The Urology Group offers the highest-quality care for treatment of bladder, prostate or kidney cancer.
Cancer strikes hundreds of thousands of people every year. Fortunately, the medical community continues to pursue the latest innovations for the complete prevention and treatment of cancer. Our physicians are trained in the latest procedures, to provide complete care from early detection to recovery.
Services and treatments offered:
Our prostate cancer treatment approach depends on each patient's situation. Common prostate cancer treatments include:
- Radical prostatectomy: The surgical removal of the prostate. This is usually done robotically as a minimally invasive surgery.
Radiation: Radiation therapy is often recommended for cancer treatment. It uses high doses of energy to kill cancer cells without long-term effect to healthy cells. This occurs because radiation damages the genetic material of cells in the area being treated, leaving the cells unable to continue to grow. Although radiation damages normal cells as well as cancer cells, the normal cells usually can repair themselves and function, while the cancer cells cannot.
At The Urology Group, radiation therapy is used for treating prostate cancer.
External, or image-guided radiation therapy: Using two- and three-dimensional imaging to direct radiation
External radiation uses three-dimensional imaging to direct radiation at the tumor (a process often referred to as IMRT or IGRT). It is a local treatment, meaning that the radiation is aimed only at a specific part of your body.External radiation therapy is provided on an outpatient basis. The radiation equipment operated by The Urology Group (Image Guided Radiation Therapy, or IGRT) is among the most advanced available anywhere.The Procedure:Patients who undergo external beam radiation with The Urology Group's equipment first undergo a brief preliminary procedure during which the physician inserts two markers into the prostate. The markers are placed through a probe inserted into the patient's rectum. This procedure is similar to (but less involved than) a prostate biopsy. It takes only a matter of seconds, and most patients do not require an anesthetic. Our sophisticated radiation equipment is able to use these markers in the prostate to target the radiation beam.After the markers have been placed, patients receive a daily radiation treatment at the radiation facility. Treatments are delivered Monday through Friday, usually for four to eight weeks depending on each patient's treatment program. During these treatments, the radiation beam itself does not touch you but rotates around you as you lie on the examination table, sending radiation from many directions. The treatments are painless. The entire visit usually lasts 30 minutes, including time to get undressed and dressed again.What to Expect After Treatment:External radiation therapy is a daily outpatient procedure, and you should expect to be able to participate in normal activities, including work, during the treatment program. Short-term side effects include the possibility of urinary difficulty or burning due to prostate swelling. Some patients experience increased bowel movements or temporary mild fatigue. Long-term side effects may occasionally include urinary difficulty or, rarely, blood in the stool. Sometimes patients confuse radiation therapy with chemotherapy; common side effects of chemotherapy – such as nausea, hair loss and loss of appetite – are not the side effects of radiation therapy for prostate cancer.
Radioactive Seed Implementation (brachytherapy): Inserting seeds that contain radioactive material into the prostate
Radioactive seed implantation is a treatment for prostate cancer in which the surgeon inserts radioactive material (“seeds”) directly into the tissues that harbor cancerous tumors. The word "brachytherapy" means "short therapy," indicating that the radiation is limited to short distances. Unlike external beam radiation therapy, where radiation energy must traverse normal tissues from outside the body to reach the cancerous organ, brachytherapy energy is emitted outward from each "seed," allowing a concentration of radiation energy in the diseased tissue.The Surgery:Brachytherapy is a two-step process. First, the physician must measure the precise size and shape of the prostate so that the proper number and strength of seeds can be determined for each patient. This step is traditionally performed by trans-rectal ultrasound, but due to the discomfort and inconvenience of this procedure, physicians at The Urology Group have pioneered an alternative approach using a non-invasive CT scan.Once the patient's prostate anatomy has been defined, and the physician has determined the optimal number, strength and position of seeds, implantation can take place. This second step is performed as an outpatient procedure, under general anesthesia, usually one to two weeks after the initial "mapping" of the prostate.An ultrasound probe is placed in the rectal cavity and a template is affixed to the ultrasound probe. Needles, each loaded with one to five or six seeds, are then passed through the template into the prostate under ultrasound guidance, and the seeds deposited. Many practices rely solely upon the preliminary "mapping" procedure to determine the position the needles and seeds should be placed in the prostate. At The Urology Group, we have helped develop a more accurate intra-operative mapping approach. The intraoperative mapping approach is preferable because it allows the treating physicians to assess the precise shape, position, and size of the patient's prostate – with adjustment to the seed positions as the implant progresses – during the procedure, rather than relying on the preliminary map as is done at most other centers.What To Expect After Surgery:Because brachytherapy is an outpatient procedure, you should expect to be able to go home the same day. The primary short-term side effect of prostate brachytherapy is urinary difficulty due to prostate swelling. Approximately 6 percent of patients require a urinary catheter for more than one night. Some patients may also develop burning with urination, which is usually temporary.Also, all forms of prostate cancer treatment can result in erectile dysfunction. Research show ED develops in as many as 40 percent of men within five years of prostate brachytherapy.
- Hormone therapy: Lowering testosterone production to place prostate cancer in a state of remission
Immunotherapy: White blood cells are "taught" to attack the cancer
In these new, promising treatments, a patient's own white blood cells can be "taught" to attack their cancer. This is accomplished either through immunization (through a cancer vaccine such as Provenge), in which case the patient's own immune system is trained to recognize tumor cells as targets to be destroyed, or through the administration of therapeutic antibodies, in which case the patient's immune system is recruited to destroy tumor cells by the therapeutic antibodies.
Provenge is typically used in cases of prostate cancer after the cancer becomes resistant to hormone therapy. It does not cure prostate cancer, but does delay its progression.
- Chemotherapy: For cancer that has spread and no longer responds to hormone therapy
- Active Surveillance: The patient gets regular urological exams, including a PSA (prostate-specific antigen) test, at least every six months and a repeat prostate biopsy after a year
Our bladder cancer treatment approach depends on each patient's situation. Common bladder cancer treatments include:
Cystoscopy with bladder biopsy or TURBT (transurethral resection of the bladder tumor): The use of a flexible tube with a lighted camera to view the bladder and biopsy or remove a tumor from the bladder wall.
A cystoscopy is a test that enables the physician to see inside the bladder and urethra using a thin, flexible tube with a tiny, lighted camera. This instrument is called a cystoscope.
The cystoscope is inserted into the urethra and slowly advanced into the bladder, providing the physician a view of areas of the bladder and urethra that usually do not show up well on X-rays. Tiny surgical instruments can be inserted through the cystoscope to remove tissue or urine samples. Further, small bladder stones and some small growths may be removed during cystoscopy, eliminating the need for more extensive surgery.
Intravesical chemotherapy: Medicine is administered through a catheter.
In this cancer treatment, medication is administered directly to the bladder through a catheter, typically given weekly for six weeks and possibly followed by a series of periodical booster treatments.
Though similar to instilled medications that treat interstitial cystitis, intravesical chemotherapy specifically treats bladder cancer and, notably, only non-invasive or minimally invasive cancer. This is because medicines administered in this fashion primarily affect only the cells lining the bladder. Any cancer cells outside of the bladder lining, including those that have grown deeply into the bladder wall, are not treated. Drugs placed in the bladder also can't reach cancer cells in the kidneys, ureters and urethra, or that have spread to other organs.
- Radical cystectomy: surgical removal of the bladder. This sometimes can be done robotically as a minimally invasive surgery.
Our kidney cancer treatment approach depends on each patient's situation. Common kidney cancer treatments include:
- Partial or radical nephrectomy: Either a partial or complete removal of the kidney. This is often done robotically or laparoscopically as minimally invasive surgery.
Cryoablation of renal (kidney) tumor: Small tumors can be removed by cryoablation (freezing).
In this procedure, small tumors are removed by freezing. Using laparoscopic or robotic guidance, the physician will insert several ablation needles into the tumor. Once the needles are in place, the cryoablation machine will deliver temperatures of -140 degrees C or lower until the entire tumor and surrounding area is frozen.
- Active Surveillance For some small renal masses monitoring with regular CT scans or MRI is sufficient treatment.
Additionally, our physicians can treat more uncommon cancers, such as urethral and penile.