Michael A. Brooks, MD

Michael A. Brooks, MD

Baylor College of Medicine

Houston, Texas

Michael A. Brooks, MD, is an Assistant Professor of Urology and Oncology at Baylor College of Medicine in Houston, Texas. Dr. Brooks graduated from Baylor College Of Medicine with his medical degree in 2011. He is also affiliated with the Cleveland Clinic in Cleveland, Ohio. In his practice, he specializes in treating prostate cancer, erectile dysfunction, prostatitis, bladder issues, and other urologic disorders.


Talks by Michael A. Brooks, MD

Active Surveillance – When Can You Continue Watching and When Do You Intervene?

Guilherme Godoy, MD, MPH, Assistant Professor of Urology and Urology Oncology, Dov Kadmon, MD, Professor of Urology, and Michael A. Brooks, MD, Assistant Professor of Urology and Oncology, all at Baylor College of Medicine in Houston, Texas, discuss active surveillance (AS) for prostate cancer by using numerous case studies outlining patient characteristics, evaluation methods and diagnosis, the discussion and decision-making process, treatment, and outcome data to illustrate best practices. Their panel discussion covers magnetic resonance imaging (MRI)-fusion biopsy and systematic biopsy and highlights the need to use both as they are complementary. The doctors also discuss risk-benefit analysis; the role of urine, blood, and genomic testing; treatment algorithms, and important considerations such as those surrounding the patient’s overall health and life expectancy. Dr. Kadmon highlights the importance of integrating experience, common sense, and research. He emphasizes that integrating prostate MRI in AS protocol is imperative and MRI is important both when starting AS and in follow up. The doctors caution that MRI is not infallible; if the follow-up MRI is negative but there is strong suspicion for progression, a regular follow-up biopsy is justified. They advise that these follow-up biopsies be done for a reason and not just not based on an arbitrary time interval. Dr. Kadmon reiterates the point that a fusion biopsy and a systematic biopsy are complementary and should be carried out simultaneously and concludes by reviewing success elements involved in prostate MRI, including the equipment and protocols used, the experience of the radiologist, and whether the radiology program includes a quality improvement feedback loop, emphasizing that all these factors are important.

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Is Open Partial Nephrectomy Still an Option for Challenging Renal Masses?

Michael A. Brooks, MD, Assistant Professor of Urology and Oncology at Baylor College of Medicine in Houston, Texas, evaluates open partial nephrectomy as an option for challenging renal masses and compares it to the robotic retroneoscopic and laparoscopic techniques. He begins by discussing three patient cases, each one using a different treatment option. The robotic retroneoscopic partial nephrectomy patient experienced minimal blood loss, an operation time of 4 hours, and was discharged on the 3rd day post-op. The laparoscopic partial nephrectomy patient also had minimal blood loss, a 3-hour operation time, and was discharged on post-op day 3. The open partial nephrectomy patient experienced greater blood loss, a 5-hour operation time, and was discharged on post-op day 2. Dr. Brooks also explained the technique for each, highlighting the importance of port placement for robotic surgery, a lack of cortical stitches to avoid compressing the kidney for open partial nephrectomy, and the use of intraoperative ultrasound for all three procedures. He then considers two papers, the first of which found that oncological outcomes for open and robotic patients were very similar but that open partial nephrectomy produced higher blood loss, longer ischemia time, and a longer post-op course in patients. The second paper focused on the impact of specific surgeons and found that surgeon skillset and experience created high variability in outcomes. Dr. Brooks concludes that open partial nephrectomy remains a good option for complex renal masses, that the approach can vary from patient to patient based on tumor characteristics, and that the approach is likely less important than surgeon training, experience, and case volume.

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Active Surveillance Criteria and Follow-up Protocol

Michael A. Brooks, MD, Assistant Professor of Urology and Oncology at Baylor College of Medicine in Houston, Texas, discusses active surveillance and follow-up protocol best practices. In 2020 BCM started integrating MRI Fusion Biopsy into active surveillance protocol using best evidence. Dr. Brooks starts off by discussing the evidence for this new protocol from two different North American cohorts. He looks at MRI fusion biopsy in biopsy naive men, and discusses using MRI fusion biopsy for confirmation. He considers whether we can get rid of diagnostic and confirmation systematic biopsies as they can be replaced by the more accurate MRI fusion biopsy. He continues to discuss how often the biopsy needs to be repeated and special considerations that may need to be made when using this technology. He emphasizes that this is still very new and there are some special scenarios that are under studied. Some of the special scenarios include patients with high volume GG1, patients with GG2, and African American patients. Dr. Brooks also goes over the specific protocols that Baylor College of Medicine follows before discussing some pitfalls of the MRI fusion biopsy using a few case reviews as examples.

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Case-Based Tumor Board: Confronting Management Controversies in Renal Cell Carcinoma

Michael A. Brooks, MD; A. Edward Yen, MD; Richard E. Link, MD, PhD; and Wesley A. Mayer, MD, an interdisciplinary panel of kidney cancer experts, present representative cases of renal cell carcinoma in order to discuss current management controversies. The session reviews data supporting management recommendations, surgical approaches for small renal masses, lymphadenectomy, adjuvant therapy, and cytoreductive nephrectomy and partial nephrectomy.

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