POPULARITY
How can pediatric and adult urologists team up to tackle complex cancer cases? In this episode of the BackTable Urology, host Dr. Amanda Buchanan, Division Chief of Pediatric Urology at the University of Kentucky, is joined by her colleagues Dr. Patrick Hensley, an adult urologic oncologist, and Dave Rodeberg, Division Chief of Pediatric Surgery. Their discussion centers around the importance of professional collaboration in urologic oncology care in order to improve patient outcomes.---SYNPOSISThe urologists discuss topics such as the experiences and benefits of interdisciplinary collaboration in complex cases and the role of pediatric urologists in treating adolescent and young adult patients. They also provide insights into the Children's Oncology Group (COG) studies and their intersections with adult oncology research. The episode concludes with practical advice for other institutions aiming to improve collaborative efforts between pediatric and adult urology departments.---TIMESTAMPS00:00 - Introduction02:35 - Challenges and Lessons in Multidisciplinary Collaboration08:24 - Pediatric vs. Adult Urologic Oncology11:07- Clinical Trials and Research Collaborations12:49 - Navigating Oncology Groups for Children and Adults19:06 - Collaborative Models in Kidney Cancer Care22:18 - Benefits and Challenges of Collaboration35:24 - Final Thoughts and Recommendations---RESOURCESSociety of Urologic Oncology:https://suonet.org/home.aspxChildren's Oncology Grouphttps://www.childrensoncologygroup.org/
What does it take to deliver truly personalized, multidisciplinary care in testicular cancer? Get an inside look in this episode of BackTable Urology, where renowned testicular cancer experts Dr. Nabil Adra and Dr. Richard Matulewicz join host Dr. Aditya Bagrodia for a virtual tumor board session on the nuanced management of germ cell tumors. This episode was produced in collaboration with the Society of Urologic Oncology. --- SYNPOSIS The expert panel uses specific patient cases to review their decision-making processes on the use of surgery, chemotherapy, and radiation. They highlight the importance of a multidisciplinary approach, particularly for advanced disease and challenging surgical scenarios. The episode reviews patient-specific factors, standard treatment protocols, post-treatment surveillance, and the latest research. This episode also highlights the benefits of personalized cancer care. --- TIMESTAMPS 00:00 - Introduction 01:45 - Case Presentation: 23-Year-Old Male with Testicular Mass 02:14 - Initial Counseling and Management 04:03 - Orchiectomy and Post-Surgery 06:27 - Stage I Management 10:00 - Surveillance and Adjuvant Therapy 13:56 - Recurrence 23:13 - Case Study: 44-Year-Old with Non-Seminoma 28:14 - Case Study: 17-Year-Old with Developmental Delay and Cancer 29:42 - Chemotherapy Decisions 30:31 - Brain Imaging and Metastasis Predictions 33:54 - Chemotherapy Regimens 35:53 - Monitoring and Salvage Therapy 45:01 - Case Study: 21-Year-Old with Teratoma 55:21 - Concluding Thoughts --- RESOURCES Society of Urologic Oncology: https://suonet.org/home.aspx
In this episode, I discuss with urologist, Dr. Jeff Zorn: The prostate and age related changesSigns and symptoms of prostate cancerScreening in Canada Typical movement through the medical system if prostate cancer is suspectedTreatment options (active surveillance, surgery, radiation, chemotherapy, hormone therapy)Risks for each treatment (incontinence, bladder/bowel, sexual health)Where does pelvic health physiotherapy come in?Dr. Jeff Zorn, Urologist, Comox BC. Joined North Island Urology, in August of 2014, after completing his urology residency training at the University of Alberta. Originally from Tisdale, Saskatchewan, Dr. Zorn has an interest in Urologic Oncology, minimally invasive surgery, in addition to general urologic practice and surgical volunteer work abroad. THANK YOU TO THE EPISODE SPONSORSSRC Health: discount code and website: https://srchealth.com/?ref=Sto_l3PawmnH4. Discount Code: THEPELVICFLOORPROJECTThanks for joining me! Here is where you can find out how to work with me: www.pelvicfloorprojectspace.com/Support the show
Host Dr. Shannon Westin and guests Dr. Bill Aronson discuss the article "High Omega-3, Low Omega-6 Diet With Fish Oil for Men With Prostate Cancer on Active Surveillance: The CAPFISH-3 Randomized Clinical Trial" and how Omega-6 are predominant in the American diet while the study significantly lowered the intake of Omega- 6 fats. TRANSCRIPT Dr. Shannon Westin: Hello everyone and welcome to another episode of JCO After Hours, the podcast where we get in depth on manuscripts published in the Journal of Clinical Oncology. I'm your host, Dr. Shannon Westin, GYN Oncologist by trade and one of the grateful Social Media Editors of the JCO. And I am very excited to welcome a special guest today, Dr. William Aronson. He is professor of Urology in the UCLA Department of Urology, the Chief of Urology at Olive View UCLA Medical Center, and Chief of Urologic Oncology at the Veterans Administration West Los Angeles. Welcome, Dr. Aronson. Dr. William Aronson: Thank you, Shannon, and delighted to be here. Dr. Shannon Westin: We are so excited to have you discussing your manuscript, “High Omega-3, Low Omega-6 Diet With Fish Oil for Men With Prostate Cancer on Active Surveillance: The CAPFISH-3 Randomized Clinical Trial,” which was published in the Journal of Clinical Oncology on December 13, 2024. So let's get right to it. First of all, you know we have a very mixed audience, so can you just level set for us and speak about the population you studied in this important trial - that low risk, favorable, intermediate risk prostate cancer. How common is that? How is it defined? That would really help. Dr. William Aronson: I would say about 50% of the patients that we diagnose with prostate cancer either have low risk disease or what we call favorable intermediate risk disease. So when the pathologists look at the cancer under the microscope, they assign what's called a Gleason grade. Grade 3 is the slower growing type of prostate cancer, grade 5 is the fastest growing type, and grade 4 is somewhere in between. So a low risk group would be only the grade 3, the slower growing type. And the favorable intermediate risk group would actually be the grade 3+4, which means they mostly see the low risk type in there, but they also see the slightly faster growing type, grade 4. So this is what we typically see. We see these patients on a very regular basis when they're newly diagnosed with prostate cancer. Dr. Shannon Westin: Okay, got it. And then can you walk us through just what the management options are typically for this patient population? Dr. William Aronson: So typically for what we call the low risk group, the patients with a low PSA and only that grade 3 type, slower growing type of prostate cancer, the standard recommendations are active surveillance. So typically, we'll periodically monitor these patients with PSA blood testing and periodically do prostate biopsies depending upon the patient's other medical problems. Dr. Shannon Westin: So I think it would also be really helpful just to understand what your typical management options are for this patient population. Dr. William Aronson: So for patients with low risk prostate cancer, they only have the Gleason Grade 3+3 with a low PSA. The standard practice is observation. And so these men will periodically see them and measure their PSA values. And periodically, they'll undergo prostate biopsy to make sure they're not getting progression of their disease. For men with favorable intermediate risk prostate cancer, that's a little different. In some practices, the patient and the urologist will decide to do active surveillance. In other scenarios, these patients will definitely elect treatment, either with radical prostatectomy or radiation therapy or other treatments that are available. Dr. Shannon Westin: So your manuscript notes that there was a high level of interest in dietary supplements and approaches among patients with prostate cancer that do elect for active surveillance. Prior to the results of CAPFISH-3, did we have any data to support those types of recommendations? Dr. William Aronson: We actually don't have any long term prospective randomized trials that support that recommendation. There have been a number of very interesting epidemiologic studies, for example, suggesting maybe a plant-based diet might be helpful. Or a number of other studies suggesting maybe more tomato-based products like tomato sauces or tomato paste may be helpful. But no prospective longer term randomized trials that were positive. Dr. Shannon Westin: Okay, that makes sense. So what led you all to explore the high omega-3, low omega-6 fatty acid diet in this trial? Dr. William Aronson: After our initial omega-6 studies, we subsequently did some studies where we raised the omega-3 from fish oil and lowered the 6, looking at a more favorable ratio of the omega-3 to omega-6. And once again, we found that in our animal models, there was a significant delay in progression of prostate cancer. That then led us to perform a clinical trial. It was a short term trial in men prior to undergoing radical prostatectomy. And in these men, they were randomly assigned to one of two groups, either a western high fat diet or a low fat diet with fish oil. And we found after just four to six weeks, a significant change in the Ki67 level in their radical prostatectomy tissue. And Ki67 is actually a strong indicator of prostate cancer progression, spread, or even death from prostate cancer. Dr. Shannon Westin: Well, and I think that leads us really nicely into the design of the current study. So why don't you walk us through how CAPFISH-3 was designed. And you've already spoken a little bit about your primary endpoint. Dr. William Aronson: Based on the results of what we saw in the lab and what we saw in our short term clinical trial, we decided to perform a one year trial, a longer term trial in men on active surveillance. And these men were randomly assigned to either a diet with slight reduction in dietary fat, specifically reduction in the omega-6 intake as well as increase in foods with omega-3 and fish oil capsules. The other group, we asked the men to just not take fish oil capsules, but they could eat whatever else they wanted during the course of the study. Men in the diet where we lowered the omega-6 and raised the omega-3, they were seen by a dietitian once a month to really ensure that they were compliant with that intervention, which they were. The other intriguing part of our study, which I think is super important, is the precision that was used when these men underwent prostate biopsy. So, at baseline and at one year, when these men underwent prostate biopsy, they had the same site within the prostate biopsied. That's important because it's not so easy to find the same site within the prostate because of heterogeneity throughout the prostate. And so we were able to obtain that high level of precision as they were in an active surveillance program at UCLA with Dr. Leonard Marks. Dr. Shannon Westin: So we spoke a little bit about what's important about the Ki67 index as your primary endpoint. Can you talk a little bit about what the study found with your intervention? Dr. William Aronson: So we found that the Ki67 index increased by 24% in the control group and decreased by 15% in the low omega-6, high omega-3 group with fish oil capsules. So that ended up resulting in a statistically significant change between the groups favoring the low omega-6, high omega-3 group. Dr. Shannon Westin: And then what were the secondary endpoints that CAPFISH-3 explored? Anything of note that you want to review for the listeners? Dr. William Aronson: So a number of positive secondary endpoints from the trial. Firstly, we saw that the triglyceride levels were lower, which is what can typically be seen with omega-3 intake. We also saw reduced levels of a cytokine, a circulating factor in the bloodstream called ‘macrophage colony stimulating factor'. And that's particularly interesting because there's a certain type of macrophage which is well known to be involved in prostate cancer progression in men with more advanced prostate cancer, and we've been able to inhibit that in our animal models and in our tissue culture studies. And it was especially interesting to see that we did have an effect on this particular cytokine in this prospective randomized trial. We did not see changes in a number of other measures, including Gleason grade or PSA. These are measures that we use in clinical practice. To see an effect on those would have required a longer term and larger study to be performed. Dr. Shannon Westin: That makes sense. I think it's always great to try to get as much of these types of translational data as we can. But sometimes you just have to do what is reasonable and you get what you get. It looks to me like this regimen was fairly well tolerated. Did you obtain any patient reported outcomes or feedback on the trial? Dr. William Aronson: So, there were four patients in the fish oil group that did have some side effects, and we withdrew them from the study. They did have some effects on their upset stomach, and a number of men also had some diarrhea as well. And so for those four patients, we did withdraw them from the study. Dr. Shannon Westin: And then I guess the last question I have is really, what's next for this intervention? Are we ready to move this to the clinic or what do you see as next steps? Dr. William Aronson: Well, this next step that we're working on right now is to better understand exactly what happened in these patients. So we have blood, we have tissue, we're doing genetic studies on these patients. So that's really the first step, in our mind, to better understand what happened before moving to the next step. I'm particularly intrigued about trying this intervention in men with more advanced prostate cancer, specifically because of what we see, this particular diet and how it's affecting the patient's immune system and how that may favorably affect their course of their prostate cancer. Dr. Shannon Westin: Well, great. Well, thank you so much for taking the time to chat with us about such an important clinical trial, and I really appreciate all the work you're doing and hope to get to see you soon. Dr. William Aronson: Well, thanks for having me, Shannon. It's really an exciting finding and I think it's something that clinicians and patients are going to be super interested in. Dr. Shannon Westin: We love straightforward interventions that actually make a difference, so you guys are to be congratulated for that. And I just want to thank all of you for listening. Thanks again, and I hope you enjoyed this episode of JCO After Hours. Be sure to check out our other podcast offerings wherever you get your podcasts. Have an awesome day. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Dr. Aronson Disclosures: Stock and Other Ownership Interests Johnson and Johnson Speakers' Bureau Company name: Janssen Oncology, Bayer, Blue Earth Diagnostics, AstraZeneca, Pfizer/Astellas Research Funding: Lantheus Medical Imaging UCLA Health Article Video
Evgenia Koutsouki, EMJ Editor, reflects on the most memorable moments from the EMJ Podcast over the past year in this festive highlight's episode. Throughout 2024, our podcast has featured an impressive lineup of guests discussing groundbreaking topics, including advancements in breast cancer care, the evolving landscape of heart failure treatment, revolutionary approaches to prostate disease management, and much more. Join us this holiday season as we celebrate the best conversations and insights from an incredible year in healthcare! Timestamps: (00:00)-Introduction (01:00)-Advancing breast cancer care (05:52)-The hidden drivers of hunger and weight (12:12)-The evolving landscape of heart failure treatment (16:24)-Revolutionising prostate disease management (21:18)-Sepsis – the silent killer (26:46)-Individualised prostate cancer care (31:22)-Wrap up Featured Episodes: Advancing Breast Cancer Science and Patient Care Endocrinology: The Hidden Drivers of Hunger and Weight Heartbeats and High Achievements Revolutionising Radiology: Innovations and Advances in the Field The Silent Killer: Spotlight on Sepsis Breaking Barriers in Urologic Oncology
Stay up to date in your bladder cancer practice with this insightful episode of the BackTable Urology podcast, developed in collaboration with the Society of Urologic Oncology. Dr. Betsy Koehne (University of Wisconsin) and Dr. Amir Salmasi (UC San Diego) talk through the contemporary management of low and intermediate-risk non-muscle-invasive bladder cancer. --- SYNPOSIS The doctors explore the challenges and nuances of patient communication, intravesical therapy, and postoperative surveillance. They also cover emerging treatments and clinical trials that hold promise for improving patient outcomes and quality of life. Emphasis is placed on the distress experienced by patients and the need for personalized treatments. --- TIMESTAMPS 00:00 - Introduction 01:51 - Initial Consultation 08:01 - TURBT Procedure Insights 23:14 - Managing Low and Intermediate Risk Bladder Cancer 26:47 - Recurrence and Surveillance Strategies 27:48 - Prognostication Tools 30:10 - Intravesical Chemotherapy Options 33:24 - High Grade Tumors 42:33 - Clinical Trials and Emerging Therapies 49:19 - Concluding Thoughts
Join us for part two of our post-chemotherapy RPLND discussion with Society of Urologic Oncologists (SUO) members Tim Masterson from Indiana University and Rob Hamilton from Princess Margaret Hospital, University of Toronto. --- This podcast was developed in collaboration with: Society of Urologic Oncology https://suonet.org/home.aspx --- SYNPOSIS The conversation covers critical aspects of RPLND, including surgical techniques, preoperative considerations, common complications like chyle leaks, and post-operative care. Both surgeons emphasize the importance of humility, constant learning, and interprofessional collaboration to enhance surgical outcomes. The experts provide valuable insights and detailed discussions meant to guide urologists. --- TIMESTAMPS 00:00 - Introduction 01:16 - General Steps for RPLND Surgery 07:23 - Finding the Ureters 11:53 - Vascular Control 23:26 - Mitigating Chyle Leak 32:32 - Conclusion --- RESOURCES Expert Approaches to Complex PC RPLND Cases Part 1: https://www.backtable.com/shows/urology/podcasts/201/expert-approaches-to-complex-pc-rplnd-cases-part-1 Society of Urologic Oncology: https://suonet.org/home.aspx
In this episode of Bladder Cancer Matters, host Rick Bangs speaks with Dr. Armine Smith, Director of Urologic Oncology at Sibley Memorial Hospital and a leading expert in bladder cancer. They dive deep into the significant disparities in bladder cancer diagnosis and outcomes between men and women, exploring the biological, socioeconomic, and healthcare-related factors behind these differences. Dr. Smith highlights the urgent need for better awareness, timely diagnosis, and gender-sensitive treatment options, including exciting new research into the role of the microbiome and sex hormones in bladder cancer progression. With her passion and expertise, Dr. Smith offers actionable insights for both patients and healthcare providers. Tune in to learn about these critical issues and how we can collectively work to improve bladder cancer care for women.
Forget Ozempic & Wegovy. The Biggest Opportunity In Weight Loss Today. Lose Weight, Not Muscle $VERU Guest: * CEO: Dr. Mitchell Steiner * Title: Founder, Chairman, CEO, and President * Website: www.verupharma.com * Ticker: NASDAQ: Veru * Bio: Mitchell S. Steiner, M.D., F.A.C.S. has served as President and Chief Executive Officer of Veru and as a director of the Company since October 2016. Dr. Steiner was the co-founder of Aspen Park and served as Aspen Park's Chief Executive Officer, President and Vice Chairman of the Board from July 2014 to October 2016. From 2014 to 2016, Dr. Steiner was a consultant and then the President, Urology and member of senior management of OPKO Health, Inc. (NYSE:OPK) and had responsibilities for the launch, marketing, sales and reimbursement of 4Kscore prostate cancer test to urologists and primary care physicians. Dr. Steiner was also the co-founder of GTx, Inc., a men's health and oncology public company, where he served as Chief Executive Officer and Vice Chairman of Board of Directors from 1997 to 2014. Dr. Steiner is a Board Certified Urologist and a Fellow of the American College of Surgeons and has held numerous academic appointments, including Assistant Professor of Urology, Cell Biology, and Pathology at Vanderbilt School of Medicine from 1993 to 1995 and Chairman and Professor of Urology, Director of Urologic Oncology and Research and the Chair of Excellence in Urologic Oncology at the University of Tennessee from 1995 to 2004. Dr. Steiner holds a B.A. in Molecular Biology and Chemistry from Vanderbilt University and an M.D. from the University of Tennessee. He performed his surgical and urologic training at The Johns Hopkins Hospital and postdoctoral research fellow in cell biology at Vanderbilt School of Medicine. --- Support this podcast: https://podcasters.spotify.com/pod/show/smartmoneycircle/support
Oncotarget #published this #editorial on September 30, 2024, in Volume 15, entitled “Lessons from the ACDC-RP trial: Clinical trial design for radical prostatectomy neoadjuvant therapy trials” by Rashid K. Sayyid and Neil E. Fleshner from the Division of Urologic Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada. DOI - https://doi.org/10.18632/oncotarget.28648 Correspondence to - Rashid K. Sayyid - rksayyid@gmail.com Video short - https://www.youtube.com/watch?v=APkPoTlXBWY Sign up for free Altmetric alerts about this article - https://oncotarget.altmetric.com/details/email_updates?id=10.18632%2Foncotarget.28648 Subscribe for free publication alerts from Oncotarget - https://www.oncotarget.com/subscribe/ Keywords - cancer, clinical trial, prostatic neoplasms, neoadjuvant therapy, chemotherapy; androgen receptor agonist About Oncotarget Oncotarget (a primarily oncology-focused, peer-reviewed, open access journal) aims to maximize research impact through insightful peer-review; eliminate borders between specialties by linking different fields of oncology, cancer research and biomedical sciences; and foster application of basic and clinical science. Oncotarget is indexed and archived by PubMed/Medline, PubMed Central, Scopus, EMBASE, META (Chan Zuckerberg Initiative) (2018-2022), and Dimensions (Digital Science). To learn more about Oncotarget, please visit https://www.oncotarget.com and connect with us: Facebook - https://www.facebook.com/Oncotarget/ X - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Spotify - https://open.spotify.com/show/0gRwT6BqYWJzxzmjPJwtVh MEDIA@IMPACTJOURNALS.COM
Urologic Oncology: Genetics And Genomics AUA Urology Core Curriculum: auau.auanet.org/core Host: Jay D. Raman, MD, FACS, FRCS(Glasg) Guest: Hong Truong, MD, MS Outline: Segment 1: Genetics 101 – How Genes Influence Cancer Risk Segment 2: Genetic Risk Assessment Segment 3: Genetics of Kidney Cancer Segment 4: Genetics of Upper Tract Cancer Segment 5: Genetics of Prostate Cancer
Our guest is Dr. Daniel Lin, a urologist, professor and Chief of Urologic Oncology at the University of Washington and professor of the Division of Public Health Sciences at the Fred Hutchinson Cancer Center. The goal of this podcast is to help patients and caregivers learn how prostate imaging is used to detect prostate cancer. Dr. Lin talks about prostate imaging as it relates to the American Urological Association, or AUA, clinical guidelines. Our hope is that this podcast will help patients to better talk with their doctors so they can make informed decisions about their prostate health and care. This podcast was sponsored in part by Blue Earth Diagnostics. For more information, please visit www.UrologyHealth.org and don't forget to subscribe to our free digital magazine, UrologyHealth extra® at www.urologyhealth.org/uhe. **** September 12, 2024
Dr. Nam is Professor of Surgery and Urologic Oncology at the University of Toronto / The verdict is in, Dan needs to get a colonosopy / Kamala Harris crushes the Orange Idiot / Listener email / Sherpa Jay / Toronto to New York in the blink of an eye Humble and Fred is proudly brought to you by Bodog, Kelseys Original Roadhouse, The Chambers Plan, The Retirement Sherpa Tim Niblett
This week, Jonathan is joined by Neal Shore, Medical Director at Carolina Urologic Research Center and Chief Medical Officer of Surgical Oncology and Urology at GenesisCare USA. In an enlightening conversation, they discuss the latest advancements in the field of urologic oncology and the wonderment of medicine. Timestamps: (00:00)-Introduction (03:08)-What initially drew Neal to urologic cancers (05:44)-His most significant research advancements (12:30)-The privileges of medicine (18:45)-Changes in the field (23:30)-Current guidance on the use of PSA to screen for prostate cancer (28:20)-How can we drive greater awareness of men's health issues? (33:40)-The robotic approach to prostate cancer (36:23)-Targeted alpha therapy (42:10)-Exciting innovations in urologic oncology (45:50)-Values in patient care (50:55)-Neal's three magic wishes
In this episode I sit down with Kelowna based Urologist, Dr. Matthew Ho to discuss: What you can expect at a Urology appointmentDiagnostic tests commonly ordered Common reasons men are referred to a urologist and treatment suggestions that may be provided Urinary issuesStorage issues (frequency, urge, incontinence, pain, nighttime urination)Issues with emptying (weak flow, straining, blockage, stop/start, not fully emptying)Erectile dysfunctionGenital painPremature ejaculationProstate related issuesPhysiotherapy is a common treatment recommendation, stay tuned for the next episode where I cover the physiotherapy approach to the above symptoms Dr. Matthew Ho is a Royal College of Physicians and Surgeons of Canada-certified Urologist practicing in Kelowna, BC. Born and raised in Vancouver, B.C., he attended the University of British Columbia for undergraduate studies and medical school. He completed his Urology residency in Vancouver and subsequently moved to Chicago for an accredited fellowship in Urologic Oncology. While he specializes in urologic cancers, Dr. Ho sees patients with the whole spectrum of urologic concerns.How to Contact Dr. Matthew HoWebsite - www.homdurology.caTHANK YOU TO THE EPISODE SPONSORSRC: discount code and website: https://srchealth.com/?ref=Sto_l3PawmnH4Thanks for joining me! Here is where you can find out how to work with me: www.pelvicfloorprojectspace.com/Support the Show.
Dr Matthew Galsky from The Tisch Cancer Institute in New York and Dr Ashish Kamat from The University of Texas MD Anderson Cancer Center in Houston summarize recent clinical advances in the management of urothelial bladder cancer, including data from the 2024 AUA annual meeting.
Featuring perspectives from Dr Matthew D Galsky and Dr Ashish M Kamat, including the following topics: Introduction: Urologist for Life (0:00) Non-Muscle-Invasive Urothelial Bladder Cancer (UBC) Update (9:54) Enfortumab Vedotin/Pembrolizumab Now and in the Future (30:21) HER2-Positive UBC (37:33) Future Directions — ctDNA (55:39) CME information and select publications
Dr Matthew Galsky from The Tisch Cancer Institute in New York and Dr Ashish Kamat from The University of Texas MD Anderson Cancer Center in Houston summarize recent clinical advances in the management of urothelial bladder cancer, including data from the 2024 AUA annual meeting, moderated by Dr Neil Love. Produced by Research To Practice. CME information and select publications here (https://www.researchtopractice.com/AUA2024/UBC).
Featuring perspectives from Dr Rahul Aggarwal, Dr Adam S Kibel, Dr Laurence Klotz and Dr Sandy Srinivas, moderated by Dr Elisabeth I Heath, including the following topics: Introduction (0:00) Recent Data Defining the Optimal Use of Hormonal Therapy for Nonmetastatic Prostate Cancer — Dr Kibel (2:39) Side Effects and Other Practical Considerations with Hormonal Therapy for Nonmetastatic Prostate Cancer — Dr Klotz (27:04) Current and Future Approaches to Hormonal Therapy for Metastatic Prostate Cancer — Dr Aggarwal (51:07) New Considerations with the Use of PARP Inhibitors for Metastatic Castration-Resistant Prostate Cancer (mCRPC) — Dr Srinivas (1:13:53) Other Novel Therapies for Patients with Metastatic Prostate Cancer — Dr Heath (1:38:52) CME information and select publications
The government's role in public health is a hot-topic discussion in a world dedicated to scientific advancement and safety. Today's episode discusses the Food and Drug Administration's role in promoting and protecting public health, the goals needed to cure disease on a national and worldwide scale, and the essential qualities of public health leadership. We sat down with former Commissioner of the FDA and renowned cancer specialist Dr. Andrew von Eschenbach to dive into the process and policy. Dr. Andrew von Eschenbach is the former Commissioner of the Food and Drug Administration and Director of the National Cancer Institute at the National Institutes of Health. He served as the Executive Vice President and Chief Academic at the University of Texas M.D. Anderson Cancer Center as well as Chairman of the Department of Urologic Oncology. Dr. von Eschenbach is an internationally renowned cancer specialist and served as a Lt. Commander in the U.S. Navy Medical Corps.(02:37) – An interest in science(05:04) – Investigating and treating cancer(09:04) – National Cancer Institute (12:17) – Public policy and healthcare leadership(15:57) – Food and Drug Administration(19:06) – Joining the agency(23:25) – Promote and protect public health(30:59) – Leadership in process and policy, not practice(33:52) – Increasing interest in supplements(38:43) – Personalized medicine and digital health(43:01) – An issue of trust(47:36) – Engaging real-world evidence(49:39) – Innovation in the delivery of care infrastructureIf there are topics that you are interested in learning more about, please visit MichaelJLeeMD.com.If you'd like to receive new episodes as they're published, please follow I'd Love to Know in Apple Podcasts, Spotify, or wherever you get your podcasts. If you enjoyed this episode, please consider leaving a review on Apple Podcasts or Spotify. It really helps others find the show.The information from this podcast does not constitute medical advice and is meant for basic informational purposes only. If you're interested in pursuing any of the therapies, supplements, or medications discussed here, please consult with your physician.Podcast episode production by Dante32.
In honor of National Cancer Prevention Month, Dr. Stephen Freedland, Urologist at Cedars-Sinai Medical Center and Oncology Data Advisor Editorial Board Member, sat down with Dr. William Aronson, Professor of Urology at the University of California, Los Angeles (UCLA) and Chief of Urologic Oncology at the West Los Angeles Veterans Affairs (VA) Medical Center for a conversation about the multitude of factors under investigation for prostate cancer prevention. Dr. Freedland and Dr. Aronson discuss prostate-specific antigen (PSA) screening recommendations, medications being investigated, the roles of diet and exercise, and how they personally counsel their patients regarding prostate cancer prevention and risk reduction.
Better Edge : A Northwestern Medicine podcast for physicians
In this Better Edge podcase episode, Joshua Meeks, MD, PhD, the Edward M. Schaeffer, MD, PhD, Professor of Urology, sits down with Song Jiang, MD, PhD, a new member of Urologic Oncology at Northwestern Medicine's Central DuPage Hospital. Dr. Meeks and Dr. Jiang discuss advanced therapies in the management of bladder cancer, and how Northwestern Medicine's integration efforts are extending leading-edge treatments and clinical trials past Chicago, to the west and beyond.
In this segment, Dr. Mistry and Donna Lee discuss the diagnosis and treatment of prostate cancer. Despite being one of the most common cancers affecting men, prostate cancer has a low mortality rate because it is highly treatable. Dr. Mistry offers state of the art treatment options to his patients: radical prostatectomy (removing the entire prostate), HIFU, and Cyberknife. No matter which treatment you ultimately choose, it is critical to find a surgeon who is experienced and comfortable performing it. Dr. Mistry recommends that anyone diagnosed with a major or potentially life-threatening condition seek out a second opinion before committing to treatment. Importantly, the treatment option you and your doctor select should be chosen to help you live not just longer, but also BETTER. People today live longer than ever, but many of those years are spent in ill health. To extend your life span AND your health span, give us a call today!Voted top Men's Health Podcast, Sex Therapy Podcast, and Prostate Cancer Podcast by FeedSpotDr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.We enjoy hearing from you! Email us at armormenshealth@gmail.com and we'll answer your question in an upcoming episode.Phone: (512) 238-0762Email: Armormenshealth@gmail.comWebsite: Armormenshealth.comOur Locations:Round Rock Office970 Hester's Crossing Road Suite 101 Round Rock, TX 78681South Austin Office6501 South Congress Suite 1-103 Austin, TX 78745Lakeline Office12505 Hymeadow Drive Suite 2C Austin, TX 78750Dripping Springs Office170 Benney Lane Suite 202 Dripping Springs, TX 78620
This episode is brought to you by PearsonRavitz - helping physicians safeguard their most valuable assets. Dr. David Canes, a board-certified urologist specializing in urologic oncology and robotic surgery, has developed WellPrept, a platform that enhances the efficiency of doctor-patient interactions by providing patients with information before their appointments. This approach addresses the repetitive nature of medical consultations and burnout among healthcare professionals, fostering better patient engagement and understanding. Looking for something specific? Here you go! [00:00:00] Introduction to the episode and Dr. David Keynes' background [00:01:00] Dr. Keynes' role as CEO of WellPrepped and its mission [00:02:00] The realization of repetitive consultations leading to burnout [00:03:00] Dr. Keynes' personal experience with patient engagement [00:04:00] The moment of conceptualizing WellPrepped [00:05:00] Developing the initial version of WellPrepped [00:06:00] The challenge of finding an English equivalent for 'spiel' [00:07:00] Incorporating YouTube videos in patient communication [00:08:00] Positive patient feedback on pre-appointment content [00:09:00] Transition from prototype to a software solution [00:10:00] Feedback from other doctors and realizing the broader impact [00:11:00] The challenge of balancing a medical career with entrepreneurship [00:12:00] Validation of the idea among urologists [00:13:00] The journey of creating and scaling up WellPrepped [00:14:00] Learning curve in software development and entrepreneurship [00:15:00] The difference between efficiency and productivity in medical practice [00:16:00] The impact of WellPrepped on reducing clinical burnout [00:17:00] The role of WellPrepped in improving patient-doctor relationships [00:18:00] Dr. Keynes' experience in balancing doctor and entrepreneur roles [00:19:00] The perception of colleagues towards entrepreneurial doctors [00:20:00] The importance of exploring beyond traditional medical practice [00:21:00] Explaining the core function of WellPrepped [00:22:00] Anecdotal evidence of increased efficiency in patient visits [00:23:00] Enhancing patient experience through pre-visit content [00:24:00] Differentiating between efficiency and productivity in healthcare [00:25:00] Building patient trust before the physical consultation [00:26:00] The importance of face-to-face interactions in patient care [00:27:00] Utilizing waiting time effectively in patient education [00:28:00] The need for a holistic approach in patient care experience [00:29:00] Leveraging waiting periods for patient education [00:30:00] The impact of visual content in building patient trust [00:31:00] Challenges of forming patient bonds with masked interactions [00:32:00] Innovative uses of WellPrepped by healthcare professionals [00:33:00] Unexpected applications of WellPrepped in patient journey visualization [00:34:00] The emotional impact of patient anxiety reduction [00:35:00] How to access and utilize WellPrepped for healthcare providers More on Dr. David Canes: Dr. David Canes, M.D. CEO of WellPrept | Board Certified Urologist | Expert in Urologic Oncology and Robotic Surgery Dr. David Canes is a distinguished urologist renowned for his commitment to enhancing patient care through innovation and advanced technology. As the CEO of WellPrept, he leads the charge in revolutionizing doctor-patient communication, developing a content distribution system that greatly benefits healthcare providers and patients alike. With his extensive experience at the Leahy Hospital and Medical Center, along with his role as the medical director at Leahy's New Hampshire Satellite Clinic at Parkland Medical Center, Dr. Canes brings invaluable expertise in urologic oncology and robotic surgery. His dedication to his field is paralleled by his determination to improve the healthcare experience. Motivated by his personal experiences with professional burnout and the repetitive aspects of medical consultations, Dr. Canes was inspired to create WellPrept. His platform stands as a testament to his belief in leveraging technology to streamline patient education, alleviate the burden on healthcare professionals, and enhance the overall quality of medical consultations. A staunch advocate for addressing burnout in the medical profession, Dr. Canes' work with WellPrept goes beyond educating patients. It is a tool designed to reignite the joy and engagement in healthcare by enabling more meaningful patient interactions and reducing the repetitiveness of conventional medical advisories. As a visionary leader and innovator, Dr. Canes continues to inspire the medical community to embrace new, creative approaches to patient care, and to think beyond traditional boundaries. "Transforming patient care through innovation and understanding – one consultation at a time." Did ya know… You can also be a guest on our show? Please email me at brad@physiciansguidetodoctoring.com to connect or visit www.physiciansguidetodoctoring.com to learn more about the show! Socials: @physiciansguidetodoctoring on FB @physicianguidetodoctoring on YouTube @physiciansguide on Instagram and Twitter
Dr. David Penson, Chair of the Department of Urology at Vanderbilt University, discusses his comparative effectiveness research in prostate cancer. In the second of our two-part prostate cancer series, we delve deeper into the world of prostate cancer treatment decision-making. Dr. Penson discusses the emotional and informational hurdles that patients face, as well as the importance of patient education, understanding patient preferences, and the ongoing battle against overtreatment in prostate cancer. Key Highlights: Importance of informed decision making and arming patients with accurate and reliable information. Understanding the concept of patient preferences in treatment decision making. Overcoming decision biases and how the emotion of a cancer diagnosis can outweigh a rational decision-making process. About our guest: David F. Penson, MD, MPH is the Hamilton and Howd Chair in Urologic Oncology, Director of the Center for Surgical Quality and Outcomes Research and Professor and Chair, Department of Urology at Vanderbilt University. He currently maintains a clinical practice in urologic oncology at the Vanderbilt-Ingram Cancer Center. While his general research focus is clinical epidemiology and health services research across all urologic disease, his specific interests include the comparative effectiveness of treatment options in localized prostate cancer and the impact of the disease and its treatment on patients' quality of life. Key Moments: 4 minutes: On the clinical shift to active surveillance. “We have this situation where we were over diagnosing. Half the men who were detected by PSA screening at the turn of the century were overdiagnosed, depending on how you defined overdiagnosis. And they were all getting treated. So you had this terrible problem where we were just kind of treating everybody. I think what we've learned is that, in fact, not everyone with prostate cancer needs to be treated. That PSA picks up a lot of clinically indolent prostate cancer.” 24 minutes: On determining a patient's priorities: “The cancer control and cure piece is not quite as clear [with radiation] because you're not pulling the cancer out. So you don't have the psychological benefit of knowing what you're dealing with. And it's very hard to do surgery after radiation. So it becomes this set of options, a set of what's important to you, right? So patients may not walk in the door saying, ‘I have a preference set.' But as you start talking to them, their preference set becomes relatively clear. And when I talk to them, I say, ‘Listen, I can tell you what I would do,' because a lot of times they say, ‘Doc, what would you do?' But the problem is, I can't take Dave out of Dr. Penson, right? So I have my own set of preferences.” 36 minutes: On emotional vs. rational decision making. “But I think it's very hard to sort of turn down the emotional volume because the word ‘cancer', any human hears that, and it scares you. Right? That goes back to what we were saying before about maybe we shouldn't be calling Gleason 6 cancer, cancer. Because there's a charge that goes with that word that freaks people out.” This episode was supported by the Patient Centered Outcomes Research Institute (PCORI) and features this PCORI study by Dr. Penson. Visit the Manta Cares website Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions. --- Support this podcast: https://podcasters.spotify.com/pod/show/manta-cares/support
Dr. David Penson, Chair of the Department of Urology at Vanderbilt University, discusses his comparative effectiveness research in prostate cancer. He talks about the evolution of Prostate Cancer awareness in the US, and historic screening and side effect issues that have made it a stigmatized topic for many men. Dr. Penson describes the nuances of PSA testing and how higher diagnosis rates of Prostate Cancer has led to overtreatment in the past, and the current shift to focus on active surveillance is helping to better balance the treatment paradigm for men with Prostate Cancer. Key Highlights: What is comparative effectiveness research and why does it matter to cancer patients? The evolution of the stigma associated with Prostate Cancer. How to think about the nuances of PSA screening tests. About our guest: David F. Penson, MD, MPH is the Hamilton and Howd Chair in Urologic Oncology, Director of the Center for Surgical Quality and Outcomes Research and Professor and Chair, Department of Urology at Vanderbilt University. He currently maintains a clinical practice in urologic oncology at the Vanderbilt-Ingram Cancer Center. While his general research focus is clinical epidemiology and health services research across all urologic disease, his specific interests include the comparative effectiveness of treatment options in localized prostate cancer and the impact of the disease and its treatment on patients' quality of life. Key Moments: 6 minutes: What is CER and why does it matter? “Comparative effectiveness research has been around forever. People have different names for it, but it's comparing the effectiveness of various interventions for a condition. I've been focused in prostate cancer, so a lot of what I'm focused on is comparing the effectiveness of surgery and radiation and, for that matter, active surveillance in outcomes in prostate cancer.” 21 minutes: How cultural differences impact stigma. “In the US, prostate cancer is much more common in Black men. And the way they respond to the diagnosis may be different than other cultural groups. Hispanic men have another way of looking at it, white men, etc. So you do have this cultural element to it too, because sexuality and body image is often tied to cultural norms.” 31 minutes: The nuances of PSA screening. “The American Urological Association just came out with new recommendations around screening and does say, discuss screening, but doesn't say everyone should be screened. They've sort of started talking about getting a PSA test in your mid-40s, because there's pretty good literature that a baseline PSA test will establish your pretest probability of clinically significant prostate cancer in your lifetime. But the other thing that they mentioned is they basically say we should probably not be doing annual screening with PSA testing, probably every other year. Because less may be more here.” This episode was supported by the Patient Centered Outcomes Research Institute (PCORI) and features this PCORI study by Dr. Penson. Visit the Manta Cares website Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions. --- Support this podcast: https://podcasters.spotify.com/pod/show/manta-cares/support
Two cracking bladder cancer studies to discuss on GU Cast today (in our brand new GU Cast studio)! We are joined by Dr Sia Daneshmand, Urologist and Director of Urologic Oncology at the University of Southern California, who presented the headline-making Tar-200/SunRIse-1 study at the recent Annual Meeting of the American Urological Association. Not sure what a urological pretzel is and how it can help patients with high-grade non-muscle-invasive bladder cancer? Sia explains all! He was also an investigator on the SWOG 1011 trial presented at the ASCO Annual Meeting recently by Dr Seth Lerner. A practice-changing randomised trial of standard vs extended pelvic lymph node dissection for patents with invasive bladder cancer. These are very significant papers and we really enjoyed having Sia on GU Cast to discuss. Even better on YouTube when you can check out our new studio!
Featuring perspectives from Prof Sia Daneshmand, Dr Joshua J Meeks, Dr Matthew Milowsky and Prof J Alfred Witjes, moderated by Dr Arlene Siefker‑Radtke, including the following topics: Introduction (0:00) Current Role of Anti-PD-1/PD-L1 Antibodies in the Treatment of Non-Muscle-Invasive Bladder Cancer — Joshua J Meeks, MD, PhD (2:49) Contemporary Management of Muscle-Invasive Bladder Cancer — J Alfred Witjes, MD, PhD (26:30) Novel Strategies Under Investigation for Nonmetastatic Urothelial Bladder Cancer (UBC) — Sia Daneshmand, MD (48:02) Current and Future Up-Front Management of Metastatic UBC (mUBC) — Matthew Milowsky, MD (1:12:26) Selection and Sequencing of Therapy for Relapsed/Refractory mUBC — Arlene Siefker-Radtke, MD (1:33:25) CME information and select publications
In Episode 45 of Bladder Cancer Matters, host Rick Bangs talks with Dr. Michael O'Donnell, Director of Urologic Oncology at the University of Iowa. He is the author of over 150 peer-reviewed manuscripts and serves on the editorial board of the Journal of Urology and CURE. Dr. O'Donnell leads several national clinical trials using immune therapy to treat bladder cancer. Rick and and Dr. O'Donnell talk about: Why BCG is the gold standard when treating non-muscle invasive bladder cancer How Dr. O'Donnell has dealt with the BCG shortage while studying the effectiveness of other intravesical treatments When BCG treatments fail a patient, what options they may have New drugs and treatments like Adstiladrin, a genetically engineered virus that produces interferon What patients need to know about the toxicity of non-muscle invasive treatments for bladder cancer What "salvage treatments" are Never miss an episode of Bladder Cancer Matters by subscribing in your favorite podcasting platform. Thank you for listening!
Featuring perspectives from Dr Himisha Beltran, Dr Stephen J Freedland, Dr Fred Saad and Dr Neal D Shore, moderated by Dr Matthew R Smith, including the following topics: Introduction (0:00) Management Approaches for Nonmetastatic Prostate Cancer — Dr Freedland (1:45) Optimizing the Care of Patients with Metastatic Hormone-Sensitive Prostate Cancer — Dr Saad (26:14) Therapeutic Considerations for Patients with Newly Diagnosed Metastatic CRPC (mCRPC) — Dr Shore (51:51) Contemporary Management of mCRPC in Patients Harboring a Homologous Recombination Repair Gene Alteration — Dr Smith (1:16:20) Current and Emerging Strategies in the Treatment of Recurrent mCRPC — Dr Beltran (1:36:47) CME information and select publications
A leader, a mentor, and a nationally acclaimed expert is the new leader of The University of Kansas Cancer Center. Meet the man who is leading innovative research and patient care. Guests include Dr. Roy Jensen, director and vice chair, The University of Kansas Cancer Center, and Dr. Jeff Holzbeierlein, new physician-in-chief, The University of Kansas Cancer Center; president, Society of Urologic Oncology, Inc.
Christopher Weight, MD, Center Director of Urologic Oncology at Cleveland Clinic joins the Cancer Advances podcast to discuss using artificial intelligence to diagnose kidney cancer. Listen as Dr. Weight explains the progress we have made with imaging-generated software and a fully automated equivalent nephrometry score.
Dr. Elizabeth "Betsy" Koehne, MD is at the wonderful transition between training and complete surgical independence. She is a urologist and Acting Instructor and Society of Urologic Oncology fellow at the UW School of Medicine in Seattle. While she is may be junior is her surgical experience, she is seasoned in transcendental meditation, yoga, and incorporating mindfulness into her daily and surgical existence. I learn a ton from Betsy every time we speak and I hope you enjoy this conversation.
Costas Lallas went to Duke University where he double majored in Classical Studies and Latin. He then went to medical school at Jefferson and residency at Duke. He completed a fellowship in Minimally Invasive Surgery, Urologic Oncology, at May Clinic Arizona. He is now the vice chair of education, director of robotic surgery, and director of surgical simulation at Thomas Jefferson University. He is also the Program Director for the Urology Residency at Einstein Medical Center in Philadelphia.___0:00 - Intro0:52 - Statistics About Urology6:45 - Burnout Rates16:31 - What Is Urology?18:16 - Why Urology?25:10 - Maximizing Competitiveness as a Med Student Going Into Urology37:07 - Specializing After Urology Residency43:54 - Average Day/Week of a Urologist49:21 - If I Give You $100 Million, What Would You Do?52:58 - Best Things About Urology57:50 - Worst Things About Urology1:00:23 - Things That Would Have Been Done Differently in Your Career?1:02:49 - What Advice Would You Give Your 18-Year-Old Self?1:04:46 - Common Mistakes1:06:00 - Positive Qualities & Characteristics1:07:44 - Advice for Students Looking Into Urology1:09:44 - Interesting Plugs1:10:38 - Love for Basketball1:14:56 - Outro___Resources: Residency Information: https://students-residents.aamc.org/applying-residencies-eras/applying-residencies-eras___View the Show Notes Page for This Episode for transcript and more information: zhighley.com/podcast___Connect with Dr. LallasBio: https://www.jefferson.edu/academics/colleges-schools-institutes/skmc/departments/urology/faculty/lallas.html___Connect With ZachMain YouTube: @ZachHighley Newsletter: https://zhighley.com/newsletter/Instagram: https://www.instagram.com/zachhighley/?hl=enWebsite: https://zhighley.comTwitter: https://twitter.com/zachhighleyLinkedln: https://www.linkedin.com/in/zach-highley-gergel-44763766/Business Inquiries: zachhighley@nebula.tv___Listen for FreeSpotify: https://open.spotify.com/show/23TvJdEBAJuW5WY1QHEc6A?si=cf65ae0abbaf46a4Apple Podcast: https://podcasts.apple.com/us/podcast/the-zach-highley-show/id1666374777___Welcome to the Zach Highley Show, where we discuss personal growth and medicine to figure out how to improve our lives. My name is Zach and I'm a medical student, and soon to be physician, in Philadelphia. Throughout these episodes I'll interview top performers from around the world in business, life, and medicine in hopes of extracting the resources and techniques they use to get to the top.The best way to help the show is share episodes on any platform. If you think a friend or family member will like a certain episode, send it to them!See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
In this episode we discuss focal therapy for the treatment of prostate cancer. Historically, men diagnosed with localized prostate cancer have had to choose between two treatment options: surgery and radiation therapy. Both options involve treating the entire prostate gland, regardless of the size, location, or number of cancerous tumors. Recently, however, more localized treatment options have become available for prostate cancer that involve focally treating only the tumors, rather than the entire prostate gland. So, what are these focal therapies? How do they work? What risks are involved? What advantages do they have over traditional therapies? And, probably most importantly, how successful are they at actually curing prostate cancer? To answer these questions and many more, we turned to a true expert. Dr. Arvin George is an Associate Professor of Urology at the University of Michigan. After obtaining his medical degree from the Royal College of Surgeons in Ireland, he completed his Urology Residency at the Smith Institute for Urology at the Hofstra North Shore-LIJ School of Medicine. He remained to complete his Endourology fellowship in New York gaining additional subspecialty expertise in robotic, laparoscopic, and percutaneous surgery. Subsequently, he completed a Urologic Oncology fellowship at the National Cancer Institute, National Institutes of Health. Dr. George's research interests include minimally invasive and image-guided treatments, functional prostate imaging and focal therapy for prostate cancer. He is an active member of the American Urological Association, Society of Urologic Oncology, the Endourological Society, and the American College of Surgeons.#prostate #prostatecancertreatment #prostatecancer #focaltherapy
This episode follows 2 Kidney Cancer expert Urologists in understanding Kidney tumors from diagnosis to treatment options. Guest: John L. Gore, M.D. Professor of Urology, Professor of Surgery, Health Services Researcher, University of Washington. Urologist, surgeon, clinician, researcher, educator and expert in clinical care guidelines and outcomes. Dr. Gore is the PI of a large pragmatic trial in bladder cancer, and a quality of care expert. He previously served as the American Urological Association (AUA) representative to the National Quality Forum, which endorses national health care performance measures, and has been on guidelines panels for the National Comprehensive Cancer Network (NCCN) for kidney cancer, and the AUA for bladder cancer. Brian Shuch, MD is the Director of the Kidney Cancer Program and the Alvin & Carrie Meinhardt Endowed Chair in Kidney Cancer Research. He completed his urology training at UCLA followed by a Urologic Oncology Fellowship at the National Cancer Institute. He is an accomplished surgeon (open/laparoscopic/robotic surgery and percutaneous ablations) and clinical/translational researcher. He serves in leadership positions within various kidney cancer research organizations such as SWOG and the Society of Urologic Oncology. He is recognized as an expert in the genetics of kidney cancer and runs a translational research program with over 140 peers reviewed publications including primary research published in prestigious journals such as Nature, Nature Genetics, Proceedings of the National Academy of Sciences, Journal of Clinical Oncology, and Clinical Cancer Research. He is one of the few clinicians to bring bench science to the bedside in an upcoming therapeutic clinical trial for metastatic kidney cancer. During This Episode We Discuss: The types of Kidney Cancer Non cancerous kidney cysts (benign) versus cancerous kidney cysts, Solid kidney tumors, benign and malignant Diagnosis of kidney cancers: Imaging and Biopsy Risk factors for kidney cancers Genomics of kidney cancer Treatment of kidney cancer: Localized and Metastatic Quotes (Tweetables) Back in the olden days we used to talk about the triad of three symptoms people associated with kidney cancer. Those three symptoms were hematuria or blood in the urine, palpable mass, and flank pain. Realistically in 2023 this triad happens less than 1% of the time. What has changed is that there is a much higher frequency of use of imaging to diagnose problems in our bodies. Kidney cancer is one of the fastest growing cancer types in terms of it's incidence, because of incidental detection. Dr Gore Regarding tumor size, it all depends on the scenario.The larger the lesion the more concerning it is for cancer, but even a 1 cm tumor can have some aggressive elements. There is not an absolute size where you say that a tumor below this threshold cannot be a cancer. Dr Shuch Most kidney cancers are what we would call sporadic, in that it occurs in the absence of known risk factors. The 2 biggest risk factors that are more behavioral are smoking and obesity. Dr Gore Recommended Resources: KCA: Kidney Cancer Association www.kidneycancer.org Kidney Can www.kidneycan.org KC Cure www.kccure.org American Cancer Society Fred Hutchinson UCLA
Dr. Jason M. Alter is the Head of Scientific Affairs for Exosome Diagnostics. He has extensive experience in prognostic and predictive testing in Urologic Oncology. He has played key roles in the development of prostate cancer assays (biopsy and post-radical prostatectomy) at multiple companies. Dr. Alter has published on genomic and non-genomic risk assessment methods for prostate cancer and is very familiar with available molecular and genomic testing for the disease. Dr. Alter has a dual B.A. in Biology and History from Alfred University, an M.S. degree in Immuno-Parasitology from Texas A&M University, and a Ph.D. in Molecular Biology from Binghamton University. He did a postdoctoral fellowship at Schering Plough Pharmaceuticals.In this episode, Dr. Geo and Dr. Alter discuss the effectiveness of urine tests in identifying prostate cancer. ----------------Thanks for listening to this week's episode. Subscribe to The Dr. Geo Youtube Channel to get more content like this and learn how YOU can live better with age. Join below: https://www.youtube.com/c/GeoEspinosaND/featuredYou can also listen to this episode and future episodes of the Dr. Geo Podcast by clicking the link below:The Dr. Geo Podcast: https://link.chtbl.com/8Z6hUclo----------------Follow Dr. Geo on Social MediaFacebook: https://www.facebook.com/drgeoespinosa/Instagram: https://www.instagram.com/Real_DrGeo/Become a member of Dr. Geo's community and go to:https://drgeo.comImprove your urological health with Dr. Geo's formulated supplement linesXY Wellness: https://www.xywellness.com/Mr. Happy: https://iammrhappy.com/You can also check out Dr. Geo's other supplement recommendations for overall health and wellness
Developed by the AUA Residents & Fellows Committee, the Meet the Subspecialties series provides an inside look at the various urologic subspecialties, including the process of fellowship applications. In this first installment, Dr. Woodson Smelser, Assistant Professor of Surgery in the Division of Urology at Washington University in St. Louis and past Society of Urologic Oncology Fellow at Vanderbilt University, sits down with Dr. Bogdana Schmidt, Urologic Oncologist at the University of Utah, to explore the subspecialty of Urologic Oncology. Today's guests are available at @WSmelser @BogdanaSchmidt. For more information on the AUA Fellowship Match, click here.
Christopher Weight, MD, Center Director of Urologic Oncology at Cleveland Clinic joins the Cancer Advances podcast to discuss robot assisted retroperitoneal lymph node dissection (RPLND) for the treatment of testicular cancer. Listen as Dr. Weight explains how this robotic surgery allows shorter hospital stays, quicker recovery time, and a lower rate of chylous ascites.
Dr. Phil Kantoff is the CEO and Co-Founder of Convergent Therapeutics, a clinical-stage pharmaceutical company focused on developing next-generation radiopharmaceutical therapies for prostate and other cancers. The company's proprietary technology involves dual-targeted radionuclide therapy developed by Dr. Neil Bander, Professor of Urologic Oncology at Weill Cornell Medicine. Prior to founding the company, Dr. Kantoff spent six years as Chairman of the Department of Medicine at Memorial Sloan Kettering Cancer Center, caring for cancer patients and developing improved cancer testing and cancer therapies. He is the Emeritus Jerome and Nancy Kohlberg Chair in Medicine at Harvard Medical School, and he was the Chief of the Solid Tumor Oncology Division and Director of the Lank Center for Genitourinary Oncology, at Dana Farber Cancer Institute.In this episode, we discuss Phil's transition out of academic medicine, the field of radiopharmaceuticals, Convergent's approach to drug development, and specific business considerations for a unique class of molecules.Hosted by Joe Varriale.
We welcome Dr. Svetlana Avulova to Medical Monday. Dr. Avulova is a urologic oncologist at Albany Med. Call at 2pm with your question. 800-348-2551. Ray Graf hosts.
Should I Order a PET Scan? Integrating Molecular Imaging Into Urologic Oncology Clinical Practice: Current Approaches and Future Opportunities CME Available: https://auau.auanet.org/node/36003 LEARNING OBJECTIVES At the conclusion of this course, participants will be able to: 1. Analyze the best available evidence on the current diagnostic imaging options for prostate, kidney and urothelial cancer detection, staging and follow-up. 2. Determine the benefits of combined functional and anatomical information gained through accurate matching of anatomical (CT/MRI) and functional (PET) images. 3. Debate the strengths and limitations of emerging molecular imaging techniques compared to existing diagnostic tests. 4. Utilize performance characteristics of standard and emerging molecular imaging modalities to stage urologic oncology patients. 5. Describe the emerging role of PET imaging and novel radiotracers to assess chemotherapy and immunotherapy response.
Dr. Davies shares his valuable insights about post-operative opioid studies, disproves some myths about NSAIDs, and explains his pre-operative and post-operative pain management regimen. --- CHECK OUT OUR SPONSOR Laurel Road for Doctors https://www.laurelroad.com/healthcare-banking/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/XyDsiw --- SHOW NOTES In this episode of BackTable Urology, Dr. Aditya Bagrodia and Dr. Ben Davies, Director of Urologic Oncology at the University of Pittsburgh Medical Center, discuss non-opioid approaches for post-operative patients. First, Dr. Davies discusses diversion as an indirect problem with prescribing too many opioids because many urologists forget that patients with opioid prescriptions can have family members and close contacts who have access to these pills as well. According to Dr. Davies, data shows that post-operative urologic surgery patients have a rate of addiction of 1-2% when prescribed opioids. In his opinion, most patients who undergo urologic procedures, such as cystectomies, TURPs, and partial nephrectomies, do not need narcotics for post-operative pain management. Prospective studies done in the general surgery and urological surgery field prove that there is no difference in satisfaction between patients who manage their pain via non-opioid and opioid approaches. Furthermore, opioids may cause idiosyncratic results in post-operative patients, such as anxiety and GI problems. Next, Dr. Davies disproves some myths about NSAIDs. He does not agree with the practice of holding off NSAIDs for a week post-operatively, Also, he sees no problem with giving oral Tylenol to NPO patients. He strongly believes that bleeding risk and kidney damage as a result of toradol is minimal, and explains that creatinine levels always rise a bit post-operatively. He encourages urologists to walk their patients through the post-op pain regimen before surgery and to have pamphlets ready for distribution. Dr. Davies explains that for the most part, patients understand that opioid-related mortality deaths are rising and that 90% fentanyl and heroin users start with opioids. He also discourages doctors from prescribing extra opioid pills to patients. Then, Dr. Davies explains his pre-operative and post-operative pain management regimen. Pre-operatively, he uses Tylenol, gabapentin, and celebrex. Intraoperatively, he uses IV ketamine, propofol, and precedex. As patients are waking up from surgery, he will give toradol. Post-operatively, he will prescribe Tylenol and Motrin. Finally, he emphasizes the need for buy-in from the hospital administration for a non-opioid approach. He discusses the importance of meeting with hospital administration and nurses to change the pain management culture of an institution. In his personal experience, he made a quality improvement project out of his non-opioid approach and figured out his personal strategy towards pain management before presenting it to his department. --- RESOURCES Pekala KR, Jacobs BL, Davies BJ. The Shrinking Grey Zone of Postoperative Narcotics in the Midst of the Opioid Crisis: The No-opioid Urologist. Eur Urol Focus. 2020 Nov 15;6(6):1168-1169. doi: 10.1016/j.euf.2019.08.014. Epub 2019 Sep 26. PMID: 31563546. Yu M, Davies BJ. Opium Wars to the Opioid Epidemic: The Same Narcotics Cause Addiction and Kill. Eur Urol. 2020 Jan;77(1):76-77. doi: 10.1016/j.eururo.2019.10.006. Epub 2019 Nov 8. PMID: 31711720. “Dreamland” by Sam Quinones https://samquinones.com/dreamland “The Least of Us” by Sam Quinones https://samquinones.com/theleastofus
In this episode we discuss testicular cancer. Being diagnosed with testicular cancer can be devastating for the nearly 10000 men found to have the disease yearly in the United States. And unlike many other cancers, testicular cancer actually affects younger rather than older men, making the diagnosis all the more traumatizing. But, in reality, testicular cancer is often considered a cancer “success story,” often resulting in a good outcome for men diagnosed early and treated appropriately. But how do men know if they have testicular cancer? How can they check to see if they have it? If they are diagnosed with testicular cancer, what are the treatment options? And, probably most importantly, what is the prognosis for men with testiuclar cancer? In order to answer these questions and many more, we turned to a true expert. Dr. Sia Daneshmand is Professor of Urology and serves as director of clinical research at the University of Southern California (USC) in Los Angeles. He is a leading authority in the management of complex testicular cancers and is one of the highest volume surgeons for this disease in the country. He serves on the editorial board of the Journal of Urology as well as the AUA/SUO Guideline Committee on testicular cancer. He is a member of Alpha Omega Alpha medical honor society and has been designated one of the “America's Top Cancer Doctors” for the past 11 consecutive years. He is an active member of the Society of Urologic Oncology, has presented over 400 abstracts at scientific meetings and has authored over 300 peer-reviewed articles, reviews, and book chapters. And now, without further ado, I bring you our conversation with Dr. Sia Daneshmand about testicular cancer.
Moderator: Samir S. Taneja, MD Panelists: Simpa Salami, MBBS, MPH Edouard Trabulsi, MD Brian Shuch, MD Cheryl T. Lee, MD
In this episode we discuss robotic radical prostatectomy as a treatment option for prostate cancer. Over the last 20 years, robotic radical prostatectomy has become the gold standard for surgical management of prostate cancer. While the concept of robotic surgery is exciting, it also leads to a lot of questions amongst men faced with a decision as to how to treat their prostate cancer. How does the procedure actually work? Is the surgery performed by a surgeon or by a robot? What are the risks and side effects? Are all men good candidates for the procedure. And, of course, how effectively does it cure prostate cancer? To answer these questions we turned to Dr. Alexander Kutikov. Dr. Kutikov is a Professor and Chief of Urology and Urologic Oncology at the Fox Chase Cancer Center. He is a board certified, academic urologic surgical oncologist who treats urologic tumors using minimally invasive (robotic / laparoscopic) and traditional surgical techniques. Dr. Kutikov received an MD from Harvard Medical School's Harvard-MIT Health Sciences and Technology Program in 2003. He then completed his Urologic residency training at the University of Pennsylvania in 2008 and finished a 2-year Society of Urologic Oncology fellowship at the Fox Chase Cancer Center in Philadelphia, USA. He has co-authored more than 170 original manuscripts in peer-reviewed journals and has published chapters in leading urologic textbooks as well as holding leadership positions both in the American College of Surgeons and the American Urological Association.
Shane Pearce is the Director of Urologic Oncology at Sacred Heart Hospital in Spokane, WA. He talks with us about advances in robotic surgery, immunotherapy, and why the Sears Tower isn't a reliable unit of measurement!
The team traveled to Moore's Cancer Center at UCSD to record this special episode. Dr. Millard was a great source of information for all things cancer and you can learn more about him below.Learn more about the podcast & follow our story - deathwithdignitypodcast.com // @DWDPodcast2021 (Twitter) About Frederick Millard, MDFrederick Millard, MD, is a board-certified medical oncologist who specializes in treating people with genitourinary (urologic) cancers, including bladder cancer, kidney cancer, prostate cancer, testicular cancer and other germ cell tumors, as well as other rarer cancer types.He is a founder and former co-director of the genitourinary oncology team at UC San Diego Health's Moores Cancer Center. His particular interest is in treatment of patients with germ cell tumors (testicular cancer) and improving the care of these patients in the San Diego community.Dr. Millard also participates in the clinical research effort for patients with these illnesses, conducting clinical trials to help find new ways to improve treatments and the quality of life for people with urologic cancer. He is part of the only oncology clinical research program dedicated solely to urological cancers in the San Diego area.As a professor in the Department of Medicine, Dr. Millard instructs medical students, residents, and fellows at UC San Diego School of Medicine. His work has appeared in many peer-reviewed publications, including Urologic Oncology, Clinical Cancer Research and the Clinical Genitourinary Cancer.Dr. Millard completed a fellowship in hematology/oncology, and a residency in internal medicine at the Naval Medical Center in San Diego. He earned his medical degree from Sidney Kimmel Medical College in Philadelphia.He is board certified in medical oncology, hematology and internal medicine, and is a member of the American Society of Clinical Oncology.
We talk with Dr. Siamak Daneshmand, Director of Urologic Oncology at USC Institute Of Urology, about the management of muscle-invasive bladder cancer. Listen to the full episode to learn tips for successful transurethral resections of bladder tumor (TURBT) and cystectomies, using imaging to stage bladder cancers, deciding between a cystectomy vs. trimodality therapy (TMT), and comparisons between neobladder procedures and urinary diversions. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/hEi42s --- SHOW NOTES First, the doctors discuss the initial workup of a referred bladder tumor patient. Because almost all bladder cancers are malignant, a transurethral resection of the bladder tumor (TURBT) is the first step. Dr. Daneshmand notes that imaging may be helpful in patients with complex anatomy. He prefers to perform a CT over an MRI scan due to patient discomfort and costs. Next, Dr. Daneshmand shares his tips for a TURBT procedure. His main goal is to perform a complete resection of the tumor. He often uses blue light enhancement to visualize the edges of tumors better, improve the educational experiences of his residents, and stage smaller tumors more easily. He notes that doing an extensive TURBT does not lead to a higher likelihood of bladder cancer metastasis. Although uncommon, bladder perforation during TURBT is a possible and serious complication. To prevent seeding in the scenario of a perforation, he advises urologists to stop high-pressure irrigation immediately. Furthermore, he trains his residents to be vigilant of the amount of fluid going in and out of the abdomen. Another important aspect of bladder cancer care is accurately staging the bladder cancer after the TURBT. Dr. Daneshmand usually orders a CT scan of the abdomen, chest, and pelvis in order to check for metastases. He prefers not to order a PET scan, as it results in too many false positives and false negatives. In the case of the discovery of suspicious pelvic lymph nodes, he will move on with neoadjuvant therapy and keep assessing the lymph nodes via imaging. He does not usually biopsy these lymph nodes due to their precarious location between the external and internal iliac arteries. After staging the bladder cancer, a treatment modality must be chosen. Two common options are a cystectomy or trimodal therapy (TMT). Both Dr. Bagrodia and Dr. Daneshmand agree that variant histology results do not immediately indicate one treatment over the other—a patient's tumor must be evaluated holistically. TMT is very effective in patients with T2-T3 unilateral, muscle-invasive bladder cancer. For patients who do not meet this narrow criteria, cystectomy remains a valid option. Next, Dr. Daneshmand gives advice for performing a successful cystectomy. He notes that the surgeon should always handle the urethra with great care, as meticulousness can lead to a lower risk of post-surgical incontinence. Also, he notes that nerve-sparing techniques for male bladder cancer patients can help with post-surgical incontinence and erectile dysfunction. However, he warns urologists to be careful not to accidentally leave tumor tissue behind during female cystectomies involving gynecologic organ preservation. After a cystectomy, patients can either choose to undergo a urinary diversion procedure, in which the surgeon creates a different way for urine to leave the bladder, or a neobladder (ileal conduit) procedure, in which the surgeon creates a new bladder from the small intestine. Dr. Daneshmand emphasizes that having a standardized and specific approach to the patient conversation about these treatment options is very important. He encourages urologists to be clear about the consequences of each of these options on incontinence and catheter usage.
Here's a guest who knows more about the penis and male anatomy than most. Dr. Jonathan Silberstein is Chief of Urologic Oncology at Memorial Healthcare System in South Florida…. He cares for patients