Ep. 135 Considerations for Post-Chemo RPLND with Dr. Clint Cary and Dr. Gagan Prakash

This week on BackTable Urology, Dr. Aditya Bagrodia (UC San Diego), Dr. Clint Cary (Indiana University), and Dr. Gagan Prakash (Tata Memorial Hospital) discuss the diagnosis and management of metastatic testicular cancer. --- SHOW NOTES First, the doctors discuss when orchiectomy and retroperitoneal lymph node dissection (RPLND) are necessary. They also summarize the relevant tumor markers and laboratory values to obtain and discuss the possibility of teratomas. Then, they examine the role of chemotherapy in the treatment of metastatic testicular cancer. The doctors then transition to explaining how to manage patient expectations before orchiectomy and RPLND. They discuss the various complications of the procedure as well as the potential benefits of using 3D models and animations to explain the surgery to patients. They also cover the complications of chemotherapy as well and emphasize the importance of preparing the patient for the side effects of all treatment combinations. Then, they delve into specific surgical techniques that can prevent surgical complications when resecting testicular cancers. Finally, the doctors discuss the importance of gaining experience with observing RPLND and training at a high volume urology center to gain more insight into the complexities of the operation. Finally, they emphasize the importance of having an experienced team to handle the operation.