Cancer is a big health hazard nowadays due to increasing incidence of number of cancer patients worldwide. Urological cancers includes cancers of kidney, adrenal. urinary bladder, prostate, testicles & penis.
As a dedicated center of excellence for urologic cancers, we at Metro Heart Institute with Multispecialty, Faridabad, provide comprehensive care to such type of patients. Our aim is not only just to treat the cancer but to improve the quality of life with modern minimally non-invasive technology. Here is a brief of urologic cancers.
About 50% of kidney cancers are detected incidentally i.e. while investigating for some other disease. Rest of cases usually present with blood in urine, pain abdomen, palpable lump in abdomen, low haemoglobin level and weight loss. Traditionally most of kidney cancers were treated with radical nephrectomy i.e. complete removal of kidney via open method through a large flank incision of 15 to 20 cms. With recent advancement in surgical techniques, now it is possible to do surgery laparoscopically i.e. key holes surgery. These minimal invasive surgeries help in faster post-operative recovery, less pain, cosmetically better scar and minimal wound infection. With more advancement in technology it is now possible to remove only tumor part of kidney and preserve the rest of the kidney i.e. nephron sparing surgery or partial nephrectomy. Treatment with partial nephrectomy helps to minimize the risk of development of kidney failure and thus need for dialysis after surgery. The most important part of kidney cancer treatment is its early detection and management at a specialized uro-oncological centre.
Urinary Bladder Cancer
Urinary Bladder cancer is commonly found in elderly person (Average age is 79 yrs). Most common causes of this cancer are smoking, environmental and industrial toxins eg. Leather industry, petro chemical industry etc. Most of patients present with blood in urine. Like others cancers, its treatment also depends on stage of cancer. Most of these cancers can be managed endoscopically (TURBT). Rest of cases i.e. in muscle invasive cancers, radical cystectomy and urinary diversion is required which includes surgical removal of urinary bladder with prostate in male and anterior part of vagina in female and then urinary diversion. Urinary diversion is of two types. One is ileal conduit, in which a small part of gut is used to divert the urine out of abdominal wall into a pouch, which is emptied regularly. While in neobladder, part of gut is used to make a new bladder, which is then connected to urethra and patient passes urine through normal passage. Early detection and diagnosis helps minimize the extent of surgery and faster recovery.
Prostate cancer is one of the most common urological cancer in elderly men (life time risk of 16.72%). Most of the patients will have no symptoms at all and are detected incidentally by a streaming blood test, PSA, while very few patients complain of difficulty in passing urine or blood in urine. Rarely, it is detected on biopsy report of prostate surgery done for BPH. Management comprises of surgical removal of prostate or radiotherapy, hormone therapy and chemotherapy in advance stages. For organ confined & locally advanced cancer surgery do well while radiotherapy, hormone therapy and chemotherapy is good when disease spread to other organ of body. Traditionally surgery was done by open method by a long lower abdominal incision. Nowadays this surgery can be done by key holes methods i.e. laparoscopically or robotically. Advantage of these minimally invasive ways are less pain, less wound related complication, early recovery and less hospital stay.
It is one of the cancer which effect younger group of men (mostly between 20 to 40 years) affecting 1% to 2% of general population. As this cancer presents as painless mass in testicles they are often neglected by patient due to social embarrassment and its painless nature. Treatment of these cancer mostly comprises of removal concerned testis and further treatment with radiotherapy or chemotherapy or surgery depending on types of cancer and its spread. Surgery is done for abdominal lymph nodes involvement. Early diagnosis and correct management improves outcome many folds.
Cancer of penis usually presents as a mass or non-healing ulcer over the penis, effecting 0.4 % to 0.6% of population. Mostly cancer arises from distal end of penis and slowly engulf proximal part of penis and the inguinal lymph nodes. Diagnosis is usually made by biopsy of the mass/ ulcer on penis. Depending on its stage further course of action is decided which comprises of excision of mass/ ulcer or part of penis (Penis preserving surgery) followed by removal of groin lymph nodes.
The author of this article is Dr. Rajiv Kumar Sethia, he is a Senior Consultant and Unit Head of Urology & Renal Transplant at Metro Heart Institute with Multispecialty. He has treated hundreds of national and international patients for various urological cancers and have done many successful kidney transplants too.