Urologic Oncology

Anyone can be diagnosed with bladder cancer. It is the fourth most common cancer in men and the sixth most common cancer overall; to read a list of commonly asked questions by bladder cancer patients, click here.

There are many different types of bladder cancer. “High grade” and “low grade” are the terms used to differentiate most types of bladder cancer.

• High-grade bladder cancer cells look more aggressive under a microscope and have the ability to progress through the bladder wall.
• Low-grade bladder cancer is usually not associated with progression; however, patients can have both low and high-grade bladder tumors.

The next consideration for determining the type of bladder cancer is staging. Staging usually includes imaging with a CT scan, exam of the bladder under anesthesia and a resection of the bladder tumor. Bladder cancer treatment varies widely based on the type of cells causing the cancer, the grade, and stage.

Treatments

Cystoscopy is an integral way for monitoring the bladder for recurrence of bladder cancer. Cystoscopy can be done usually in the office. The schedule for this varies based on the frequency of recurrences, type, grade and stage of bladder cancer.

Intravesical Treatment is medication used within the bladder. There are many different types of intravesical treatments. One of the most common treatments is BCG, but there are many others. In addition, there are ongoing clinical trials in the area to improve treatment for patients who qualify for this type of treatment.

Lastly, the Radical Cystectomy is the most intense treatment option. This procedure removes the bladder itself. The reason it is referred to as radical is that it implies removing the bladder and any other adjacent structures where the bladder cancer may have spread. This includes surrounding bladder fat, lymph nodes, occasionally the urethra, the prostate in males, and a portion of the vagina (plus or minus the uterus) in females. Although this sounds like a lot, control of the cancer is of the utmost importance in bladder cancer, which can be deadly if not controlled properly at the time of initial diagnosis. Cystectomy in the 21st century is a safe, effective procedure with many ways of creating new urinary drainage systems after bladder removal. Most patients opt for the creation for a new bladder using bowel once the bladder is removed, but other systems of draining the urine (a bag to the skin or new bladder hooked up to the skin that is catheterized to release urine) do exist.

Testicular cancer is a malignancy of the testicle. It is the most common type of cancer in men from 15 to 40 years of age, but it can occur at any age from infancy through adulthood.

There are several types of testicular tumors and tumors that surround the testicle, but by far the most common (90-95% of cases) is a type of cancer called a Germ Cell Tumor (GCT). The information below will focus on testicular tumors of this type.

Germ Cell Tumors are typically detected as a mass felt by the patient or doctor. Sometimes the mass causes pain or discomfort, sometimes not.  Any lump, swelling, or unusual sensation in the testicle should lead to an exam by a physician and potentially an ultrasound of the scrotum and testicles.  At this point, if a mass or tumor is detected in the testicle, it requires evaluation by a urologist.

Treatment Options

Most patients with a testicular mass or tumor will be advised to undergo Orchiectomy, or surgical removal of the testicle.  This will allow the pathologists to look under the microscope and determine what type of tumor it is and help guide what further treatment is required.  Additionally, some radiologic imaging (X-rays and CT Scans) and blood tests (tumor markers such as Alpha-Fetoprotein and Beta-HCG) will be required to evaluate the tumor and determine the likelihood that the cancer has spread to other parts of the body.

The good news is that testicular cancer is treatable and has a favorable outlook; most patients are cured.  However, at a minimum, this will require close follow-up with your urologist..  It may also include further surgery, chemotherapy, radiation, and routine imaging to see if the cancer has spread or returned.

We are experienced with all phases of treatment for testicular cancer and can provide care for patients with all stages of disease. The proper treatment for this type of cancer is not always straightforward, and we believe it helps to get some advice from physicians with abundant experience treating this cancer. It would be our pleasure to meet with you to discuss your specific situation. We offer both traditional and cutting-edge options for treatment, as well as the opportunity to be involved with the latest in research for testicular cancer. 

Follow-Up Treatments

Following treatment for testicular cancer, a doctor may recommend a Retroperitoneal Lymph Node Dissection, or RPLND. Some cancers are more likely to spread than others, and if a testicular tumor is likely to spread, the lymph nodes of the abdomen may be removed to prevent them becoming cancerous. 

Read more about RPLND

Kidney cancer, also known as renal cell carcinoma, is cancer that begins in the kidneys when cells begin to grow out of control. The kidneys are bean-shaped organs located on both sides of the spine behind the other abdominal organs. The main job of kidneys is to remove excess water, salt, and other waste from the blood. The waste that is filtered by the kidneys becomes urine that collects in the center of each kidney in the renal pelvis and exits the kidneys through tubes called ureters. These tubes lead to the bladder.  

According to the American Cancer Society, Kidney cancer is among the 10 most common cancers among men and women, with men (one in 43) being twice as likely as women (one in 73) to be diagnosed. Kidney cancer is more common among African Americans and American Indian/Alaska Natives. The median age of people diagnosed with kidney cancer is 64. The American Cancer Society estimates about 81,610 new cases of kidney cancer, about 52,380 in men and 29,230 in women, are diagnosed and about 14,390 people, 9,450 men and 4,940 women, die from the disease every year. 

Renal cell carcinoma is the most common type of kidney cancer in adults, making up about nine out of every 10 kidney cancers diagnosed. Although rare, a solid kidney cancer tumor called Wilms tumor is the third most common type of solid tumor affecting children.

Read More about Kidney Cancer

Prostate cancer occurs when cells in the prostate gland develop changes in their DNA, causing the cells to multiply rapidly. These abnormal cells form a tumor that can destroy normal body tissues and structures. The prostate is a small, walnut-sized gland located behind the base of the penis and below the bladder. The prostate produces seminal fluid, the liquid in semen that protects, nourishes, and helps transport sperm.

Prostate cancer is among the most diagnosed cancers in men. About one in every eight men will be diagnosed with prostate cancer during their lifetime. According to the American Cancer Society, more than 299,010 new cases of prostate cancer are diagnosed in the U.S. each year, resulting in about 35,250 deaths.

In Colorado, there are approximately 4,490 new cases of prostate cancer each year.

Read More about Prostate Cancer

Penile cancer is exceedingly rare in the United States, accounting for less than 1% of all cancer diagnoses in the US. 

This means that for those with this diagnosis, a top-notch care team is required.

The three most common types of penile cancer are basal cell carcinoma, melanoma, and sarcoma, most commonly forming on the glans of the penis.

Read More about Penile Cancer