Uro Oncology

Urologic-oncology is a specialized section of urology for the diagnoses and treatment of urologic cancers - i.e. - kidney, bladder, prostate, testicular, adrenal and other genito-urinary cancers. The focus on cancer management enables a patient to get the best possible treatment and outcomes.

Urologic-oncologists are fellowship trained, with expertise in advanced surgery of complex cancers, and minimally invasive surgery of cancers i.e., Robotic-surgery and Laparoscopic surgery. This optimizes outcomes related to cancer treatment and also enables the best possible functional outcomes.

At the Department of Uro-oncology at Amrita Hospital, Kochi, the Urologic-oncologist works closely with a multispecialty team comprising medical oncologists, Radiation-oncologists, Pathologists with expertise in Urologic cancers, and Molecular Oncologists, to plan, coordinate and optimize treatment of urologic cancers.

Decisions for complex cancers are best made with inputs from all the above on a multispecialty board.

• Kidney tumors (Mass in the kidney) 

What is kidney cancer? 

Kidney cancer, in simple terms, is a disease where abnormal cells in the kidneys start to grow uncontrollably. The kidneys are important organs that filter waste and excess fluids from our blood, so when cancerous cells develop in them, it can disrupt their function. Kidney cancer accounts for about 3% of all adult cancers. It is more frequently diagnosed in individuals aged 50 to 70, and it affects men at a higher rate than women. Certain risk factors, such as smoking, obesity, and high blood pressure, have been associated with an increased likelihood of developing kidney cancer. Approximately 2-5% of kidney cancers are estimated to have a clear genetic or hereditary basis. 

Common symptoms

Common symptoms of kidney cancer typically include blood in the urine (hematuria), persistent lower back pain, a noticeable lump or mass in the side or abdomen, unexplained fatigue, unintentional weight loss, and a loss of appetite. It's important to remember that some individuals with kidney cancer may not experience any symptoms, particularly in the early stages of the disease and these account for more than 50% of the cases diagnosed nowadays.

Commonly done tests

Common diagnostic tests for kidney cancer include imaging studies like ultrasound, CT scans, or MRI scans to visualize the kidneys and identify potential tumors. Blood tests, such as blood chemistry and urinalysis, assess kidney function and look for cancer-related metabolic changes. In some cases, a biopsy of kidney tissue may be conducted to confirm the presence of cancer and determine its type and grade. 

Treatment 

The treatment of kidney cancer depends on various factors, including the stage of the cancer, the patient's overall health, and the specific characteristics of the tumor. Common treatment options for kidney cancer include surgery, which often involves removing the affected kidney (partial or radical nephrectomy) and can be done via minimally invasive procedures like laparoscopic or robotic-assisted surgery. In cases of advanced kidney cancer, targeted therapies or immunotherapy may be recommended to help slow the progression of the disease. Radiation therapy is used in certain situations to target tumors or alleviate symptoms. Treatment plans are individualized, and patients should consult a healthcare team to determine the most suitable approach based on their circumstances. Early detection and intervention can lead to better outcomes for kidney cancer patients.

• Bladder tumors

What is Bladder Cancer?

Bladder cancer is a disease that begins in the cells of the bladder, a hollow organ located in the lower abdomen responsible for storing and releasing urine. This type of cancer often starts in the inner lining of the bladder and can, in some cases, spread to nearby tissues. Bladder cancer is the 17th most common cancer in India. Risk factors for bladder cancer include smoking, exposure to industrial chemicals, chronic bladder inflammation or infections, a family history of the disease, older age, male gender, and a history of previous cancer treatments like radiation therapy.

Common symptoms

Common symptoms of bladder cancer include blood in the urine (hematuria), which is often painless but can make the urine appear pink, red, or brown (tea or cola colored). There may also be associated passage of blood clots. Other signs may include frequent urination, a persistent urge to urinate, discomfort or pain during urination, and lower back or pelvic pain. 

Commonly done tests

The most commonly performed test for diagnosing bladder cancer is a cystoscopy. During this procedure, a thin, flexible tube with a camera (cystoscope) is inserted into the bladder through the urethra, allowing the doctor to examine the bladder's inner lining for any abnormalities or signs of cancer. If suspicious areas are found, a biopsy may be conducted to collect a tissue sample for further analysis. Additionally, urine tests such as urinalysis or cytology may be done to check for abnormal cells or blood in the urine. Imaging tests like CT scans, ultrasound, or MRI are used to evaluate the extent and stage of the cancer. These tests collectively help in the diagnosis and staging of bladder cancer, guiding treatment decisions.

Treatment

The treatment of bladder cancer depends on the stage and grade of the cancer, as well as the patient's overall health. For early-stage and non-invasive tumors, the primary treatment is often the surgical removal of the tumor from the bladder lining, followed by surveillance or intravesical therapy. This is done using an endoscope under anesthesia and is a minimally invasive procedure. High-grade tumors will require further treatment in the form of the instillation of immunotherapy such as BCG therapy or chemotherapy into the bladder periodically. In cases of more advanced disease, treatments may include a combination of surgery to remove the bladder (radical cystectomy), radiation therapy, and chemotherapy. Some patients may receive immunotherapy or targeted therapies, particularly for advanced or metastatic bladder cancer. The choice of treatment is highly individualized, and a healthcare team will consider various factors to create the most effective treatment plan. Early detection and intervention are vital for improving outcomes in bladder cancer cases.

• Prostate Cancer
• Testicular tumors
• Penile Cancer
• Adrenal tumors
• Other Urologic Cancers

• Robotic Surgery
• Surgery for Kidney tumors   
   
  • Radical nephrectomy
  • Partial nephrectomy
• Surgery for Bladder Cancer   
   
  • TURBT (Endoscopic surgery for bladder tumors)
  • Radical cystectomy
  • Neobladder reconstruction
  • Conduit urinary diversion
  • Bladder preservation
• Surgery for Prostate Cancer   
   
  • Robotic surgery 
  • Laparoscopic / Open radical prostatectomy
• Surgery for Testicular Cancer 
   
  • High inguinal Orchidectomy
  • Retroperitoneal lymphadenectomy (RPLND)
• Surgery for Penile Cancer   
   
  • Robot-assisted inguinal lymphadenectomy.
• Other Urologic Cancers

The outcomes of cancer treatment relies heavily on early diagnosis and the implementation of appropriate interventions. 

In cases of advanced cancers, a multimodality treatment approach becomes indispensable. Therefore, it is crucial to entrust the care of these malignancies to specialists who exclusively focus on this field. Only a handful of centers in India boast a subspecialty in urologic oncology, and we take pride in being one of them.

We ensure optimal care and strive for superior oncologic outcomes. Our commitment extends beyond conventional practices, as we house an advanced research facility that encompasses research into cancer diagnosis and management. This allows us to explore novel avenues in areas where definitive treatments are currently unavailable. Our infrastructure is at par with global centers.

Our specialized services include Urologic oncology, with specific focus on Robotic-surgery, Uro-pathology, Nuclear Medicine – theranostics, Radiation Oncology equipped with cyberknife technology, and Bone Marrow Transplantation for cases requiring intensive chemotherapy.

This comprehensive approach ensures that our patients receive the best possible care, incorporating cutting-edge techniques and a commitment to advancing medical knowledge in the field of urologic oncology.

• State of the art comprehensive management of Urologic cancers.
• Robotic Surgery performed by fellowship trained Urologic oncologists
• Treatment decisions based on multidisciplinary tumor boards.
• Multispecialty treatment of hereditary cancers.

• Operating Hours of Urologic-Oncology Outpatient Department (OPD):

Our Urologic-Oncology Outpatient Department is at your service every day of the week, running from 8:30 AM to 5:30 PM, Monday through Saturday.

• Pioneering Hereditary Cancer Clinic for Complex Genetic Syndromes:

In a first of its kind in India, The Hereditary Cancer Clinic, specializes in the comprehensive management of genetic cancer syndromes. These include conditions like VHL (Von Hippel-Lindau disease), Tuberous Sclerosis, Papillary RCC syndromes, Translocation RCC, and more. 

*This specialized clinic is scheduled for the third Thursday of every month.

• Outpatient services include procedures performed under local anesthesia such as cystoscopy, intravesical therapy for bladder cancer and prostate biopsy.
• Round-the-Clock Emergency Services via On-Call Urology:

Ensuring your peace of mind, we provide continuous access to emergency services. Our on-call Urology team is available 24/7, ready to respond to your urgent needs promptly.

With a strong academic background, the department has been successfully conducting a two-year fellowship program in Urologic Oncology and Robotic Surgery since 2013, and thus far, it has groomed 9 accomplished urologic oncologists. Our esteemed alumni have assumed leadership roles in various medical centers across India and have been pivotal in the establishment of new robotic surgery programs at their respective institutions.

The Department of Urologic-Oncology at Amrita has academic and research collaborations with Miami Cancer Institute, United States.

• Pioneer in Robotic Surgery
• The Head of the department Dr. Ginil Kumar P, is the President of Southern Urology Association (USI south zone) 

• Hereditary cancer clinic, every Thursday.

It is the first of its sort for multispecialty management of hereditary renal cancers. We collaborate with the Departments of Neurosurgery, Gastrointestinal surgery, Genetics and Molecular Pathology, for management of cancer syndromes involving multiple organ systems.

The clinic attracts patients from all over India, particularly with VHL syndrome.