Urological cancers are tumours of the genitourinary system of the human body. The burden of Urologic Cancer has increased across the globe in the last decade or so, amid an ageing and growing population. The increase is seen in both the developed and the developing world.
Table of Contents
Feel free to skip ahead if one topic catches your eye:
- What are Urologic Cancers?
- Symptoms of Urologic Cancers
- How are Urologic Cancers diagnosed?
- Treatment of Urologic Cancers
What are Urologic Cancers?
Cancers of the genitourinary system are commonly referred to as Urological Cancers. The affected organs include the Kidney, Prostate, Bladder. Testes, Penis, Urethra and Transitional Cell cancers of Ureter and upper tract.
Prostate Cancer
Prostate cancer is the most common cancer in males. The prostate is an organ in male which is involved in genitourinary function in a male and often causes difficulty in urination as the organ enlarges with age. The Cancer of the prostate affects the peripheral zone of the prostate and rarely causes urinary difficulties. The prostate cancer is now detected in early or treatable stages by screening tests such as S. PSA and biopsy. The disease commonly spreads to bones. The disease is further classified according to the grade of the biopsy so as to tailor best-fit treatment plans
Bladder Cancer
Bladder cancer is the 4th most common cancer in males around the world. It is closely linked with smoking. It has a livid presentation with blood in urine or haematuria. The cancer is wide of Transitional Cell cancer type. This type may be superficial in which the endoscopic treatment may be sufficient. The deep variety usually needs more comprehensive efforts such as Radical Cystectomy or Chemotherapy and radiation therapy.
Kidney Cancer
Kidney cancer or Renal cancer is the sixth most common malignancy worldwide in males and 9th most common in females. It is associated with a tumour of the kidney which may cause pain in the loin, blood in the urine and symptoms suggestive of metastasis. It sometimes can grow into the veins or the major blood vessels of the human body and thereby causing symptoms because of venous congestion. Kidney tumour easily spreads to the adrenals, lungs or the bones. It is treated by Laparoscopic or Robotic or Open removal of the tumour ( partial nephrectomy) if the size permits or the removal of the entire kidney ( radical nephrectomy)
Testicular Cancers
Testicular Cancer is the cancer of the testes or the male gonads. The most common age of affection is 15 to 35 years and usually presents as painless enlargement of the testicles. The treatment is highly effective and varies from Radical removal accompanied by various cycles of chemotherapy and the removal of nodes in the abdominal region.
Penile Cancer
The cancers of the penis of the male copulatory and urinary organ are associated with a visible swelling or non-healing wart or ulcer. It is often a sequela of HPV infection and other cancer-predisposing conditions such as lichen sclerosus. The condition involves biopsy to diagnose and definitive treatment which includes surgery and chemotherapy. The surgery now aims at organ preservation to provide maximum sexual and urinary function optimization for the patient as far as possible.
Transitional cell cancer of the upper tracts of the transitional cell lining
The TCC of the upper tracts are uncommon but are the same types as the bladder cancers. The treatment involves removal of the entire kidney as well as the ureter of the affected side known as radical Nephroureterectomy
Symptoms of Urologic Cancers
Symptoms of Prostate cancer
- Usually asymptomatic in early stages, need screening in the form of blood test (PSA) and biopsy
- Associated difficulty in urination
- Blood in urine or semen fluid
- Back pain, weight loss and malaise in advanced stages
Symptoms of Bladder Cancer
- Blood in the urine or haematuria with clots and fresh blood
- Painful urination or dysuria
- Difficulty in urination
- Bone pain, weight loss and malaise in advanced stages.
- Symptoms of Kidney Cancer
- Mostly detected incidentally as a part of Ultrasound or CT for other diseases
- Lump in the abdomen
- Pain in the flank associated with bleeding or haematuria and worm-like blood clots
- Advanced stages present as fever, anaemia, back pain or elevated blood tests such as ESR
- Undiagnosed fever
Symptoms of Penile Cancer
- Swelling or non-healing wart or ulcer on the male reproductive organ
- Swollen lymph nodes in the groin
- A foul-smelling discharge either from the swelling or from the urinary passage or from the groin node
- A sore or growth on the male reproductive organ that doesn’t heal in 4-5 weeks
Symptoms of Testicular Cancer
- A lump in the testicle
- An enlarged testicle
- Breast growth or tenderness
- Sudden buildup of fluid in the scrotum
Apart from these symptoms, it is important to undergo screening for prostate cancer above the age of 50 years using PSA as a marker. Also, testicular self-exam is important for the affected age group to detect any testicular cancer or lump in time.
How are Urologic Cancers diagnosed?
Urologic cancers can be diagnosed using the following tests:
- Most of the diseases are diagnosed in early stages using a screening Ultrasound for other unrelated diseases and blood tests such as PSA
- The self-examination of testes and penis is of significant importance in the early detection of diseases affecting the organs
- Other tests which may be needed are
- Blood tests are PSA, Kidney Function tests, Complete Blood profile
- Ultrasound and CT or other imaging of the abdomen which delineate the entire organ anatomy with its blood supply helping in diagnosis
- MRI of the pelvis for Cancer prostate detection
- Cystoscopy and Ureteroscopy: This is the direct endoscopic visualization of the bladder and the ureters from inside the organ, accessed through the urinary passage. This may be followed up by the excision, biopsy or the resection and hence treatment of the tumour
- TRUS biopsy of the prostate which may be done in cases of suspicious involvement of the prostate.
Treatment of Urologic Cancers
Urological cancer treatment depends on a series of critical factors, such as the stage and grade of the tumour along with the preference of the patient.
The treatment of the Urologic cancers has taken leaps and bounds with current technology and medication which has refined treatment even in the most advanced stages of disease presentation Such treatment paradigm includes surgical robot or da Vinci platform, availability of targeted therapy and immunotherapy to provide precision.
- Robot-assisted radical prostatectomy: this is the robot-assisted radical excision of the cancer-bearing tissue or the prostate. This aids in precise surgery and quicker surgical times and faster recovery of the patient. The blood loss usually is minimal
- Robot-assisted or laparoscopic partial nephrectomy: this surgery essentially removes the tumour of the kidney while preserving the total kidney parenchyma. This is done in cases of small renal masses as they present early
- Robot-assisted or laparoscopic radical Nephrectomy: This surgery entails the radical removal of the entire kidney along with the tumour tissue for larger kidney masses
- Radical nephrectomy with IVC thrombectomy: For kidney masses that are large and involve the major Veins of the body ( IVC) this surgery may rarely be required and need the help of a tertiary care oncology centre for the same.
- Partial or radical penectomy: This is done for small or large tumours of the penis and the thrust is on organ preservation as much as possible to aid urinary and sexual rehabilitation.
- Radical Inguinal Orchidectomy: The procedure entails the removal of the tumour-bearing testes from the groin. This is important as the violation of scrotal skin is counterproductive for cancer control. This is usually the first step in the diagnosis and management of the testicular tumours
- HIFU (High-Intensity Focussed Ultrasound): It is one of the latest advancements in the treatment of Cancer Prostate and helps in the gland or focussed ablation of the tumour tissue or nodule in the prostate It avoids surgery and anaesthesia
- Transurethral resection: Also known as the transurethral resection of the bladder tumor,This is the first line of treatment for any bladder mass or suspected tumour. Along with a cystoscopic examination of the bladder, any visible tumour is identified and resected endoscopically and sent for biopsy. For superficial tumours, this may be the only surgery which is needed whereas the deep tumours may need radical surgery as the disease is advanced
- Robot-assisted or laparoscopic or Open Radical cystectomy: The surgeon may recommend the removal of the entire bladder if the cancer is found highly aggressive and invasive. During this medical procedure, the surgeon may also remove the nearby lymph nodes along with the prostate for men and the fallopian tubes, the ovaries, a small part of the vagina, and the uterus for women. The urinary bladder may be reconstructed as neobladder using the intestines or a part of intestines may provide a conduit to the outside(Ileal conduit)
At The Urethra Clinic, you will get the best treatment, treatment options, suggestions, and care for your health condition from Dr Vikram Shah Batra, the best urologist in Delhi. It provides evidence-based, quality care so that you are always assured of complete peace of mind. The teams of surgical oncologists, radiation oncologists, medical oncologists, and others make sure that a complete continuum of care is offered that incorporates uninterrupted access and best practices to the latest urological treatment therapies.
Takeaway
Urologic Cancers are debilitating health conditions and everyone must seek immediate medical intervention if any signs and symptoms are noticed. It is always advised that you must always choose a reputed and professional urologic cancer clinic such as The Urethra Clinic to receive evidence-based, personal urologic cancer treatment, tailored to your stage and type of urologic cancer.
At The Urethra Clinic, you would always be assured of the best medical care services. The teams of surgical, medical, and radiation oncologists at The Urethra Clinic along with eminent pain specialists, nutrition experts, and others ensure you get compassionate and complete care at every stage.
