Yu Guang Tan1, Jin Ye Yeo2
1Department of Urology, Singapore General Hospital, Singapore; 2TAU Editorial Office, AME Publishing Company
Correspondence to: Jin Ye Yeo. TAU Editorial Office, AME Publishing Company. Email: tau@amepc.org
Expert Introduction
Dr. Yu Guang Tan (Figure 1) is an Associate Consultant with the Department of Urology, Singapore General Hospital. He manages general urological conditions with a subspecialty interest in uro-oncology and minimally invasive surgery.
Dr Tan completed his medical training at the Yong Loo Lin School of Medicine, National University of Singapore in 2014, and graduated with distinction across the medicine and surgery tracks. He commenced his urology residency the following year, making him the youngest among the trainees. During his training, he was awarded the Outstanding Resident Award on multiple occasions and underwent the National Chief Resident Program of which he was recognized with the Outstanding Chief Resident Award. He completed his residency in 2023, where he was conferred the Gold Medalist for his top performance at the exit examination.
Dr Tan is a keen academic researcher, and he believes in incorporating evidence-based medicine to provide the best care for his patients. His main research interests include prostate and bladder cancers. He is highly recognized for his research works with over 40 peer-reviewed published manuscripts. He has won numerous international prizes, and has been regularly an invited speaker for regional conferences. He also completed a Masters in Clinical Investigation (MCI) and is currently the PI for several AI-related grants and projects.
Figure 1 Dr. Yu Guang Tan
Interview
TAU: What drove you into the field of uro-oncology?
Dr. Tan: I truly enjoy the breadth and depth that uro-oncology has to offer. The breadth – in terms of the various urological malignancies and organs involved; the depth – in terms of the burgeoning literature and evidence we have today. Uro-oncology is fast paced and exciting. We are seeing patients living longer with minimal treatment side effects and certainly, we are also improving our surgical outcomes. Beyond managing the disease, what I truly enjoy is building the relationships with my patients and their family members, and being there at their lowest and happiest moments.
TAU: What are your thoughts on how the field of uro-oncology has evolved over the years?
Dr. Tan: The pace of evolution of uro-oncology in recent years is astonishing, and we are seeing landmark practice-changing research published at such an expeditious rate. We are also seeing greater collaboration between institutions to demonstrate the replicability of results across different demographics and geographical locations. The field of uro-oncology is fast changing and is extremely exhilarating for any urologist wishing to pursue a parallel academic track. Ultimately, it is our patients who will benefit from these groundbreaking research outcomes, and we are seeing our patients living longer and with better quality of life even in advanced diseases.
TAU: How have advancements in minimally invasive surgery (MIS) improved patient care for prostate and bladder cancer?
Dr. Tan: Prostate cancer management has been the brainchild for the development of robotic surgery, and in the last decade we have witnessed the increasing role of MIS with focal therapy (FT) for prostate cancer, and I am a strong proponent of this therapy in suitable patients. We now have better biopsy techniques with magnetic resonance imaging-ultrasound (MRI-US) fusion platforms and transperineal biopsy that reduces infections. All these have allowed us to locate the prostate cancer foci with great accuracy which makes FT possible. And in our published study, the oncological outcomes of cancer-free rate are promising at ~70-80%. In bladder cancer diagnosis, we have improved resection techniques with en-bloc transurethral resection of bladder tumor (TURBT) which can potentially achieve more complete tissue representation and reduce the recurrence rate. Robotic cystectomy techniques are constantly being refined to reduce the operating time while achieving the benefits of reducing pain, blood transfusion, and hospital stay.
TAU: What are some active steps you take to incorporate evidence-based medicine in the care you provide for your patients?
Dr. Tan: The truth is, patients today are very well informed, plucking information off the internet. However, that can be a double-edged sword as they may be exposed to hearsay information rather than evidence-based medicine. As an uro-oncologist, my role is to dispel the myths and provide hard evidence and guidelines-based practices. More importantly, I understand that every patient is unique and different, and my role is to leverage on the evidence and tailor a management plan that is personalized to every patient. In that manner, we are marrying knowledge and empathy to benefit our patients.
TAU: Do treatments with low real-world uptake pose a challenge in the incorporation of evidence-based medicine? If yes, how do you overcome them?
Dr. Tan: Clinical trials and real-world practice often have stark differences, largely due to access challenges and costs. Real world practice, in my opinion, is always about incorporating evidence-based medicine in a somewhat restrictive environment specific to an individual’s practice. As clinicians, we need to be adaptive, innovative, and empathetic, and always try to find alternate solutions for our patients.
TAU: In your research, you explored the use of machine learning (ML) algorithms in the provision of tailored patient care (1). What are some aspects of treatment and patient care you hope to explore/are currently exploring with the use of artificial intelligence (AI) and ML algorithms? Are there any applications of artificial intelligence and ML algorithms that seem promising thus far?
Dr. Tan: I started off looking at our database of localized prostate cancer undergoing radical prostatectomy, and incorporating ML algorithms to predict recurrence and progression. We demonstrated that ML algorithms, in this nature of a non-discriminatory analytical approach, were more accurate than conventional logistic models. But AI has the capability and capacity to do much more, especially in image-based analytics. For instance, prostate segmentation and lesion identification in MRI prostate can ease the workload on radiologists and provide more consistency in reporting. Beyond oncology, my team has also been using image-based ML algorithms to detect detrusor overactivity solely based on cystoscopy, which can potentially obliterate the need for urodynamics studies. Our preliminary studies were highlighted at both the European Association of Urology (EAU) and the American Urological Association (AUA), conferences and we are currently in the next phase of the study.
TAU: How have your collaborations with TAU been? Could you elaborate on any interesting projects you have embarked on with TAU?
Dr. Tan: It has certainly been an exhilarating journey collaborating with TAU. I was fortunate to be able to publish in this journal, and subsequently be invited onboard as a reviewer. TAU has an efficient and robust reviewing process with a quick turnaround time. This is paramount to ensure that studies published are relevant to current practices, while papers that unfortunately are unaccepted can move on to other journals for submissions. This approach recognizes the hard work of each and every contributor. I applaud TAU’s efforts in also recognizing the reviewers’ contributions and creating a separate page to honor these recognitions.
TAU: As an author and collaborator, what are some goals you hope to achieve with TAU?
Dr. Tan: TAU has received several commendations and recognition despite being a relatively young journal. I certainly hope that TAU can continue to aspire towards a leading urological journal that provides quality and impactful publications that will benefit our community. I look forward to seeing the growth of its impact factor, and certainly with the robust turnaround review time, TAU should be on every author’s list for manuscript publication.