Genitourinary Oncology

Genito-urinary malignancies comprise upper and lower genitourinary cancers.

Upper cancers are those arising from the kidney, adrenal glands, renal pelvis, and upper ureters.

Lower cancers arise from the urinary bladder and lower ureters urethra in both sexes and males. Primarily it adds cancers of the prostate, seminal vesicles, penis, and testis. In females, it adds to ovarian cancers, cancers of the uterine body, fallopian tubes, cervix, vagina, and vulva ( introitus ).

In males, prostate cancer is most common among all the genitor urinary cancers and cancers of the penis come second; in females, the cancers of the cervix are most common in India, and cancers of the uterus and ovaries come next.

Upper genitourinary tract cancers are usually silent and may not show any specific signs; it might be incidentally detected on a scan of the abdomen done for some other purposes or excessive red blood cells noted in routine urine examination done for different purposes (microscopic hematuria. Rarely can it grow to a considerable size, so the patient notices a lump or fullness in the abdomen.

Cancers of the urinary bladder or the ureter, while mostly present as gross blood in urine, are noted by the patients. Penis cancers start as ulcers and swellings on the penis pointed out by the patients; it is difficult to identify or noted late in non-circumcised males; circumcision seems protective. Testicular cancers are usually noted by patients as hard mass replacing the testis.

Prostatic cancers are also silent and standard in old age above 60 years, while non-cancerous enlargement of the prostate is common from age 40 years. Difficulty in urination is the major problem; if cancer has spread to the bone, the patient may have bone pains and unexplained backache, which may bring the patient to the hospital.

In females, ovarian cancers present as lumps or swelling in the abdomen, and uterine cancers as postmenopausal bleeding. Cervix cancers more common in menstruating women present as spotting intermenstrual bleeding and post-coital bleeding.

Evaluation of these patients includes specific blood tests called tumour markers, e.g., PSA in the prostate, CA125 in ovaries, etc., urine tests, and scans including PET SCAN, MRI, OR combined PET MRI. Patients usually require a biopsy, but certain conditions like cancers of the testis, early cancers of ovaries, or kidney cancers need not require a biopsy; in other words, a biopsy will help spread the tumour.

Treatment options are usually multimodal, which includes surgery, chemotherapy, and radiation. The treatment is generally planned by a panel of experts, each leading in the field of radiation oncology, Uro oncology, medical oncology, Surgical oncology, and Gynecology, the team understands the needs of the patient, general health condition and standardized treatment and gives informed options to the patient and family member to take the best treatment option among various.

Various latest technologies are also applied by our renowned experts, like the latest PET MR in scanning methods, Setinel node Biopsy in Gynecological cancers, Latest HIPEC (hyperthermic intraperitoneal chemotherapy - given during surgery ), Adaptive intelligence AI-based radiotherapy to minimize the radiation effects, CYBERKNIFE radiotherapy to precisely target and kill cancer cells without the need for surgery, our institute is a part of various ongoing studies, where latest medicines and immunotherapy are utilized for the benefit of the patient.