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surgery, then we moved to lap and then we moved to robot. So, I have a global view of all the surgery. But, since I told you, I think that Urology is a very nice speciality, because you are not only a surgeon but you are also a doctor. You take care of your patients, you diagnose them, you follow them and you treat them. For me, being with the patient through all the oncological process, is something really inspiring. I am treating metastatic patients, I am treating patients with advanced disease, I am treating patients with localized disease and in every single stage you learn and you need different skills, not only surgical skills but different skills. This is really inspiring for me and this is probably the main reason for choosing Uro-Oncology.
T.S.: In your opinion, what will be the most important step in Uro-Oncology in the close future?
M.R.: I would say that there will be a lot of them. I think that in Oncology in general, if we were honest enough, our main goal should be prevention and early detection. We should be best on that. I will tell you that, in the future there will be targeted therapies, precision oncology, minimal invasive surgery, molecular imaging. For sure all these will be the future of our specialty. But, being honest, we should be the best in prevention and early detection. Because, this must be the focus of all of us, dedicated to oncology. Just to try to prevent the disease or being able to treat it when it’s really curable, in the very beginning. But obviously, I think that there are a lot of things coming, not only in Uro-Oncology but in Oncology in general, like precision medicine, targeted therapies, to learn how genetics influence the disease and how to target these genetic footprints that different tumours have.
I think this will be the future. Also, in our specialty technology is important. We will see revolution in technology, not only at the OR but also in the imaging. For example, now we have molecular imaging, but I am sure it will improve and it will be even better. Also, for example, there will be ways on how to improve in our pathological diagnosis. So, I think there are a lot of things that will come to us and they will help us to treat our patients better.
T.S.: When it comes to Uro-Oncology, how important is it to have a multi-disciplinary approach? What are the keys of the effective cooperation between doctors of different specialties?
M.R.: The multidisciplinary approach in Oncology is crucial. Because treating patients in a multidisciplinary way gives you better comprehensive treatment planning. So, you take into account all the perspectives and then you can give a personalized decision for every single patient, based on all the opinions and knowledge. You have all the different knowledge of different specialities, like medical oncologists, radiation oncologists, pathologists, radiologists, nurses, psychotherapists, psychologists, all the components of the multidisciplinary team and this improves the quality of the decisions and the recommendations that you make for the patient. For me it is crucial and it is the only way to understand how to provide the best healthcare to the patients.
T.S.: During the past few years, there
have been advances in the technology of urological surgical oncology, for example in robotic surgery. How much these advances have improved, according to your opinion, the oncological outcomes of the patients, compared to the past?
M.R.: As I told you I can speak properly, because when I started to be trained, I was doing open surgery. So, I know open surgery, I know lap and now I know the robot. I think that the robotics brought a revolution in the way that we do the surgeries. It is more precise; it improves our dexterity and shortens the learning curve, for example. Robotics allows you to reduce some complications, for example blood loss, or it allows you to speed recovery, not only the discharge of the patients from the hospital but even the incorporation of the patients in their normal life. This is a revolution. But it’s true that it is not only the robot.
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