Uro Oncology

An initial assessment is done of the tumor load and location , most often by blood tests and CT scan . Depending on the size and stage of the disease, the following procedures are done

• Partial Nephrectomy: Removal of the tumor alone and sparing the rest of the kidney. This allows good preservation of kidney function and also adequate caner control 
• Radical Nephrectomy:  For large tumors the complete kidney along with the tumor is excised . This allows adequate cancer control and the patient then can lead a near normal life on the other kidney function alone 
• Post surgery, patients may need additional chemotherapy drugs orally if the disease has spread in the body

The preliminary assessment of this condition is to stage the spread of the disease. 

An initial assessment of the depth of spread of the tumor into the depth of the bladder wall is made by a procedure called Trans Urethral Bladder Tumor Resection . This is a biopsy and serves as an important guide for the type and staging of the disease. Additional a CT scan of the abdomen is usually done.

If the disease has remained in the superficial layers only , it s a Non Muscle Invasive Bladder Cancer(NMIBC). This needs only instillation of drugs in the bladder periodically ( Intravesical Instillation ) and bladder surveillance with periodic cystoscopy of the bladder.

If the disease had invaded in the depth of the bladder muscle , then it is a Muscle Invasive Bladder Tumor. This disease has the potential to spread rapidly in the body. It hence needs removal of the bladder and Chemotherapy . Sometimes Radiation is also added.

The operation of bladder removal is Radical Cystectomy. In most cases the urinary passage can be reconstructed using the intestine to fashion a new bladder ( Neo Bladder). On other occasions, a small length of intestine is connected to the ureters to drain the urine externally ( Ileal Conduit)

This cancer is increasingly being recognized due to the widespread availability of screening tests like Serum PSA. 

When the PSA is elevated, the presence of a cancer of prostate must be evaluated. This needs a physical examination, MRI scan of the prostate and a Trans Rectal Ultrasound Guided Prostate Biopsy (TRUS biopsy)

Thereafter some additional tests like a bone scan may be needed 

Radical Prostatectomy: When the cancer is confined to the prostate, the complete prostate is removed. This operation has the best potential to cure the patient

If the cancer has spread to the lymph nodes or seminal vesicles, then additionally the patient may need hormone therapy and/or Radiation.

In advanced disease Chemotherapy and Hormone therapy are the main stay of treatment.