Enhanced Cancer Therapy

Overview

Male genital and female urinary organ cancers both fall under the category of urologic cancers. Approximately 27% of all new cases of cancer in males and 14% of cancer-related fatalities in the United States are caused by urologic malignancies. Urinary tract malignancies cause 3% of cancer fatalities and 4% of new cancer cases in women. Bladder cancer has received the most epidemiological research attention among urologic cancers. The primary known preventable cause of the disease is cigarette smoking. Workplace exposures are still regarded with suspicion. Both drinking coffee and using artificial sweeteners don't seem to be significant risk factors. Treatment of urologic cancer constitutes a challenging area in medicine with new agents and procedures being studied to make these cancer curable.

 

Urologic Cancer Types

Types of urologic malignancies are identified by the structures they impact, including:

• Bladder cancer harms The cells that line the bladder, a tiny sac that stores urine for excretion. Every year, doctors in the US identify over 71,000 people with bladder cancer.
• In the tiny tubes that the kidneys use to filter the blood, renal (kidney) cancer develops. One uncommon variation of this disease is renal pelvis carcinoma. It takes place in the region of the kidney that communicates with the bladder. Each year, approximately 49,000 instances of renal and renal pelvis cancer are diagnosed by doctors.
• Only 1% of all malignancies in males are testicular cancers, which develop in the testes. Around 8,300 cases are diagnosed by doctors each year in the USA.
• It's uncommon to develop penile cancer. It has an impact on the male reproductive system's penis, which is a component of the urinary system.
• The urethra, the tube that carries pee from the bladder to the outside of the body, is where urethral cancer develops. The urethra and semen both pass through the penis in men. Urethral cancer is uncommon and more frequently affects men than women.

 

Bladder Cancer Treatment

There are various bladder cancer therapies available. The treating physician will determine the best treatment option for your bladder cancer based on the kind, stage, and grade of cancer. Among the possible therapies for bladder cancer are:

• Surgical removal of the cancerous cells.
• Chemotherapy is administered inside the bladder to eradicate cancerous cells found there.
• Chemotherapy is administered throughout the body, as the main treatment when surgery is not an option or to boost the likelihood of a cure in patients having surgery to remove the bladder.
• When surgery is not an option or is not preferred, radiotherapy is frequently used as the primary treatment to eradicate cancer cells.
• Bladder immunotherapy, which uses the body's defenses to combat cancer.
• Whole body immunotherapy
• When other therapies failed to control advanced cancer, targeted therapy was used.

Bacillus Calmette-Guerin, also known as BCG, is the most frequently prescribed medication for bladder cancer in early-stage malignancies. Immunotherapy like BCG activates the immune system and sends immune cells to the bladder. Following surgery for bladder cancer, BCG treatment is administered to help stop cancer from returning.

 

Targeted Therapy for Bladder Cancer

For patients with advanced cancer whose illness has worsened on chemotherapy and immunotherapy, targeted therapy is a novel method of treatment. Antibody-drug conjugates (ADC), which can target and destroy cancer cells while preserving healthy cells, are one type of targeted therapy. ADCs consist of three components:

• A particular class of protein known as an antibody recognizes and binds to the antigen found on cancer cells.
• Anti-cancer medication that, once cancer cells are identified, kills them.
• The linker is a substance that joins (links) the antibody to the cancer treatment.

There are numerous authorized treatments for bladder cancer. Here are a few examples:

• Adult patients should use the immunotherapy drug Bavencio (avelumab).
• Antibody-drug conjugate (ADC) trodelvy (sacituzuma) is used to manage adult patients.
• Kinase inhibitor Balversa (erdafitinib) is employed to treat bladder cancer in people that are advanced or cannot be surgically removed.
• An antibody-drug conjugate (ADC) called Padcev (enfortumab) is used to treat adults with bladder tumor that has spread or cannot be surgically removed. It is recommended for bladder cancer patients whose condition has worsened despite receiving chemotherapy and immunotherapy.

 

Kidney Cancer Treatment

Renal cell cancer patients can choose from a variety of treatments. Clinical trials are being conducted to test various treatments, some of which are standard (already used treatments). A clinical trial for treatment is a research project designed to find out more about potential new treatments for cancer patients or to assist enhance existing treatments. A new treatment might replace the standard one if clinical trials reveal that it is superior to the current one. Patients might consider participating in a clinical trial. Only patients who have not begun treatment are allowed to participate in some clinical trials.

 

Renal Cancer Surgery

Treatment for renal cell carcinoma frequently involves surgery to remove all or a portion of the kidney. The following surgical procedures could be used:

• Partial nephrectomy is a surgery to remove renal cancer and some of the surrounding tissue. When the other kidney is compromised or has already been removed, partial nephrectomy may be performed to prevent the renal function from declining.
• Simple nephrectomy is a kidney-only removal procedure.
• In a radical nephrectomy, the kidney, adrenal gland, adjacent tissue, and typically neighboring lymph nodes are removed during surgery.

 

Radiotherapy

High-energy x-rays or other forms of radiation are used in radiation therapy, a cancer treatment, to either kill or stop the growth of cancer cells. A machine outside the body is used in external radiation therapy to direct radiation toward the cancerous part of the body. In addition to being used to treat renal cell carcinoma, external radiotherapy can also be used to ease symptoms and enhance the quality of life.

 

Chemotherapy

Chemotherapy is a form of cancer treatment that employs medications to kill cancer cells or prevent them from proliferating to halt the growth of the tumor cells. Chemotherapy enters the bloodstream whether administered orally or through an injection into a vein or muscle, where it can reach cancer cells throughout the body.

 

Immunotherapy

Immunotherapy is a form of cancer treatment that activates the patient's immune system. The natural immune defenses against cancer are boosted, directed, or restored using substances produced by the body or in a lab. Biologic therapy is a category of treatment for cancer.

 

Targeted Therapy

A type of therapy called targeted therapy identifies and kills particular cancer cells using medications or other chemicals. Compared to chemotherapy or radiation therapy, targeted therapies typically have a lower impact on healthy cells. Advanced renal cell cancer is treated with targeted therapy and antiangiogenic drugs. Antiangiogenic drugs prevent the growth of blood vessels in tumors, depriving them of nutrients and causing them to cease growing or facilitate shrinking. The two main categories of antiangiogenic drugs used to treat renal cell carcinoma are monoclonal antibodies and kinase inhibitors.

 

Testicular Cancer Treatment

Men should discuss their desire to have children with their urologist before beginning any form of treatment. Following some treatments, infertility and abnormalities in male hormones are frequent. Before starting treatment, sperm banking may be helpful, especially if you intend to have kids in the future. Before surgery, men can inquire about a testicular prosthesis (artificial body part). After a testis has been removed, this procedure can help the testicles appear more natural.

 

Surveillance

In addition to routine checkups, surveillance is a means to look for changes. These consist of a physical examination, imaging testing, and tumor marker tests. The first step in imaging examinations is an ultrasound of the scrotum. CT scans or chest x-rays may also be used. Most men should have their testosterone levels monitored regardless of treatment. For some Stage 1 and Stage 0 malignancies, surveillance is advised. More treatment may be provided if cancer exhibits signs of growth or if hormone levels shift. If not, only observation is required.

 

Testicular Cancer Surgery

The main form of treatment for testicular cancer is surgery. The entire testis is often removed during an orchiectomy. The diagnosis will determine whether other choices are available. The question of fertility changes should come up first.

• Testicular cancer in both its early and advanced stages can be identified and treated through an orchiectomy. Through a little incision in the groin, the entire testicle and tumor are removed during this procedure. Additionally removed is the spermatic cord. With this procedure, the cell type will be identified and staged.
• Testis-sparing surgery (TSS) is only advised in certain circumstances. Only the tumor tissue is removed during this procedure; the testis is left intact. This requires both a very small mass and the absence of tumor markers. For males with benign tumors, this is preferred.
• Retroperitoneal lymph node dissection (RPLND) is a complicated procedure performed to reduce the negative effects of cutting the lymph nodes in the back of the abdomen. It can be advantageous for some men and is performed by a qualified surgeon. Patients who have stage I cancer and a high chance of recurrence may choose to have this procedure. Usually, males with non-seminomatous germ cell cancers receive it. For patients with non-seminoma tumors in stages IIA or IIB, it may be administered instead of chemotherapy.

 

Radiotherapy

Cancer cells on the testis or in adjacent lymph nodes are destroyed by radiation. Because some non-seminoma tumors are radiation-resistant, it is only used for seminoma-cell malignancies. If either type of testicular cancer has progressed to distant organs like the brain, it might be an option. A few different types of radiation therapy are applied.

 

Chemotherapy

Cancers that have spread outside the testicles or if tumor markers increase after surgery are treated with chemotherapy. Imaging studies and serum tumor markers help determine whether and how much chemotherapy should be given. These medications have negative effects and circulate in the bloodstream throughout the body. Cancer cells that might have spread to lymph nodes can be eliminated by them. Additionally, it is used to lessen the likelihood of post-operative cancer recurrence. For the treatment of testicular cancer, multiple chemotherapy drugs may occasionally be used in combination. Three or four three-week rounds of these medications are administered. After chemotherapy, additional surgery may occasionally be required to remove tumors.

 

Penile Cancer Treatment

Penile Cancer Surgery

One of the most popular treatments for penis cancer is penile cancer surgery. The kind of surgery you need is determined by the type, extent, and size of the malignancy. After surgery, some men could also receive chemotherapy or radiotherapy (adjuvant therapy) to eradicate any cancer cells that may have persisted.

• Mohs surgery. Your surgeons will layer-by-layer remove the penile tumor from the skin during Mohs surgery (Mohs micrographic surgery). They use a microscope to inspect each layer. When there is no longer any visible cancer, the surgery is over.
• Circumcision. Doctors may remove all or a portion of the penis foreskin during a circumcision. Only foreskin-specific cancer can be treated using this treatment.
• Wide Local Excision. Wide local excision surgery removes the malignancy as well as some surrounding healthy tissue (wide margins). To ensure that all of the tumors are removed, doctors remove the healthy tissue.
• Penectomy (penis removal surgery). A total penectomy removes the entire penis as well as the roots of the penis that enter the pelvis in cases of deep malignancy. Part of the penis is removed during a partial penectomy.
• Perineal urethrostomy. You will require a new way of urination if you undergo a total penectomy treatment. A perineal urethrostomy will be performed by your surgeon to make a new hole where urine can drain.
• Lymph node surgery. If there is a chance that cancer has gone beyond the penis, an operation to remove one or more lymph nodes may be required. To check for malignancy, the pathologists microscopically inspect the tissue (biopsy).

 

Chemotherapy

Drugs are used in chemotherapy to delay or stop the spread of cancer. Some early-stage penile malignancies can be managed with specialized topical chemotherapy creams. Other chemotherapy medications function by targeting cancer cells all around the body. They are referred to as systemic chemotherapy by doctors. Systemic chemotherapy can be administered subcutaneously, intramuscularly, intravenously, or orally.

 

Radiotherapy

Doctors treat penile tumors either alone or in combination with other therapies. Cancer cells are killed by radiotherapy by damaging their DNA. Experts employ cutting-edge technology to simulate radiation exposure to your body in a procedure known as radiation simulation. Then, they may select the therapy that will help you the most.

 

Immunotherapy for Penile Cancer

Penile tumors can be treated with immunotherapies. Because it uses the body's natural immune system, immunotherapy, also known as biologic therapy, frequently has fewer adverse effects than traditional cancer therapies.

• Targeting particular cancer cells can help prevent harm to healthy cells.
• Make it simpler for the immune system to detect and eliminate cancer cells.
• Halt or reduce the growth of tumors and the spread of cancerous cells

One immunotherapy medication used by doctors to treat penile cancer is imiquimod. Imiquimod is available as a cream, which you apply over the afflicted area for several weeks.

 

Ablation Therapy

Penile cancer cells can be eradicated utilizing the energy of light or extremely low temperatures. A laser beam used in laser therapy kills cancer cells. Cancer cells are frozen to kill them during cryosurgery (also known as cryoablation and cryotherapy). Alternatives to standard surgery that are less invasive include these treatments. They don't use blood and harm the penis less than other procedures. If your penile cancer is in an earlier stage and has not yet spread, ablation therapy can be the best option for you.

 

Urethral Cancer Treatment

The kind of urethral carcinoma you have, where it is present in the urethra, your gender, the results of any tests, and the stage of the disease will all affect your treatment options. Treatment may aim to cure you, manage your cancer, or lessen any side effects brought on by it. Discuss your treatment options, the desired outcomes, and any potential risks or side effects with your healthcare team.

Cancer treatments can be either local or systemic. Local treatments remove, kill, or suppress cancer cells in a specific area. The two local therapies are surgery and radiation. Cancer cells that may have spread throughout your body are eliminated or controlled with systemic therapy. Chemotherapy is a systemic therapy when administered as a tablet or an injection. You might receive a single treatment or a mix of treatments. Treatment options for urethral carcinoma include:

• Surgery
• Radiotherapy
• Chemotherapy

In some situations, active surveillance is a different choice. This indicates that the cancer is not immediately treated. Instead, it is closely monitored by your healthcare practitioner through routine exams and tests. You can begin therapy if the tests reveal that cancer has begun to spread or is causing issues. With this choice, you can postpone or even skip treatments that could have severe side effects and other issues.

 

Prostate Cancer Treatment

Treatment options available for prostate cancers include:

• Active surveillance
• Prostate surgery such as radical prostatectomy
• Radiotherapy
• Chemotherapy
• Hormonal therapy
• Immunotherapy
• Cryotherapy
• High-intensity focused ultrasound (HIFU) and focal therapy

 

Conclusion

Numerous different urological cancer kinds can be treated. Although the types of chemotherapy medications used and the duration of treatment can vary greatly, some types of treatment, such as chemotherapy and radiotherapy, are the same for all urological cancers. Prostatectomy for prostate cancer and segmental cystectomy for bladder cancer are two examples of treatments that are tailored to the type of cancer.