Video Archives

Creating a Positive First Impression for Every New Patient

Posted by Neil H. Baum, MD | Apr 2021

Grand Rounds in Urology Contributing Editor Neil H. Baum, MD, Professor of Urology at Tulane Medical School, discusses the importance of creating a positive first impression for new patients. He outlines several examples that establish a welcoming environment beginning with the patient’s first call to the practice. Dr. Baum emphasizes that when a patient has a positive experience, it will serve as effective marketing for the practice. The receptionist has the initial opportunity to make an impression by preparing patients for their upcoming visit, directing them to educational materials online, and reminding them to both fill out demographic information in advance and to hydrate appropriately to facilitate the collection of a urine sample during their visit. When patients arrive for their appointment, it is important to be respectful of the patient’s time by minimizing their wait time. Lastly, Dr. Baum shares a unique tip to impress patients by creating a personalized introduction video for each new patient welcoming them to the practice and reminding them of any pre-appointment information.

Case Study on HIFU for Prostate Cancer

Posted by Vahan Kassabian, MD | Apr 2021

Vahan Kassabian, MD, Director of the Atlanta Prostate Center and Advanced Therapeutics at the Advanced Urology Institute of Georgia, presents a case study to illustrate the benefits of treating certain prostate cancer patients using high-intensity focused ultrasound (HIFU) instead of radical prostatectomy and radiation therapy. He begins by reviewing the circumstances of the patient’s diseases in 2015, then summarizes treatment and followup from early 2016 through January 2021. Finally, he explains how HIFU has been beneficial for the patient so far and what options are available at this point in their still-evolving journey.

FGFR3 Inhibitors for Upper Tract Urothelial Cancer

Posted by Sumanta Kumar Pal, MD | Mar 2021

E. David Crawford, MD, Professor of Urology at the University of California, San Diego, and Editor-in-Chief of Grand Rounds in Urology, interviews Sumanta Kumar Pal, MD, Clinical Professor in the Department of Medical Oncology & Therapeutics Research and Co-Director of the Kidney Cancer Program at City of Hope in Duarte, California, about his recent paper looking at FGFR3 inhibitors for treating upper tract urothelial cancer. Dr. Pal explains that upper tract urothelial cancer, which is both more rare and more aggressive than lower tract urothelial cancers, seems to be enriched in mutations in FGFR3, making FGFR3 inhibition a potentially good treatment for this disease state. While one such inhibitor, erdafitinib, is already approved for treating upper tract urothelial cancer, Dr. Pal suggests that a different inhibitor, infigratinib, has a profile that might lend itself better to clinical practice, with lower incidence of hyperphosphatemia and other side effects. He goes over the results of the initial phase 1 study of infigratinib, noting the 25% response rate and considering different biomarkers as indicators of response. Dr. Pal concludes by introducing the Proof 302 study, a phase 3 trial looking at infigratinib for upper tract urothelial cancer which he hopes urologists will consider signing eligible patients up for.

Integrated Multi-Modality Diagnostic Evaluation of Prostate Cancer

Posted by Sanoj Punnen, MD, MAS | Mar 2021

Sanoj Punnen, MD, MAS, Associate Professor of Clinical Urology in the University of Miami Health System, explains how multimodal detection options could improve and personalize prostate cancer diagnosis, specifically the combination of MRI and biomarkers. He reviews the pros and cons of each option, noting incidence and mortality rates. To bolster his points, Dr. Punnen summarizes data from the PRECISION trial and the PROMIS trial. He also looks at a 2018 trial studying MRI and 4Kscore® for significant prostate cancer detection and a 2021 study that developed a 4Kscore®/MRI‐based tool to assist clinicians in biopsy decision‐making and counseling of those at risk for prostate cancer. Dr. Punnen concludes by calling for further research, specifically studies comparing biomarkers head-to-head and trials focusing on PET imaging and quantitative imaging.

Current State-of-the-Art Molecular and Multi-Modality Imaging and Theranostics of Prostate Cancer

Posted by Wolfgang Weber, MD | Mar 2021

Wolfgang Weber, MD, Professor and Chair of the Department of Nuclear Medicine at the Technical University of Munich in Germany (TUM), reviews a half-decade of progress in the field of prostate cancer imaging and theranostics. First, he introduces glutamate carboxypeptidase, which is highly expressed in primary and metastatic prostate cancer. Dr. Weber then compares different PSMA ligands for PET imaging, finding that GA-PSMA-11 has extensive clinical experience but has small batch sizes; GA-THP-PSMA is very easy to label and has a lower uptake by normal organs but also has small batch sizes, renal excretion, and lower tumor uptake; F-DCFPyL has large batch production but renal excretion; F-PSMA-1007 has large batches and low renal excretion but suffers from a higher frequency of non-specific uptake; and F-rhPSMA-7.3 has large batches and low renal excretion but higher frequency of non-specific uptake. He displays a graph comparing the focal uptake in benign lesions between GA-PSMA-11 and F-PSMA-1007, revealing that GA-PSMA-11 is only displayed in 52 lesions vs. F-PSMA-1007’s 542. Dr. Weber then reviews a study of a specific patient who experienced normalization after 4 treatment cycles to depict the possible effectiveness of ligands. However, he observes that such success is not true for all patients, citing a study of the clinical experience in 100 consecutive mCRPC patients treated with Lu-177 PSMA I and T, finding a median of 12.9 months of survival for patients. Another similar study found a median of 13.5 months of survival for patients. Dr. Weber concludes by looking at a comparison of Lu-PSMA-617 and cabazitaxel which suggests that Lu-PSMA-617 is more effective and could be used to treat earlier stages of prostate cancer.