Dr. Mark S. Soloway (born 1943) is an American urologist and professor emeritus of urology. His work has focused on prostate, bladder, and kidney cancer research. He served as a professor and chairman of the Department of Urology at the University of Miami Miller School of Medicine, and as chief of urologic oncology at Memorial Hospital in Hollywood, Florida.
Soloway graduated from Case Western Reserve University School of Medicine, in Cleveland, Ohio, and completed his residency in urology at University Hospitals of Cleveland. He completed a two-year surgery branch fellowship at the National Cancer Institute (NCI) of the National Institute of Health (NIH) in Bethesda, Maryland. There, he developed an animal model to investigate the efficacy of several investigative chemotherapeutic drugs for bladder cancer. He later returned to Case Western Reserve to complete his residency in urology.
Early life and education Mark Soloway was born in the Midwest in 1943. In 1964, he received a bachelor's degree in biology from Northwestern University in Chicago. He graduated from the Case Western Reserve University School of Medicine in Cleveland in 1968. While there, neurosurgeon Robert J. White reportedly influenced his interest in translational research.
Early career In 1968, Soloway conducted a two-year clinical fellowship at the National Cancer Institute (NCI) of the National Institutes of Health (NIH) in Bethesda, Maryland, specializing in urology. He developed an animal model for bladder cancer to research treatments for locally advanced or spreading bladder cancer. This model, induced by the chemical FANFT in mice, allowed him to investigate the effectiveness of several experimental chemotherapy drugs for bladder cancer. He also investigated the hypothesis that the high rate of local recurrence of bladder lining tumors may result from implantation of tumor cells on the urothelial surface following endoscopic resection of bladder tumors. By developing an animal test for bladder tumor placement, Soloway's research contributed to the understanding that urothelial injury creates an environment for tumor implantation and supported the use of early intravesical chemotherapy following transurethral resection of a bladder tumor. This included his research on cis-diamminedichloro platinum, a type of cancer drug known as cisplatin. After completing his fellowship, Soloway returned to Case Western Reserve to complete his residency in urology. He then joined the University of Tennessee. His research also included early studies on combining chemotherapy and radiation.
Later career From 1991 to 2010, Soloway served as a professor and the chairman of the University of Miami Miller School of Medicine Department of Urology. In 2014, he became chief of urologic oncology at Memorial Hospital in Hollywood, Florida. Soloway was among the early urologic oncologists to incorporate flexible cystoscopy into his practice.Nieder AM, Soloway MS. Cystoscopy In. Lerner SP, Schoenberg MP, Sternberg CN. Textbook of Bladder Cancer, 2006. Taylor and Francis, England. pgs 179–185.
Transrectal ultrasonography for prostate cancer Soloway's prostate cancer research includes work related to diagnosis, treatment, and management:
Diagnosis: He contributed to the introduction of transrectal ultrasonography for prostate cancer detection. Pain Management: He developed the periprostatic nerve block technique to reduce pain during prostate biopsies. Androgen Deprivation Therapy: Soloway studied the use of hormone therapy prior to surgery (radical prostatectomy) in patients with prostate cancer that had begun to spread. Quality of Life: He researched the importance of considering patient quality of life in treatment decisions. Active Surveillance: He supported the monitoring of low-risk prostate cancer as an alternative to immediate treatment, a method known as active surveillance. Surgical Techniques: His work included research on prostate cancer surgery techniques aimed at reducing complications and improving recovery.
Soloway promoted the TRUS biopsy method for use in urologists' outpatient clinics.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.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.Hardeman SW, Causey JQ, Hickey DP, Soloway MS. Transrectal ultrasound for staging prior to radical prostatectomy. Urology, 34(4):175–180, 1989. He also contributed to the popularization of the periprostatic nerve block to minimize biopsy discomfort.Soloway MS, Obek C. Periprostatic local anesthesia before ultrasound guided prostate biopsy. J Urol, 163(1):172–173, 2000.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.
Evaluating androgen deprivation During the 1980s and early 1990s, a high percentage of men with prostate cancer were diagnosed with locally advanced disease. LHRH analogues were increasingly used as initial treatment. To assess the efficacy of neoadjuvant androgen deprivation therapy before prostatectomy in improving progression-free and overall survival, Soloway initiated a prospective randomized trial involving a multi-institutional group.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. This trial indicated that while the surgical margin rate was lower for men who received androgen deprivation before prostatectomy, there was no improvement in progression-free or overall survival.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.
Positive surgical margins Soloway's clinical research has also focused on the relationship between positive surgical margins and the preservation of the bladder neck and approach to the seminal vesicles. His 1996 publication on this topic detailed pathological analysis of the location and consequences of positive surgical margins.Watson RB, Civantos F, Soloway MS. Positive surgical margins with radical prostatectomy: detailed pathological analysis and prognosis. Urology, 48(1):80-90, 1996. In a paper published in The Journal of Urology, he reported that the recurrence rate was 20% in his patient cohort with a positive surgical margin, suggesting that routine adjuvant radiation therapy might overtreat a majority of these patients.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.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. Regarding urinary continence, Soloway has advocated for bladder neck preservation during radical retropubic prostatectomy to enhance urinary continence without compromising cancer control.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.Soloway MS, Neulander E. Bladder-neck preservation during radical retropubic prostatectomy. Semin Urol Oncol, 18(1):51-56, 2000. Soloway and M. Manoharan collaborated on techniques to minimize the side effects of radical prostatectomy, including the use of a lower abdominal transverse incision to potentially reduce pain and enhance recovery.Manoharan M, Gomez P, Sved P, Soloway MS. Modified Pfannenstiel approach for radical retropubic prostatectomy. Urology, 64(2):369-371, 2004. Their work also indicated that many patients may not require a drainSavoie M, Soloway MS, Kim SS, Manoharan M. A pelvic drain may be avoided after radical retropubic prostatectomy. J Urol, 170(1):112–114, 2003.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.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. and that an inguinal hernia could be repaired during the same operation as a radical prostatectomy using this transverse incision.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.
Watchful waiting approach (active surveillance) With the advent of PSA testing and early detection of prostate cancer, Soloway advocated for active surveillance for patients with low-risk, low-volume Gleason 6 prostate cancer who adhered to careful monitoring, citing concerns about overtreatment. In 2000, he published a series of patients, including those eligible for watchful waiting and active surveillance, reporting that a low percentage of these patients subsequently underwent treatment.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. Using a stricter definition for active surveillance, Soloway's group reported that less than 15% of these prostate cancer patients proceeded to treatment.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. This series was later updated in European Urology to include quality of life parameters, maintaining a consistent rate of 15% progressing to treatment.
Work on renal tumors Soloway collaborated with Gaetano Ciancio, a former resident and co-faculty member, on kidney cancer research. They developed a surgical approach for large renal tumors, particularly those with tumor extension into the vena cava. Ciancio, a urologist fellowship-trained in renal and liver transplantation, worked with Soloway to reduce perioperative morbidity and mortality associated with these tumor masses. Their approach aimed to integrate surgical techniques from liver transplantation to increase vena cava exposure, intending to reduce blood loss and avoid circulatory arrest. They have published articles on this technique since 2000.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. Their recent publications provide updates on their step-by-step approach to minimizing complications related to renal cell carcinoma with vena cava thrombus, highlighting improvements in safety and reduction in operative mortality and morbidity. This technique is intended for duplication in tertiary medical centers with liver transplant surgeons.
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