Genito-Urinary Cancer


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Genito-Urinary Cancer

Genito-urinary cancer includes one of the commonest cancer in men i.e, prostate cancer and other are of kidney, ureters, bladder, penile and testicular cancer. Prostate cancer affects men in their seventh decade and management of it is varied depending upon the prolonged natural history and risk for progression to disseminated, potentially fatal disease.

  • Symptoms
  • Treatment

Signs and symptoms

In lieu of screening for prostate cancer now they are detected in asymptomatic individuals. In symptomatic individual, it presents as difficulty in urination or blood in urine. Any cause for painless bleeding in urine should be evaluated and to be considered from tumors arising in kidney, ureter or bladder unless proven otherwise. Cancer of penis usually presents as growth over glans and in advanced cases may present as urinary obstruction.

Evaluation of Genito-urinary cancer

Any painless bleeding in urine should be evaluated by CT scan of abdomen that reveals the tumor of kidney, ureters or bladder and also helps in staging and local extent of the tumor for operability. Prostate cancer when detected due to screening by raised serum Prostate Specific Antigen (PSA) should be evaluated by multi-parametric MRI. Once anatomical extent of the tumor is known then a guided biopsy is taken to know the grade of the tumor. Bladder tumor also needs initial evaluation by cystoscopy and biopsy to reveal the grade and depth of tumor penetration into the wall of bladder. Penile tumors are assessed by local examination and incisional biopsy from the lesion helps to confirm the diagnosis

Management of Genito-urinary cancer

Surgery remains the corner stone for management of genito-urinary cancer, except in prostate cancer where the management is either radiotherapy or surgery with its own benefit and complications. In early stages, bladder cancer can be completely treated with cystoscopic removal of the tumor and in advanced stage needs radical treatment with complete removal of bladder and reconstruction with neo-bladder or by urinary conduit. Kidney and ureteric tumors can be excised by minimally invasive techniques either by laparoscopy or robotics. Penile tumors needs assessment before surgery whether complete removal or partial amputation  is adequate. If partial amputation is contemplated then atleast 2 cm of proximal flaccid length of penis should be available for adequate voiding of urine in standing position.

GENERAL INFORMATION





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