Genitourinary cancer refers to abnormal cell growth leading to the formation of tumors in the genital and/or urinary organs. Most genitourinary cancers occur in the prostate (in men), kidneys, or bladder.
What is prostate cancer?
Prostate cancer is a slow spreading cancer of the prostate gland, which surrounds the neck of the bladder and the urethra. Prostate cancer is the second most common cancer type and the second leading cause of cancer death in American men. Every year, the American Cancer Society estimates more than 230,000 men will be diagnosed and more than 70,000 will die of the disease.
Thanks to innovative treatments, improved diagnostic methods, and increased public awareness the death rate from prostate cancer is declining and an increasing number of tumors are being detected at an earlier more testable stage.
Once prostate cancer is found, it is assigned a stage, according to how advanced the cancer is, and a grade, based on how abnormal the cells look. The most frequently used grading system is the combined Gleason score, which ranges from 2-10. Higher the Gleason score, the greater the risk that cancer may have spread outside the prostate. This information will be used to plan your treatment.
What is kidney cancer?
The most common type of kidney cancer is called renal cell cancer, accounting for about 85 percent of kidney tumors. Risk factors for renal cell carcinoma include smoking, obesity, diet, and occupational exposures to substances such as asbestos. Renal cell carcinoma is about twice as common in men as in women and occurs mostly in adults between the ages of 50-70.
What is bladder cancer?
The wall of the bladder has several layers and cancer often begins in the lining layer and grows into the bladder wall. Bladder cancer is almost three times more common among men than women.
What treatment is available at M.D.Anderson Cancer Center Orlando
There are a number of options for treating prostate and kidney cancer, including surgery, radiation therapy, and hormone therapy.
Prostate Cancer Treatments
Surgical options include radical prostatectomy (removal of the prostate gland) and cryosurgery (freezing the prostate). The prostate gland, seminal vesicles, and cuff of the bladder neck are removed. Lymph nodes may also be removed.
Another option to traditional surgery may be the da Vinci® Prostatectomy, a less invasive approach to prostate removal. Procedures performed with the da Vinci system eliminate the need for large abdominal incisions. Instead, a smaller incision is made, and a laparoscope (a thin, flexible telescope) is inserted into the abdomen to transmit images to a nearby computer screen where they are greatly enlarged for surgeons to more easily see the prostate.
For most patients, the da Vinci™ prostatectomy offers numerous potential benefits over a traditional prostatectomy, including a shorter hospital stay, less pain, less risk of infection, less blood loss and need for transfusions, less scarring, faster recovery, and a quicker return to normal activities. Without complications, a patient usually can be discharged within 24 hours after surgery and typically can return to regular activities within a week.
To learn more about robotic-assisted surgery, talk with your M. D. Anderson – Orlando physician or call 321.841.7246. To see a 3-D animated presentation, outlining the entire da Vinci® experience, from facts and figures to incision diagrams and procedure simulation, click here.
Radiation therapy is performed by radiation oncologists who use high energy X-rays to kill cancer cells. Radiation can be delivered externally from a machine outside the body or through a technique called brachytherapy.
- Brachytherapy is the insertion of radioactive seeds directly into the prostate. These radioactive seeds are actually tiny metallic cylinders that contain a radioactive material. This technique allows the delivery of a highly concentrated and locally confined dose of radiation. The radiation helps kill cancer cells while sparing surrounding organs from excessive radiation.
- Intensity modulated radiation therapy (IMRT) is the non-invasive delivery of a precise dose of high-energy radiation to shrink or control the growth of a tumor by killing tumor cells or interfering with their ability to grow. The treatment exactly mirrors the shape and size of the patient's tumor. Each beam of radiation conforms to the tumor's exact dimensions, specifically targeting and treating diseased tissue while leaving surrounding healthy tissue unharmed. Two forms of IMRT are available at M. D. Anderson - Orlando: Peacock IMRT and Novalis Shaped Beam Surgery.
- Helical tomotherapy is currently the most advanced method of delivering IMRT to patients. This method uses a constantly modulated rotating beam of radiation that targets the exact size and shape of the tumor. This treatment is completely integrated so physicians know exactly what took place and where in the patient's previous treatment session.
Hormone therapy uses medications to decrease testosterone, a hormone that promotes growth of prostate cancer. This therapy may be done in cases of advanced prostate cancer. Hormones may also be given in conjunction with radiation therapy or surgery. Watchful waiting is another option that may be recommended, as prostate cancer generally grows slowly. Talk with your doctor about selecting your treatment and balancing the expected benefits.
Side effects of treatment
All treatment methods have side effects and the side effects most often associated with prostate cancer treatment are erectile dysfunction (inability to have an erection) and urinary incontinence (lack of bladder control). Please discuss side effects with your doctor to determine the best way to manage them.
Kidney Cancer Treatments
Surgery is the main treatment for renal cell carcinoma and the most common surgery is called radical nephrectomy. This surgery removes the whole kidney, the adrenal gland, some nearby fatty tissue and possibly nearby lymph nodes. A partial nephrectomy refers to the removal of the portion of kidney containing the cancer, an option if the cancer is in both kidneys or if the patient has only one kidney. Arterial embolization blocks the artery that feeds the kidney with the cancer. In some instances, this procedure is done before surgery to kill some of the cancer cells and to reduce bleeding during the operation.
Chemotherapy is the use of medications, given by mouth or into a vein, to kill the cancer cells. Chemotherapy may be given in addition to surgery.
Radiation therapy uses high-energy rays, such as X-rays, to kill or shrink cancer cells. The radiation may come from outside the body or from radioactive materials placed inside the tumor.
Immunotherapy promotes or supports the body's own immune system to better fight or destroy cancer cells.
Side effects of treatment
All treatment methods have side effects and the side effects most often associated with prostate cancer treatment are erectile dysfunction (inability to have an erection) and urinary incontinence (lack of bladder control). Please discuss side effects with your doctor to determine the best way to manage them.
Bladder Cancer Treatments
The main types of treatment for bladder cancer are surgery, radiation therapy, immunotherapy, and chemotherapy.
Surgery for bladder cancer in the early stages is called transurethral resection (TUR). In this operation, a cytoscope (an instrument inserted into the body to examine the interior of the bladder) is used to find the tumor, which is then removed. Cystectomy is used when cancer is invasive into the muscle of the bladder. Depending upon the size of the tumor the cystectomy may be partial, with only part of the bladder removed, or radical, with the entire bladder and nearby lymph nodes removed. Reconstructive surgery will be needed to provide a way to store and discharge urine if the whole bladder has been removed. Two types of reconstructive surgery are urostomy and continent diversion. You should discuss with your doctor which type of reconstruction is recommended in your case.
Intravesical immunotherapy uses a bacterium introduced directly into the bladder to stimulate the body's own defenses to fight the cancer cells.
Radiation therapy may be either external beam radiation or local radiation therapy using a small pellet of radioactive material placed directly into the cancer. Following surgery, radiation can kill small areas of cancer cells that may not be visible during the operation.
Chemotherapy for bladder cancer can be either intravesical or systemic. Intravesical chemotherapy means that the anticancer medication is placed directly into the bladder. Systemic chemotherapy uses anticancer medications that are injected into a vein or given by mouth.
Side effects of treatment
All treatment methods have side effects and the side effects most often associated with prostate cancer treatment are erectile dysfunction (inability to have an erection) and urinary incontinence (lack of bladder control). Please discuss side effects with your doctor to determine the best way to manage them.
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