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Dr. Suzanne Merrill

👤 Person
222 total appearances

Appearances Over Time

Podcast Appearances

BackTable Urology
Ep. 186 Blue Light Cystoscopy: Improving Bladder Cancer Detection with Dr. Suzanne Merrill

In 2023, there was a report looking at kind of a cystectomy database and looking at kind of what the path was retrieved from the, you know, whole mound specimen, the cystectomy, compared to what was their, you know, initial, you know, diagnosis from the TRBT preceding the cystectomy. And ultimately, 45% of cases actually missed CIS. So there is CIS in the cystectomy pathology and

BackTable Urology
Ep. 186 Blue Light Cystoscopy: Improving Bladder Cancer Detection with Dr. Suzanne Merrill

none detected in the TRBT.

BackTable Urology
Ep. 186 Blue Light Cystoscopy: Improving Bladder Cancer Detection with Dr. Suzanne Merrill

none detected in the TRBT.

BackTable Urology
Ep. 186 Blue Light Cystoscopy: Improving Bladder Cancer Detection with Dr. Suzanne Merrill

none detected in the TRBT.

BackTable Urology
Ep. 186 Blue Light Cystoscopy: Improving Bladder Cancer Detection with Dr. Suzanne Merrill

And so that just gives you a hint that, gosh, if we're missing up to 45% of CIS in patients and that those patients would ultimately be, you know, transitioned, you know, up kind of stage in risk status, if you will, to the high risk category, maybe even the very high risk category, we'd be having different conversations with our patients, ultimately setting them on a completely different, probably cancer journey.

BackTable Urology
Ep. 186 Blue Light Cystoscopy: Improving Bladder Cancer Detection with Dr. Suzanne Merrill

And so that just gives you a hint that, gosh, if we're missing up to 45% of CIS in patients and that those patients would ultimately be, you know, transitioned, you know, up kind of stage in risk status, if you will, to the high risk category, maybe even the very high risk category, we'd be having different conversations with our patients, ultimately setting them on a completely different, probably cancer journey.

BackTable Urology
Ep. 186 Blue Light Cystoscopy: Improving Bladder Cancer Detection with Dr. Suzanne Merrill

And so that just gives you a hint that, gosh, if we're missing up to 45% of CIS in patients and that those patients would ultimately be, you know, transitioned, you know, up kind of stage in risk status, if you will, to the high risk category, maybe even the very high risk category, we'd be having different conversations with our patients, ultimately setting them on a completely different, probably cancer journey.

BackTable Urology
Ep. 186 Blue Light Cystoscopy: Improving Bladder Cancer Detection with Dr. Suzanne Merrill

Yeah, so narrowband imaging is something we can use on our Olympus scopes. I think a majority of people, you know, perform TRBT with Olympus scopes. And so it's a, again, a kind of, if you will, button kind of toggle switch that you can use to transition images.

BackTable Urology
Ep. 186 Blue Light Cystoscopy: Improving Bladder Cancer Detection with Dr. Suzanne Merrill

Yeah, so narrowband imaging is something we can use on our Olympus scopes. I think a majority of people, you know, perform TRBT with Olympus scopes. And so it's a, again, a kind of, if you will, button kind of toggle switch that you can use to transition images.

BackTable Urology
Ep. 186 Blue Light Cystoscopy: Improving Bladder Cancer Detection with Dr. Suzanne Merrill

Yeah, so narrowband imaging is something we can use on our Olympus scopes. I think a majority of people, you know, perform TRBT with Olympus scopes. And so it's a, again, a kind of, if you will, button kind of toggle switch that you can use to transition images.

BackTable Urology
Ep. 186 Blue Light Cystoscopy: Improving Bladder Cancer Detection with Dr. Suzanne Merrill

to where now we're having kind of blue to green wavelengths, which actually kind of penetrate the superficial layers of the urethelium, allowing better visualization of the microvascular structures. And of course, you know, cancer structures have more microvascular structures to them. So they're going to kind of show a little bit more enhancement under NBI.

BackTable Urology
Ep. 186 Blue Light Cystoscopy: Improving Bladder Cancer Detection with Dr. Suzanne Merrill

to where now we're having kind of blue to green wavelengths, which actually kind of penetrate the superficial layers of the urethelium, allowing better visualization of the microvascular structures. And of course, you know, cancer structures have more microvascular structures to them. So they're going to kind of show a little bit more enhancement under NBI.

BackTable Urology
Ep. 186 Blue Light Cystoscopy: Improving Bladder Cancer Detection with Dr. Suzanne Merrill

to where now we're having kind of blue to green wavelengths, which actually kind of penetrate the superficial layers of the urethelium, allowing better visualization of the microvascular structures. And of course, you know, cancer structures have more microvascular structures to them. So they're going to kind of show a little bit more enhancement under NBI.

BackTable Urology
Ep. 186 Blue Light Cystoscopy: Improving Bladder Cancer Detection with Dr. Suzanne Merrill

I think the benefits of NBI is that certainly there's no pre-drug. It's just, again, a flip of a switch, a button pushed on the monitor. You can, again, use it during surveillance as well, just with, again, like a button push on the scope. And, you know, what the AUA says here, and I think they're very cognizant of kind of our resources, right? So,

BackTable Urology
Ep. 186 Blue Light Cystoscopy: Improving Bladder Cancer Detection with Dr. Suzanne Merrill

I think the benefits of NBI is that certainly there's no pre-drug. It's just, again, a flip of a switch, a button pushed on the monitor. You can, again, use it during surveillance as well, just with, again, like a button push on the scope. And, you know, what the AUA says here, and I think they're very cognizant of kind of our resources, right? So,

BackTable Urology
Ep. 186 Blue Light Cystoscopy: Improving Bladder Cancer Detection with Dr. Suzanne Merrill

I think the benefits of NBI is that certainly there's no pre-drug. It's just, again, a flip of a switch, a button pushed on the monitor. You can, again, use it during surveillance as well, just with, again, like a button push on the scope. And, you know, what the AUA says here, and I think they're very cognizant of kind of our resources, right? So,

BackTable Urology
Ep. 186 Blue Light Cystoscopy: Improving Bladder Cancer Detection with Dr. Suzanne Merrill

They know that NBI technology is more readily available to clinicians than blue light might be. And so they put it out there as a grade C recommendation. You can consider using this to increase detection. decrease recurrence, but they fully acknowledge that really there doesn't appear to be proven evidence that it decreases recurrence, okay?

BackTable Urology
Ep. 186 Blue Light Cystoscopy: Improving Bladder Cancer Detection with Dr. Suzanne Merrill

They know that NBI technology is more readily available to clinicians than blue light might be. And so they put it out there as a grade C recommendation. You can consider using this to increase detection. decrease recurrence, but they fully acknowledge that really there doesn't appear to be proven evidence that it decreases recurrence, okay?

BackTable Urology
Ep. 186 Blue Light Cystoscopy: Improving Bladder Cancer Detection with Dr. Suzanne Merrill

They know that NBI technology is more readily available to clinicians than blue light might be. And so they put it out there as a grade C recommendation. You can consider using this to increase detection. decrease recurrence, but they fully acknowledge that really there doesn't appear to be proven evidence that it decreases recurrence, okay?

BackTable Urology
Ep. 186 Blue Light Cystoscopy: Improving Bladder Cancer Detection with Dr. Suzanne Merrill

But there's really no additional kind of risk incurred by the patient, incurred by the operator using it. But ultimately, with, you know, kind of systematic reviews being done on NBI versus white light, Really, there's only been one that has shown an improved kind of decrease in recurrence with NBI. The other three have shown really no difference in recurrence.