Uro-Onco Cancer

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Introduction

Uro oncology or urological oncology is the branch of medical science that deals with treating cancers of the male and female urinary tract and the male reproductive organs. Uro oncology involves the risk assessment, prevention, diagnosis, management and palliative care of patients.
Uro oncology concerns cancers of the prostate, kidneys, bladder, penis and testicles.

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Uro-oncology is a sub-specialty field within urology that focuses on diagnosing and treating the cancers of the urinary system in both males and females, as well as cancers affecting the male reproductive organs. Cancer of the urological system exerts a substantial strain on our healthcare system, and this issue has elevated the importance of this ailment in the context of our aging society. Read on to enhance your understanding of common urological cancers.

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Types

Prostate Cancer

The prostate gland is a small walnut-sized gland located beneath the bladder of a man. This gland is responsible for the production of seminal fluid that nourishes and transports the semen. Prostate cancer is the growth of cancer cells inside the prostate gland. It is the most common cancers among men.

Common signs and symptoms of prostate cancer include increased urge to urinate, blood in the urine, disrupted the flow of urine, new onset of erectile dysfunction and pain.

Depending upon the stage of cancer and other factors, prostate cancer treatment options include surgical removal of cancer, chemotherapy, targeted therapy and hormone therapy.

Bladder Cancer

Bladder cancer is urological cancer that affects the cells that line inside the bladder. Bladder cancer mostly affects people elder than the age 50. This cancer can extend to the surrounding cells as well. Different types of bladder cancers are urothelial carcinoma, squamous cell carcinoma and adenocarcinoma. 

Common signs and symptoms of bladder cancer include frequent and painful urination, severe backache and presence of blood in the urine. 

Bladder cancer is treated with a combination of therapeutic ways including transurethral resection, cystectomy, chemotherapy, radiation therapy and immunotherapy. 

Kidney Cancer

Kidney cancer or renal cancer is one of the most common types of urological cancers. It is characterised by symptoms including blood in the urine, persistent lower back pain or pain at the side, lump or swelling. The exact cause behind kidney cancer is yet unknown, however, factors such as obesity, smoking, hypertension and family history of the disease can increase an individual’s chances of being affected by this cancer.

Kidney cancer treatment alternatives include surgical removal of the tumour, radiofrequency ablation, chemotherapy and more.

Penis Cancer

Penile cancer is a rare form of cancer that occurs mostly in uncircumcised penises. Uncircumcised means that the piece of skin covering the head of the penis, called the foreskin, has not been removed. Circumcision is the removal of the foreskin and may reduce the risk of penile cancer.

Testicular Cancer

Cancer that starts in the cells that make up a testicle is called testicular cancer. It’s one of the most curable forms of cancer.

The testicles are the male sex glands and are part of the male reproductive system. Testicles are also called testes or gonads. They’re behind and below the penis in a pouch of skin called the scrotum.

The testicles make sperm. Sperm are the male cells needed to fertilize a female egg cell and make a baby. The testicles also make male hormones, including testosterone. These hormones control the development of the reproductive organs. They also control other things, like body and facial hair and a lower voice.

Causes

The exact cause of urological cancer remains unclear. Some of its risk factors include:

  • Gene mutation
  • Smoking
  • Schistosoma haematobium infection
  • Work exposure to polycyclic aromatic hydrocarbons
  • Consumption of tap water containing chlorine/chlorination byproducts or arsenic  contamination
  • Family history
  • Age
  • Gender (Men have over double the risk of urological cancer compared to women)
  • Obesity
  • High blood pressure
  • Advanced kidney disease and prolonged kidney dialysis

Common Symptoms

The symptoms of urological cancer vary as per organ affected. Some of them are listed below:

  • Hematuria
  • Erectile dysfunction
  • Lower back pain
  • Painful or frequent urination
  • Blood at the opening of the penis
  • Anemia
  • Loss of appetite and weight loss
  • Hypertension
  • Ankles and leg swelling
  • Breast tenderness or growth in men
  • Variations in size or firmness of testicle
  • Pain in a testicle or the scrotum
  • Disturbed urine flow
  • Lump or cyst near penis or testicle

Diagnostics

Urologists use comprehensive diagnostic procedures to grade cancer into tumors, lymph nodes, and metastasis. Some commonly used diagnostic tests include:

  •  X-ray
  • Prostate-specific antigen (PSA) test (used to determine the stage of prostate            cancer
  • Core needle biopsy
  • Magnetic resonance imaging (MRI)
  • Computed tomography (CT) scan
  • Angiography
  • Positron emission tomography (PET) scan

Treatments

Treatment options for urologic cancers are diverse and depend on factors such as cancer type, stage, and individual patient characteristics.

Surgery: Surgery is a first-line treatment option for urological cancer. The different types of surgeries for urological cancers include prostatectomy, radical cystectomy (surgical removal of the bladder), radical orchiectomy (surgical removal of the affected testicle), and partial or total penectomy (complete or partial penis removal).

Chemotherapy: These drugs destroy or control the growth of cancer cells and are prescribed along with surgery or radiation therapy to alleviate the symptoms of advanced cancer.

Radiation Therapy: Radiation therapy includes the administration of X-rays externally to destroy cancer cells. It sometimes entails placing radioactive materials inside or close to the malignant area.

Hormonal Therapy: This therapy is also called androgen deprivation therapy, prescribed especially to treat advanced prostate cancer that helps to stop or decrease the production of testosterone.

Targeted Therapy: A precision cancer treatment directs drugs to specific features of cancer cells, inhibiting their growth or preventing new cancer cell formation. It is utilized based on advanced genomic testing and other diagnostics to determine if a patient may benefit, sparing normal cells from the damage seen with traditional chemotherapy.

Immunotherapy: Immunotherapeutic drugs activate the body’s immune system to target and destroy cancer cells. These classes of drugs detect the cancer cells and enable immune responses to eliminate them.

In order to provide individualized care catered to each patient’s needs and preferences, treatment decisions for urologic cancers are best decided through multidisciplinary teamwork comprising urologists, medical oncologists, radiation oncologists, psychologists, and other experts.

Prevention and Lifestyle Modification

Prevention and lifestyle modifications play crucial roles in reducing the risk of urological cancers:

Maintain a Healthy Weight: Obesity is a common risk factor for various urological cancers, including kidney and bladder cancer. A balanced diet and regular physical exercise can help maintain a proper weight and reduce cancer risk.

Avoid Tobacco: Quitting smoking or avoiding tobacco products can significantly lower the risk of developing bladder and other urological cancers.

Limit Alcohol Consumption: Moderating alcohol intake or abstaining from alcohol can help mitigate the risk of several urological cancers.

Stay Hydrated: Staying hydrated may reduce the risk of developing bladder cancer by diluting potential carcinogens in the urine and promoting frequent urination, which helps flush out toxins.

Practice Safe Sex: Penile cancer has been linked to certain sexually transmitted infections, including the human papillomavirus (HPV). The chance of developing penile and other urological malignancies can be decreased by using condoms and engaging in safe sexual behavior.

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