番茄社区

In this exclusive 番茄社区 video, Alexander Kutikov, MD, chair of the department of urology at the Fox Chase Cancer Center in Philadelphia, discusses the future of urologic oncology and what clinicians need to focus on in terms of risk stratification and the amount of treatment patients receive.

The interview took place at the recent American Urological Association annual meeting.

Following is a transcript of his remarks:

My name is Alexander Kutikov, I'm chair of urology at the Fox Chase Cancer Center, and one of the leads of the newly formed Fox Chase/Temple Urologic Institute.

And as far as where urologic oncology is going, I think it's a two-pronged effort. We're certainly undertreating some patients and we need novel modalities, and we need more aggressive treatments for a lot of our patients as we look to the future.

But also there's overtreatment. And it's really going to be about risk stratification and really understanding who needs more aggressive treatments and better treatments and who really need less treatments.

And this is true in the kidney cancer space with small renal masses. We know that a lot of these patients receive a lot of treatment where we may, especially in the elderly and the frail, it's better to leave those patients alone.

This is true for prostate cancer, with low-risk prostate cancer, where we are really trying to identify and better risk-stratify the patients that could be left alone, where their destiny really doesn't change if we intervene on their disease. But their quality of life is absolutely lowered by some of the treatments that we offer.

And this is true of bladder cancer as well, especially de-escalation of care in terms of cystectomy, removal of the bladder -- can we spare bladders that in the past we can't spare?

So, urologic oncology, as we move forward, is really trying to de-escalate care in patients who don't need the care and escalate care in patients who need more aggressive treatments.

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