I joined the staff at Fox Chase Cancer Center in 1983 as the first dedicated urologist. This gave me the opportunity to build a strong urology program--one that provides expert surgical care for patients with urologic cancers and their related medical issues. After all this time, the best part of my job is the smiles and gratitude I get from patients and family because of the effort put forth on their behalf, regardless of the eventual outcome.

During my training, I chose the field of urology because it offers a surgical subspecialty that encompasses many physiologic problems that require long-term 'medical' as well as surgical options. I have the opportunity for long-term follow-up of patients, rather than simply performing an operation and then sending them to another doctor for long-term care. Also, the immediate relief sometimes offered to patients feeds my own need for more immediate gratification with patient care and outcome than other areas of medicine.

I look at the whole patient and try to understand their needs within the realm of their family and their specific stage of cancer. I then try to choose the best long-term approach for every patient. I believe that our multispecialty approach to cancer benefits patients. For example, we encourage our prostate cancer patients to consider all types of treatment available to them at Fox Chase, as well as outside of the institution, prior to a final decision.

As a full-time physician at Fox Chase, I have no financial pressure to suggest surgery over a non-surgical option. Rather, I offer the best treatment plan individually tailored to the needs of the patient. I also stress quality as well as quantity of life issues. I am not afraid to tell a patient that surgery is not indicated if it is not in their best interest--even if they had decided that was how they wanted to be treated prior to our consultation. Learning whom to operate on and how to operate, but also whom not to operate on is a skill learned over many years.

I have been a urologist for 3 decades and have seen advances in technology that are too numerous to mention--but all have helped surgeons improve outcomes. Improvements in managing infections with new antibiotics have changed the face of modern urology. Improvements in both early diagnosis and treatment of almost all of the tumors urologists treat are apparent and constantly moving toward to the goal of cure without toxicity (or side effects).

An excellent example of technological advances is the DaVinci-S surgical robot which allows me to perform laparoscopic anatomical nerve sparing prostatectomies in appropriate patients. Learning this technical skill has been a worthwhile endeavor as it has improved the quality of care I can deliver to those patients with early stage prostate cancer.