Urological Cancer Treatments
PROSTATE CANCER
In Australia, prostate cancer is the most commonly diagnosed cancer in men. It occurs when abnormal cells develop in the prostate.
In general, prostate cancer is a slow growing disease and the majority of men with low-grade prostate cancer live for many years without it spreading. However, high-grade prostate cancer may spread and cause life-threatening disease. Appropriate management is key.
SYMPTOMS
The majority of patients with early prostate cancer do not have symptoms. In the later stages, symptoms include difficulty urinating, blood in semen or urine, and pain in lower back. Prostate cancer may be picked up early by a physical examination and blood test (Prostate Specific Antigen) from age 50. If you have a family history of prostate cancer, this increases your risk and you may wish to be tested from age 45.
WHAT IS A PSA TEST?
Prostate-specific antigen (or PSA) is a protein produced by normal, as well as malignant (cancerous), cells of the prostate. The blood level of PSA is often elevated in men with prostate cancer. However, a number of benign (not cancerous) conditions can also cause a man’s PSA to rise (eg. infection, benign enlargement of the prostate, ejaculation, surgery).
Below is an illustration of the prostate cancer risk according to PSA and age.
From Douglas Hanley Moir https://www.dhm.com.au/media/Multisite8416/dhm_information-for-clinicians_assessment-of-prostate-disease_201904.pdf
WHAT IS A PROSTATE HEALTH INDEX (PHI)?
A prostate health index has been shown to be a more accurate indicator of prostate cancer risk. PHI is a mathematical formula that combines total PSA, free PSA and [-2] proPSA. PHI can assist patient and doctors to make a decision about proceeding with a prostate biopsy.
TREATMENT
Active surveillance: this strategy is for low risk prostate cancer which is unlikely to spread or cause death. It involves closely following the patient’s condition without giving any treatment unless there are changes in test results.
Surgery: robotic radical prostatectomy
Radiation therapy
Focal therapy
Hormonal therapy (advanced prostate cancer)
Chemotherapy (advanced prostate cancer)
FURTHER INFORMATION
Prostate Cancer Foundation of Australia: https://www.prostate.org.au
KIDNEY CANCER
Kidney cancer is relatively common in Australia. It is a type of cancer that grows in the cells of the kidneys.
If found early, kidney cancers can usually be cured, although 1000 people still die of kidney cancer every year in Australia. Risk factors are smoking, high blood pressure, obesity, a family history of kidney cancer, having advanced kidney disease and being male.
Simple kidney cysts are fluid-filled sacs. They are common and are not cancerous. They do not need treatment if they are not causing symptoms.
Solid kidney masses need to be reviewed by a Urologist. Masses smaller than 4cm are considered small renal masses. Kidney cancers grow at an average rate of 0.28cm/year.
SYMPTOMS
Early kidney cancer often do not produce any symptoms. Symptoms include:
Blood in urine
Pain or dull ache in the side or lower back
Lump in abdomen
Constant tiredness, unexplained weight loss and night sweats
TREATMENT
Active surveillance
Surgery
Robotic/laparoscopic radical nephrectomy
Robotic/laparoscopic partial nephrectomy
Open nephrectomy with IVC thrombectomy (advanced disease)
Radiofrequency ablation
Immunotherapy (advanced disease)
Targeted therapy (advanced disease)
FURTHER INFORMATION
BLADDER CANCER
Bladder cancer is a disease in which cancerous cells form in the cells of the bladder. Smoking increases the risk of bladder cancer.
SYMPTOMS
Symptoms of bladder cancer include blood in urinary, urinary frequency and urgency.
TREATMENT
Surgery:
Cystoscopy and transurethral resection of bladder tumour
Open or robotic cystoprostatectomy with ileal conduit
Intravesical chemotherapy: chemotherapy or BCG
Radiation therapy
Chemotherapy (advanced disease)
FURTHER INFORMATION
ADRENAL CANCER
Adrenal cancer is a rare cancer that grows in the adrenal glands. When found early, there is a chance for cure.
But if the cancer has spread beyond the adrenal glands, cure becomes less likely. Most growths from the adrenal glands are benign (non-cancerous). Benign adrenal tumours, such as adenomas or phaeochromocytomas, may release different hormones.
SYMPTOMS
Adrenal cancer often does not cause any symptoms. Symptoms include weight gain, abdominal bloating, high blood pressure, muscle weakness, nausea/vomiting, back pain, loss of appetite, and unexplained weight loss.
TREATMENT
Surgery: Laparoscopic/robotic adrenalectomy
Radiation therapy
Chemotherapy