Bladder Cancer: A Practical Guide - Ashish Kamat & Peter Black

January 17, 2022

Alicia Morgans is joined by Ashish Kamat and Peter Black to discuss their recent book on bladder cancer, Bladder Cancer: A Practical Guide. This book provides a practical, comprehensive, state-of-the-art review of bladder cancer, and is a valuable resource for anyone with an interest in urothelial tumors.

Biographies:

Peter Black, MD, Senior Research Scientist, Vancouver Prostate Centre, Professor, Department of Urologic Sciences, University of British Columbia, Vancouver Prostate Center

Ashish Kamat, MD, MBBS, Professor, Department of Urology, Division of Surgery, University of Texas MD Anderson Cancer Center, President, International Bladder Cancer Group (IBCG), Houston, Texas

Alicia Morgans, MD, MPH, Genitourinary Medical Oncologist, Medical Director of Survivorship Program at Dana-Farber Cancer Institute, Boston, Massachusetts


Read the Full Video Transcript

Alicia Morgans: Hi, my name is Alicia Morgans and I'm a GU Medical Oncologist at Dana Farber Cancer Institute in Boston, United States. I'm so excited to have here with me today, Dr. Peter Black, who is a Professor in The Department of Urologic Sciences at The University of British Columbia, as well as Dr. Ashish Kamat who everyone knows very, very well, a Professor of Urologic Oncology and Cancer Research at MD Anderson in Houston. Thank you so much, both of you for being here with me today.

Ashish Kamat: Thanks for having us, Alicia, always a pleasure to join you.

Alicia Morgans: Wonderful. Well, I wanted to talk with you a little bit about a book you have on bladder cancer, that is really trying to lend to the practicing clinician, some of the pearls we wish we heard every day from professors and scientists around us in our training and practice. So Ashish, can you tell us a little bit about what inspired this bladder cancer book and how it came to be?

Ashish Kamat: Sure, absolutely. So, clearly what inspired this book was the feedback I got from referring urologists, our fellows, residents, and patients, because we would often get questions saying, "We have textbooks that talk about bladder cancer, either dedicated to bladder cancer itself, or as part of our standard textbooks in urologic oncology and medical oncology, but there's no place where we can learn the pearls of what do we do when it comes to a patient that has BCG unresponsive disease? What do we do when a patient is getting chemotherapy and calls with a particular symptom? How do you guys manage it?" For example, Alicia, how do you manage your chemotherapy? The pearls, the things that we talk to our trainees in our clinic when they are shadowing us or in surgery.

So at that point, I reached out to the publishers and I said, "Hey, this is an audience request. Do you think there is a role for such a book in your publishing house?" And they did their due diligence and came back and said, "Absolutely." They've actually heard similar requests from others for other cancers. And bladder cancer clearly was one that I'd approached them on. So when we got the go-ahead for that, obviously, I wanted to find a partner in crime, and no better person for that than Peter Black. I reached out to him and he knows this, he has not said no to me as of yet, so he said, yes. And that was the genesis of the book.

Alicia Morgans: Great. And I think there is such a need and actually not just in bladder cancer. So certainly you can get started on the rest of the GU malignancies when you have a minute. But Peter, I'd love to hear from you just in terms of what you think were the most compelling and important things to include in this book. What did you really want to highlight when you were choosing chapters and choosing authors for this update and pearl?

Peter Black: Yeah, no, it's a good question. So I think since it was supposed to be practical and full of tips and advice, that is based on experience, we needed experienced authors who are well-established in the field. And if you flip through the table of contents, you will see there a lot of very well recognized names, who have been in the business for a few years and I think that comes out in the different chapters. We've also aimed to be comprehensive. So we really cover the whole field, all aspects of bladder cancer. And we have a section on the upper tract as well, importantly. So comprehensive from the spectrum, but not trying to be too comprehensive in the writing. We don't want all the details. We want to keep it practical and really highlight the tips and tricks.

Alicia Morgans: Perfect. Ashish, are there any tips or tricks that you particularly thought, "Wow, this is something that even I haven't thought about in a while." Anything that really surprised you and was really interesting to read?

Ashish Kamat: Oh, absolutely. It's a book that I would refer to myself for tips on things that I don't normally do. One example, just to kind of expand on what Peter said is we reached out to two experts in the field and we said, "Hey, we want you to write this. We don't want to have 10 different authors in a particular chapter, because then it gets to be didactic. We want you, professor, director, people who are experienced to write this." And the reason for that was because if I reach out to someone like you, Alicia, to write a book, you're just going to distill the key points because you don't have the time to sit and write 25 pages on a topic, right? So you'll distill the key points.

So, that's what actually happened. And one example is a chapter on clinical trial design in the book. That is written by a single author, well experienced. When you go to it, and it's literally like listening to what Seth has to say, what's in his mind when he's at a panel discussion somewhere, right? So these are some of the things that really I was impressed with within the book. Now, clearly, there are some chapters where many people got together and created a group effort and that's fine too. But most of these are two or three authors at the most, each chapter.

Alicia Morgans: That's phenomenal and really including clinical trial design, I think is an interesting component too, that this really wasn't just necessarily the day-to-day management in the OR, and in the clinic, that this is really thinking about giving us pearls on the whole spectrum, including designing trials that are going to help us understand what to do tomorrow. So, that's really interesting. Peter, I'd love to hear your thoughts. How hard was it to get these leaders across bladder cancer, to commit to writing a chapter on their own? That sounds like a massive feat in itself.

Peter Black: That is indeed the hard part. So I think that most authors, prospective authors, were relatively quick to say, "Yeah, I'd be happy to do that." But of course, the delivery is sometimes challenging in the backend. And everyone is a little bit different. It is a process that stretches over a couple of years. And I think anybody who has done a book like this always finds that they are chasing somebody. I think Ashish and I know the authors well enough that we were able to anticipate where problems might be and we invited those that we thought would deliver. And it worked out in the end.

I would say there is one author, in particular, I'd like to highlight for his positive contribution was Noah Hahn, who actually, when he got the proofs, sometime after writing the chapter in the first place, actually rewrote it to update it to the current level of knowledge, because so much had changed in the meantime. So there were a lot of very positive examples like that as well.

Alicia Morgans: Well, that is wonderful. And Noah is exceptional. Being a medical oncologist, I feel like we can claim him as being wonderful all the time too. So for the two of you, I'd love to hear your final thoughts on what you think of this book. Why should people pick it up? It sounds exceptional to me, but what are your thoughts on that. Final words, let's start with you, Peter.

Peter Black: It really is for the practicing urologist in the community or at the university setting and for the residents and fellows and it is to be used really, in your day-to-day routine. I would highlight one chapter that I think is a really good teaser for the book, which is the chapter on endoscopic management of upper tract disease, which is packed with pictures of how to do things, the different tools to use, specifically from the surgical point of view, it's not just a surgery book. But I could really see fellows and residents and urologists opening up that chapter and looking at it before they go and do an upper tract urothelial cancer case, so really to be used every day.

Alicia Morgans: That's phenomenal. And it's great to know that you guys were able to get these pictures and the real how to do it, kind of information into this book, which is also a phenomenal point on why we should take an interest. Ashish, you get the final, final word. Why should we get this book?

Ashish Kamat: Well, one of the things I said in the preface is this is not just another book. It's not just another book on the topic. It's not an updated journal. It's not a webinar. What it is, is literally an insight in the minds of true experts in the field and their thoughts distilled down into the key teaching points, really, that they wanted to make to the audience per se. So it's a book that I would look to, to get an insight into what do my medical oncology colleagues think when they are treating a patient, either in the neoadjuvant or adjuvant setting. What are some of the tips, endoscopically, for example, as Peter raised, or what are people thinking about clinical trial design? What are the pathologists thinking of when they look at the slide on the microscope? It is truly a practical guide. It's not a cookbook, it's not a do-it-yourself at home, but it is a practical guide on bladder cancer.

Alicia Morgans: Well, I commend both of you for not only coming up with this idea but having the passion and the diligence to see it through, with all of these authors being so really prominent in their field and having so much to share. I think it's great that we get to hear from them in their own words and really get to have a distilled-down version of what matters most when we are treating bladder cancer. So the information on how to purchase this book will be attached to this webcast. And we really look forward to hearing from you both with updates when you publish the next edition. Thank you so much for your time today.

Ashish Kamat: Thank you.

Peter Black: Thank you, Alicia.
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