The Role of Surgery
Amid these exciting advances surgical excellence remains the basis for all progress in our field. For instance the development of modern chemotherapy for germ cell tumors did not eliminate the need for surgery, but challenged surgeons to learn to operate on highly complex tumors while reducing the burden of surgical morbidity. Similarly, chemotherapy for bladder cancer has expanded the role of surgery, with resection of previously inoperable cancers now being common. Future leaders in urologic oncology must be highly skilled and experienced surgeons fully capable of open, free-hand, and robotic-assisted laparoscopic techniques and image-guided therapy in addition to being scholars well versed in the nuances of modern diagnostic and staging procedures, and fully appreciative of the benefits and limitations of all therapeutic modalities, including systemic therapy (immunological and biologic therapy as well as classic chemotherapy) and radiation therapy.
Complete training requires equally intensive exposure to research, whether in the molecular biology laboratory or in statistical methodology. Research experience not only prepares us for the future of cancer care, it also sharpens and disciplines our thinking during a lifetime career in urologic oncology.