Urologic Oncology

 

Urology is the branch of medicine that focuses on the surgical and medical diseases of the male and female urinary tract system and the male reproductive organs. Urologic Oncology, a subspecialty, concerns the surgical treatment of cancer, including: the kidneys, urinary bladder, prostate, adrenal glands, ureters, testicles and penis.

Kidney Cancer 

Kidney cancer is any type of cancer that formed within the kidney. Kidney cancer does not usually include a cancer that grew outside the kidney and metastasized to include metastatic cancer of the kidney.

Causes

Although the exact cause of kidney cancer is not known, certain factors tend to increase the risk of getting kidney cancer, such as age. Adults, ages of 50 and 80 years are more likely to develop kidney cancer compared to other people. This type of cancer affects men more than women.

These are some other risk factors for kidney cancer:

  • Smoking. If you smoke cigarettes, your risk for kidney cancer is twice that of nonsmokers.
  • Obesity. It can cause hormonal changes which can increase your risk
  • Taking pain medications daily. There is growing evidence suggesting that long-term use of NSAIDS (non-steroidal anti-inflammatory drugs) such as aspirin, ibuprofen and naproxen can increase the risk of kidney cancer by as much as 50%.
  • Having high blood pressure. It is unclear whether it is the high blood pressure (hypertension) itself or the medication used to treat it is the source of the increased risk.
  • Being on long-term dialysis. Dialysis is a treatment that filters waste products from the blood in people whose kidneys have stopped working.
  • Being exposed to certain dangerous chemicals, such as asbestos, cadmium, benzene, organic solvents, or certain herbicides
  • Having Lymphoma, which is a type of cancer that begins in immune system cells. It is not known why, but there is an increased risk of kidney cancer in patients with Lymphoma.
  •  Genetics
    •  von Hippel-Lindau (VHL) disease or inherited papillary renal cell cancer
    •  Family history of kidney cancer, especially in siblings.
    • The risk in African-Americans is slightly higher than in whites. It is not known why.

Symptoms of kidney cancer can include:

  • Hematuria (blood in the urine which makes urine slightly rusty to deep red)
  • Pain in the side that does not go away
  • A lump in the side or the abdomen
  • Unexplained weight loss
  • Fever
  • Feeling  tired or “run down”

Having these symptoms does not mean you have kidney cancer. Infections, cysts, or other conditions also can cause similar symptoms. If you do have one or more of these symptoms, you should see a physician so the problem can be diagnosed and treated as early as possible.

Kidney Cancer Surgery

Although kidney cancer is treated primarily through surgery, surgical techniques over the last 20 years have improved significantly, leading to better patient outcomes.

Before the mid to late 1990s, the care standard for most patients with kidney cancer was the removal of the entire kidney (radical nephrectomy) through a large incision. Today, CHI Health urologists perform hand-assisted laparoscopic nephrectomy. This minimally invasive surgical technique enables removal of only the portion of the kidney with the tumor (partial nephrectomy), in many cases. This newer approach achieves outcomes similar to those obtained with radical nephrectomy, while sparing the kidney and as much kidney function as possible.

 A laparoscope, (long slender device with a tiny video camera attached), and a surgical instrument are inserted through two small "keyhole" incisions and the surgeon's hand through a small incision to remove the kidney. The hand-assisted approach is offered for kidney tumors 3 to 10 centimeters in diameter. The result of using this technique is less pain, less time in the hospital, reduced chance of infection, and a faster return to daily activities.

Percutaneous  CT-Guided Cryoablation

Percutaneous CT-Guided Cryoablation is a newer form of minimally-invasive, kidney-sparing treatment for smaller tumors. The term, “percutaneous” means “through the skin”.  Cryoablation uses extreme cold (cryo) to destroy cancerous tissue (ablation).  Using a CT scanner  to get an optimal view of the area to be treated, the urologist works with an interventional radiologist to precisely place the cryoablation probes directly through the skin and into the kidney cancer. Extreme cold is applied, which ablates the cancerous tissue. Not all cancers can be treated using this approach, however. Kidney cancers that are located too close to other body structures such as the bowel or ureters cannot be treated with percutaneous cryoablation as these other structures can be damaged by extreme cold.