Genitourinary Cancer is a special type of cancer that is found in the urinary system and the male reproductive system. It develops due to the uncontrolled growth of abnormal cells within the urinary or reproductive organs. Of the top 10 most common cancers in men, 3 are genitourinary in origin (prostate, kidney and urinary bladder). Similarly, kidney and urinary bladder cancer are among the top 12 most common in women. There are several types of genitourinary cancers.

• Types of cancer developing in the urinary system include:
  • Kidney Cancer
  • Bladder Cancer
  • Urethral Cancer
  • Ureter Cancer
  • Adrenal cancer
• Types of cancer developing in organs of the male reproductive system include:
  • Prostate Gland Cancer
  • Testicles Cancer
  • Penile Cancer
• Types of cancer developing in Women’s reproductive system:
  • Cervical Cancer
  • Endometrial Cancer
  • Ovarian Cancer
  • Peritoneal Cancer
  • Uterine Cancer
  • Vaginal Cancer
  • Vulvar Cancer

A patient might experience various signs and symptoms of genitourinary cancer depending on the organ which is affected. Important warning signs which require evaluation include:

• Blood in the urine
• Any difficulty passing urine like a weak stream, difficulty in controlling urine, burning urination, increased frequency of urination or passing small amounts of urine often
• The pain of one side of the back
• The heaviness of pain on one side of the abdomen
• Feeling a lump or mass in the abdomen, scrotum or either testicle
• Growth or ulcer over the penis
• Non-specific symptoms like loss of weight and appetite or fever can occasionally be related to genitourinary cancer
• Bone pain
• Raised PSA level on a routine check-up

Since genitourinary cancer comprises of various kinds of cancer, thus the symptoms may vary for different types of cancer. A patient experiencing some of the above-mentioned symptoms must visit a doctor to evaluate the condition in detail.

The doctor performs various tests to diagnose and stage cancer to develop an effective treatment plan. Diagnostic and staging procedures could include:

• Blood Tests like PSA level can suggest the presence of prostate cancer
• Imaging studies help us to look directly at the affected organ, as well as potential sites that the disease may have spread (staging). Some the best imagining facilities at the unit include:
  • Computed Tomography (CT)
  • Magnetic Resonance Imaging (MRI)
  • Ultrasound or Positron Emission Tomography (PET)
  • Endoscopy like cystoscopy or ureteroscopy to look at the affected site and take biopsies
  • Tissue biopsies to determine the type and grade of the tumour. This may be done endoscopically or under ultrasound or CT-guided for Genitourinary Cancer
• Molecular tissue testing

Our expert team uro-oncologist surgeons, medical and radiation oncologists, nephrologist, pathologists, radiologists, physicians follows a multidisciplinary approach to develop an individualised, state-of-the-art treatment plan for our patients suffering from genitourinary cancer. This plan could include one or more treatments from the following options:

• Surgery: Involves the removal of the tumour or diseased organ to cure the patient and/or resolve their symptoms of pain, bleeding, etc.
  • Robotic Surgery: One of the newest and most advanced robotic surgical techniques to treat genitourinary cancer. It offers 3-D imaging, removes surgeon tremor and eliminates the inverted manipulation of instruments usually required in laparoscopic procedures. The surgeon sits at a console and controls slender instruments within the patient. These patented “wristed” instruments make surgery very precise and improve patient outcomes. (Hyperlinks to Robotics)
  • Laparoscopic Surgery (Keyhole Surgery): Involves removal of the tumour and other cancerous tissues using a minimally-invasive approach by making several small incisions through which instruments are placed in the body.
  • Open surgery: Sometimes, larger or more advanced tumours may require the traditional open surgical approach for complete removal of the disease.
• Radiation Therapy: Radiation therapy is a very important tool used in the fight against cancer and the treatment of as many as 50% of all cancer patients. Radiation can be given post-operatively and post-chemotherapy for local control and palliation of distant metastases. Radiation therapy is often given in locally advanced cancers where surgical intervention or chemotherapy is not possible. Radiation therapy is a safe & effective procedure where radioactive isotopes or high-energy photons, electrons or other particles are used to destroy the cancer cells. There are two types of radiation
  • External Beam Radiotherapy (EBRT)
  • Brachytherapy or interstitial (HDR)

Radiation Oncologist is the specialised doctor for this treatment. Radiotherapy regimens or schedules and protocols are specific for different tumours and hence the time for treatment differs from case to case.

• Hormone Therapy: Hormone therapy is a treatment that uses medicines to block or lower the number of hormones in the body to slow down or stop the growth of cancer. It is used because certain cancers can grow due to excessive circulating hormones in the body.
• Chemotherapy: Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, or infusion, depending on the type and stage of the cancer being treated. It is used in advanced cancer to control the disease, currently used for those cancers that have spread to other parts of the body or recurred.
• Targeted Therapy: Targeted therapy works by targeting cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. These genes and proteins are found in cancer cells or cells related to cancer growth, like blood vessel cells.Targeted therapy is used by itself or along with chemotherapy and immunotherapy. It is used in those cancers which are spread widely in the body. It is given post-surgery in certain cancers to prevent it from coming back.
• Immunotherapy: Cancer immunotherapy is the artificial stimulation of the immune system to treat cancer, improving the immune system's natural ability to fight cancer. It is an application of the fundamental research of cancer immunology and a growing subspecialities of oncology. It is currently used as an effective modality in combination with chemotherapy or targeted therapy to control the advance and widespread cancers.

Some of the major factors that lead to Genitourinary Cancer include:

• Age: Risk of developing genitourinary cancer is higher with age so never skip your check-ups
• Gender: Most types of genitourinary cancers develop in men
• Family history: Men with a family history of prostate cancer, Kidney Cancer or Bladder Cancer have a higher risk.
• Genetic Disorders: Genetic mutations or syndromes can increase the risk of Genitourinary Cancer.
• Smoking: Smoking can cause all types of genitourinary cancer
• Alcohol: Heavy alcohol consumption is associated with many cancers including aggressive prostate cancer
• Obesity: Men with high BMI are at higher risk of developing cancer especially kidney and prostate cancer
• Unsafe sexual practices: This can cause transmission of Human Papillomavirus (HPV) which can cause penile cancer
• Chemical exposure: Exposure to chemicals in the paints, leather, rubber or plastic industries can increase the risk of urinary bladder cancer. Chlorinated chemical exposure can increase the risk of kidney cancer.
• Personal history of Radiation Treatment: Any exposure to radiation increases your risk of developing Genitourinary Cancer

• Regular PSA Screening with a blood test and Prostate check-up every year for men above 50 years is recommended to detect Prostate cancer early & in a curable stage.
• Avoid the use of tobacco: Studies have shown that the use of tobacco can cause all types of Genitourinary Cancer.
• Exercise Daily: Exercise regularly for around 30 minutes can help in maintaining better overall health including reducing the risk for many cancers.
• Healthy diet and weight: Any heart-healthy diet is also suitable to reduce the risk of genitourinary cancer. Plenty of fruits and vegetables with a reduction in red meat is advisable. Obesity can predispose to kidney and prostate cancer so it is important to maintain a healthy weight.
• Reduce the consumption of alcohol
• Safe sexual practices: Use of condoms helps prevent the transmission of HPV which is responsible for the majority of penile cancer. The HPV vaccination is also available today & is very effective.
• Testicular self-examination: Beginning from their teenage years, all men should examine their testicles once a month. This helps in detecting small lumps or nodules in an early stage.
• Exposure to radiation: Exposure to radiation in any form can elevate the risk of cancer.
• Limit exposure to chemicals: People working in previously mentioned industries should take precautions to minimise chemical exposure.