Cancers are on the rise, pan-world, probably because of early detection and longevity. The Medical fraternity has responded with minimally invasive treatment and better quality of life post- treatment. In Urology, the most commonly seen cancers in decreasing scale are: Bladder Cancer, Prostate cancer, Renal( kidney) Cancer, Testicular Cancer, Cancer of Ureter or the Pelvis and Penile Cancer.
In India Bladder Cancer is the 5th most common cancer in men.
Baldder cancer is an outcome of direct effect of exogenous exposure to carcinogens from smoking, or tobacco usage or Occupational exposure to petrochemicals, textile or printing industry.
Normally patients notice blood in urine or could also present with irritative voiding symptoms,( other causes for blood in urine are stones, infection, analgesic abuse) BUT BL OOD IN URINE SHOULD NOT BE IGNORED.
Ultra Sonography, and CT scan helps in diagnosis. Urine cytology in freshly voided sample is very helpful.
Treatment is endoscopic removal of bladder tumour using monopolar current, or Plasma Kinetic or LASERS. Once the tumor has been resected or the biopsy taken, rest depends on the histopathology. Depending on the level of penetration of cancer into the layers of bladder wall and the spread outside the bladder into the lymph nodes or not, the further management is planned.
Radical surgery with neobladder or urinary diversion Or Chemotherapy with radiation are options for the high grade tumours with muscle involvement.
Incidence of prostate cancer has increased significantly, or, is it that we have better tools to diagnose them early? Well in the Indian scenario, we are now picking up prostate cancers much earlier as compared to what we were seeing ten years ago. With the advent of laparoscopy and robotics, Radical prostatectomy has been revolutionized from a big incision and many blood transfusions to the fact that now we are discharging the patient in about 4 days, rarely requiring blood transfusion and a better social and sexual life post surgery.
Renal Cell Carcinoma is the most commonly occurring cancer of the kidney.
Patients normally present with blood in the urine(hematuria) or dull aching pain in the back or flank. USG and CT Scan clinche the diagnosis.
Mainstay of Treatment in operable cases is Laparoscopic Radical or Partial Nephrectomy, while open surgery is preferred in cases where the thrombus is spread into the renal vein or venacava.
Immunotherapy plays an important role in treatment of advanced Renal Cell Cancer and patient with metastasis.
Chemotherapy and Radiation have a limited role in the management of Renal Cell Carcinoma.
Patient might present with a painless lump or mass in either testicles , dull ache in lower abdomen , back or groin, a feeling of heaviness in scrotum or loss of weight. It is most common in between age of 18 to 39.
Treatment is dependant on the stage of tumor and its spread , and on the type of tumor ( Seminoma or Non Seminomatous ).
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