Selecting clinical research projects for the urologic oncologist

Abstract

E very urologist interested in an academic career faces the difficult question of how to pick a research project. This is especially true in a diverse and multidisciplinary field such as urologic oncology. The first decision the young urologic oncologist must make is whether to pursue laboratory or clinical investigation. Progress results from iterative basic science and clinical research studies. In my opinion, one cannot do both well. Bench and patient-related investigations require hands-on participation. Both are labor intensive and demand total commitment to achieve excellence. Even orchestrating a project where the work and observations are made solely by others cannot be considered your research. Besides, the enjoyment and sense of accomplishment of investigation is derived from the anticipations, frustrations, and surprises of doing the research, as much as possible, by one’s self. Laboratory work yields insights into basic biology. Results lead to the next question requiring subsequent experiments, rewarded, hopefully, by new insight. Laboratory science is innovative and on the cutting-edge, uses advanced technology, and lends itself to rapid quantitative analysis (and publications). We applaud, support, and recognize the vitality of basic research for the future. For example, the benefits of presymptomatic testing to determine susceptibility to common cancers or identification of a tumor marker to define the risk of a given neoplasm are potentially substantial. In the long run, the identification of cancer susceptibility genes and tumor markers should permit us to develop new and effective therapies, so that we cannot only predict future risks, but also reduce those risks reliably and safely before disease occurs or progresses. However, advances in molecular biology (the current phase) and other basic sciences can only be translated to the patient through sound clinical studies-and the challenges of clinical research require skills and carry responsibilities that are different from those faced by the laboratory investigator. It is my observation that most urologic oncologists,