Episodios

  • Ep. 256 The Role of ctDNA in Bladder Cancer Diagnosis & Treatment with Dr. Alberto Pieretti

    Ep. 256 The Role of ctDNA in Bladder Cancer Diagnosis & Treatment with Dr. Alberto Pieretti
    Aug 22 2025
    Could ctDNA testing allow us to treat bladder cancer earlier, smarter, and more effectively? In this episode of BackTable Urology, Dr. Alberto Pieretti, a urologic oncologist at Cleveland Clinic Weston Hospital, joins host Dr. Jose Silva to explore the emerging role of ctDNA in bladder cancer management.---SYNPOSISDr. Pieretti and Dr. Silva discuss how ctDNA can refine staging, identify patients at risk of recurrence, and guide decisions on when to intensify treatment. The conversation also examines its potential to detect actionable mutations, inform precision therapies, and shape the design of future clinical trials in urologic oncology.---TIMESTAMPS0:00 - Introduction2:50 - Overview of Bladder Cancer12:59 - Overview of ctDNA20:34 - Current ctDNA Trials27:21 - Clinical Implications of ctDNA31:20 - Conclusion---RESOURCESUpdated Overall Survival by Circulating Tumor DNA Status from the Phase 3 IMvigor010 Trial: Adjuvant Atezolizumab Versus Observation in Muscle-invasive Urothelial Carcinoma - PubMedhttps://pubmed.ncbi.nlm.nih.gov/37500339/Perioperative Durvalumab with Neoadjuvant Chemotherapy in Operable Bladder Cancer | New England Journal of Medicinehttps://www.nejm.org/doi/abs/10.1056/NEJMoa2408154
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    35 m
  • Ep. 255 Overcoming Imposter Syndrome: New Perspectives for Urology Trainees with Dr. Michelle Van Kuiken

    Ep. 255 Overcoming Imposter Syndrome: New Perspectives for Urology Trainees with Dr. Michelle Van Kuiken
    Aug 19 2025
    In medicine, the hardest critic you’ll face is often yourself. In this episode of BackTable Urology, Dr. Michelle Van Kuiken joins host Dr. Lindsay Hampson to unpack the realities of imposter syndrome in urology practice and discuss its impact on trainees and professionals---SYNPOSISDr. Van Kuiken and Dr. Hampson explain the basics of imposter syndrome, its prevalence, and the many ways it can show up in medical training and practice. They also share candid personal experiences and practical strategies for overcoming self-doubt, from reframing negative thoughts to embracing feedback as a tool for growth. The doctors highlight the value of mentorship, peer support, and celebrating achievements, as well as the importance of creating a culture where vulnerability and open conversations are encouraged.---TIMESTAMPS00:00 - Introduction02:29 - Defining Imposter Syndrome04:24 - Personal Experiences with Imposter Syndrome08:44 - Impact of Imposter Syndrome in Medicine10:39 - Strategies to Overcome Imposter Syndrome13:59 - The Role of Mentorship16:28 - Gender and Mentorship in Medicine27:24 - Peer Support and Building Community32:13 - Final Thoughts and Takeaways---RESOURCESMedical Trainees and the Dunning–Kruger Effect: When They Don't Know What They Don't Know:https://doi.org/10.4300/JGME-D-20-00134.1Imposter Syndrome in Surgical Trainees: Clance Imposter Phenomenon Scale Assessment in General Surgery Residents:https://doi.org/10.1016/j.jamcollsurg.2021.07.681Defining the Incidence of the Impostor Phenomenon in Academic Plastic Surgery: A Multi-Institutional Survey Study:https://doi.org/10.1097/prs.0000000000010821Academic Urology Endowments and Leadership Roles are Disproportionately Held by Male Urologists:https://doi.org/10.1016/j.urology.2025.04.038Implementation of a “Best Self” Exercise to Decrease Imposter Phenomenon in Residents:https://doi.org/10.4300/JGME-D-23-00873.1Keep-Stop-Start Framework:https://meded.ucsf.edu/sites/meded.ucsf.edu/files/2024-06/TipSheet-Feedback.pdfLean In: https://leanin.org/W. Brad Johnson, PhD: https://www.wbradjohnson.com/
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    37 m
  • Ep. 254 New Guidelines for Genitourinary Syndrome of Menopause with Dr. Melissa Kaufman and Dr. Giulia Ippolito

    Ep. 254 New Guidelines for Genitourinary Syndrome of Menopause with Dr. Melissa Kaufman and Dr. Giulia Ippolito
    Aug 12 2025
    The guidelines are in and the myths are out. In this episode of the BackTable Podcast, Dr. Suzette Sutherland hosts Dr. Melissa Kaufman and Dr. Giulia Ippolito to discuss the new 2025 AUA/SUFU guidelines on genitourinary syndrome of menopause (GSM). ---SYNPOSISThe doctors delve into what GSM is, its symptoms, and the new evidence-based clinical guidelines for screening, diagnosing, and treating this condition. The episode emphasizes shared decision-making, safe use of local low-dose vaginal estrogen, and addresses concerns related to hormone therapy and cancer risks. Additionally, the doctors cover non-hormonal interventions, the role of vaginal moisturizers and lubricants, and the use of vaginal lasers. The importance of follow-up and ongoing patient education is also highlighted. The conversation aims to equip clinicians with the knowledge to better manage GSM and improve patient outcomes.---TIMESTAMPS00:00 - Introduction 01:35 - Overview of the 2025 AUA/SUFU Guidelines02:27 - Guideline Development Process05:48 - Categories of Guidelines07:03 - Understanding GSM: Symptoms and Diagnosis10:28 - Patient Education and Shared Decision Making15:22 - Hormonal Interventions and Safety Concerns17:17 - Local Vaginal Estrogen: Recommendations and Usage23:12 - Compounded Estrogens and Alternative Therapies25:48 - Understanding Estrogen Dosage Forms26:11 - Introduction to DHEA and Its Benefits27:15 - Exploring Ospemifene as an Alternative28:05 - Guidelines for Treating GSM Symptoms30:11 - The Role of Vaginal Estrogen in UTI Prevention33:01 - Non-Hormonal Interventions for GSM35:39 - Laser Treatments for GSM39:59 - Addressing Cancer Risks with Vaginal Estrogen44:48 - Endometrial Surveillance and Follow-Up49:14 - Advocating for Vaginal Estrogen Use51:13 - Conclusion and Final Thoughts
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    54 m
  • Ep. 253 BCG Shortage: Salvaging Bladder Cancer Care When Standard Care Is Scarce with Dr. Amy Luckenbaugh

    Ep. 253 BCG Shortage: Salvaging Bladder Cancer Care When Standard Care Is Scarce with Dr. Amy Luckenbaugh
    Aug 5 2025
    How do you effectively treat your bladder cancer population with an insufficient supply of BCG? Dr. Amy Luckenbaugh, a urologic oncologist at Vanderbilt University Medical Center, joins host Dr. Ruchika Talwar to highlight challenges and solutions to managing bladder cancer amidst ongoing BCG shortages. --- This podcast is supported by an educational grant from UroGen Pharma. UGN-102 was approved by the FDA on June 12, 2025. --- SYNPOSIS Dr. Luckenbaugh and Dr. Talwar delve into the history and significance of BCG in bladder cancer treatment, exploring the reasons behind the shortages and discussing various coping strategies, including split dosing and alternative intravesical therapies like gemcitabine, docetaxel, and the new mitomycin hydrogel. The conversation also covers emerging treatments for high-risk patients, the role of radical cystectomy, and the importance of standardization and innovation in dealing with medication shortages. Dr. Luckenbaugh highlights the importance of patient quality of life, cost considerations, and the need for resilient pharmaceutical supply chains. --- TIMESTAMPS 00:00 - Introduction01:56 - History and Importance of BCG in Bladder Cancer03:21 - Challenges and Shortages of BCG06:36 - Managing BCG Shortages in Clinical Practice12:33 - New Alternatives and Treatments for Bladder Cancer23:28 - The Role of Cystectomy in Bladder Cancer Treatment26:12 - Future Directions and Final Thoughts --- RESOURCES BCG Shortage AUA Recommendations:https://www.auanet.org/about-us/bcg-shortage-info Reduced-dose bacillus Calmette-Guérin (BCG) in an era of BCG shortage: real-world experience from a tertiary cancer centre: https://pmc.ncbi.nlm.nih.gov/articles/PMC11951178/ Bladder Cancer Advocacy Network (BCAN):https://bcan.org/ Primary Chemoablation of Recurrent Low-Grade Intermediate-Risk Nonmuscle-Invasive Bladder Cancer With UGN-102: A Single-Arm, Open-Label, Phase 3 Trial (ENVISION)https://pubmed.ncbi.nlm.nih.gov/39446087/b FDA Approves Intravesical Mitomycin in Non–Muscle-Invasive Bladder Cancer:https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-mitomycin-intravesical-solution-recurrent-low-grade-intermediate-risk-non-muscle TAR-200 - SunRISe-3 Study:https://www.jnjmedicalconnect.com/products/tar-200/medical-content/tar-200-sunrise-3-study First results from TAR-200 - SunRISe-1 Study:https://www.jnj.com/media-center/press-releases/johnson-johnsons-tar-200-monotherapy-achieves-high-disease-free-survival-of-more-than-80-percent-in-bcg-unresponsive-high-risk-papillary-nmibcN-803 Plus BCG Treatment for BCG-Naïve or -Unresponsive Non-Muscle Invasive Bladder Cancer: A Plain Language Review:https://pmc.ncbi.nlm.nih.gov/articles/PMC11524197/
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    36 m
  • Ep. 252 Performance Medicine at the Crossroads of Orthopedics & Urology with Dr. Vonda Wright

    Ep. 252 Performance Medicine at the Crossroads of Orthopedics & Urology with Dr. Vonda Wright
    Aug 1 2025
    Physical performance, recovery, longevity–are these outcomes part of your urology practice? In this episode of BackTable Urology, Dr. Vonda Wright, a renowned orthopedic surgeon and expert in aging and longevity, joins Dr. Amy Pearlman to discuss the intersection of surgical practice, longevity medicine, and patient-centered healthcare in urology. --- SYNPOSIS The discussion covers the significance of whole-person care in surgery and the critical role of empathy in surgical practice. Dr. Wright shares her experiences from her extensive career and research, including her innovative work in hip arthroscopy and advocacy for performance-based care for middle-aged patients. The surgeons also explore the impact of hormonal health on physical performance and quality of life, the value of tailored exercise and nutrition plans, and practical strategies for optimizing long-term vitality in both men and women. Dr. Wright emphasizes the need for healthcare professionals to lead by example in prioritizing their own well-being while staying informed on emerging science that supports longevity and quality of life. --- TIMESTAMPS 00:00 - Introduction13:50 - Urology Applications in Orthopedics24:18 - Optimizing Longevity and Lifestyle29:08 - Musculoskeletal Syndrome of Menopause42:12 - Approach to Protein Intake and Supplements50:48 - Practicing Longevity Medicine53:26 - Final Thoughts --- RESOURCES Unbreakable: A Woman’s Guide to Aging with Power by Dr. Vonda Wright:https://www.drvondawright.com/resources/books/unbreakable
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    56 m
  • Ep. 251 Evaluating Hormone Therapy in Menopause Management with Dr. Yahir Santiago-Lastra

    Ep. 251 Evaluating Hormone Therapy in Menopause Management with Dr. Yahir Santiago-Lastra
    Jul 29 2025
    Is one outdated warning label standing between millions of women and safe, effective care? In this episode of BackTable Urology, Dr. Yahir Santiago-Lastra, a urologist specializing in female pelvic medicine and reconstructive surgery at UC San Diego, joins host Dr. Suzette Sutherland to discuss the black box warning on vaginal estrogen, its historical context, and the ongoing advocacy efforts to update outdated FDA guidelines. --- SYNPOSIS The conversation covers the importance of low-dose vaginal estrogen in treating genitourinary syndrome of menopause (GSM), the fear surrounding hormone therapy due to misinterpreted data from the Women's Health Initiative (WHI) study, and the inequities faced in women's health, particularly in the context of hormone replacement therapies. They discuss the legislative and advocacy strategies needed to enact change, emphasizing the role of professional societies, legislative efforts, patient advocacy, and industry support in overcoming the barriers to updating the black box warning. --- TIMESTAMPS 00:00 - Introduction03:43 - History Behind the Estradiol Black Box Warning13:44 - The FDA Citizen Petition18:18 - Gender Inequity in Medicine24:05 - The Role of Organizational Guidelines in Patient Advocacy28:51 - Vaginal Estrogen for Genitourinary Syndrome of Menopause (GSM)32:57 - Medicare Spending and Legislative Advocacy44:56 - Recap and Future Directions --- RESOURCES (TRAVERSE Trial) Cardiovascular Safety of Testosterone-Replacement Therapyhttps://www.nejm.org/doi/full/10.1056/NEJMoa2215025 Systemic or Vaginal Hormone Therapy After Early Breast Cancer: A Danish Observational Cohort Studyhttps://doi.org/10.1093/jnci/djac112 (ASCO Study) Use of local estrogen therapy among breast cancer patients in SEER-MHOS databasehttps://doi.org/10.1200/JCO.2025.43.16_suppl.578 Vaginal estrogen use in breast cancer survivors: a systematic review and meta-analysis of recurrence and mortality riskshttps://doi.org/10.1016/j.ajog.2024.10.054
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    50 m
  • Ep. 250 Treating Low T: Safe and Effective Testosterone Therapy with Dr. Abraham Morgentaler

    Ep. 250 Treating Low T: Safe and Effective Testosterone Therapy with Dr. Abraham Morgentaler
    Jul 25 2025
    Have we been wrong about testosterone and prostate cancer all along? In this episode of BackTable Urology, Dr. Abraham Morgentaler, who pioneered the modern use of testosterone therapy, joins Dr. Amy Pearlman to discuss the evolving understanding of testosterone therapy in clinical practice and its implications on patient care. --- SYNPOSIS Dr. Morgentaler shares insights from his decades-long career, including his pivotal research that refuted the presumed harms of testosterone therapy and belief that it contributes to the development of prostate cancer. The conversation explores the evolution of testosterone therapy, its misunderstood role in prostate cancer, and the need for broader clinical recognition of testosterone deficiency. The discussion also explores potential future applications of testosterone therapy, including its role in perioperative optimization and the growing need for nuanced, evidence-based guidelines in men’s health care. --- TIMESTAMPS 00:00 - Introduction08:45 - The Evolution of Testosterone Therapy20:10 - Challenging Conventional Wisdom on Testosterone34:04 - Reevaluating Testosterone and Prostate Cancer51:20 - Testosterone and Prostate Cancer Recurrence55:44 - Managing Testosterone Therapy in Prostate Cancer Patients01:12:45 - Final Thoughts --- RESOURCES The Sex Doctors:https://www.amazon.com/The-Sex-Doctors/dp/B0DCJQ5B5Q
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    1 h y 29 m
  • Ep. 249 Palliative Care in Urology with Dr. Pauline Filippou and Dr. Ashwin Kotwal

    Ep. 249 Palliative Care in Urology with Dr. Pauline Filippou and Dr. Ashwin Kotwal
    Jul 22 2025
    Often misunderstood as end-of-life care, palliative care is actually about improving quality of life at any stage of serious illness. In this episode of BackTable Urology, Dr. Ashwin Kotwal, a geriatrician and palliative care physician at UCSF, and Dr. Pauline Filippou, a urologic oncologist at Kaiser Permanente in Northern California join hosts Dr. Gina Badalato and Dr. Lindsay Hampson to discuss the importance of palliative care in the field of urology. --- SYNPOSIS The episode covers how palliative care can improve quality of life for patients with serious illnesses, the challenges and opportunities of integrating palliative care into urology practice, and specific training resources and frameworks for effective communication and symptom management. From addressing common misconceptions to providing practical advice on implementing palliative care, this episode is an essential guide for trainees and urology professionals looking to deepen their understanding of palliative care and enhance their practice. --- TIMESTAMPS 00:00 - Introduction03:04 - Understanding Palliative Care04:43 - Misconceptions and Communication Strategies07:45 - Integrating Palliative Care in Urology10:26 - Collaborative Approaches and Multidisciplinary Teams15:48 - Training and Education for Trainees20:25 - Effective Communication Techniques28:18 - Impact of Palliative Care34:33 - Final Thoughts and Takeaways --- RESOURCES Center to Advance Palliative Care website:https://www.capc.org/ AUA White Paper: https://www.auanet.org/documents/guidelines/white%20papers/postoperative.pdf VitalTalk:https://www.vitaltalk.org/ Eliciting the Patient’s Agenda- Secondary Analysis of Recorded Clinical Encounters: https://link.springer.com/article/10.1007/s11606-018-4540-5 Family Meetings on Behalf of Patients with Serious Illness: https://www.nejm.org/doi/full/10.1056/NEJMvcm1913056
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    40 m