Rafael Sanchez-Salas, MD

McGill University

Montreal, Quebec

Rafael Sanchez-Salas, MD, is an Associate Professor of Urology in the Department of Surgery at McGill University in Montreal, Quebec. He is a surgeon and clinician-scientist whose primary interest is in minimally-invasive treatments in urological oncology. He is an established leader in the field of focal therapy for the treatment of localized prostate cancer. Dr. Sanchez-Salas earned his medical degree from the Universidad de los Andes in Mérida, Venezuela, and he was valedictorian of the class of 1998. He completed his basic surgical and urological training at Universidad Central de Venezuela in 2005.
He was awarded with scholarships from Confederacion Americana de Urologia and The European Association of Urology to pursue fellowship training in urological oncology and minimally-invasive urological surgery at Memorial Sloan Kettering Cancer Center in the US, Clinica Santa Maria in Chile, and L’Institut Mutualiste Montsouris in France, where, after his training, he joined the faculty in 2008. Dr. Sanchez-Salas has enjoyed a sound international career as a talented surgical proctor and cancer researcher. His current research priorities include focal therapy for prostate cancer and its impact on prostatic micro-environment and outcomes. He chaired the SIU-International Consultation on Urological Disease on image-guided therapy for Prostate and Renal Carcinomas in 2015.

Talks by Rafael Sanchez-Salas, MD

Urologic Perspective on the Clinical Utility of and Emerging Data on Micro-Ultrasound

Posted by Rafael Sanchez-Salas, MD | Dec 2021

In part 2 of a 2-part series on micro-ultrasound for prostate cancer imaging, Rafael Sanchez-Salas, MD, Associate Professor of Urology at McGill University in Montreal, Quebec, reviews data on micro-ultrasound (microUS) from a urologic perspective, comparing it to MRI in order to evaluate its clinical utility. He explains that there is more and more data suggesting microUS’s superiority to multiparametric (mp)MRI in screening and the benefits of using it in addition to MRI in clinically significant prostate cancer (csPCa). Dr. Sanchez-Salas discusses microUS’s comparable detection rates to mpMRI as shown by a balanced forest plot with ratios ranging between .94 and 1.05 and its ability to help 23% of patients avoid biopsy with no cases of missed csPCa. He then looks at a study testing a proposed protocol for assessing risk based on microUS which showed a much higher sensitivity than mpMRI in microUS of 87.5% vs. 55-61% but lower specificity of 80% vs. 87-88%. Dr. Sanchez-Salas states that there are still several questions to be answered about microUS’s utility on its own, during active surveillance, for focal therapy, and for bladder cancer staging. He concludes with a discussion of the OPTIMUM trial, which will conclude in spring of 2023 and which is meant to provide level-1 evidence regarding the use of microUS in prostate biopsy.

HIFU: The European Experience

Posted by Rafael Sanchez-Salas, MD | Aug 2020

Rafael Sanchez-Salas, MD, attending surgeon at L’Institut Mutualiste Montsouris in Paris, France, and member of the Focal Therapy Society, discusses high-intensity focused ultrasound treatment (HIFU) in the context of the European experience with focal therapy. He gives an overview of the 18 current registered clinical trials in Europe focused on HIFU, highlighting that the large majority involve only minor reported complications. Dr. Sanchez-Salas also looks at the intermediate outcomes, concluding that HIFU shows promise for lowering PSA. He also notes that improved procedural controls have led to some groundbreaking technological development. Overall, Dr. Sanchez-Salas argues that the European experience with HIFU includes some of the most relevant advances in the field of focal therapy.