Treating Urological Cancers

Treatment for urological cancer depends on a number of factors, including:

  • Type of cancer
  • Stage of cancer (how far the cancer has spread)
  • Your age
  • Your overall health
  • Your personal preferences

There are many treatment options available for different types of urological cancers . Some types of treatment are similar for all urological cancers, like chemotherapy and radiation therapy, although the types of chemotherapy drugs used and the length of treatment can vary widely.

Some treatments are specific to the type of cancer, like prostatectomy for prostate cancer and segmental cystectomy for bladder cancer.

General cancer treatments

  • Chemotherapy treats cancer by killing rapidly growing cells, which includes cancer cells. There are many types of chemotherapy drugs. Sometimes they are used alone, and sometimes they are used in conjunction with other chemotherapy drugs. Typically, they are injected into a vein through an IV, and they travel throughout the body to attack cancer cells. Chemotherapy drugs can be very effective at finding and killing cancer cells that have spread to other areas of the body. Low-dose chemotherapy is often used together with radiation therapy.
  • Radiation therapy uses energy beams to destroy cancer cells. It can be used by itself or in conjunction with other treatments, such as surgery or chemotherapy. There are two basic types of radiation therapy - external beam radiation that is given externally and internal radiation that is injected directly into the areas affected by cancer (such as brachytherapy for prostate cancer treatment).
  • Surgery
    • Mohs surgery , also known as microscopically controlled surgery, is used to remove cancer cells while preserving as much of the surrounding healthy tissue as possible. During Mohs surgery, a surgeon removes layers of the affected tissue a little at a time, checking to see if there is any evidence of cancer in that layer. If there is, he or she removes the next layer and repeats the process until they find a cancer-free layer. Surgeons must be trained to perform Mohs surgery because it is a highly specialized technique that requires specific training. It can be used to treat some cancers that have not spread to deep tissue, such as early-stage penile cancer.
    • Laparoscopic surgery (laparoscopy) involves using a camera and thin surgical instruments that are inserted through small incisions to perform surgery. Laparoscopy is a minimally invasive technique that can have benefits, such as less pain, quicker recovery, less scarring and shorter hospital stays.
    • Robotic surgery is a minimally invasive surgery that uses a robot to assist the surgeon with the procedure. Robotic surgeries are becoming more common as more surgeons are being trained to use the surgical robots. Robotic surgery can reduce swelling, bleeding, scarring and recovery time.
  • Biologic therapy , otherwise known as biotherapy and immunotherapy, works by encouraging the body's immune system to help fight cancer cells. Using the immune system to fight cancer can be done in two ways: by stimulating your immune system to work harder and/or smarter to attack specific cancer cells and by giving your immune system a boost, which in turn can help your body fight off cancer.
  • Cryoablation , otherwise known as cryosurgery, freezes tissue in order to kill cancer cells. It can be used for a number of urological cancers, including cervical cancer, kidney cancer and prostate cancer.
  • Radiofrequency ablation (RFA) involves inserting an X-ray guided needle into the cancer cells and using electricity to heat and burn cancer cells. It is a new treatment that isn't widely done, but it may be an option for people who cannot safely have surgery. RFA may be used to treat kidney cancer, among other types of cancer.
  • Targeted therapy is done to block abnormal signals present in cancer cells that allow them to spread. There are a number of different types of targeted therapy. The FDA has approved certain types of therapy for kidney, prostate and cervical cancer. Targeted therapies include signal transduction inhibitors, gene expression modulator, angiogenesis inhibitor, apoptosis inducer, immunotherapies, hormone therapies and toxin delivery molecules. Learn more about targeted therapies from the National Cancer Institute .

Cancer-specific treatments

  • Brachytherapy is a type of radiation treatment for prostate cancer that involves putting tiny radiation seeds directly into the prostate tissue to deliver low doses of radiation over time. The goal is to kill cancer cells while preserving as much healthy tissue as possible.
  • Prostatectomy is a surgery to remove the prostate gland. There are four basic techniques used.
    • Robotic prostatectomy is a minimally invasive surgery in which a surgeon uses a robot to assist with removing the prostate gland. This type of surgery can be more precise, and it can reduce scarring, bleeding and healing time.
    • Retropubic surgery involves making an incision in the abdomen to remove the prostate. One of the benefits of this surgery is that is reduces the risk of nerve damage. Nerve damage can lead to bladder control problems and erectile dysfunction, so this type of surgery is preferable to some men.
    • Perineal surgery involves removing the prostate through an incision made between the scrotum and anus. The recovery time is usually reduced with this type of surgery, but it can make lymph node removal difficult, and it can increase the risk of nerve damage.
  • Hormone therapy is one prostate cancer treatment option. When men have early-stage cancer, hormone therapy is sometimes used to shrink tumors prior to radiation therapy. In men who have later-stage prostate cancer, it is sometimes used to both shrink the cancer cells and slow tumor growth. Hormone therapy may also be used after surgery or radiation. There are a few options for hormone therapy for prostate cancer.
    • Luteinizing hormone-releasing hormone (LH-RH) agonists block messages telling the testicles to make testosterone.
    • Anti-androgens keep testosterone from reaching cancer cells. They are often used along with LH-RH agonists.
    • Removing the testicles through a surgery called orchiectomy lowers testosterone levels.
  • Radical inguinal orchiectomy involves removing one testicle. It is used to treat testicular cancer. In most cases of testicular cancer, only one testicle is involved. When two are removed, it is called an orchiectomy. The surgeon makes an incision in the groin and removes the entire testicle. Some men choose to have a prosthetic testicle inserted at the time of surgery, but that is not necessary.
  • Penectomy (partial or total) is a treatment for some stages of penile cancer. It is usually reserved for cancer that has spread deep into the penis. A partial penectomy involves removing the end of the penis, and a total penectomy involves removing the entire penis.
  • Nephrectomy involves removing a kidney, some surrounding tissue and the lymph nodes that are closest to the affected kidney in order to treat kidney cancer (renal cancer). This surgery can be done traditionally with open surgery or by using minimally invasive laparoscopy.
  • Nephron-sparing surgery , otherwise known as partial nephrectomy, is a surgery to treat kidney cancer. The goal is to save some healthy kidney tissue. During nephron-sparing surgery, surgeons remove the tumor and some healthy tissue surrounding the tumor (the margin), leaving some kidney behind. It is most common when people have small tumors or only have one kidney left. It is preferred over nephrectomy whenever possible.
  • Intravesical immunotherapy , such as Bacillus Calmette-Guerin (BCG) for treating early-stage bladder cancer, involves injecting a liquid drug into the area affected by cancer.
  • Transurethral resection (TUR) is a surgery done to remove bladder cancer that is in the inner layers of the bladder and hasn't spread. A loop-shaped wire burns away cancer cells with an electric current. Sometimes TUR is done using a laser rather than electricity.
  • Radical cystectomy is a surgery performed to remove the bladder and the surrounding lymph nodes when cancer has invaded the bladder wall and possibly surrounding lymph nodes and organs. When men have this surgery, surgeons often remove the prostate gland and the seminal vesicles, while women typically have their uterus and ovaries removed along with the bladder. If the bladder is removed, the surgeon will have to create a way to pass urine from the body. There are a few different surgical techniques used to achieve this goal.
  • Segmental cystectomy , otherwise known as a partial cystectomy, is a surgical procedure done to remove the part of the bladder that contains cancer cells.

The above is a partial list of cancer treatments. Other treatments may be available to you.

Learn more about urological cancers

If you have urological cancer, Beaumont's Urological Cancer Multidisciplinary Clinic will get you in touch with a nurse navigator who will help you through the entire treatment process. Call 877-BEAT-CANCER (877-232-8226).

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