n this episode of Pearls and Perspectives, Amy Pearlman, MD, speaks with Vahan Kassabian, MD, director of the Atlanta Prostate Cancer Center and Advanced Therapeutics at Advanced Urology in Atlanta, Georgia. Kassabian is a nationally recognized surgeon and pioneer in high-intensity focused ultrasound (HIFU), with a strong focus on advanced prostate cancer and on sustaining private practice models. Kassabian describes the evolving practice landscape for urologists, contrasting academic medicine, hospital employment, private practice, and private equity-backed models. He emphasizes that modern private practices can mirror academic centers in subspecialization, research, and advanced therapeutics, while still offering physicians greater autonomy. As a board member of LUGPA, he highlights efforts to keep independent practice viable and competitive. A major focus of the discussion is the integration of advanced prostate cancer therapeutics into urology offices. Kassabian outlines how practices can implement in-office dispensing pharmacies, infusions, and theranostics, such as prostate-specific membrane antigen (PSMA) imaging and lutetium (177Lu) vipivotide tetraxetan (177Lu-PSMA-617; Pluvicto) therapy, noting that even small groups can successfully run oral therapeutic programs. He stresses that urologists—who see patients with prostate cancer daily—are well-positioned to manage the disease across its continuum, often more consistently than medical oncologists whose scope is broader. The conversation also touches on practical infrastructure needs, from nurse navigators to imaging investments, and on survivorship concerns such as bone health and frailty prevention. Kassabian underscores the importance of exercise, vitamin D, and multidisciplinary collaboration in optimizing patient outcomes. Looking ahead, he sees PSMA theranostics, focal therapy, and precision medicine via tumor sequencing as transformative. For younger urologists, his message is to remain adaptable—pivoting every decade if needed to stay current—and to embrace innovation while keeping patient-centered care at the core. Learn more about Kassabian here

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