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Newcastle Herald
Newcastle Herald
Damon Cronshaw

'Barely changed in 100 years': the doctor doing surgeries like her ancestor

Professor Alison Blatt and her great grandfather Paul Blatt with his family. Alison and Paul were both urologists. Pictures supplied
Professor Alison Blatt and her team will conduct research on using MRIs for bladder cancer diagnosis. Picture supplied
Paul Blatt was a urologist in Austria in the 1930s before the Nazis ousted him for being Jewish. Picture supplied
Paul Blatt and his family. Picture supplied
Paul Blatt and his sons John and Franz. Picture supplied

When Alison Blatt says the surgery technique for bladder cancer has "barely changed in 100 years", her great-grandfather comes to mind.

Paul Blatt was a Jewish urologist in Vienna, who lost his position due to Nazi persecution in 1938.

Luckily, he was able to move with his family to Paris. In 1939, he emigrated to the US and settled in Cincinnati.

Dr Blatt, director of research in John Hunter Hospital's urology department, followed in the footsteps of her forebear.

The associate professor, of University of Newcastle and Hunter Medical Research Institute (HMRI), said it wasn't a deliberate decision to become a urologist like her relative.

But the parallels are notable, given they both did bladder cancer surgery.

"There have been big improvements in the technology - the lights, sensors and cameras," Dr Blatt said.

"And we now have fibre optics, so it has changed a great deal.

"But in the very basic concept of putting a camera inside the bladder, a scope we call it, and removing the cancer piece by piece - that concept hasn't changed.

"If you look at the historical pictures of the instruments, they don't look that different either."

The first camera to go through the urethra and look in bladders was created in 1878, but the earliest prototype was Bozinni's 1806 urethral viewing tube.

Dr Blatt said it was a "common procedure for urologists like me to go into bladders and remove bladder tumours".

She said there wasn't "chemotherapy or radiation that replaces us going in the bladder with a camera, taking the tumour out and looking at it under the microscope."

Given this, Dr Blatt is seeking to investigate a way to use MRI (magnetic resonance imaging) for bladder cancer diagnosis.

"MRI is a common thing in looking for prostate cancers, but we still need to put in a biopsy to make the diagnosis.

"It might be that bladder MRI will be similar. That it won't necessarily make the diagnosis, but will give us more information."

She said most bladder cancers were superficial - "maybe 70 per cent of them".

"When I'm talking to patients about it, I often liken it to skin cancer," she said.

"Once you've got one, you've got a pretty high chance you'll recur.

"So these patients get lots of cystoscopies to check for recurrence, sometimes awake and a lot of times under anaesthetic.

"We don't have an imaging technique that replaces that."

Her research team aims to assess whether MRI could do this.

"It'd be amazing if it could. At the moment, it probably won't," she said.

"But there might be a time where MRIs could supplement our surveillance cystoscopies, so we don't need to do them quite as frequently."

She said bladder cancer was "a significant cause of mortality and morbidity in Australia, and deserves a lot more attention than it gets.

"We desperately need more funding to support this trial."

About 680 people in Hunter New England were diagnosed with bladder cancer from 2017 to 2021, and 311 died from the disease over this period.

More than 3100 people were diagnosed with bladder cancer and more than 1060 died from the disease in Australia last year.

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