URO ONCOLOGY SERVICES
Overview
Department of Uro-oncology was started in 1996. We started with conventional open surgeries but have evolved into a world class centre capable of doing all textbook Laparoscopic and Robotic Uro-Gynae procedures over the years.
Cancer is a major health hazard in the world. Number of cancer patients is increasing all over due to various known and unknown factors. India is not unaffected by this change. We provide not only curative and palliative treatment but also address preventive aspect of cancer. Early detection and timely intervention can change outcomes significantly.
What Is Urinary Tract Cancer
Cancer of the urinary tract comprises some of the most common cancers affecting males. With the rising trend of smoking, alcohol consumption, and increased awareness among patients, we see higher number of patients falling under the operable category.
The urinary tract is lined by epithelium extending from renal collecting tubules (part of kidney) proximally to the urethral meatus distally. These epithelial cells are known as urothelial cells or transitional cells. More than 90% cancers are of transitional cell origin.
Urinary Tract Cancer Includes
Urinary Bladder Cancer
Prostate Cancer
Renal Malignancies
Ureter Malignancies
Testicular Tumor
Adrenal Tumor
Penile cancer
Urethral cancer
Symptoms Of Urinary Tract Cancer
Symptoms depend on the site of cancer originating in the urinary tract. Common symptoms including.
- Having to urinate more often than usual.
- Pain or burning during urination.
- Feelings as if you need to go right away, even when your bladder isn’t full.
- Having trouble urinating or having a weak stream.
- Having to get up to urinate many times during the night.
- Blood in urine – obvious blood or detected on urine examination.
- Lower backache on one side of the body.
- Pain abdomen and flank.
- Bone pain or tenderness.
- Unintended weight loss and loss of appetite.
- Swelling in the feet.
- Feeling tired.
- Nodes in groin.
- Non healing ulcer or growth on penis or urinary or orifice.
- Low grade fever.
- Asymptomatic. Picked up only on ultrasound or blood investigations.
Diagnosis & Investigations
- Ultrasound of abdomen and pelvis is basic investigation
- CT Scan/ MRI of abdomen/Pelvis
- PET Scan in selected cases
- TRUS guided Prostate Biopsy
- MRI-TRUS Fusion Guided Prostate Biopsy
- Ultrasound guided biopsies
- Flexible Cystoscopy
- Flexible Ureteroscopy
- Punch biopsy from penile growth
Treatment Of Urinary Tract Cancer
Focus is on combined modality treatment. Special features of Tech savvy department are
- Hyperthermic intravesical chemotherapy (HIVEC) for Urinary Bladder Cancer
- High intensity focused ultrasound (HIFU) for Prostate Cancer
- Open/ Robot-Assisted Laparoscopic Prostatectomy for Prostate cancer
- Open/ Robot-Assisted Cystoprostatectomy with intracorporeal/extracorporeal ilial conduit/ orthotopic neobladder for Urinary Bladder cancer
- Open/ Laparoscopic/ Robot assisted radical nephrectomy/ Nephron sparing surgery for Renal malignancies
- Open/ Laparoscopic/ Robot assisted nephroureterectomy with bladder cuff excision for Ureter Malignancy
- Robot assisted retroperitoneal lymph node dissection for Testicular tumor
- Open/ Laparoscopic/ Robot assisted Adrenelectomy for Adrenal tumor
How is RGCI Different
Modern health care paradigm emphasizes not just on treating the disease, but also on improving the quality of life of patients while minimising the morbidity and stress of the treatment. We take pride in shouldering the responsibility of pioneering the best in surgical craft for our patients. It is our guiding principle that no patient should have any unmet need once he or she visits RGCI&RC and thus, our infrastructure always stays in evolution in sync with latest times. Presently we have 2 Da Vinci Robotic systems and one Indian version installed and have performed more than 4000 robotic surgical procedures. RGCI has been designated as epicentre for robotic surgery training in India in recognition of our high volumes and technical expertise, while maintaining an impeccable track record of surgical safety.
In India, our centre is credited with the highest numbers of neobladder formation after radical cystectomy. Our own innovation “Pitcher Pot Neobladder” has minimal requirement for clean intermittent catheterization, which is main drawback of conventionally described neobladders. Results proving excellent outcomes consistent over more than a decade have been published in international peer reviewed academic journals(https://bjui-journals.onlinelibrary.wiley.com/doi/full/10.1002/bco2.82
Post prostatectomy urinary incontinence is one of the most dreaded complications of robotic radical prostatectomy. We were the pioneers of the “Retzius sparing technique” in the Indian subcontinent which restores urinary continence early, resulting in better quality of life after prostatectomy. We have the largest published series of some of the most challenging and rare procedures in Uro-oncology such as robotic post chemotherapy retroperitoneal lymph node dissection (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5635672/), and robotic video-endoscopic groin dissection(https://www.sciencedirect.com/science/article/abs/pii/S0022534718300107) in the world. We are ably supported by world class laboratory services and have an in-house molecular lab equipped with latest Next generation sequencing platform – ion torrent S5 with chef. We can also perform Nano string, droplet digital PCR, 10 color flowcytometry, and count circulating tumour cells. We were one of the initial practitioners of HIFU and MRI Fusion biopsy in India and have gained the largest experience in the Indian subcontinent over years.
Featured Doctors Of Urinary Tract Cancer
(PROF) SUDHIR KUMAR RAWAL
Uro Oncology
AMITABH SINGH
Uro Oncology
Urinary Tract Cancer : Risk Factors
- Tobacco use-Smokers are five times more likely to develop cancer.
- Age—More than 70% are above 65 yrs of age ( bladder cancer)
- Gender- Men are more likely to develop bladder cancer than females.
- Chemicals- Chemicals used in textile , rubber, leather, dye, print and paint industry workers.
- Previous radiation therapy to pelvis
- Drugs- Cyclophosphamide, Pioglitazone( doubtful)
- Schistosomiasis- parasitic infection
- Genetic syndromes -Lynch syndrome
- Arsenic exposure
- Family history of cancer-BRCA 2 Mutated
- Sexual hygiene, uncircumcised penis, HPV Infection
- Obesity linked to prostate cancer
- Hypertension,Diabetes
Urinary Tract Cancer : Prevention
- Stop smoking.
- Avoid exposure to chemicals and dyes.
- Family history of cancer-colon,prostate,breast ,ovary.
- Drink lots of fluids especially water.
- Strict follow up if you have received pelvic radiotherapy or received Cyclophosphamide.
- Report to a doctor if you notice any of the warning signals of urinary cancers especially if you are a painter, hairdresser or in leather industry.
- Eat a healthy diet that includes lot of vegetables and fruits.
DO’s after Surgery
- Don’t just keep lying in bed.Continue walking.
- Walking upstairs is allowed with abdominal binder if it was open surgery.
- Use abdominal binder in cases of open surgeries.
- Maintain body hygiene, genital hygiene
- Stoma care as advised by doctor or stoma nurse.
- Eat balanced diet as advised
- Chest physiotherapy or deep breathing excercises
- Continue medication for DM, hypertention
- Report if there are RED ALERT SIGNS.
DON'Ts after Surgery
- Bending, Driving, Lifting heavy weight.
- Tub bathing
- Constipation
- Junk food or eatables from hawkers