Are you a private practice urologist looking to build your bladder cancer service lines? In this episode of the BackTable Urology Podcast, Dr. Tom Jayram, urologist from Nashville joins host Dr. Aditya Bagrodia to discuss the latest advancements in non-muscle invasive bladder cancer treatment. The conversation focuses on the unique experiences and practical considerations in managing this complex condition in the community setting.

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This podcast is supported by:

Ferring Pharmaceuticals

https://www.ferring.com/home-classic/people-and-families/uro-uro-oncology/bladder-cancer/

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SYNPOSIS

The two urologic oncologists share their decision-making process for different therapies such as BCG, gemcitabine-doxorubicin, and Adstiladrin. The conversation also touches on the challenges of integrating new technologies into practice, managing the BCG shortage, and the role of multidisciplinary care. They discuss patient-centered care and the potential for personalized treatment plans. Finally, Dr. Jayram reflects on the lessons he has learned from his own practice, offering a unique insight into the differences between academic and community urology.

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TIMESTAMPS

00:00 - Introduction

04:47 - Community Practice and New Technologies

09:59 - Clinical Trials for Bladder Cancer Care

15:52 - Patient Referrals

29:27 - Exploring New Treatment Options

30:46 - Bladder Sparing Strategies

32:21 - BCG Treatment and Surveillance

47:04 - Implementation of New Therapies

54:27 - Future Directions

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RESOURCES

Ferring Pharmaceuticals

https://www.ferring.com/

If you manage a busy men’s health practice, you may have considered the value of staffing Advanced Practice Providers (APPs). In this episode of BackTable Urology, Dr. Alex Tatem and Kristen Gumpf, PA-C join host Dr. Jose Silva to discuss the role of APPs in men’s health.

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This podcast is supported by:

Photocure

https://www.photocure.com/

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SYNPOSIS

Their discussion highlights the rewarding experience in seeing patients throughout their treatment journey. Dr. Tatem, a men's health specialist with an extensive academic background, emphasizes the value of integrating APPs like Kristen into his practice. Kristen shares her journey, highlighting the importance of continuous learning. Both share their personal stories on the early days and evolution of their partnership. The conversation delves into the dynamics of their successful clinic model, the impact of their work on patient care, and their plans for expanding and educating within the field of men's health.

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TIMESTAMPS

00:00 - Introduction

05:10 - Kristen's Path to Specialization

17:42 - Redefining Roles and Responsibilities

28:00 - Work-Life Balance

31:12 - Office Procedures

34:35 - Expanding the Team

47:26 - Team Dynamics

54:18 - Concluding Thoughts

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RESOURCES

Dr. Alex Tatem’s practice website:

https://www.alextatemmd.com/

APP Fellowship Program in Indianapolis, Indiana:

https://menshealthin.com/training/

2024 Prosthetic Urology Institute: Advanced Practice Provider Preceptor Program - Kristen Gumpf, PA-C:

https://cvent.me/mNE3ly

2024 Prosthetic Urology Institute: Preceptor and Clinic Communications Program with Dr. Alex Tatem:

https://cvent.me/1ZKdEq

How can urologists run clinical trials efficiently while improving enrollment and reducing costs? In this episode of the BackTable Urology Podcast, Dr. Behfar Ehdaie, a urologic oncologist at Memorial Sloan Kettering Cancer Center, joins host Dr. Aditya Bagrodia to discuss methods and practical implementation strategies for clinical trials in urology.

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This podcast is supported by:

Photocure

https://www.photocure.com/

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SYNPOSIS

First, Dr. Ehdaie shares personal experiences from starting pilot trials, engaging stakeholders, and integrating trial processes into clinical practice. He also discusses mechanisms to reduce cost and improve enrollment while explaining the concept of two-stage consent to minimize patient anxiety. This episode aims to provide valuable pearls for young investigators and experienced practitioners alike on conducting successful clinical trials.

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TIMESTAMPS

00:00 - Introduction

04:39 - Challenges in Clinical Trials

06:21 - Case Study: Focal Therapy Trial

16:45 - Case Study: Hernia Trial

20:17 - Innovation in Clinical Trials

26:25 - Two-Stage Consent

36:11 - Final Thoughts

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RESOURCES

Photocure

https://www.photocure.com/

Have you checked out the AUA/ASTRO/SUO’s recently released guidelines for salvage therapy in prostate cancer biochemical recurrence? In this episode of the BackTable Urology Podcast, guest Dr. Todd Morgan from the University of Michigan and host Dr. Aditya Bagrodia continue with part two of our series on prostate cancer biochemical recurrence management.

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This podcast is supported by:

Veracyte

https://www.veracyte.com/decipher

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SYNPOSIS

The doctors focus on the difficulty in declaring a patient 'cured' and the implications of biochemical recurrence after treatment. Dr. Morgan highlights the importance of PSA in the postoperative setting and explores the role of the Decipher Prostate Genomic Classifier in personalizing treatment. He talks through the latest AUA/ASTRO/SUO consensus on biochemical recurrence guidelines, including the significance of early salvage therapy and the integration of advanced imaging techniques like PSMA PET scans. Further, Dr. Morgan emphasizes the role for multidisciplinary evaluation, patient counseling, and future directions of research to refine treatment options.

This discussion underscores the transition from adjuvant to early salvage radiation as a standard practice and considers emerging biomarker strategies to inform treatment decisions.

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TIMESTAMPS

00:00 - Introduction

03:41 - Consensus Biochemical Recurrence Guidelines

08:56 - Evolution of Post-Prostatectomy Biochemical Recurrence Management

13:24 - Patient Counseling and Risk of Recurrence

17:42 - PSMA PET Scans

20:44 - Postoperative PSA Monitoring

28:35 - The Role of Radiation

31:56 - Hormone Therapy

39:00 - Salvage Lymphadenectomy

46:30 - Future Directions and Concluding Thoughts

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RESOURCES

Veracyte

https://www.veracyte.com/

Salvage Therapy for Prostate Cancer: AUA/ASTRO/SUO Guideline (2024)

https://www.auanet.org/guidelines-and-quality/guidelines/salvage-therapy-for-prostate-cancer

While benign prostatic hyperplasia (BPH) care has historically focused on immediate symptom management, often by way of long-term polypharmacy, leading urologists are now considering long-term bladder health when determining the most appropriate BPH treatment. In this episode of the BackTable Urology Podcast, Dr. Shawn West, a urologist practicing at McIver Clinic in Florida, discusses the contemporary management of BPH with host Dr. Jose Silva, emphasizing the newly appreciated role of first-line interventional therapy.

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This podcast is supported by:

Teleflex UroLift

https://www.urolift.com/

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SYNPOSIS

First, Dr. West delves into the initial patient consultation, diagnostic procedures, and the diverse treatment options for BPH including UroLift, GreenLight laser therapy, and Aquablation. Dr. West emphasizes the importance of individualized patient care, the role of objective symptom scoring systems, and the significance of setting realistic expectations for patients. The discussion also covers the benefits and challenges of different BPH treatments amidst the evolving landscape of minimally invasive urological procedures.

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TIMESTAMPS

00:00 - Introduction

03:59 - BPH and Voiding Dysfunction

10:21 - Patient-Centered Approach to BPH

19:46 - Diagnostic Workup for BPH

24:53 - Postoperative Catheter and Complications

25:02 - Aquablation

26:04 - UroLift

31:06 - Challenges with Median Lobes

41:02 - Postoperative Care

47:14 - Conclusion

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.

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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.

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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

Recent research is changing how we manage low risk prostate cancer. In this BackTable Urology Podcast episode, Dr. Dan Lin, a urologist at the University of Washington, walks through contemporary diagnosis, surveillance, and management of Grade Group 2 prostate cancer with host Dr. Aditya Bagrodia.

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This podcast is supported by:

Veracyte

https://www.veracyte.com/decipher

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SYNPOSIS

The doctors delve into real-world implementation of active surveillance, alongside the use of advanced diagnostics, biopsy methods, and personalized care plans. The conversation highlights the Canary Prostate Active Surveillance Study (PASS) and the prognostic role of biomarkers and genomic testing. Dr. Lin and Dr. Bagrodia also discuss how lifestyle factors such as diet impact cancer progression and how patients can be empowered to manage their disease. Strategies for transitioning patients off surveillance are highlighted. Finally, the two experts discuss insights from recent clinical trials like PIVOT, PROTECT, and SPCG and how they’re impacting prostate cancer management.

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TIMESTAMPS

00:00 - Introduction

02:54 - Active Surveillance and Canary PASS Data

12:02 - Biopsy Considerations

19:44 - Active Surveillance Protocols

26:58 - Patient Concerns and Risk Reduction

30:52 - Transitioning Off Surveillance

33:39 - Grade Group 2: Treatment vs. Monitoring

46:24 - Surgical Considerations and Node Dissection

49:25 - Future Directions

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RESOURCES

Veracyte

https://www.veracyte.com/

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.

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This podcast was developed in collaboration with:

Society of Urologic Oncology

https://suonet.org/home.aspx

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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.

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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

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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

Retroperitoneal lymph node dissection (RPLND) for testicular cancer can be a challenging surgery, even for the most experienced urologic oncologists. In part one of this special two-part series, host Dr. Aditya Bagrodia invites Society of Urologic Oncologists (SUO) members Dr. Timothy Masterson (Indiana University) and Dr. Robert Hamilton (Princess Margaret Hospital/University of Toronto) to cover current approaches to post-chemotherapy RPLND.

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SYNPOSIS

First, the urologists delve into the technical considerations and perioperative planning for post-chemotherapy retroperitoneal lymph node dissections (RPLND) in patients with germ cell tumors. They discuss the importance of patient preparation, imaging assessments, and surgical approaches. Additionally, they explain their own surgical techniques as well as tips for dealing with operative complications. To end, their discussion addresses the importance of a multidisciplinary team and practical tips for ensuring successful surgical outcomes.

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TIMESTAMPS

00:00 - Introduction

01:37 - Preparing for Post-Chemotherapy RPLND

08:10 - Intraoperative Considerations

11:02 - Handling Complications

20:11 - Vascular Anatomy and Preoperative Planning

27:13 - Anesthesia Considerations and Pain Management

29:22 - Essential Tools and Techniques for Surgery

38:24 - Incision Strategies and Post-Chemotherapy Considerations

46:32 - Extraperitoneal Approach and Future Research

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RESOURCES

Society of Urologic Oncologists

https://suonet.org/home.aspx

Biochemical recurrence of prostate cancer can be difficult to diagnose and treat. In this episode of BackTable Urology, where Dr. Aditya Bagrodia hosts Dr. Amar Kishan, a genitourinary radiation oncologist at UCLA, to discuss the complexities of biochemical recurrence and local failure after radiation therapy for prostate cancer.

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This podcast is supported by:

Veracyte

https://www.veracyte.com/decipher

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SYNPOSIS

First, they evaluate alternatives to androgen deprivation therapy (ADT), the benefits and risks associated with ADT, and the role of genetic classifier tests. They also detail the goals of prostate-specific antigen (PSA) monitoring, PSA trends post-radiation, and advancements in PSMA PET scans. Then, the conversation highlights modern treatment options like targeted radiation, low dose rate brachytherapy, salvage radical prostatectomy, and focal therapy. Finally, the doctors emphasize personalized and multidisciplinary treatment plans as they hope to improve long-term outcomes for patients with prostate cancer.

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TIMESTAMPS

00:00 - Introduction

04:31 - PSA Levels Post-Radiation

13:21 - Local Recurrence and PSMA PET

21:29 - Explaining Radiation Effects to Patients

22:41 - Managing PSA Bounce

26:05 - Imaging and Biopsy Techniques

28:55 - Treatment Options for Local Recurrence

30:16 - Re-Irradiation and Focal Therapy

33:13 - Concluding Thoughts

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RESOURCES

Veracyte

https://www.veracyte.com/