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I am Dr. Todd Brandt. I am a urologist. 

These are words I couldn't have imagined myself saying as I was growing up thinking about medicine as a career. 

And I have been asked many, many times why I went into urology as a medical specialty. In this podcast I attempt to explain how I got here. Why did I choose urology as a specialty? Why do I like it? Why, if you are someone with a urinary tract, should you care? Get it? Why Urology.

This podcast is a personal experiment in medical audio content. I make the obvious disclaimer that this is not medical advice. You should be going to your own physician for that.

These episodes are meant to educate, entertain, inspire or inform you in some way with urology as the launching point for each episode. Each episode is varied in format and length as I have experimented with content. 

Listen, follow, share, rate, review, know what to do.

If you have kidney stones, or prostate cancer, or another urologic health concern this podcast may help you.

If you have a loved one with any urologic health concern this podcast may help you. 

If you are someone who has asked, "How does my bladder do it's thing?", this podcast may help you.

If you make urine, or even if you don't, this podcast may help you.

Thank you for listening to this podcast. I do appreciated any feedback I get so please reach out to me at the link provided on this website. 

Be well,

Dr. Todd Brandt

Nov 8, 2020

Kidney cancer is most commonly a Renal cell carcinoma (RCC). Renal Cell Carcinoma, with its various subtypes, will be diagnosed in an estimated 73,750 adults (45,520 men and 28,230 women) in the United States this year. Kidney cancer is the sixth most common cancer for men, and it is the eighth most common cancer for women.

A Renal Cell Carcinoma begins in what I call the meaty portion of the kidney, the renal parenchyma. It grows slowly most of the time, forming a mass somewhere in the kidney. If the mass is less than 7 cm and there is no spread to lymph nodes or distant organs it is a stage 1 tumor. If it is larger than 7 cm, but still no spread, it becomes a stage 2 tumor.

Treatment for a Renal Cell Carcinoma, when it is large enough, approaching 2 cm or greater is to either remove or ablate the tumor. If possible, we can remove to tumor from the rest of the kidney leaving a large portion of the kidney intact and functional.

A stage 3 tumor is one of several subtypes.  It can invade into the fat around the kidney, called Gerota’s fascia, or into nearby lymph nodes, or, somewhat unique to kidney cancer, RCC has the ability to locally invade  the veins of the kidney with tumor thrombus that can propagate distally from the segmental renal veins to the main renal vein,  then into inferior vena cava (IVC) and all the way up to the heart into the right atrium. Around 5 % of cases of RCC are reported to have some level of venous invasion, most commonly into the segmental renal veins still within the kidney.

Medicine, they say, is both an art and a science.

The science part slowly removes the veil of mystery about disease. And once the mystery is gone, the art of medicine is at risk of fading in the background. It’s a tug of war, and science is always winning.

Because science is so powerful, there is a constant effort within medical education to make sure we are accepting and training young physicians who are caring, kind, and compassionate to balance the science with the art of medicine. It is a worthy goal.

In this episode I tell you how poetry can help.