Urinary tract cancers can present themselves with a number of symptoms, or none at all. If you are concerned you may have cancer or have already received a diagnosis, you need expert knowledge and compassionate care. Through our team approach, Western Michigan Urological Associates provides world-class care from your initial visit and evaluation through treatment, recovery and follow-up consultations.
After a complete patient assessment and diagnostic evaluation, our experienced team members work together to develop an individualized treatment plan using the most advanced techniques of traditional surgery, minimally invasive surgery, laparoscopic and da Vinci® robotic approaches, radiotherapy and chemotherapy. We want to ensure you receive the smoothest, most efficient and best care possible.
- Prostate cancer
- Kidney cancer
- Bladder cancer
- Testicular cancer
The prostate is the walnut-sized organ located just below the bladder and in front of the rectum that produces fluid that makes up a part of semen. Cancer can develop in this organ. Prostate cancer is the most commonly diagnosed cancer in men, and second only to lung cancer in the number of cancer deaths. Prostate cancer tends to occur most commonly in men over age 50, and greater than 65% of all cases are diagnosed in men 65 years and older. The incidence of prostate cancer increases with age.
The American Cancer Society and American Urologic Association recommend prostate cancer screening starting at age 40 for most men. Generally, prostate cancer is symptomatic at early states. Depending on your screening results a prostate biopsy may be recommended.
- Being 40 years old or older
- African-American background
- Having a father, brother, or son who has had prostate cancer
- About 90% of prostate cancers are diagnosed at a localized stage (cancer confined to prostate without evidence of spread).
- Digital rectal exam (DRE): We contour a gloved finger into the rectum to feel the prostate’s size, shape, and hardness.
- Prostate specific antigen test (PSA): The prostate makes a substance called PSA. This test measures the PSA level in the blood, which may be higher in men with prostate cancer. However, other conditions such as an enlarged prostate, prostate infections, and certain medical procedures may also increase PSA levels.
Several treatment options are effective for men with prostate cancer. We look at each patient individually to determine the right approach to care.
- Active surveillance (observation) is used in some cases of low-risk disease, as well as among older patients for whom active treatment with surgery or radiation therapy may not be possible or necessary. Active surveillance is most often used because some prostate cancers may never become life threatening.
- Radical retropubic prostatectomy (RRP) – involves removing the prostate gland and surrounding lymph nodes through a small open incision above the pubic bone. The procedure can be used to treat a range of prostate cancer, including low, intermediate and high-risk localized prostate cancer. Depending on the stage and risk, radical retropubic prostatectomy can be performed with nerve-sparing. Nerve-sparing prostatectomy provides the best chance of return of erections following surgery in men with good erectile function before treatment.
- Robotic-assisted laparoscopic prostatectomy (RALP) is the most common surgical treatment for prostate cancer. This approach uses laparoscopy as well as small surgical working elements that replicate human hand movement. Generally, RALP means less blood loss, a lower chance of a needed blood transfusion, decreased pain after surgery, and shorter recovery.
- Radical perineal prostatectomy involves removing the prostate through an incision in the area between the scrotum and anus. Perineal prostatectomy is relatively uncommon, but is still used in certain cases, such as in larger patients in which getting to the prostate from pelvis would be difficult.
- 3D conformal and Intensity-Modulated Radiation Therapy – Radiation therapy can be used to manage low and high-risk cases. This approach targets the prostate with the aid of imaging guiding to more accurately deliver radiation dose to the prostate with less radiation exposure to surrounding tissues.
- Interstitial prostate brachytherapy places small radioactive pellets, or “seeds” into the prostate. Generally, this treatment can be used for small to normal sized prostates.
Kidney cancer tends to occur most commonly in individuals older than age 40 and is more frequent in men than women. Most kidney cancers occur spontaneously, although some result from hereditary conditions.
- Local kidney cancer – Roughly 60% of kidney cancers are diagnosed at a localized stage (cancer confined to kidney without spread). Localized cancers may not have symptoms or may be associated with hematuria (blood in the urine), flank pain or abdominal discomfort. Surgery is the most effective treatment.
- Advanced kidney cancer – Approximately 40% of kidney cancers are diagnosed at an advanced stage that has spread to surrounding structures, lymph nodes or metastasis to more distant sites. Common sites of metastatic spread include the lung, bone and brain.
- Blood in urine, which may make urine look rusty or darker red
- Side pain that doesn’t go away
- A lump or mass in your side or abdomen
- Weight loss for no known reason
- Family history — People with a family member who had kidney cancer have a slightly increased risk. Certain conditions that run in families also can increase risk.
- Urinalysis (urine test) – checks urine for blood and other disease signs
- Blood tests — checks blood for several substances, including creatinine. A high creatinine level may mean the kidneys aren’t functioning properly.
- Ultrasound — sound waves that create a picture of your kidneys and nearby tissues can show a kidney tumor.
- CT scan – a series of detailed pictures of your abdomen show your urinary tract and lymph nodes, and may show if cancer is present in your kidneys, lymph nodes, or elsewhere in the abdomen.
- MRI – this large machine with a magnet linked to a computer creates detailed pictures of your urinary tract and lymph nodes. You may receive an injection of contrast material. An MRI can show cancer in your kidneys, lymph nodes or other tissues in the abdomen.
- IVP – a dye, injected into a vein in your arm, travels through the body and collects in your kidneys. The dye makes the kidneys show up on x-rays. A series of x-rays tracks the dye’s movement through your kidneys to your ureters and bladder. The x-rays can show a kidney tumor or other problems.
- Active surveillance of small, early-stage, low-risk kidney cancers may be an option for those not interested in (or candidates for) surgery or ablative therapy. Active surveillance may be appropriate for older individuals with small kidney tumors for whom surgery risk is too great.
- Ablative therapies use radiofrequency energy and extremely low temperatures to cause tissue destruction. Ablative therapy is most commonly used in older or medically unhealthy patients for whom surgical risk is too great.
- Partial nephrectomy – removal of the tumor without removing the entire kidney – is often recommended for smaller kidney tumors, in patients with a single kidney or tumors in both kidneys. We may also recommend this procedure for patients with diabetes or hypertension to preserve as much renal function as possible. This can be done through a conventional (larger) incision or with a robotically assisted laparoscopic approach.
- Radical nephrectomy consists of removing the entire kidney with the surrounding tissue. This approach is most often used in cases in which a partial nephrectomy is not possible because of tumor size or location. Radical nephrectomy is also the standard treatment for high-risk kidney cancers.
Bladder Cancer tends to occur most often in individuals older than age 60 and is two to three times more common in men than in women.
There are two broad categories:
- Non-muscle invasive bladder cancer — Approximately 70% of patients have non-muscle invasive cancer.
- Muscle-invasive and advanced bladder cancer — Between 20% and 25% of bladder cancer cases are muscle-invasive.
- Blood in the urine (hematuria)
- Painful urination
- Urinary frequency
- Urinary urgency
- Abdominal pain
- Bone pain or tenderness
- Lethargy or fatigue
- Urinary incontinence
- Weight loss
- Cigarette smoking — increases bladder cancer risks nearly fivefold. As many as 50% of all bladder cancers in men, and 30% in women may be caused by cigarette smoke. People who quit smoking have a gradual decline in risk.
- Chemical exposure at work — About one in four bladder cancer cases is caused by exposure to cancer-causing chemicals (carcinogens) on the job. Dye workers, rubber workers, aluminum workers, leather workers, truck drivers and pesticide applicators are at the highest risk.
- Radiation and chemotherapy — Women who received radiation therapy to treat cervical cancer have an increased risk of developing transitional cell bladder cancer. Some people who have received the chemotherapy drug cyclophosphamide (Cytoxan) are also at increased risk.
- Bladder infection — A long-term (chronic) bladder infection or irritation may lead to squamous cell bladder cancer. Bladder infections do not increase the risk of transitional cell cancers.
- Parasite infection — Infection with the schistosomiasis parasite has been linked to bladder cancer.
- Abdominal CT scan
- Cystoscopy (examining the inside of the bladder with a camera)
- Bladder biopsy (usually performed during cystoscopy)
- Intravenous pyelogram — IVP
- Urine cytology
If the cancer has spread into the bladder wall or outside the bladder, treatment may include:
- Cystectomy with urinary diversion — In men, the bladder and prostate are identified, dissected and removed. In women, the bladder, uterus, fallopian tubes, ovaries and anterior portion of the vagina are identified, dissected and removed. Surrounding lymph nodes are removed to assess the extent or spread of the cancer.
- Chemotherapy — a systemic treatment in which drug is given throughout the entire body. It’s designed to kill cancer cells. Typically, it is administered intravenously (through a vein).
- Radiation therapy with chemotherapy — Radiation uses high-energy x-rays to destroy cancer cells. The addition of systemic chemotherapy makes cancer cells more vulnerable to the killing effects of radiation. Radiation therapy is also used to relieve symptoms of advanced bladder.
This cancer is the most common malignancy in men between ages 15 to 35 years, although the occurrence is still very low. Only about 0.2% of American men will develop testicular cancer during their life time. Fortunately, it is also one of the most curable cancers due to early diagnosis and effective treatments.
Early detection is important, so we recommend a monthly self-examination. This is best performed in a warm shower. Please let us know of any suspicious areas.
- A lump or enlargement in either testicle
- A heavy feeling in the scrotum
- A dull ache in the abdomen or groin
- A sudden collection of fluid in the scrotum
- Pain or discomfort in a testicle or the scrotum
- Enlarged or tender breasts
- Unexplained fatigue or a general feeling of not being well
- An undescended testicle (cryptorchidism) — Testes usually descend into the scrotum before birth. Men who have a testicle that never descended are at greater risk of testicular cancer than men whose testicles descended normally. The risk remains even if the testicle has been surgically treated.
- Abnormal testicle development — Conditions that cause testicles to develop abnormally, such as Klinefelter’s syndrome
- Family history
- Age — Testicular cancer affects teens and younger men, particularly between ages 15 and 34. However, it can occur at any age.
- Race — More common in white men than in black men
- Blood test