters that not only to be clinicians or researchers in our own setting but to really participate in the public dialogue in order to help the broader population.

Andrea Miyahira: Thank you. And so urology is still largely a male-dominated profession. So tell us about your experiences as a woman in this space, the need for more women in this space, and how we can go about to increase the pipeline.

Stacy Loeb: Great question. Yes, absolutely very male-dominated specialty. I think it's only around 11% or 12% of practicing urologists are female.

I remember a couple of years ago it hit 10%, and there was a press release. And I thought, yikes, I don't know that this is something that we should be celebrating. It seems actually pretty sad that here we are, and we're only at 10, but creeping up.

Unfortunately, I don't think we're going to reach parity within my career in the field. I will be long retired by the time it could get that far, but I think there's a lot of hope here. More and more young women are entering the field and just having mentorship and representation is so very important.

Andrea Miyahira: And thank you. And tell us about any advice you have for young women who want to follow in your footsteps.

Stacy Loeb: Yeah, so I think one important thing is collaboration and mentorship. Both of these have been incredibly important in my career. I've served as a mentor for many young women who are interested in joining the field, even from high school students on up. So finding mentors—even cold-call somebody who does research or practice in the area that you're interested in.

Collaboration is huge. I can't tell you how many projects I've been involved in, just as a random middle author, just to learn and participate. And when you help other people, you learn from them and you develop networks and more people to work with. So that's been tremendously rewarding.

And then I think just staying nimble and always watching where things are going is very important. I mean, I've made so many pivots along the way in terms of the main topics of my research, and it's been very interesting to just see where things are headed.

I mean, some of the things that are happening now, like AI, weren't even around when I started, but they're very important. So just watching what's happening in the world. Recently, we've been starting to research microplastics—which has really been sort of a burgeoning area of research in general but which hasn't been studied for prostate cancer yet. So I think just always keeping an eye on what's happening in the world and how could we take lessons from other fields, and even outside of medicine, to get new ideas for new paradigms in prostate cancer.

Andrea Miyahira: Thank you. And so, yeah, as you mentioned, a lot of your research has been in various fields. One of your major topics has been looking at the prevalence of false or misinformation about prostate cancer in the media. So what you've learned from your studies, how can clinicians and scientists better communicate with the public about accurate information and where to get the accurate information, especially now, as you mentioned, the onset of AI?

Stacy Loeb: For sure. I mean, this is a huge problem that's not limited to prostate cancer, but unfortunately, misinformation is very prevalent in prostate cancer. And we've looked at this across a whole bunch of platforms—TikTok, Instagram, YouTube, podcasts, et cetera. In some of these platforms, a full 40% of the posts that contain any objective information have guideline-discordant information.

So it is out there, it is concerning, and it is a problem that is not going away. I think there are many. This requires a multifaceted solution. This is not an easy problem because of the just vast amount of user-generated content that is put online every single day.

For one thing, as clinicians, I think one of the key strategies is we really have to give our patients an information prescription. I literally sign my patients up for the PCF Prostate Cancer Patient Guide. We really have to be very prescriptive and proactive about giving our patients and their families other sources of information. We are never going to have enough time in the clinical encounter to go over every single detail, and it is very natural that people are going to want additional sources of information.

So instead of allowing our patients and their families to run the risk of this Wild West of information, it's important that we identify the best information sources that are specific to their case because that's another problem. There's so much anecdotal information out there. And while some of this may be very true for the experience of that particular person, every person is an individual; every cancer is different.

And so what worked for somebody or didn't work for somebody may not apply to your case. And so I'd be very wary of online information. And for patients and families, ask your health care team for recommended resources.

And if you do hear about something online, I would definitely run it by your health care team before taking any personal action. Even something seemingly benign, like taking a supplement, these could have interactions with prescription medications, for example. So always best just to check first.

Andrea Miyahira: That's really great advice. Thank you. And do you have any other really exciting research that's ongoing that you'd like to share?

Stacy Loeb: Absolutely. Well, I'm very excited about our Challenge Award from the Prostate Cancer Foundation studying plant-based diets. We found a lot of great data suggesting that people who eat more plant-based and less animal-based food have a lower risk of developing fatal prostate cancer, and also that consuming more plant-based is associated with better scores for quality of life after prostate cancer treatment.

So all of that has been very exciting. So we're very excited about taking this to the next level—for example, determining whether in patients who are genetically at high risk for prostate cancer, some of these dietary patterns are helpful to mitigate risk, and also just looking more at implementation.

What are some of the barriers, especially for patients with advanced prostate cancer and trying to implement healthy diet and lifestyle changes? So we're in the midst of a qualitative study right now with health care providers working in the prostate cancer space to really get ideas for how we can better assist our patients with advanced prostate cancer to do healthy lifestyle modifications. So very excited. Please stay tuned.

Andrea Miyahira: Thank you. And I'm also excited about the planetary health aspects of that study that you're doing.

Stacy Loeb: Yes, absolutely. So certainly, these plant-forward dietary patterns are not only having a lot of health benefits for humans but also are better for the planet. So it'll be very interesting, as part of this study, to look at some of the joint benefits—for example, how many carbon emissions or other environmental metrics can be improved upon alongside some of these human health benefits?

So thank you for bringing that up. I do think it's an important piece. And honestly, it's great when everything tracks together. So if we can have recommendations that are good for the prostate, good for the heart, good for the planet, this is really a win-win-win.

Andrea Miyahira: Well, that's really wonderful. I'm really excited to see the results of that study. So thank you so much for sharing about your career and about your research with us today.

Stacy Loeb: Thank you so much for having me.