“I think we really hit upon how we work closely together in renal cell cancer—urothelial cancers in particular,” says Joelle Hamilton, MD.
In this video, Joelle Hamilton, MD, discusses the Specialty Networks Spring 2023 National Conference presentation "Multi-Disciplinary Uro-Onc Care: Creating a Collaborative Relationship for Patient Success.” Hamilton is a medical oncologist at Urology Centers of Alabama in Homewood.
I really appreciated the fact that we had such a broad spectrum of those of us who care for patients with urologic malignancies. The most common interaction that I have is with urologists, and I also work collaboratively very closely with our colleagues on radiation oncology. I really appreciated that we are all very aware of how we work closely together to take care of our patients with prostate cancer, whether that is kind of a higher risk, localized prostate cancer where we're combining systemic therapies and local therapy, or metastatic cancer, where probably it's mainly a systemic therapy but definitely a role for radiation and/or surgery. I think we really hit upon how we work closely together in renal cell cancer—urothelial cancers in particular. A few of the topics that we addressed are for individuals with renal cell cancer in the adjuvant setting. So whether that is stage 2 with our grade 4 sarcomatoid pathology or stage 3 and higher, or node-positive cancers or even patients who've had a metastasectomy, we do have improved progression-free survival when we consider intravenous pembrolizumab [Keytruda] for a year afterwards. So that was one of the topics discussed; when does a patient need to see a medical oncologist in a setting of renal cancer? We also talked about the importance of a close working relationship in bladder cancer or upper tract urothelial cancers. So whether it is neoadjuvant intravenous chemotherapy, like cisplatin, followed by cystectomy, and then perhaps adjuvant nivolumab [Opdivo], or even, say, when we have a non-invasive, high-grade urothelial cancer. And I think we also really are going to probably collaborate a lot in the future with non–muscle-invasive space, high-grade urothelial cancers with intravesical devices and intravenous, whether it's immunotherapy or another type of systemic therapy. I think just the importance of having that very close relationship is crucial. I know some of my colleagues across the country, my urologist friends who are giving immunotherapies in their clinic, whether it be a trial or off protocol, I know that they all have their "specialist du jour" that they call, particularly if the patient has cardiac, gastrointestinal, pulmonary, endocrine, or dermatologic toxicity. Having those folks that you know well—and I can't emphasize enough having their cell number to reach out to when you have questions or patient issues—is such a crucial part of taking care of patients well.
This transcript was edited for clarity.