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Genitourinary Cancer - GU

The genitourinary system includes organs that are involved in reproduction and help to rid the body of waste.

Bladder Cancer

The bladder is an expandable and retractable organ in the pelvis that holds urine until the body is ready to urinate. It is made up of an inner layer of transitional cells and an outer layer of muscle. Malignant bladder cancer is classified as noninvasive (keeping to the inner layer) or invasive (found in both the inner and outer layers). The most common bladder cancer, transitional cell carcinoma (TCC), has several subcategories that include noninvasive TCC, Invasive TCC, papillary TCC, and flat TCC. Other bladder cancers are squamous cell carcinoma and adenocarcinoma.

Patients with noninvasive, invasive, and metastases have a 94%, 55%, and 10% respectively chance of surviving five years after diagnosis. Risk factors include smoking, age, gender (found more often in men), race (found more often in Caucasians), exposure to chemicals (occupational hazard found in paint, print, rubber, leather and textile production), chronic bladder problems (infection), personal history of bladder cancer, exposure to Cytoxan, not taking in enough fluids day to day, and parasitic disease (Schistosomiasis). Symptoms may include blood found in the urine, altered bowel movements, unintentional weight loss, low appetite, pain during urination, urination more than normally, and having the feeling of a full bladder but not able to urinate.

Kidney Cancer

The kidneys are two organs found toward the back of the abdomen. The hormones they produce affect blood pressure and production of red blood cells. One of the most important functions is the filtering of blood to remove waste and excess of other protein and nutrients. When one kidney fails, a patient can survive without treatment, but if both kidneys fail, patients must be put on dialysis.

Renal cell carcinoma, transitional cell carcinoma, sarcoma, and Wilms tumor are the different types of kidney cancer. Patients have a 66% chance of surviving 5 years after diagnosis of kidney cancer. Risk factors are smoking, gender (found more often in men), age (more often diagnosed between 50-70), obesity, diets high in fat, high blood pressure, cadmium exposure, and long-term dialysis. Genetic risks are Von Hippel-Lindau syndrome, Birt-Hogg-Dube, hereditary leiomyomatosis, and tuberous sclerosis. Symptoms may include blood found in the urine, pain felt in the back or side, ankle and leg swelling, anemia, high blood pressure, fatigue, unintentional weight loss, fever, and reduction in appetite. In men, the formation of a varicocele surrounding the testicles may be present as a symptom of kidney cancer.

Prostate Cancer

The prostate is a male reproductive organ that produces seminal fluid to assist in the transport and release of sperm. Types of prostate cancer are adenocarcinoma (most common type) and small cell anaplastic cancer. Patients have a 99% chance of surviving at least 5 years after diagnosis. Risk factors include age (over 50), race (found more often in African Americans), family history of prostate cancer, and large amounts of testosterone production. Some symptoms that may present are blood in the urine, fatigue, unintentional weight loss, pain felt in the pelvis and back, abnormally frequent urination especially during the night, and pain or burning during urination.

Penile Cancer

The penis is a male reproductive and urinary organ that has three layers made up of the corpora cavernosa and corpus spongiosum. Types of penile cancer include epidermoid carcinoma (the most common form), basal cell penile cancer, melanoma, and sarcoma. Patients have a 75% chance of surviving 5 years after diagnosis. Risk factors are infection with the human papillomavirus, smoking, age (over 50), having smegma and/or phimosis, not being circumcised, and personal hygiene of foreskin. Symtoms include any mass, ulcer, or lesion found on or surrounding the penis, discharge from foreskin, blood found coming from the foreskin or penis, pain or swelling without explanation, rash, surrounding swollen lymph nodes, and any changes in tissue color.

Testicular Cancer

The testicles are a male reproductive organ that produces sperm and the hormone testosterone. They are found outside of the body underneath the penis in a sac called the scrotum. The placement of the testes are due to sperm needing an environment cooler than normal body temperature to develop and function. Types of testicular cancer are germ cell tumors, which include seminoma and non-seminoma forms; leydig cell tumor; sertoli cell tumor; and carcinomas. Patients have a 96% chance of surviving 5 years after diagnosis. Risk factors include age (often found ages 20-45), family history of testicular cancer, personal history (already have one testis diagnosed), undescended testicles, infection with HIV, and having Klinefelter’s syndrome (a genetic disorder). Symptoms that may present are swelling, pain of the testes or surrounding areas, enlargement, tenderness of the breast and increased weight or fluid buildup of the scrotum.

Preventive measures

There are no ways to prevent bladder, kidney, prostate, penile or testicular cancer. Healthy lifestyle changes that may help reduce risk of the diseases are exercising; eating a low-fat diet high in fruits, vegetables, and fish; avoiding tobacco use; avoiding exposure to industrial chemicals; drinking plenty of fluids, especially water; and controlling high blood pressure. If you notice blood in your urine, you should seek immediate medical attention. Males should examine their testicles monthly for any lumps after a warm bath or shower. Regular self exam may improve the chances of finding a tumor at its earliest stage. Circumcision at birth and good hygiene may prevent penile cancer.

Screening 

Risk factors for prostate cancer include being 50 years of age or older, being African American, having a brother, son, or father who had prostate cancer, eating a diet high in fat, and drinking alcoholic beverages. Screening is looking for cancer before a person develops any symptoms. By the time symptoms appear, cancer may already have spread to other parts of the body. Screening tests are helpful in finding cancer early when treatments are most effective, thus decreasing the risk of death from prostate cancer. A digital rectal exam (DRE) is when a physician inserts a lubricated gloved finger into the lower part of the rectum to feel the prostate for any lumps or abnormal findings. A prostate-specific antigen (PSA) measures the amount of PSA in the blood. PSA is a substance made by the prostate, and an increased amount is found in the blood of men who have prostate cancer. Infection, inflammation, or benign prostatic hyperplasia (an enlarged, but not cancerous prostate) can also increase the level of PSA.

Partners in Wellness - Free Health Screening Opportunities

Diagnostic Process

A prostate biopsy (a sample of the prostate tissue) is currently the only definite method of diagnosing prostate cancer. A biopsy is performed on all men with a strong suspicion of cancer based on PSA (prostate-specific antigen) test results and additional risk factors. Diagnosis tools for bladder cancer are urine and blood lab work, cystoscopy (a flexible tube is inserted through the urethra to look for any obstructions), intravenous pyelogram (x-ray to evaluate your blood flow to the kidney and bladder and detect any abnormalities), and bladder tumor marker studies (look at cellular substances that a bladder tumor could release into the urine).

Tests

Tests to diagnose kidney cancer include urine tests, blood tests, CAT scans, intravenous pyelogram, biopsy, ultrasound, and surgery. Computed tomography (CAT) scan combines X-ray images with computers to produce a highly detailed cross-sectional picture of the body. Diagnostic tests for testicular cancer are a blood test to determine tumor markers, ultrasound, and surgery. The only diagnostic test for penile cancer is a biopsy.

Treatments

Your oncology team consists of medical oncologists, radiation oncologists, and surgical oncologists. They all collaborate together to plan the best treatment plan for each individual. The medical oncologist initiates chemotherapy which is medications that kill cancer cells. The chemotherapy medications may be given by mouth, intravenously (through a vein), or intramuscular (in the muscle). We offer a wide range of chemotherapy treatment options depending on each individual case. Your medical oncologist will also make any adjustments to your treatment plan as needed, answer any questions, and explain complicated issues that may arise. A radiation oncologist uses radiation therapy, or high energy X-rays, to kill cancer cells or inhibit them from growing. A surgical oncologist is specialized in performing surgery to remove cancerous tumors. Surgery depends on the size, location, and extent of the tumor. Each treatment plan is targeted to each individual and may differ from another treatment plan. 

Advanced Science & Research

We are continuously participating in research for our genitourinary cancer patients. Newly developed treatments or investigational drugs can also reduce tumor size and eliminate symptoms. Patients are voluntarily asked to participate in our research trials to evaluate new cancer prevention and treatment choices.

Clinical Trials

We are actively participating in clinical trials and research for our cancer patients. Newly developed treatments or investigational drugs may reduce tumor size and eliminate symptoms better than treatments currently available.

Patients are asked if they would like to participate in our clinical trials to evaluate new cancer prevention and treatment choices. Participation is completely voluntary. Ask the doctor about clinical trials at your visit.

See the patient information on Clinical Trials at the Feist-Weiller Cancer Center. Additional information is available for medical professionals.  For more information about ongoing clinical trials at the Feist-Weiller Cancer Center, please call us toll-free at 1-866-LSU-FWCC (578-3922) or (318) 813-1410.

Cancer Support Group

The Feist Weiller Cancer Center offers two patient support groups, meeting once a week, for all types of cancer. For more information about these two support groups, please call:

Jo Ann Stewart, RN at (318) 813-1409
Susie Wiggins, RN at (318) 813-1417
Ron Nierman at (318) 470-6180

Genetic Testing and Counseling 

Almost all of us have known someone with cancer, be it a colleague, friend, or family member. For many, these acquaintances are few, and family occurrences sporadic, but for some families, cancer appears to have a much higher prevalence and may be passed throughout many generations. Our expanding knowledge regarding the hereditary aspect of cancer has enabled genetic counselors, nurses, and physicians to provide risk counseling to patients; and advances in genetics have allowed us to develop tests that help to pinpoint this hereditary risk. 

At the Feist-Weiller Cancer Center, the Hereditary Cancer Risk Assesment Program performs an initial cancer risk assessment for all patients by recording a complete family history and creating a pedigree in which all affected relatives are shown. If the patient has a positive family history of cancer, he or she is referred for genetic counseling in order to determine if genetic testing is the next appropriate step. Once genetic testing is completed, patients receive an additional counseling session in which results are disclosed and discussed. If a patient tests positively for a given mutation, specific surveillance and preventive options, as well as additional genetic testing for other family members, are discussed.

If a genetic mutation is detected in at-risk individual, which predisposes him to development of a hereditary cancer syndrome, this information is crucial in guiding the future medical and surgical management of this individual. In addition, certain hereditary cancers have unique behaviors at both a clinical and molecular level, and detection of specific mutations may help to guide therapy for these types of cancer. Discovery of a mutation specific for a hereditary cancer syndrome is not only helpful in guiding future management of that individual, but it also provides useful information about disease risk in other family members, and also the risk of the affected individual passing the mutation to his or her unborn offspring.