How We Treat Genitourinary Cancer

Surgery is done for many cancers, including bladder and kidney cancers. The type of surgery you’ll have depends on the type and stage of your cancer.

Bladder cancer surgery

Surgery, alone or along with other therapies, is a key component of the treatment plan for most bladder cancers. While surgery can often remove early-stage bladder tumors, new cancers often form in other parts of the bladder over time. Having your entire bladder removed (known as a radical cystectomy) is one way to avoid this, but comes with major side effects. If the entire bladder is not removed, other medical treatments will likely be needed to reduce your risk of new cancers.

The three main types of surgery for bladder cancer are:

• Transurethral resection (TUR) - Removes cancerous tissue from the bladder using high-energy electricity to burn away cancerous cells.
• Cystectomy - Removes the bladder, either partially or completely. A complete bladder removal may require removing nearby organs and tissues, including the uterus, ovaries and part of the vagina in women, and the prostate and seminal vesicles in men.
• Urinary diversion procedure - Reroutes the urinary tract and allows urine to exit the body through the colon or through a small opening in the abdomen and into an external catheter bag.

Kidney cancer surgery

Surgery known as nephrectomy is the most common treatment for kidney cancer, and often the only treatment required. Depending on your cancer, your surgeon may decide to remove a portion of your kidney (partial nephrectomy), the entire kidney (simple nephrectomy), or the entire kidney with nearby lymph nodes, adrenal glands and surrounding tissue (radical nephrectomy). When possible, this surgery is performed laparoscopically, a minimally invasive method that uses small cuts and tiny instruments so you have a shorter hospital stay and easier recovery.

Kidney surgical care can also include:

• Cryotherapy - Treats tumors through freezing (known as cryotherapy), eliminating the need to remove any portion of the kidney.
• Arterial embolization - Blocks the blood supply to the kidney and its tumor. This treatment can help shrink a tumor to relieve discomfort and is often offered when surgery is not possible. Arterial embolization is done by interventional radiology specialists.

Learn more about cancer surgery.

Radiation therapy uses high-energy X-rays to kill or shrink cancer cells. Your doctor may use internal or external radiation, or both, to treat your cancer. This treatment can be used to shrink a tumor before surgery. Or it may be used after surgery to kill cancer cells that remain in the genitourinary system, which encompasses the urinary organs.

Chemotherapy and infusion therapy use powerful medicines to kill cancer cells all through the body. These treatments may be used to shrink a tumor before surgery or to kill any cancer cells that remain after local treatments. Chemotherapy may also treat tumors that have grown in other places in the body. Cancers that have spread are usually treated with chemotherapy, sometimes in combination with hormone therapy.

Chemotherapy doesn’t work well for kidney cancer. Therefore, it is typically only tried after other therapies have been shown to be ineffective.

Immunotherapy is the use of medicines to help a person’s own immune system recognize and destroy invading cancer cells. These medicines can be in the form of pills or injections or given through an IV.

Immunotherapy may be given after surgery. Or it may be given along with other cancer treatments.

This treatment is used with early-stage, superficial bladder cancer. During treatment, medicines are put directly into your bladder. These may be immunotherapy medicines, which make your body’s immune system fight the cancer, or chemotherapy medicines designed to kill cancer cells.

Targeted therapy drugs target the changes in cells that cause cancer cells to form. These drugs affect the cancer cells in your body and leave your normal cells alone. This treatment course sometimes works when standard chemotherapy drugs don’t, and they often have different (and less severe) side effects. Targeted therapy drugs come as pills that you take at home.

Targeted drugs are proving to be particularly beneficial for people with kidney cancer as chemotherapy has not been shown to be effective. If fact, many times this treatment course is tried before chemotherapy is considered.

Tumor ablation treatment destroys a tumor without surgically removing it from the body. This is often the medical recommendation when you’re too sick to have surgery. Ablation techniques include heating the tumor with radio waves (known as RFA), freezing the tumor (known as cryoablation), or killing the tumor by blocking certain blood vessels and cutting off the blood supply that feeds the kidney.

You should always talk to your doctor about your specific treatment plan and what you can expect.