Aditya Bagrodia, MD

Aditya Bagrodia, MD is an Associate Professor and genitourinary oncology disease team leader in the Department of Urology at UC San Diego Health.

Dr. Bagrodia earned his medical degree from the University of Tennessee Health Sciences Center, graduating with highest honors. He was awarded a Doris Duke Clinical Research Fellowship in clinical research at UT Southwestern Medical Center where he completed his residency in urology. Dr. Bagrodia completed a fellowship in urologic oncology at Memorial Sloan Kettering Cancer Center, where he received an American Urological Association Urology Care Foundation Research Scholars Grant.

Dr. Bagrodia’s clinical practice comprises all urologic malignancies including adrenal, upper tract, renal, bladder, prostate, penile, and testicular cancers. He has expertise in complex multidisciplinary management and minimally invasive approaches to urologic surgery.

Dr. Bagrodia’s clinical and research focus is on patients with germ cell tumors. His laboratory centers on sequencing efforts to understand tumor evolution and heterogeneity in germ cell tumors as well as to identify novel biomarkers to recognize occult metastatic disease. On the clinical side, Dr. Bagrodia is actively involved with understanding and overcoming unique socio-epidemiological considerations that adversely impact oncologic outcomes in patients with germ cell tumors. He is also the principal investigator for several germ cell tumor-directed clinical trials.

Dr. Bagrodia has conducted extensive research in urologic oncology, primarily in biomarker profiles and molecular signatures of urologic tumors as predictors of clinical outcomes. He is funded through competitive grants from the Cancer Prevention and Research Institute of Texas (CPRIT), intramural grants, and NIH funding.

Dr. Bagrodia is the principal author or co-author of more than 190 articles, including more than 50 articles devoted to germ cell tumors, in peer-reviewed publications such as the Journal of Clinical Oncology, Nature Genetics, European Urology, and the Journal of Urology. He is also the co-host of Backtable Urology, a podcast devoted to the practical education of urology providers.

Disclosures:

Talks by Aditya Bagrodia, MD

Point-Counterpoint: Active Surveillance for Intermediate-Risk Disease – Pro

Posted by Aditya Bagrodia, MD | Nov 2023

Aditya Bagrodia, MD, FACS, asserts that active surveillance (AS) for intermediate-risk prostate cancer is a viable option, emphasizing the current epidemic of overtreatment. He shares data from The Prostate Cancer Intervention Versus Observation Trial (PIVOT) showing that after a median of 10 years, between-group differences in all-cause and prostate-cancer mortality were not significant among men who either had radical prostatectomy or AS.

Dr. Bagrodia shares data from the ProtecT trial on 10-year outcomes after monitoring, surgery, or radiotherapy for prostate cancer, and he highlights morbidity data from prostate cancer among the subgroups and points out that over the years about 50 percent of patients on AS had treatment intervention. He draws the conclusion that in unselected patients with intermediate-risk (or worse) prostate cancer, early intervention is not associated with better outcomes. Additionally, many patients on AS may ultimately require treatment.

Dr. Bagrodia lists important aspects of selection such as tumor volume, percentage pattern four, adverse histology, genomic risk classifier, magnetic resonance imaging (MRI) findings, patient comorbidities, and patient compliance. He shares data showing that increased age, prostate-specific antigen (PSA) density, percentage pattern four, and core involvement were all reliable risk factors. Dr. Bagrodia addresses pathology and germline characteristics as important considerations for practitioners. He advises using molecular characteristics to augment National Comprehensive Cancer Network (NCCN) risk groups.

Dr. Bagrodia shares guidelines stating that with asymptomatic patients with limited life expectancy, clinicians should recommend AS and, for patients with favorable intermediate-risk prostate cancer, clinicians should discuss AS, radiation therapy, and radical prostatectomy. He concludes that AS is a guideline-directed option for patients with intermediate-risk prostate cancer. He emphasizes a personalized approach that considers patient comorbidities, disease features, and molecular features.

This lecture is part of a Point-Counterpoint debate. Its opposing lecture is “Point-Counterpoint: Active Surveillance for Intermediate-Risk Disease–Con.”

Testicular Cancer

Posted by Aditya Bagrodia, MD | Oct 2023

Aditya Bagrodia, MD, FACS, discusses testicular cancer in this lecture. Dr. Bagrodia explains that, though it is highly curable, testicular cancer is the most common cancer in men ages 18-45 and results in the most life years lost for non-pediatric cancers.

Dr. Bagrodia asserts that delays in diagnoses are associated with worse clinical outcomes. He says it is paramount to minimize toxicity while maintaining excellent oncological outcomes. The United States Preventive Services Task Force (USPSTF) recommends against screening for testicular cancer but if a patient has risk factors, self-exams are warranted.

Dr. Bagrodia covers signs and symptoms, the most common being abdominal, back, or flank pain and emphasizes that the scrotum should be checked in patients with an abdominal/retroperitoneal mass. He summarizes evaluation and explains that with a suspicious scrotal mass, ultrasound and serum tumor markers should be obtained (ideally getting staging scans prior to orchiectomy).

Dr. Bagrodia addresses prosthesis placement, fertility concerns, sperm banking, and anxiety and depression as topics practitioners should address with men who have a testicular cancer diagnosis. He addresses strategies to avoid a full orchiectomy before turning to post-orchiectomy procedures, emphasizing the importance of following serum tumor markers to nadir and a high-quality, contrasted CT scan.

Dr. Bagrodia explains stage one and stage two seminoma treatment principles and asserts that for patients undergoing both radiation and chemotherapy, the risk of long-term toxicity is significant. He explains efforts to minimize toxicity and summarizes the Surgery for Early Stage Metastatic Seminoma (SEMS) study. Dr. Bagrodia addresses stage two nonseminoma and emphasizes novel strategies to limit toxicity before concluding with a final emphasis on the curability of testicular cancer as well as the significant toxicities associated with its treatment. He asserts that efforts to minimize long-term side effects in early-stage disease are mandatory.

Penile Cancer Fundamentals

Posted by Aditya Bagrodia, MD | Sep 2023

Aditya Bagrodia, MD, FACS, discusses the fundamentals of penile cancer. He begins by acknowledging that penile cancer is rare, with approximately 2,000 cases diagnosed and 470 deaths reported each year.

In this presentation, Dr. Bagrodia covers, Types of Penile Cancer, Risk and Mitigating Factors for Penile Cancer, and Diagnosis, Treatment, and Outcomes for Penile Cancer.

Dr. Bagrodia concludes that penile cancer is treatable when diagnosed at an early stage. He stresses the importance of early biopsies, and overcoming patient hesitance and embarrassment by reinforcing the gravity of the situation.

Point-Counterpoint: Cystectomy vs. Trimodal Therapy for Muscle Invasive Bladder Cancer – Cystectomy

Posted by Aditya Bagrodia, MD | Jul 2023

Aditya Bagrodia, MD, FACS, discusses the standard treatment for muscle-invasive bladder cancer, cystectomy, focusing on the effectiveness of cystectomy in comparison to trimodal therapy. He highlights the weaknesses of trimodal therapy, focusing on the importance of selecting highly suitable candidates for trimodal therapy, emphasizing factors such as tumor size, absence of extra bladder disease, proper bladder function, and lymph node evaluation.

Dr. Bagrodia presents data from German and Mass General Hospital experiences, demonstrating the negative outcomes of trimodal therapy. The results show that while trimodal therapy can achieve disease-free status in about two-thirds of patients initially, a significant proportion may require subsequent treatment, including cystectomy. Cancer-specific and overall survival rates at 10 years vary depending on the extent of the disease, with more advanced stages showing a decline in outcomes. The study also compares these outcomes to those of cystectomy, highlighting the higher recurrence-free survival rates associated with organ-confined disease and the potential benefits of neoadjuvant chemotherapy.

Overall, the data suggests that highly selected patients receiving cystectomy may have better outcomes compared to those receiving trimodal therapy. However, individual patient characteristics and preferences should be considered when deciding the most appropriate treatment approach.

This lecture is part of a Point-Counterpoint debate. Its opposing lecture is “Point-Counterpoint: Cystectomy vs. Trimodal Therapy for Muscle Invasive Bladder Cancer–Trimodal Therapy.”

About the 30th Annual Perspectives in Urology: Point Counterpoint conference: Presented by Program Chair and Grand Rounds in Urology Editor-in-Chief E. David Crawford, MD, this conference brought together leading experts in urology, medical oncology, and radiation oncology to discuss and debate the latest topics in genitourinary cancers, primarily prostate cancer and bladder cancer. This interactive conference offered topical lectures, pro/con debates, interesting-case presentations, interactive panel discussions, and interactive audience and faculty networking.

Point-Counterpoint: Erectile Dysfunction After Local Therapies: PDE5 Inhibitors and Early Penile Rehab Improves ED Recovery Following Radical Surgery – Con

Posted by Aditya Bagrodia, MD | Jun 2023

Aditya Bagrodia, MD, FACS, Associate Professor of Urology and Genitourinary Oncology Team Lead at the University of California, San Diego, presents the cons of using PDE5 inhibitors and early penile rehabilitation to treat erectile dysfunction post-radical prostatectomy. In this presentation, Dr. Bagrodia discusses, the known adverse effects of early use of PDE5is in patients, the failure of PDE5is to out-perform placebos, and the strengths and weaknesses of known treatment options for post-operative erectile dysfunction.

This lecture is part of a Point-Counterpoint debate. Its opposing lecture is “Point-Counterpoint: Erectile Dysfunction After Local Therapies: PDE5 Inhibitors and Early Penile Rehab Improves ED Recovery Following Radical Surgery – Pro.

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