Urological Oncology

  • Each year thousands of men and women are diagnosed with cancer of the kidney, bladder, penile cancer as well as testicular cancer.

  • Kidney cancer is caused when kidney cells grow out of control to form a tumor. Kidney cancer can be of different types including, renal cell cancer, transitional cell carcinomas, renal sarcoma and Wilms Tumor (commonly found in children, and very rarely in adults).

  • Bladder cancer is caused when bladder cells grow out of control to form a tumor.

  • Penile Cancer starts developing at the skin cells of the penis and may spread inside. It is a very rare type of cancer but can be treated if detected at an early stage.

  • Testicular Cancer as the name suggests, is the cancer of the testicles (testes). Testicles are located inside the scrotum. Scrotum is a loose bag of skin underneath the penis).

Urological Oncology (Brief)

Urological Oncology

Each year thousands of men and women are diagnosed with cancer of the kidney, bladder, penile cancer as well as testicular cancer.

Kidney Cancer

Kidney cancer is caused when kidney cells grow out of control to form a tumor. Kidney cancer can be of different types including, renal cell cancer, transitional cell carcinomas, renal sarcoma and Wilms Tumor (commonly found in children, and very rarely in adults). The most common type of kidney cancer include is renal cell cancer. It can be of different types including:

- Clear cell renal cell carcinoma
- Papillary renal cell carcinoma
- Chromophobe renal cell carcinoma
- Rare types
- Unclassified
When kidney cancer spreads to another body part from the kidney, it is known as metastatic cancer.

The most common reason for developing bladder cancer include:

- Smoking (most prominent risk factor)
- Obesity
- Workplace exposure to cadmium, some herbicides, and some organic solvents
- Family history of kidney cancer
- Other risk factors include: analgesic abuse, high blood pressure, hereditary diseases including von Hippel-Lindau disease and polycystic kidney disease.

Symptoms of kidney Cancer

The most common sign of kidney cancer include:
- Hematuria (blood in the urine)
- Stomach pain
- Flank mass
If the cancer spreads from kidneys to other parts of the body, the symptoms could include:
- Fever
- Weight loss
- Night Sweats
- Hypertension (high blood pressure)
- Increased calcium level in the blood
- Liver problems

Diagnosis of Kidney Cancer

The doctor may suggest the following tests to diagnose kidney cancer:
CT Scan
MRI
Blood Tests
Urine Tests
Biopsy of the mall to test for cancer

Treatments for Kidney Cancer include:

- To treat kidney cancer, surgery is the primary choice. Either a part of the kidney is removed, known as partial nephrectomy or the entire kidney is removed, known as complete nephrectomy.
- For patients who can not tolerate surgery, radiation therapyis used, either external beam radiation or internally implanted radiation, known as brachytherapy is used.
- Immunotherapy is the use of medications to boost the immunity system of the body to fight against and destroy cancer cells.
- Targeted therapy is medication used to treat kidney cancer by targeting a receptor found on the cancer cells and destroying it.

Bladder Cancer

Bladder cancer is caused when bladder cells grow out of control to form a tumor. The two types of bladder cancer include:

- Transitional cell or urothelial cell bladder tumor: These kind of tumor start in the innermost lining of the bladder
- Adenocarcinomas, squamous cell carcinomas or small cell carcinomas: This starts in other parts of the bladder.
When the bladder cancer spreads to another body part from the bladder, it is known as metastatic cancer.

Bladder cancer is more common in men than in women and is usually detected in those over the age of 65. The most common reason for developing bladder cancer include:

- Smoking
- Family history
- Genetic mutations
- Occupational exposure to chemicals
- Previous exposure to certain chemotherapy medications
- Radiation to the pelvis
- Exposure to arsenic in well water
- Aristolochic (a Chinese herb)
- Bladder infections caused by schistosoma haematobium
- Neurogenic bladder and the overuse of indwelling catheters

Symptoms of Bladder Cancer

The most common sign of bladder cancer include:
- Hematuria (blood in the urine).
- Increased frequency of urination
- Urgency to urinate
- Nocturia (waking up at night to urinate)
- Pain or burning with urination
- Feeling of incomplete emptying of bladder
- Flank pain (pain in upper back, abdomen or sides of these areas)
- Frequent Urinary Tract Infection

Diagnosis of Bladder Cancer

If you have blood in your urine, doctor will ask for a urine test to find the existence of bladder cancer cells. This test however may not provide the most accurate results.Hence it is adviced to undergo:

- X-ray of the upper urinary tract
- Ultrasound
- CT Scan
- Intravenous pyelogram: In this procedure a dye is put into a vein, which travels through the kidneys and bladder and can be seen on an x-ray
- Cystoscopy with biopsy: In this procedure, a camera is placed through the urethra into the bladder to examine the inside of the bladder. A biopsy is performed to investigate cancer.
- If the biopsy result shows cancer, a second cystoscopy with a resection (also called a transurethral resection or TUR) is done to further evaluate or remove the tumor.

Bladder Cancer Treatment

The treatment for Bladder Cancer depends on what stage it is in. Stages range from stage 1 to stage 4. The stage of the cancer is based on:
- Size and location of the tumor
- Whether cancer cells are found in the lymph nodes
- Whether cancer cells are found in other areas of the body

Superficial Bladder Cancer

(cancer that has not invaded the muscle), Transurethral resection or TUR can be done, post which the patient will have to undergo intravesicular chemotherapy that is infused directly into the bladder to kill remaining cancer cells.

Muscle Invading Bladder Cancer

(cancer that has invaded the muscle wall), requires advanced extensive treatment. In some cases, the doctor may recommend the removal of the bladder, also known as cystectomy. Chemotherapy will also be advised before the surgery to shrink the tumor and make the surgery easier or after the surgery to prevent recurrence. Radiation and TUR along with chemotherapy may be advised by the doctor to avoid cystectomy.
In some cases, where the condition is more severe or with patients with metastatic disease who can not receive chemotherapy, the doctor may advice immunotherapy. Immunotherapy is the use of medications to boost the immunity system of the body to fight against and destroy cancer cells.

Penile Cancer

Penile Cancer starts developing at the skin cells of the penis and may spread inside. It is a very rare type of cancer but can be treated if detected at an early stage. The exact cause for penile cancer is not known, but some studies suggest that not being circumcised might increase the chances of it, as if the bodily fluids gets trapped in the foreskin and are not cleaned, they may contribute to growth of cancer cells. Some studies also suggest that men exposed to strains of HPV (human papillomavirus) may get penile cancer.

Penile cancer is more common is men over the age of 60 years who are smokers and a weakened immune system.

Symptoms of Penile Cancer

The most common symptoms of penile cancer include:
- Changes in the penis foreskin of uncircumcised men
- Changes in the penis tip or shaft
- Changes in thickness or color of skin on the penis
- A lump on the penis
- A rash or small bumps on the penis
- Bluish-brown growths on the penis
- Smelly discharge underneath the foreskin of the penis
- A bleeding sore on the penis
- Swelling at the end of the penis
- Lumps under the skin in the groin area

Diagnosis of Penile Cancer

The doctor will perform a physical exam on the patient with the above symptoms. A biopsy may be done on a small sample of tissue from the skin lesion on the penis. Imaging tests like X-rays, CT Scan, ultrasound and MRI may also be recommended by the doctor for accurate investigation and to check how far the cancer has spread.

Treatments for Penile Cancer

Penile cancer is treatable if detected in early stages. The treatment for early stage may include:
- Application of medicine that goes on your skin as a cream
- Cryotherapy, a procedure in which extremely cold liquid or a device is used to freeze and destroy tissue that contains cancer
- Mohs surgery, in which doctors removes the affected skin of the penis, one layer at a time, until they reach normal, healthy tissue
- Lasers to cut and destroy areas that contain cancer
- If the cancer is on the foreskin of the penis, the doctor may suggest Circumcision, a procedure to remove the foreskin of the penis.

If the cancer has spread and is in advanced stage, a surgery to remove some or all of the inguinal lymph nodes may be suggested by the doctor along with radiation and/or chemotherapy. If none of the treatments from above work,the doctor may suggest a "penectomy", a surgery to remove some part or the entire penis

Testicular cancer

Testicular Cancer as the name suggests, is the cancer of the testicles (testes). Testicles are located inside the scrotum. Scrotum is a loose bag of skin underneath the penis). The testicles are responsible for producing male sex hormones and sperm for reproduction.

When compared with other types of cancer, testicular cancer is very rare. Males between the age group of 15 and 35 are most affected by this cancer. Testicular cancer is highly treatable, even in advance stages when the cancer spreads beyond the testicles. Testicular cancer usually affects only one testicle.

Symptoms of Testicular Cancer:

- Testicular lumps or enlargement of either testicle.
- A feeling of heaviness in the scrotum
- Ming pain in the abdomen or groin
- A sudden collection of fluid in the scrotum
- Mind pain or discomfort in a testicle or the scrotum
- Back pain

Causes of Testicular Cancer

The exact cause of testicular cancer is not known but as studies suggest testicular cancer occurs when healthy cells growth in the testicles is altered. Or if some cells develop abnormalities, causing the cell to divide and growth to get out of control. The continuous growth of these abnormal cells start accumulation to form a mass in the testicles.

Factors that may increase the risk of developing testicular cancer include:

Abnormal testicle development

a condition in which the testicles develop abnormally.

- Testicular cancer may also develop due to family history

Testicular cancer is treated by surgically removing the testicle. One can opt for prosthetic testicle to be fitted in its place. For advanced stage of testicular cancer, radiotherapy or chemotherapy may be required to stop and prevent further growth of cancer cells.

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