Dr. Suzette Sutherland
speaker
230 appearances
4 recordings
1 series
first heard Aug 2024
last heard Jan 2025
Dr. Suzette Sutherland’s voice in public audio — every appearance, attributed to the second.
Trend
recordings per month · last 12 monthsNo recordings in the last 12 months.Older appearances are listed below; set an alert to hear about the next one.
Appearances
Unfortunately, there's data that shows that carcinoma in situ, or CIS, was missed on TURBT more than 45% of the time on subsequent radical cystectomy cases. And 86% of residual tumors have been found at the original resection site. With this, it's clear that enhanced visualization is of utmost importance and will be a significant benefit during TURBT.
Furthermore, patient compliance can often be an issue, with only 23% of patients coming back for re-resection. It's therefore all the more important to ensure a complete TURBT The first time, right from the start. Listen to this podcast interview with Dr. Suzanne Merrow, who discusses the benefits of blue light cystoscopy to enhance visualization and ensure a high quality TURBT.
I'm your host today, Dr. Suzette Sutherland, and I'm super excited to have Dr. Suzanne Merrill here today to talk to us about diagnostic aspects of bladder cancer and how to enhance that, specifically with a newer type of technology called blue light cystoscopy. Thanks for being here with us today, Dr. Merrill. It's my pleasure. Thanks for having me, Suzette.
Yeah, let me tell you a little bit about Dr. Suzanne Merrill. She is trained at Duke University for her urology residency and then did a GU oncology fellowship at Mayo Clinic in 2015. She's now 10 years out of fellowship, so she has a lot of experience under her belt. She started on faculty at Penn State Hershey Medical Center. where she was program director there too for the urology residents.
And now since about a few years, since 2021, she's in Colorado at Colorado Urology, which is under a bigger umbrella of United Urology and specializing in GU oncology and also considered a regional bladder cancer specialist. So she really knows what she's talking about here today. And I'm so happy that she's here to share that with us today. Well, thank you. So let's just get started.
Like, first of all, just a couple of, you know, good fun facts, I suppose, not so fun. But, you know, we know bladder cancer, it seems like it's getting even more common today than it was even when I was training. It's quite common, more so in men than women. Tell us the statistics around the epidemiology today.
Right. So we know when we talk to patients about cancer, oftentimes I say the C word before I say the word, right? Because it's so frightening, right? And we as physicians and surgeons know that one person's cancer isn't another person's cancer, especially when we're talking about different organs, right?
But even the case when you're talking about bladder cancer, and we know the earlier you find it, it's totally treatable, right? And when it's late in the diagnosis, it's a whole nother issue for the patients, right? So that's another thing that we're talking about here today, how we can do a better job at detection early. and utilizing some of the newer tools that we have.
Let's look at the AUA guidelines really quickly, right? For the risk stratification, we know it's determined low risk, intermediate high risk, and the things that come into play for that, much of it histological things, and that's where our technology can help us. Can you briefly kind of go into a little bit of the main points that go into our risk stratification today?
Yeah. So it's oh so important to really know the accurate histology, right? At the time of biopsy, at the time of look-see, right? When we take them for a look, cystoscopically, whether it's in the office or in the OR, we want to be really confident that we know what we're seeing, that when we see nothing, as an example, that we really are seeing nothing.
So tell us about the blue light cystoscopy, the cyst view, and how that works and how that enhances our visualization. Yes.
I've had the opportunity to use this myself and was really astounded at what I saw on white light versus what I then was able to see on blue light. And so it really was an eye opener. The first time I used it was several years ago, but it really was an eye opener.
And I'm a firm believer that it helps with diagnostics at this point and really that, you know, it should be used if possible on almost all patients. What are your thoughts on that? when it should be used? Or is there a time when it shouldn't be used?
So that's a huge number, right? One third of the patients. And we're talking about something as serious as CIS. Exactly.
It is amazing having trained in the era before blue light and how we thought we were doing such a good job with our two RBTs. And now with the blue light, you see the residual tumor, as you said, that you miss. I mean, I didn't know until doing a little more research myself in anticipation of this podcast how high that number was.
And when you look at the recurrence rates or the residual tumor rate, I mean, as you said, sometimes this can be up to two thirds in some reports, but even how much of T1 disease versus T2 disease gets missed, you know, because the resection isn't done adequately enough just with white light. So up to 15 to almost 30%. So of the residual disease being T1 to T2.
So again, we know this totally changes the The prognosis of the patient, right, and what we're going to do next or what we should be advocating for next. I just wanted to make that point that when we look at the newer, I think they came out in 2024, yeah, just last spring, the AUA-SUO guidelines concerning this.
They actually say in patients with non-muscle invasive bladder cancer, we should be offering blue light cystoscopy. Now they make the caveat, you know, at the time of TURBT, the caveat is if available to enhance detection and decrease recurrence. So it's a moderate grade, grade B evidence strength. But again, they do put that word should in there as opposed to saying should. could, right?
So the data is pushing a little more towards or pointing towards the real potential, the benefits of this blue light imaging.
And then I guess to take it to another direction a little bit, these patients that have mixed, you know, low and high grade histology or uncommon variants, does it help to determine, you know, is it picked up by the uncommon variants as well so it can help to determine these more really high, high risk patients? Yes.
Showing 181–200 of 230 · page 10 of 12
← Previous
Next →