Urological Cancer Medical Program
Urological cancers are a group of cancers that develop in the urinary tract and the male reproductive system They include kidney cancer, bladder cancer, testicular cancer, prostate cancer, penile cancer, adrenal cancer and cancers of the ureter.
Treatment of each urological cancer differs and is dependent on the size of cancer, how far it has spread and on the overall health of the patient.
The bladder, an expandable muscular sac, is the body’s urine storage before it is released out the body. Bladder cancer is a common type of cancer that, as with other cancers, develops when cells begin to divide and grow uncontrollably. There are three main types of bladder cancer most common of which is transitional cells carcinoma (develops in the cells that line the inside of the bladder), squamous cell carcinoma (usually develops after an infection and irritation) and adenocarcinoma (begins in the mucus secreting glands). Most types of bladder cancers are highly treatable (50%) when diagnosed at an early stage.
The surgical operation, alone or combined with other treatment, are usually performed in the treatment of bladder cancer. The following is a list of surgical treatments offered:
- Transurethral resection of bladder lesions (TURB): the initial treatment for beginning stages of bladder cancer. A cystoscope (a viewing instrument for examining the bladder) is inserted into the urethra in order to remove tumours and to examine bladder tissue.
- Cystectomy: the surgical removal of all or part of the bladder for the treatment of bladder cancer or the treatment of a recurred bladder cancer after initial treatment.
- Partial cystectomy: the surgical removal of parts of the bladder where the tumour has developed as well surrounding bladder wall. This is only performed if the cancer is not at the opening of the bladder (where the urine enters and exists).
- Partial cystectomy with ureteral reimplantation: the surgical removal of parts of the bladder in which cancer has developed with the re-routing of the ureter to another part of the urinary bladder.
- Cystectomy with sigmoid or ileal bypass: the surgical removal of all of the bladder. An ileal bypass or conduit (urostomy) is created to allow urine to flow out of the body through a stoma ( a small surgically made opening in the abdomen to allow the passage of urine). A sigmoid bypass (also known as Mainz II pouch) is created from a segment of the rectum and sigmoid colon and is used to allow urine to flow out of the body with the stool out of the rectum.
- Cystectomy with Reservoir Development and emptying: the surgical removal of the bladder with a reservoir (Indiana pouch) to store and eliminate urine. This is done by surgically creating a pouch by sewing together the ileum and parts of the large colon. Though the pouch functions as a bladder it cannot empty on demand and the patient needs to catheterize to drain the urine.
Kidney (Renal) Cancer
Kidney cancer develops when cells in the one or both kidneys grow uncontrollably and form tumours. Found on both sides of the backbone just below the rib cage, the kidneys filter water and waste material from the blood creating urine. Kidneys also regulate electrolyte balance (salts and minerals such as sodium, potassium, chloride, calcium and phosphate, that conduct electrical impulses in the body) and produce hormones and enzymes (such as erythropoietin and renin) that regulate blood pressure and the production of red blood cells.
Nephrectomy is the most common type of treatment practised for kidney cancer if cancer has not spread to other body parts. It involves the surgical removal of the cancerous tissues in order eliminate cancer and to stop it from developing further.
The following are surgical treatment offered:
- Partial Nephrectomy: the surgical removal of part of the kidney.
- Simple Nephrectomy: the surgical removal of all of one kidney.
- Radical Nephrectomy: the surgical removal of all of one kidney, the surrounding lymph nodes as well as the adrenal gland.
A rare type of cancer that can develop anywhere on the penis, but is most often found on the foreskin. It is slow to spread and can be cured when diagnosed early. If left untreated, however, it can spread to the lymph nodes and other body parts. Surgery remains one of the most common types of treatment for penile cancer. Not all growth on the penis is cancerous though they can look and act as such. Non-cancerous (benign) abnormal growth sometimes can develop on the penis. Most affect the foreskin or the glans.
Treatment for penile cancer is dependent on stage and location of the cancer. The following are surgical treatments offered:
- Excision of large lesions of the penis: the surgical removal of the tumour as well as surrounding non-cancerous skin. If the area removed is small the remaining skin is stitched back together.
- Excision of deep lesions of the penis (penectomy): the surgical removal of all or part of the penis in order to ensure the removal of all of the cancer.
- Excision of small superficial lesions of the penis: the surgical removal of tumours that have not developed beyond their site of origins and have not invaded other parts of the body (in situ).
The prostate is a walnut-shaped gland located under the bladder and in front of the rectum and is responsible for the production of seminal fluids. Prostate cancer is one of the most common cancer in men and is due to cancerous cells developing in the prostate gland. For the most part prostate cancer is slow in developing and slow in spreading to other organs. However, as tumours begin to develop cells break away and may reach the lymph nodes, seminal vesicles, bones around the hip and pelvis area and/or the lungs. Depending on the stage of the most common treatment for prostate cancer is surgery.
- Radical Prostatectomy: The surgical removal of all of the prostate gland and neighbouring tissue.
- Transurethral prostatic resection: a minimally invasive surgery for the removal of parts of the prostate gland through the penis in order to treat benign swelling of the prostate or if the the cancer puts pressure on the urethra.