BackTable Urology

Can genomic classifiers close the gap between what we see and what a tumor will do? In this episode of BackTable Urology, Dr. Carissa Chu (UCSF) joins Dr. Ruchika Talwar (Vanderbilt) to explore how genomic classifiers are reshaping the way clinicians diagnose and manage bladder cancer. --- This podcast is supported by: VeracyteVeracyte.com/decipher-bladder --- SYNPOSIS They discuss the limitations of traditional staging systems and how molecular subtyping is providing deeper insight into tumor biology, treatment response, and prognosis. Dr. Chu highlights where these classifiers can be integrated into real-world clinical decision-making today, where the evidence is still emerging, and which ongoing trials may define the next era of precision medicine in urologic oncology. --- TIMESTAMPS 0:00 - Introduction3:01 - Overview of Genomic Classifiers9:34 - Risk Stratification15:22 - Current Evidence for Genomic Classifiers22:07 - Clinical Implications of Biomarkers27:23 - Ordering Genomic Classifiers33:46 - Future Directions37:57 - Final Takeaways --- RESOURCES Alignment of molecular subtypes across multiple bladder cancer subtyping classifiershttps://pubmed.ncbi.nlm.nih.gov/38480079/ GUSTO Trialhttps://fundingawards.nihr.ac.uk/award/NIHR128103

If you’re navigating pregnancy, postpartum, or return-to-work stress, you are not alone. In this BackTable Urology × SWIU collaboration, Dr. Danielle Velez (Rutgers Health) joins host Dr. Helen Bernie (Indiana University Health) for a candid conversation on navigating parental leave, lactation, and the emotional turbulence of stepping back into clinical practice. Together, they unpack boundary-setting, finding a support system, protecting partnership time, and giving yourself grace through each stage of early parenthood. --- SYNPOSIS The discussion highlights the power of mentorship, community, and transparency, especially for physicians balancing patient care and family life. From combo-feeding and night nannies to sleep deprivation, identity shifts, and the six-month reevaluation rule, both guests share wisdom they hope future trainees and new parents won't have to learn alone. This episode is a reminder that things get easier with time, that asking for help is strength, not weakness, and that paying it forward makes the path smoother for the next generation. --- TIMESTAMPS 00:00 - Introduction03:07 - Support Systems, Mentorship and Maternity Leave09:03 - Navigating Lactation and Pumping19:21 - Lactation Resources25:58 - Finding Your Village and Outsourcing Tasks34:31 - Balancing Parenthood and Career42:26 - Sleep Deprivation and Protecting Your Schedule55:14 - Maintaining Spousal Relationships59:20 - Rebuilding Your Practice Post-Maternity Leave01:03:56 - Final Thoughts and Advice for New Parents --- RESOURCES Dr. MILK (Mothers Interested in Lactation Knowledge) Support Grouphttps://www.drmilk.org/

When it comes to GU cancers, fear and uncertainty often shape a patient’s treatment decisions well before the clinical data does. Dr. Hung-Jui (Ray) Tan of UNC Health sits down with host Dr. Ruchika Talwar to unpack why decision-making around small renal masses, low-risk prostate cancer, and other GU conditions can be so challenging. Dr. Tan explains the concept of decisional conflict, a patient’s internal uncertainty about the “right” course of action, and how it predicts downstream satisfaction and health outcomes. --- SYNPOSIS Dr. Tan shares practical, evidence-based strategies for improving decision-making conversations, from clearer framing to simple visual aids that reduce anxiety. They discuss how patients often perceive much greater risk of metastasis than what data shows, and why “turning down the temperature” is essential before discussing options. They also touch on evolving tools, including AI, that may improve how clinicians communicate risk and support patients through uncertainty. --- TIMESTAMPS 00:00 - Introduction01:02 - Journey to Decision Science05:59 - Research on Decision Making14:41 - Shared Decision Making in Practice22:39 - Resources for Shared Decision Making39:54 - Improving Decision-Making Conversations --- RESOURCES Decisional conflict among patients newly diagnosed with clinical T1 renal masses: a prospective studyhttps://pmc.ncbi.nlm.nih.gov/articles/PMC11233232/ Decisional Quality in Patients With Small Renal Masseshttps://pubmed.ncbi.nlm.nih.gov/29574123/ Impact of renal mass biopsy on decision-making experience for clinical T1 renal masseshttps://pubmed.ncbi.nlm.nih.gov/41151063/ MUSIC Patient and Provider Resources for Shared Decision Makinghttps://musicurology.com/programs/kidney/ P3P - Prostate Cancer Shared Decision Making Resourcehttps://www.p3p4me.org/users/login Best Case/Worst Case Treatment Decision Toolhttps://patientpreferences.org/best-case-worst-case/ Better Conversations Treatment Decision Toolhttps://patientpreferences.org/better-conversations/

One of the most common dilemmas in urologic oncology: what do you do when a patient has T1 disease in both the bladder and the ureter? In the final episode of the 2025 NMIBC Creator Weekend™ series, Dr. Vignesh Packiam, Dr. Mark Tyson and Dr. Sarah Psutka share how they approach complex bladder cancer cases with upper tract involvement. --- This podcast is supported by: Ferring Pharmaceuticalshttps://ad.doubleclick.net/ddm/trackclk/N2165306.5658203BACKTABLE/B33008413.420220578;dc_trk_aid=612466359;dc_trk_cid=234162109;dc_lat=;dc_rdid=;tag_for_child_directed_treatment=;tfua=;gdpr=${GDPR};gdpr_consent=${GDPR_CONSENT_755};gpp=${GPP_STRING_755};gpp_sid=${GPP_SID};ltd=;dc_tdv=1 --- SYNPOSIS The doctors discuss complex bladder cancer cases, sequencing treatments for patients with dual ureteral and bladder T1 disease, the impact of cystectomy on quality of life, and the use of blue light cystoscopy and intravesical therapy. They also delve into the rise of bladder cancer in younger patients, considerations for low-grade intermediate-risk disease, and emerging therapeutic options. --- TIMESTAMPS 00:00 - Introduction05:52 - Upper Tract Positive Cytology Dilemma09:10 - Cystectomy Considerations15:55 - Developing Better Patient-Reported Outcomes20:26 - Challenges with New Therapeutics26:31 - Deescalating Treatment for Low-Grade Cancer33:29 - Closing Remarks --- RESOURCES CISTO Trialhttps://pubmed.ncbi.nlm.nih.gov/37980511/

Can we reduce OR waste without compromising patient care? In this episode of BackTable Urology, Dr. Sunil Patel (Johns Hopkins) joins host Dr. Ruchika Talwar (Vanderbilt) to explore strategies for improving environmental sustainability in surgical practice. --- SYNPOSIS They discuss the scope of OR-generated waste, the impact of plastics and carbon emissions, and emerging data linking environmental exposures to carcinogenesis. Dr. Patel highlights evidence supporting reusable vs. single-use instruments, shares examples of successful waste-reduction initiatives, and emphasizes the importance of cross-disciplinary collaboration to make sustainable practices achievable across healthcare systems. --- TIMESTAMPS 0:00 - Introduction3:29 - Current State of OR Waste20:09 - Strategies to Reduce Waste24:52 - Impact of Climate Change on Patients33:55 - Future Directions40:27 - Conclusion