S. Machele Donat, MD, FACS

When treating patients with superficial bladder cancer, I use conservative therapies and preventive approaches whenever possible. For patients with invasive bladder cancer, I have extensive experience in bladder-sparing surgery, and often use nerve-sparing techniques, which can help preserve sexual and urinary function.

Some patients require an operation to remove the bladder (cystectomy), and I have expertise in urinary reconstructive techniques such as continent urethral diversion (neobladder), in which a new bladder is constructed from a segment of the intestine and connected to the urethra; continent stomal diversion, in which a segment of intestine is used to form a catheterizable pouch; and ileal conduits, in which a segment of the small intestine is used to create a channel through which urine is drained to the skin and into a collection bag.

For patients with kidney cancer, it is often important to preserve kidney function because many have a pre-existing kidney disease, high blood pressure, or diabetes. Whenever possible, I also perform kidney-sparing surgery in patients with renal cell cancers to preserve their renal function, and I am involved in research studies at Memorial Sloan Kettering evaluating ablative therapies, which use heat or cold to destroy tumor cells.

In addition, I am involved in a number of research studies, some of which are examining the role that heredity plays in tumor recurrence and progression in certain forms of bladder cancer. I am also helping to establish a registry of familial and atypical bladder and upper urinary tract cancers at Memorial Sloan Kettering. I am evaluating the effectiveness of several new imaging approaches for diagnosing genitourinary cancers as well as a blood test for detecting metastatic bladder cancer, and I am helping design the protocols that will guide the Center’s acquisition and preservation of tissue, blood, and urine samples; these may be used in future studies on the prevention and treatment of genitourinary cancers. I am also a leader in research studies looking at our ability to minimize postoperative complications, shorten hospital stays for all our major surgical operations, and improve patients’ quality of life following treatment for their genitourinary cancer.