Uro-Oncology

Uro-oncology is a specialized branch of medicine focused on the diagnosis, treatment, and management of cancers affecting the urinary system, including the prostate, bladder, kidneys, and testicles. These cancers are among the most common malignancies in men, with prostate cancer alone accounting for 27% of male cancer cases. Advances in robotic surgery, immunotherapy, and precision medicine have significantly improved survival rates and quality of life for patients.

Types of Urological Cancers

1. Prostate Cancer

• Most common male cancer (after skin cancer)
• Often slow-growing but can be aggressive

2. Bladder Cancer

• Linked to smoking & chemical exposure
• Early-stage tumors often recur

3. Kidney Cancer (Renal Cell Carcinoma)

• Rising incidence due to obesity & hypertension
• Often detected incidentally on imaging

4. Testicular Cancer

• Most common in young men (20-35 years)
• Highly curable even when advanced

Risk Factors & Prevention

Modifiable Risks:

• Smoking (bladder/kidney cancer)
• Obesity (kidney cancer)
• Chemical exposure (bladder cancer)

Non-Modifiable Risks:

• Age (prostate cancer risk ↑ after 50)
• Family history (BRCA mutations, Lynch syndrome)

🔹 Prevention Tips:

• Regular PSA testing (for high-risk men)
• Smoking cessation
• Healthy diet & exercise

Symptoms & Early Detection

Warning Signs:

• Blood in urine (hematuria) – Bladder/kidney cancer
• Persistent pelvic pain – Prostate cancer
• Testicular lump – Testicular cancer
• Unexplained weight loss – Advanced disease

Diagnosis & Staging

• Imaging: MRI (prostate), CT urogram (bladder/kidney)
• Biopsy: Transrectal (prostate), cystoscopy (bladder)
• Tumor Markers: PSA (prostate), AFP/HCG (testicular)
• Molecular Testing: PD-L1, MSI status for immunotherapy

Treatment Options

1. Surgery

• Robotic Prostatectomy – Nerve-sparing for potency preservation
• Nephron-Sparing Surgery – Partial nephrectomy for kidney tumors
• Radical Cystectomy – Bladder removal with neobladder reconstruction

2. Radiation Therapy

• Brachytherapy (prostate seeds)
• SBRT for localized prostate/kidney tumors

3. Systemic Therapies

• Immunotherapy (Keytruda for advanced bladder cancer)
• Targeted Therapy (Cabozantinib for kidney cancer)
• Chemotherapy (Cisplatin for testicular cancer)

Breakthrough Advances

• PSMA PET-CT – Precision imaging for prostate cancer
• Liquid Biopsies – Early detection of recurrence
• Focal Therapy – HIFU/cryoablation for localized tumors

Life After Urological Cancer

• Erectile rehabilitation post-prostatectomy
• Continence management after bladder surgery
• Surveillance protocols for recurrence monitoring