Mark Soloway

Mark S. Soloway is a leading authority in urologic cancer,[1] researcher, former departmental chair, medical professor and invitational lecturer. He served as Chairman of the University of Miami Miller School of Medicine Department of Urology[2] and is currently a professor at the Miller School of Medicine. Born in Cleveland, Soloway received his B.Sc. from Northwestern University in Chicago (1961–1964). He completed his M.D. and residency at Case Western Reserve University School of Medicine in Cleveland, Ohio (1964–1970). He completed a fellowship at the National Cancer Institute of the National Institute of Health in Bethesda, MD (1970–1972). Soloway has received numerous awards for his work as a researcher and teacher, These awards are American Urological Association's Gold Cystoscope award, Mosby Scholarship for Scholastic Excellence award (1967), North Central Section of American Urological Association Traveling Fellowship award (1972)[3] and many others. These are outstanding achievements for an individual who has contributed most to the field of urology within ten years of completion of his residency program” (1984).[4]

Mark Soloway
Born
Cleveland, Ohio
EducationMD (1970)
Alma materNorthwestern University, Case Western Reserve
OccupationUrologic Oncology

Honors and awards

Soloway has received numerous honors and awards. These include the Gold Cystoscope Award from the American Urological Association in 1984, and the Presidential Citation of 2008[5] from the American Urological Association for his contributions to clinical urology and his educational innovations. Soloway was honored with a corresponding membership in the German Urology Association and the Dutch Urologic Society.[6] Soloway has been the visiting professor in over 50 academic programs both nationally and internationally and a guest speaker at national meetings in over 30 countries.[7][8][9] He was one of the founding members of the International Urologic Research Society. In 2004–2005 Soloway served the chair of the first International Panel on Cancer,[10] a project that included fourteen individual panels and over one hundred experts in different aspects of bladder cancer. The Societe Internationale de Urologie (the governing body of the International Panel on Bladder Cancer)[11] and the International Consultation of Urologic Diseases have jointly commissioned him again to Chair the second International Panel on Bladder Cancer.[12]

Research

Work at National Cancer Institute

Soloway's contribution to the field of bladder cancer began when he was a Clinical Associate at the National Cancer Institute of the National Institutes of Health.[13] While working at the NCI, Soloway was instrumental in developing a unique carcinogen-induced animal model for urothelial carcinoma.[14] This FANFT-induced primary and transplantable tumor model allowed him to investigate the efficacy of several investigational chemotherapeutic drugs for the treatment of bladder cancer.[15][16][17] Today, even after more than thirty years, this transplantable tumor model, now established as the MBT-2 tumor and its more malignant derivative MBT-9, are still being used by researchers all over the world to test experimental and targeted therapeutic agents. Soloway's research was supported by NIH funding throughout his residency in Urology at Case Western Reserve University and as faculty at the University of Tennessee Center for the Health Sciences.

Orthotopic Development

At the same time, Soloway was studying the usefulness of different investigational drugs in the animal model, he was also testing the hypothesis that the high rate of local recurrence of urothelial tumors may be the result of implantation of tumor cells on the urothelial surface following endoscopic resection of bladder tumors.[18] By developing an orthotopic bladder implantation animal tumor model, Soloway was able to establish that an injury to the urothelium created the necessary environment for tumor implantation and the scientific evidence in support of early intravesical chemotherapy following transurethral resection of a bladder tumor.[19][20][21] Twenty years later, a series of prospective randomized clinical trials have firmly established the benefit of post-TURBT intravesical chemotherapy.[22] It is also noteworthy that the orthotopic tumor model developed by Soloway is still the only tumor model that recapitulates the development of muscle-invasive bladder cancer in patients.

Use of Flexible Cystoscopy

Soloway was one of the first urologic oncologists to use flexible cystoscopy as an integral part of his office practice; today, the majority of the world uses it.[23]

Transrectal Ultrasonography for Prostate Cancer

In contrast to Soloway's work in bladder cancer, which was largely initiated by laboratory work using his animal model, his research on prostate cancer is clinically oriented and has focused in six different areas: the use of transrectal ultrasonography for the diagnosis of prostate cancer; the development of the periprostatic nerve block to decrease pain during biopsy; the evaluation of the role of androgen deprivation prior to radical prostatectomy for locally advanced prostate cancer; the importance of quality of life in treatment decision-making; the recognition of active surveillance as a management strategy for low-risk prostate cancer; and surgical techniques for total prostatectomy.

Always fascinated with new technology, very early on Soloway saw the potential of ultrasound guided biopsies over the digitally guided biopsies and soon he began promoting the TRUS biopsy method to urologists for their outpatient clinics.[24][25][26] In an effort to minimize the discomfort from biopsies, he also popularized the use of the periprostatic nerve block.[27][28] This procedure is used to minimize the pain associated with a prostate biopsy and is used in over 500,000 procedures annually in the US alone.

Evaluating Androgen Deprivation

During the 1980s and early 1990s, a high percentage of patients with prostate cancer were diagnosed with locally advanced disease. Anecdotally, many of these patients were given the newly developed LHRH analogs as initial treatment for their disease. Since their initial responses were impressive, it seemed reasonable to give androgen deprivation prior to prostatectomy with the hope of improving progression free and overall survival.[29][30] Enlisting the cooperation of a multi-institutional group, Soloway initiated a prospective randomized trial to test the efficacy of neoadjuvant androgen deprivation therapy. This randomized trial showed that although the surgical margin rate was lower for men who had received androgen deprivation prior to prostatectomy, there was no improvement in progression free or overall survival.[31][32] Other groups who later performed similar studies have substantiated these results.

Positive Surgical Margins

Another focus of Soloway's clinical research has been on the relationship between positive surgical margins and the preservation of the bladder neck and approach to the seminal vesicles. His first publication in 1996 on this topic detailed pathological analysis of the location and consequences of positive surgical margins.[33] In a more recent paper published in the Journal of Urology, he reported that the recurrence rate was only 20% in his patient cohort with a positive surgical margin and therefore, the routine adjuvant radiation therapy would over treat 80% of the patients.[34][35] On the subject of urinary continence, for over 20 years, Soloway has been a proponent of bladder neck preservation for enhancing urinary continence without compromising cancer control for patients undergoing radical prostatectomy.[36][37] Soloway and M. Manoharan have worked together to minimize the side effects of a radical prostatectomy. They have popularized the lower abdominal transverse incision to minimize pain and enhance recovery as well as providing a smaller, less obvious scar.[38] They have shown that most patients do not require a drain[39][40][41] and an inguinal hernia can be easily be repaired at the same operation of a radical prostatectomy using this transverse incision.[42][43]

Watchful Waiting Approach

With the advent of PSA and early detection of prostate cancer, Soloway, concerned about the risk of overtreatment, has been an advocate of active surveillance for patients with low-risk, low volume Gleason 6 prostate cancer who are compliant with careful monitoring. In 2000 he published his first series of patients including those eligible for watchful waiting, as well as active surveillance and reported that only a few of these patients went on to have treatment.[44] Using a tighter definition for active surveillance, Soloway's group reported that less than 15% of these prostate cancer patients went on to treatment.[45] This series was updated recently in European Urology with the addition of quality of life parameters and a constant of 15% progressing to treatment.

Work on Renal Tumors

Over the last two decades, Soloway has worked closely in tandem with a former resident and co-faculty member, Gaetano Ciancio on kidney cancer. Together they have revolutionized the surgical approach for large renal tumors, particularly those in which the tumor extends into the vena cava. Ciancio is a urologist, who is fellowship trained in renal and liver transplantation. More than 10 years ago, Soloway and Ciancio worked as a team to reduce the perioperative morbidity and mortality associated with these large tumor masses. Their idea was to incorporate surgical techniques from liver transplantation to increase the exposure of the vena cava with the anticipation that this would reduce blood loss and obviate circulatory arrest. Together they have published over 35 articles beginning with their first description of this technique in 2000.[46] Their most recent publication[47] is an update of their step-by-step approach toward minimizing complications related to renal cell carcinoma with vena cava thrombus. This series emphasizes the improvements in safety and reduction in operative mortality and morbidity related to their technique. Since most tertiary medical centers where these procedures are likely to be performed now have liver transplant surgeons, this technique can easily be duplicated.

Cancer Support Group

Despite his busy clinical practice and research programs in the mid-1980s, Soloway recognized the need to address quality of life issues associated with the treatments for prostate cancer. He developed one of the first prostate cancer support groups in the country in Memphis, Tennessee. In 1992, he co-authored one of the first QOL studies[48] examining patient preference related to LHRH versus orchiectomy for patients with advanced disease. In 1995 Soloway and his colleagues reported on a study that looked at patients with localized prostate cancer and the QOL implications of surgical management vs. radiation therapy.[49] Recognizing that prostate cancer is a couple's disease, Soloway also studied the psychosocial and sexual implications of this disease on patients and their partners.[50]

References

  1. Sun Sentinel, 1/18/2006. http://articles.sun-sentinel.com/2006-01-18/news/0601170579_1_bladder-cancer-urine-test-new-test
  2. Miami Herald, 11/26/2007. http://www.miamiherald.com/2007/11/26/v-print/320778/mystery-cure.html
  3. North Central Section of the American Urological Association Awards. 2011. Accessed October 11, 2011. http://www.ncsaua.org/meetings/awards.aspx
  4. American Urological Association Gold Cystoscope Award Recipients List. 2011. Accessed October 11, 2011. "AUA - Awards". Archived from the original on March 30, 2012. Retrieved October 24, 2011.
  5. American Urological Association Presidential Citation Award Recipients List. 2011. Accessed October 11, 2011. "AUA - Awards". Archived from the original on March 30, 2012. Retrieved October 24, 2011.
  6. Mark Soloway Leads German Urological Association Conference. 2011. Accessed October 11, 2011. "Berlin 2011 | SIU World Meeting". Archived from the original on October 29, 2011. Retrieved October 24, 2011.
  7. Mark Soloway Recognized as World-Renown Urologic Oncologist. 2011. Accessed October 11, 2011. (http://www.urologysurgeon.com.au/about)
  8. Mark Soloway Speaks Nationally and Internationally. 2011. Accessed October 11, 2011. "Archived copy" (PDF). Archived from the original (PDF) on March 31, 2012. Retrieved October 24, 2011.{{cite web}}: CS1 maint: archived copy as title (link)
  9. BCAN (Bladder Cancer Advocacy Network) Describes Dr. Soloway’s Achievements. 2011. Accessed October 11, 2011. "Mark Soloway, M.D., FACS at Bladder Cancer Advocacy Network – BCAN". Archived from the original on April 25, 2012. Retrieved October 24, 2011.
  10. Mark Soloway Leads International Panel on Urologic Cancer. 2011. Accessed October 11, 2011. "Research | Sylvester". Archived from the original on November 28, 2010. Retrieved October 24, 2011.
  11. Mark Soloway Speaks at the Societe Internationale de Urologie Conference. 2011. Accessed October 11, 2011. "Archived copy" (PDF). Archived from the original (PDF) on March 31, 2012. Retrieved October 24, 2011.{{cite web}}: CS1 maint: archived copy as title (link)
  12. Mark Soloway Co-Chairs the International Consultation of Bladder Cancer. 2011. Updated July 14, 2011. http://www.icud.info/futureconsultations.html
  13. Soloway, M.D.: Rationale for intensive intravesical chemotherapy. In: Kueth, K.H., Debruyne F.M.G., Schroeder, F.S., Splinter, T.Q.W., Wagener, T.D.J. (ed): Progress and Controversies in Oncological Urology. Alan R. Liss, Inc., New York, pp. 287–296, 1984.
  14. Soloway MS: The use of an animal model to gain insights into bladder cancer therapy. In: Testicular Cancer and Other Tumors of the Genitourinary Tract. (ed): Pavone-Macaluso, M., Smith, P.H. and Bagshaw, M.A. Plenum Publishing Corp., New York, London, Washington, D.C., pp. 315–327, 1985.
  15. Soloway MS, Kurth, K.H., Herr, H., Huland, H., Denis, L., Suzuki, K., Blandy, J., Hisazumi, H., Koontz, W., and Tsugawa, R.: Surgical techniques in the management of patients with superficial bladder cancer. In: Developments in Bladder Cancer. (ed): Denis,L., Niijima, T., Prout, G. Jr., and Schroeder, F.H. Progress in Clinical and Biological Research, Volume 221. Alan R. Liss, Inc., New York, pp. 123–132, 1986.
  16. Soloway MS: Should all superficial bladder tumors be treated with intravesical therapy. In: Progress in Clinical and Biological Research, Volume 303; Therapeutic Progress in Urological Cancers. (ed): Murphy, G.P. and Khoury, S. Alan R. Liss, Inc., New York, pp. 491–501, 1989.
  17. Soloway MS: Studien der National Prostatic Cancer Project and Treatment Group des fortgeschrittenen prostatakarzinoms. In: Aktuelle Therapie des prostatakarzinoms. (ed): R. Ackermann, J. Altwein. Springer-Verlag, Berlin, pp. 361–369, 1991.
  18. Soloway MS: Intravesical chemotherapy in superficial bladder cancer. In: Genitourinary Cancer - Contemporary Issues in Clinical Oncology. (ed): Garnick, Mark B. Churchill Livingston, New York, pp. 163–192, 1985.
  19. Aso, Y., Anderson, L., Soloway, M., Bouffioux, C., Chisholm, G., Debruyne, F., Kawai, T., Kurth, K.H., Maru, A., and Straffon, W.G.E.: Prognostic factors in superficial bladder cancer. In: Developments in Bladder Cancer. (ed): Denis, L., Niijima, T., Prout, G. Jr., and Schroeder, F.H. Progress in Clinical and Biological Research, Volume 221. Alan R. Liss, Inc., New York, pp. 257–269, 1986.
  20. Soloway MS: The case for chemotherapy as the initial management of patients with carcinoma in situ of the urinary bladder. In: Controversies in Urology. (ed): Carlton, C.E., Jr. Yearbook Medical Publishers, Chicago, pp. 237–241, 1989.
  21. Soloway MS: Studien der National Prostatic Cancer Project and Treatment Group des fortgeschrittenen prostatakarzinoms. In: Aktuelle Therapie des prostatakarzinoms. (ed): R. Ackermann, J. Altwein. Springer-Verlag, Berlin, pp. 361–369, 1991.
  22. Soloway MS, Masters S. Urothelial susceptibility to tumor cell implantation: influence of cauterization. Cancer, 46(5):1158–1163, 1980.
  23. Nieder AM, Soloway MS. Cystoscopy In. Lerner SP, Schoenberg MP, Sternberg CN. Textbook of Bladder Cancer, 2006. Taylor and Francis, England. pgs 179–185.
  24. Hardeman SW, Wake, R.W., and Soloway MS. The role of prostate specific antigen and transrectal ultrasound in the diagnosis and management of prostate cancer. Postgraduate Medicine, 86:197-208, 1989.
  25. Hardeman SW, Wake RW, Soloway MS. Two new techniques for evaluating prostate cancer. The role of prostate-specific antigen and transrectal ultrasound. Postgrad Med, 86(2):197–198, 201, 204 passim, 1989.
  26. Hardeman SW, Causey JQ, Hickey DP, Soloway MS. Transrectal ultrasound for staging prior to radical prostatectomy. Urology, 34(4):175–180, 1989.
  27. Soloway MS, Obek C. Periprostatic local anesthesia before ultrasound guided prostate biopsy. J Urol, 163(1):172–173, 2000.
  28. Alavi AS, Soloway MS, Vaidya A, Lynne CM, Gheiler EL. Local anesthesia for ultrasound guided prostate biopsy: a prospective randomized trial comparing 2 methods. J Urol, 166(4):1343–1345, 2001.
  29. Soloway MS, Sharifi R, Wajsman Z, McLeod D, Wood DP, Jr., Puras-Baez A. Randomized prospective study comparing radical prostatectomy alone versus radical prostatectomy preceded by androgen blockade in clinical stage B2 (T2bNxM0) prostate cancer. The Lupron Depot Neoadjuvant Prostate Cancer Study Group. J Urol, 154(2 Pt 1):424–428, 1995.
  30. Soloway MS, Pareek K, Sharifi R, Wajsman Z, McLeod D, Wood DP, Jr., Puras-Baez A. Neoadjuvant androgen ablation before radical prostatectomy in cT2bNxMo prostate cancer: 5-year results. J Urol, 167(1):112–116, 2002.
  31. Soloway MS, Sharifi R, Wajsman Z, McLeod D, Wood DP, Jr., Puras-Baez A. Randomized prospective study comparing radical prostatectomy alone versus radical prostatectomy preceded by androgen blockade in clinical stage B2 (T2bNxM0) prostate cancer. The Lupron Depot Neoadjuvant Prostate Cancer Study Group. J Urol, 154(2 Pt 1):424–428, 1995.
  32. Soloway MS, Pareek K, Sharifi R, Wajsman Z, McLeod D, Wood DP, Jr., Puras-Baez A. Neoadjuvant androgen ablation before radical prostatectomy in cT2bNxMo prostate cancer: 5-year results. J Urol, 167(1):112–116, 2002.
  33. Watson RB, Civantos F, Soloway MS. Positive surgical margins with radical prostatectomy: detailed pathological analysis and prognosis. Urology, 48(1):80-90, 1996.
  34. Wieder JA, Soloway MS. Incidence, etiology, location, prevention and treatment of positive surgical margins after radical prostatectomy for prostate cancer. J Urol, 160(2):299-315, 1998.
  35. Simon MA, Kim S, Soloway MS. Prostate specific antigen recurrence rates are low after radical retropubic prostatectomy and positive margins. J Urol, 175(1):140–144, 2006.
  36. Shelfo SW, Obek C, Soloway MS. Update on bladder neck preservation during radical retropubic prostatectomy: impact on pathologic outcome, anastomotic strictures, and continence. Urology, 51(1):73-78, 1998.
  37. Soloway MS, Neulander E. Bladder-neck preservation during radical retropubic prostatectomy. Semin Urol Oncol, 18(1):51-56, 2000.
  38. Manoharan M, Gomez P, Sved P, Soloway MS. Modified Pfannenstiel approach for radical retropubic prostatectomy. Urology, 64(2):369-371, 2004.
  39. Savoie M, Soloway MS, Kim SS, Manoharan M. A pelvic drain may be avoided after radical retropubic prostatectomy. J Urol, 170(1):112–114, 2003.
  40. Araki M, Manoharan M, Vyas S, Nieder AM, Soloway MS. A pelvic drain can often be avoided after radical retropubic prostatectomy--an update in 552 cases. Eur Urol, 50(6):1241–1247, 2006.
  41. Sachedina N, De Los Santos R, Manoharan M, Soloway MS. Total prostatectomy and lymph node dissection may be done safely without pelvic drainage: an extended experience of over 600 cases. Can J Urol, 16(4):4721–4725, 2009.
  42. Manoharan M, Gomez P, Soloway MS. Concurrent radical retropubic prostatectomy and inguinal hernia repair through a modified Pfannenstiel incision. BJU Int, 93(9):1203–1206, 2004.
  43. Manoharan M, Vyas S, Araki M, Nieder AM, Soloway MS. Concurrent radical retropubic prostatectomy and Lichtenstein inguinal hernia repair through a single modified Pfannenstiel incision: a 3-year experience. BJU Int, 98(2):341-344, 2006.
  44. Neulander EZ, Duncan RC, Tiguert R, Posey JT, Soloway MS. Deferred treatment of localized prostate cancer in the elderly: the impact of the age and stage at the time of diagnosis on the treatment decision. BJU Int, 85(6):699–704, 2000.
  45. Soloway MS, Soloway CT, Williams S, Ayyathurai R, Kava B, Manoharan M. Active surveillance; a reasonable management alternative for patients with prostate cancer: the Miami experience. BJU Int, 101(2):165–169, 2008.
  46. Ciancio G, Hawke C, Soloway MS. The use of liver transplant techniques to aid in the surgical management of urological tumors. J Urol,164(3 Pt 1):665–672, 2000.
  47. Ciancio G, Gonzalez J, Shirodkar SP, Angulo JC, Soloway MS: Liver transplantation techniques for the surgical management of renal cell carcinoma with tumor thrombus in the inferior vena cava: Step-by-step description. Eur Urol (in print).
  48. Cassileth BR, Soloway MS, Vogelzang NJ, Chou JM, Schellhammer PD, Seidmon EJ, Kennealey GT. Quality of life and psychosocial status in stage D prostate cancer. Zoladex Prostate Cancer Study Group. Qual Life Res, 1(5):323–329, 1992.
  49. Braslis KG, Santa-Cruz C, Brickman AL, Soloway MS. Quality of life 12 months after radical prostatectomy. Br J Urol, 75(1):48–53, 1995.
  50. Soloway CT, Soloway MS, Kim SS, Kava BR. Sexual, psychological and dyadic qualities of the prostate cancer 'couple'. BJU Int, 95(6):780–785, 2005.

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