Talking About Tumors

Chapter 4

Chapter 4: Genitourinary Malignancies

Prostate, bladder, urothelial, renal cell, and testicular cancer topics.

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S04 E01

Fundamentals of Localized Prostate Cancer 101

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Show notes

Topics covered

  1. Background and presentation of prostate Cancer
  2. Evidence behind PSA screening and hallmarks of a screening test
  3. Staging and risk stratification of Localized Disease
  4. Management options and the ProtecT Trial
References and source notes

As always, citations, and sources include education from our respective training programs, the Devita textbook, and Uptodate.com. We highly encourage review of guidelines published by ASCO, ESMO and other organizations local to your practice.

DeVita, Vincent T., Jr., Theodore S. Lawrence, and Steven A. Rosenberg. Devita, Hellman, and Rosenberg's Cancer: Principles & Practice of Oncology. 10th edition. Philadelphia: Wolters Kluwer, 2015.

Uptodate.com Waltham, MA: Wolters Kluwer.

  1. 1. Schroder F et al. NEJM. 2009; 360(13):1320-1328. doi: 10.1056/NEJMOA0810084
  2. 2. Andriole G el al. NEJM. 2009; 360(13):1310-1319. doi: 10.1056/NEJMOA0810696
  3. 3. Lane J et al. Lancet. 2014; 15(10):1109-1118. doi: 10.1016/S1470-2045(14)70361-4
  4. 4. Hamdy F et al. NEJM. 2016; 375(15):1415-1424. doi: 10.1056/NEJMOA1606220
  5. 5. Hamdy F et al. NEJM. 2023; 388(17):1547-1558. doi: 10.1056/NEJMOA2214122
  6. 6. Ilic D et al. BMJ. 2018; 362:k3519. doi:10.1136/BMJ.K3519
  7. 7. Maurer T et al. Nat Rev Urol. 2016;13(4):226-235. doi: 10.1038/nrurol.2016.26 Epub 2016 Feb 23
Disclosure and tags

Talking about Tumors with Ryan and Ryann is not medical advice. We have received no funding in relation to the information discussed within this episode and have no financial conflicts of interest to disclose. All opinions are those of whoever stated them. We have compiled this podcast to serve as an introduction to the field of medical oncology for post-graduate trainees interested in the topic.

Tags: Hematology/Oncology, evidence based medicine, education, chemotherapy, immunotherapy, medical oncology

S04 E02

Adjuvant Options for Prostate Cancer

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Show notes

Topics covered

  1. Physiology, efficacy and toxicities of androgen deprivation
  2. Evidence for adjuvant intervention after definitive surgery or radiation
  3. Role of abiraterone in high-risk localized prostate cancer
  4. Limited evidence to support definitive salvage approach
References and source notes

As always, citations, and sources include education from our respective training programs, the Devita textbook, and Uptodate.com. We highly encourage review of guidelines published by ASCO, ESMO and other organizations local to your practice.

DeVita, Vincent T., Jr., Theodore S. Lawrence, and Steven A. Rosenberg. Devita, Hellman, and Rosenberg's Cancer: Principles & Practice of Oncology. 10th edition. Philadelphia: Wolters Kluwer, 2015.

Uptodate.com Waltham, MA: Wolters Kluwer.

  1. 1. Attard G et al. Lancet. 2022;399(10323):447-460. doi:10.1016/S0140-6736(21)02437-5
  2. 2. Xie W et al. J Clin Oncol. 2017;35(27):3097-3104. doi:10.1200/JCO.2017.73.9987
  3. 3. Bolla M et al.. NEJM. 2009;360(24):2516-2527. doi:10.1056/NEJMOA0810095
  4. 4. Kishan AU et al. Lancet Oncol. 2022;23(2):304-316. doi:10.1016/S1470-2045(21)00705-1
  5. 5. Bolla M et al. Lancet. 2002;360(9327):103-108. doi:10.1016/S0140-6736(02)09408-4
  6. 6. Bolla M et al. Lancet Oncol. 2010;11(11):1066-1073. doi:10.1016/S1470-2045(10)70223-0
  7. 7. Bolla M et al. NEJM. 2009;360(24):2516-2527. doi:10.1056/NEJMOA0810095
  8. 8. Hanks GE et al. J Clin Oncol. 2003;21(21):3972-3978. doi:10.1200/JCO.2003.11.023
  9. 9. Bolla M et al. Lancet. 2002;360(9327):103-108. doi:10.1016/S0140-6736(02)09408-4
  10. 10. Huggins C, Hodges C V. CA Cancer J Clin. 1972;22(4):293-297. doi:10.3322/CANJCLIN.22.4.232
  11. 11. Huggins C et al. Arch Surg. 1941;43(2):209-223. doi:10.1001/archsurg.1941.01210140043004
  12. 12. Rosenthal SA et al. J Clin Oncol. 2019;37(14):1159-1168. doi:10.1200/JCO.18.02158
Disclosure and tags

Talking about Tumors with Ryan and Ryann is not medical advice. We have received no funding in relation to the information discussed within this episode and have no financial conflicts of interest to disclose. All opinions are those of whoever stated them. We have compiled this podcast to serve as an introduction to the field of medical oncology for post-graduate trainees interested in the topic.

Tags: Hematology/Oncology, evidence based medicine, education, chemotherapy, immunotherapy, medical oncology

S04 E03

Metastatic Castrate Sensitive Prostate Cancer

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Show notes

Topics covered

  1. The chemotherapy revolution in prostate cancer
  2. Role of ARATs in earlier disease states
  3. Triple therapy (chemotherapy, ADT, and ARAT)
  4. Considerations for frailer patients with indolent disease
References and source notes

As always, citations, and sources include education from our respective training programs, the Devita textbook, and Uptodate.com. We highly encourage review of guidelines published by ASCO, ESMO and other organizations local to your practice.

DeVita, Vincent T., Jr., Theodore S. Lawrence, and Steven A. Rosenberg. Devita, Hellman, and Rosenberg's Cancer: Principles & Practice of Oncology. 10th edition. Philadelphia: Wolters Kluwer, 2015.

Uptodate.com Waltham, MA: Wolters Kluwer.

  1. 1. Hussain M et al.. J Clin Oncol. 2023;41(20):3595-3607. doi:10.1200/JCO.23.00041
  2. 2. Smith MR et al. NEJM. 2022;386(12):1132-1142. doi:10.1056/NEJMOA2119115
  3. 3. Fizazi K et al. Lancet. 2022;399(10336):1695-1707. doi:10.1016/S0140-6736(22)00367-1
  4. 4. Sweeney CJ et al. Lancet Oncol. 2023;24(4):323-334. doi:10.1016/S1470-2045(23)00063-3
  5. 5. Wenzel M, et al. Prostate Cancer and Prostatic Diseases 2021 25:2. 2021;25(2):139-148. doi:10.1038/s41391-021-00395-4
  6. 6. Gravis G et al. Lancet Oncol. 2013;14(2):149-158. doi:10.1016/S1470-2045(12)70560-0
  7. 7. James ND et al. NEJM. 2017;377(4):338-351. doi:10.1056/NEJMOA1702900/SUPPL_FILE
  8. 8. Fizazi K, et al. Lancet Oncol. 2019;20(5):686-700. doi:10.1016/S1470-2045(19)30082-8
  9. 9. James ND et al. Lancet. 2016;387(10024):1163-1177. doi:10.1016/S0140-6736(15)01037-5
  10. 10. Gravis G et al. Lancet Oncol. 2013;14(2):149-158. doi:10.1016/S1470-2045(12)70560-0
  11. 11. Sweeney CJ et al. NEJM. 2015;373(8):737-746. doi:10.1056/NEJMOA1503747/SUPPL_FILE\
  12. 12. James ND et al. The Lancet. 2016;387(10024):1163-1177. doi:10.1016/S0140-6736(15)01037-5
  13. 13. Fizazi K et al. NEJM. 2017;377(4):352-360. doi:10.1056/NEJMOA1704174
  14. 14. Tannock et al. NEJM 2004;351(15):1502-1512. doi:10.1056/NEJMOA040720
  15. 15. Petrylak DP et al.. NEJM. 2004;351(15):1513-1520. doi:10.1056/NEJMOA041318
Disclosure and tags

Talking about Tumors with Ryan and Ryann is not medical advice. We have received no funding in relation to the information discussed within this episode and have no financial conflicts of interest to disclose. All opinions are those of whoever stated them. We have compiled this podcast to serve as an introduction to the field of medical oncology for post-graduate trainees interested in the topic.

Tags: Hematology/Oncology, evidence based medicine, education, chemotherapy, immunotherapy, medical oncology

S04 E04

Metastatic Castrate Sensitive Prostate Cancer

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Show notes

Topics covered

  1. The chemotherapy revolution in prostate cancer
  2. Role of ARATs in earlier disease states
  3. Triple therapy (chemotherapy, ADT, and ARAT)
  4. Considerations for frailer patients with indolent disease
References and source notes

As always, citations, and sources include education from our respective training programs, the Devita textbook, and Uptodate.com. We highly encourage review of guidelines published by ASCO, ESMO and other organizations local to your practice.

DeVita, Vincent T., Jr., Theodore S. Lawrence, and Steven A. Rosenberg. Devita, Hellman, and Rosenberg's Cancer: Principles & Practice of Oncology. 10th edition. Philadelphia: Wolters Kluwer, 2015.

Uptodate.com Waltham, MA: Wolters Kluwer.

  1. 1. Freedland SJ et al. NEJM. 2023;389(16):1453-1465. doi:10.1056/NEJMOA2303974
  2. 2. de Bono J et al. NEJM. 2020;382(22):2091-2102. doi:10.1056/NEJMOA1911440
  3. 3. Haslam A, Prasad V. Annals of Oncology. 2018;29(5):1079. doi:10.1093/ANNONC/MDY116
  4. 4. Parker C et al. NEJM. 2013;369(3):213-223. doi:10.1056/NEJMOA1213755
  5. 5. Khalaf DJ et al. Lancet Oncol. 2019;20(12):1730-1739. doi:10.1016/S1470-2045(19)30688-6
  6. 6. Saad F et al.. J Natl Cancer Inst. 2004;96(11):879-882. doi:10.1093/JNCI/DJH141
  7. 7. Sartor O et al. NEJM. 2021;385(12):1091-1103. doi:10.1056/NEJMOA2107322
  8. 8. de Wit R et al. NEJM. 2019;381(26):2506-2518. doi:10.1056/NEJMOA1911206
Disclosure and tags

Talking about Tumors with Ryan and Ryann is not medical advice. We have received no funding in relation to the information discussed within this episode and have no financial conflicts of interest to disclose. All opinions are those of whoever stated them. We have compiled this podcast to serve as an introduction to the field of medical oncology for post-graduate trainees interested in the topic.

Tags: Hematology/Oncology, evidence based medicine, education, chemotherapy, immunotherapy, medical oncology

S04 E05

Muscle Invasive Bladder Cancer

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Show notes

Topics covered

  1. Etymology, presentation, and work-up of bladder/urothelial cancer
  2. Role of perioperative systemic therapy
  3. Tri-modality therapy (bladder sparing approach)
  4. Considerations for upper tract urothelial cancer
References and source notes

As always, citations, and sources include education from our respective training programs, the Devita textbook, and Uptodate.com. We highly encourage review of guidelines published by ASCO, ESMO and other organizations local to your practice.

DeVita, Vincent T., Jr., Theodore S. Lawrence, and Steven A. Rosenberg. Devita, Hellman, and Rosenberg's Cancer: Principles & Practice of Oncology. 10th edition. Philadelphia: Wolters Kluwer, 2015.

Uptodate.com Waltham, MA: Wolters Kluwer.

  1. 1. Bellmunt J et al. Lancet Oncol. 2021;22(4):525-537. doi:10.1016/S1470-2045(21)00004-8
  2. 2. Birtle AJ et al. JCO. Published online February 13, 2024. doi:10.1200/JCO.23.01659
  3. 3. Birtle A et al. Lancet. 2020;395(10232):1268-1277. doi:10.1016/S0140-6736(20)30415-3
  4. 4. Bajorin DF et al. NEJM. 2021;384(22):2102-2114. doi:10.1056/NEJMOA2034442
  5. 5. James ND et al. NEJM. 2012;366(16):1477-1488. doi:10.1056/NEJMOA1106106
  6. 6. Pfister C et al. JCO 2023;41(17_suppl) doi:10.1200/JCO.2023.41.17_SUPPL.LBA4507
  7. 7. Pfister C et al. Eur Urol. 2021;79(2):214-221. doi:10.1016/J.EURURO.2020.08.024
  8. 8. Grossman HB et al. NEJM. 2003;349(9):859-866. doi:10.1056/NEJMOA022148
Disclosure and tags

Talking about Tumors with Ryan and Ryann is not medical advice. We have received no funding in relation to the information discussed within this episode and have no financial conflicts of interest to disclose. All opinions are those of whoever stated them. We have compiled this podcast to serve as an introduction to the field of medical oncology for post-graduate trainees interested in the topic.

Tags: Hematology/Oncology, evidence based medicine, education, chemotherapy, immunotherapy, medical oncology

S04 E06

Metastatic Urothelial Cancer

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Show notes

Topics covered

  1. Immunohistochemistry of urothelial cancer
  2. History of systemic therapy in advanced and metastatic disease
  3. Pembrolizumab and Enfortumab Vedotin
  4. Approach to second line therapy and beyond
References and source notes

As always, citations, and sources include education from our respective training programs, the Devita textbook, and Uptodate.com. We highly encourage review of guidelines published by ASCO, ESMO and other organizations local to your practice.

DeVita, Vincent T., Jr., Theodore S. Lawrence, and Steven A. Rosenberg. Devita, Hellman, and Rosenberg's Cancer: Principles & Practice of Oncology. 10th edition. Philadelphia: Wolters Kluwer, 2015.

Uptodate.com Waltham, MA: Wolters Kluwer.

  1. 1. Powles T et al. NEJM. 2024;390(10):875-888. doi:10.1056/NEJMOA2312117
  2. 2. Powles T et al. NEJM. 2020;383(13):1218-1230. doi:10.1056/NEJMOA2002788
  3. 3. Galsky MD et al. Lancet. 2020;395(10236):1547-1557. doi:10.1016/S0140-6736(20)30230-0
  4. 4. Powles T et al. Lancet Oncol. 2021;22(7):931-945. doi:10.1016/S1470-2045(21)00152-2
  5. 5. van der Heijden MS et al. NEJM. 2023;389(19):1778-1789. doi:10.1056/NEJMOA2309863
  6. 6. Von der Maase H et al. JCO. 2000;18(17):3068-3077. doi:10.1200/JCO.2000.18.17.3068/
  7. 7. von der Maase H et al. JCO. 2023;41(23):3881-3890. doi:10.1200/JCO.22.02763
  8. 8. Vuky J et al. . JCO. 2020;38(23):2658-2666. doi:10.1200/JCO.19.01213
Disclosure and tags

Talking about Tumors with Ryan and Ryann is not medical advice. We have received no funding in relation to the information discussed within this episode and have no financial conflicts of interest to disclose. All opinions are those of whoever stated them. We have compiled this podcast to serve as an introduction to the field of medical oncology for post-graduate trainees interested in the topic.

Tags: Hematology/Oncology, evidence based medicine, education, chemotherapy, immunotherapy, medical oncology

S04 E07

Localized Renal Cell Carcinoma

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Show notes

Topics covered

  1. Risk Factors and Presentation
  2. Staging and Paraneoplastic syndromes
  3. Localized Therapy Options and Considerations
  4. Evidence and Limitations for Adjuvant Systemic Therapy
References and source notes

As always, citations, and sources include education from our respective training programs, the Devita textbook, and Uptodate.com. We highly encourage review of guidelines published by ASCO, ESMO and other organizations local to your practice.

DeVita, Vincent T., Jr., Theodore S. Lawrence, and Steven A. Rosenberg. Devita, Hellman, and Rosenberg's Cancer: Principles & Practice of Oncology. 10th edition. Philadelphia: Wolters Kluwer, 2015.

Uptodate.com Waltham, MA: Wolters Kluwer.

  1. 1. Tannock IF et al. Evaluating Trials of Adjuvant Therapy: Is There Benefit for People with Resected Renal Cancer? Journal of Clinical Oncology. 2023;41(15):2713-2717. doi:10.1200/JCO.23.00280/ASSET/IMAGES/LARGE/JCO.23.00280F2.JPEG
  2. 2. Ravaud A et al. NEJM. 2016;375(23):2246-2254. doi:10.1056/NEJMOA1611406
  3. 3. Pal SK et al. Lancet. 2022;400(10358):1103-1116. doi:10.1016/S0140-6736(22)01658-0
  4. 4. Motzer RJ et al. Lancet. 2023;401(10379):821-832. doi:10.1016/S0140-6736(22)02574-0
  5. 5. Correa AF et al. Eur Urol. 2021;80(1):20-31. doi:10.1016/J.EURURO.2021.02.025
  6. 6. Choueiri TK et al. NEJM. 2024;390(15):1359-1371. doi:10.1056/NEJMOA2312695
  7. 7. Choueiri TK et al. NEJM. 2021;385(8):683-694. doi:10.1056/NEJMOA2106391
Disclosure and tags

Talking about Tumors with Ryan and Ryann is not medical advice. We have received no funding in relation to the information discussed within this episode and have no financial conflicts of interest to disclose. All opinions are those of whoever stated them. We have compiled this podcast to serve as an introduction to the field of medical oncology for post-graduate trainees interested in the topic.

Tags: Hematology/Oncology, evidence based medicine, education, chemotherapy, immunotherapy, medical oncology

S04 E08

Metastatic Renal Cell Carcinoma

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Show notes

Topics covered

  1. Historical Approach (cytoreduction, IFN-a, sunitinib)
  2. Prognostic risk scores
  3. Evidence for modern doublet regimens
  4. Later line therapy
References and source notes

As always, citations, and sources include education from our respective training programs, the Devita textbook, and Uptodate.com. We highly encourage review of guidelines published by ASCO, ESMO and other organizations local to your practice.

DeVita, Vincent T., Jr., Theodore S. Lawrence, and Steven A. Rosenberg. Devita, Hellman, and Rosenberg's Cancer: Principles & Practice of Oncology. 10th edition. Philadelphia: Wolters Kluwer, 2015.

Uptodate.com Waltham, MA: Wolters Kluwer.

    Disclosure and tags

    Talking about Tumors with Ryan and Ryann is not medical advice. We have received no funding in relation to the information discussed within this episode and have no financial conflicts of interest to disclose. All opinions are those of whoever stated them. We have compiled this podcast to serve as an introduction to the field of medical oncology for post-graduate trainees interested in the topic.

    Tags: Hematology/Oncology, evidence based medicine, education, chemotherapy, immunotherapy, medical oncology

    S04 E09

    Testicular Cancer I

    Open episode on Buzzsprout

    Show notes

    Topics covered

    1. Background, work up
    2. Staging of seminoma and NSGCT
    3. Young Adult/Adolescent Oncology
    4. Management of Stage I Disease
    References and source notes

    As always, citations, and sources include education from our respective training programs, the Devita textbook, and Uptodate.com. We highly encourage review of guidelines published by ASCO, ESMO and other organizations local to your practice.

    DeVita, Vincent T., Jr., Theodore S. Lawrence, and Steven A. Rosenberg. Devita, Hellman, and Rosenberg's Cancer: Principles & Practice of Oncology. 10th edition. Philadelphia: Wolters Kluwer, 2015.

    Uptodate.com Waltham, MA: Wolters Kluwer.

    1. 1. Hiester A et al. Eur J Cancer. 2021;155:64-72. doi:10.1016/J.EJCA.2021.06.022
    2. 2. Calaway AC et al. Eur Urol. 2019;76(5):607-609. doi:10.1016/j.eururo.2019.05.031
    3. 3. Oliver RTD et al. J Clin Oncol. 2011;29(8):957-962. doi:10.1200/JCO.2009.26.4655
    4. 4. Oliver RTD et al. Lancet. 2005;366(9482):293-300. doi:10.1016/S0140-6736(05)66984-X
    5. 5. Joffe JK et al. JCO. 2022;40(22):2468-2478. doi:10.1200/JCO.21.01199/
    6. 6. Bhatia S et al.. J NCCN. 2023;21(8):851-880. doi:10.6004/JNCCN.2023.0040
    7. 7. Stephenson A et al. J Urol. 2019;202(2):272-281. doi:10.1097/JU.0000000000000318
    Disclosure and tags

    Talking about Tumors with Ryan and Ryann is not medical advice. We have received no funding in relation to the information discussed within this episode and have no financial conflicts of interest to disclose. All opinions are those of whoever stated them. We have compiled this podcast to serve as an introduction to the field of medical oncology for post-graduate trainees interested in the topic.

    Tags: Hematology/Oncology, evidence based medicine, education, chemotherapy, immunotherapy, medical oncology

    S04 E10

    Testicular Cancer II

    Open episode on Buzzsprout

    Show notes

    Topics covered

    1. Stage II Disease
    2. Overview of BEP, EP, VIP
    3. Advanced, refractory disease
    4. Survivorship considerations
    References and source notes

    As always, citations, and sources include education from our respective training programs, the Devita textbook, and Uptodate.com. We highly encourage review of guidelines published by ASCO, ESMO and other organizations local to your practice.

    DeVita, Vincent T., Jr., Theodore S. Lawrence, and Steven A. Rosenberg. Devita, Hellman, and Rosenberg's Cancer: Principles & Practice of Oncology. 10th edition. Philadelphia: Wolters Kluwer, 2015.

    Uptodate.com Waltham, MA: Wolters Kluwer.

    1. 1. Pico JL et al. Ann Oncol. 2005;16(7):1152-1159. doi:10.1093/ANNONC/MDI228
    2. 2. Adra N, et al. J Clin Oncol. 2017;35(10):1096-1102. doi:10.1200/JCO.2016.69.5395
    3. 3. Nichols CR et al. J Clin Oncol. 1998;16(4):1287-1293. doi:10.1200/JCO.1998.16.4.1287
    4. 4. de Wit R et al.. JCO. 1997;15(5):1837-1843. doi:10.1200/JCO.1997.15.5.1837
    5. 5. Culine S, et al. Ann Oncol. 2007;18(5):917-924. doi:10.1093/ANNONC/MDM062
    6. 6. Lorch A, et al. Journal of Clinical Oncology. 2007;25(18_suppl):5086-5086. doi:10.1200/JCO.2007.25.18_SUPPL.5086
    7. 7. Fung C, et al.. J Natl Compr Canc Netw. 2019;17(12):1557-1568. doi:10.6004/JNCCN.2019.7369
    Disclosure and tags

    Talking about Tumors with Ryan and Ryann is not medical advice. We have received no funding in relation to the information discussed within this episode and have no financial conflicts of interest to disclose. All opinions are those of whoever stated them. We have compiled this podcast to serve as an introduction to the field of medical oncology for post-graduate trainees interested in the topic.

    Tags: Hematology/Oncology, evidence based medicine, education, chemotherapy, immunotherapy, medical oncology