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Urological Cancers

Kidney Cancer
Prostate Cancer
Testicular cancer
Bladder cancer
Adrenal Gland Cancer

KIDNEY CANCER

Kidney cancers are usually seen between the ages of 40-70. 3% of all cancer patients have kidney cancer.
In our country, approximately 5000 people are diagnosed and treated for kidney cancer annually. There are some risk factors for the development of kidney cancer. These are smoking, obesity, high blood pressure, chemical exposure and genetic causes.

Symptoms of Kidney Cancer

Kidney cancer is usually asymptomatic. It is detected randomly during radiological imaging methods for another disorder.
Side pain, which are classic symptoms, bleeding in the urine and palpable mass are seen in only 10-15% of patients.
In advanced stage disease, it causes cough, jaundice, bone pain, weight loss complaints due to spread to other organs.
Since it provides 85% survival with early diagnosis, it is important that those who have risk factors for kidney cancer or have a family history of kidney cancer do not disrupt their annual routine check-ups.

Diagnostic Methods

Physical examination
Short Story
Blood Biochemistry
Urinalysis
Ultrasound
Tomography
MRI
PET / CT

Kidney Cancer Treatment

Treatment of kidney tumors varies according to the stage. In the early stages, partial nephrectomy can be performed in small tumors where only the tumor is removed, and radical nephrectomy surgery can be performed in tumors that surround the kidney more.
These surgeries can be performed with laparoscopic or robotic methods in appropriate patients.
Radiofrequency ablation, cryotherapy and microwave thermal ablation methods can be used in patients who cannot receive anesthesia or have very small tumors.
Suitable patients with tumor spread to other organs can be treated surgically or only with targeted therapy and immunotherapy drugs that strengthen the immune system.

PROSTATE CANCER
It is a tumoral formation that occurs as a result of uncontrolled and abnormal growth of prostate gland cells.

What Are The Symptoms of Prostate Cancer?

Prostate cancer usually does not show any symptoms when it is in the early stages. It gives itself symptoms only in advanced stages. At this stage, patients usually lose the chance to recover from the disease.
For this reason, even if there are no complaints after the age of 50, annual routine check-ups are recommended, especially for people with a family history of prostate cancer.

How Often Does Prostate Cancer Occur?
Prostate Cancer is the most common type of cancer in men. It accounts for 15% of all cancers. It is seen with similar frequency in our country. Despite being so common, mortality rates from prostate cancer are very low.
This is because there is a high chance of recovery when diagnosed early and given the right treatment

How Is Prostate Cancer Determined?
PSA measurement and examination and first-line evaluation are performed. If prostate cancer is suspected as a result of this evaluation, it is diagnosed by prostate biopsy after multiparametric prostate MRI, if necessary.

What Is Prostate Biopsy?
In classical biopsy, ultrasonography-guided tissue sampling is performed from the 10-12 focus of the prostate.
The classical method diagnoses 70% -75% of prostate cancer patients. A significant part of it is overlooked.
In recent years, this rate has increased to 98% with the MRI Fusion Biopsy (smart biopsy) method.

Prostate Cancer Treatment
In determining the treatment of prostate cancer, the pathological characteristics (stage, aggressiveness, etc.) obtained as a result of biopsy should be determined by considering the general health status, age, and treatment expectations of the patient.
Considering the above-mentioned features, treatment should be selected by the patient, relatives and doctor as a result of a joint decision from active follow-up, surgical treatment (open or robotic radical prostatectomy), radiation therapy (radiotherapy), focal treatments (HIFU), Hormone Therapy, Drug therapy (chemotherapy) options.
Surgical Treatment (Radical Prostatectomy open or robotic) Radical prostatectomy surgery is the removal of the lymph nodes with prostate drainage in patients with limited tumor in the prostate.
Patients undergoing radical prostatectomy have a 10-year survival rate of over 90%.
Prostate tissue is very close to the nerves that provide sexual functions and the muscles that provide urinary retention due to their neighborhood. The most important goals during this surgery are to control the tumor, not to damage the muscles that provide urinary retention, and to protect the nerves that provide sexual functions.
The most important advantage of robotic surgery over open surgery is better protection of the nerves that provide sexual functions and structures that provide urinary retention. Other advantages are a smaller incision, less blood loss, and faster discharge.

HIFU (High Intensity Focused Ultrasound)

HIFU is the destruction of cancer cells in the prostate with the help of highly focused sound waves.
Under general anesthesia, the ultrasound source placed from the anus and the MR images taken in the prostate tissue are destroyed by destroying the targeted points with the high heat energy created by HIFU.
The most important advantages of the HIFU method are that there is no risk of urinary incontinence or sexual dysfunction in surgery or radiation therapy. It is used as an alternative to surgery or radiation therapy in appropriate patients.

Testicular cancer
The function of the testicles:

The facilities are responsible for sperm production in men and the secretion of the male hormone testosterone.
Testicular cancer is the most common type of solid cancer in men between the ages of 18-35. It accounts for 1% of all cancers seen in men.

What Are The Symptoms?
The most common finding is a palpable painless testicular mass.
It somestimes may cause pain.
When there is distant organ spread, there may be complaints such as back pain, bone pain, cough, change in consciousness, and sometimes growth and pain in the breasts due to hormone release.

What Are The Risk Factors?
History of undescended testicles
History of testicular tumor in family or self
Genetic diseases (klinefelter syndrome, down syndrome)
Cannabis use
White race

How Is Calcification Diagnosed?
Tumor markers AFP, BHCG, LDH in case of mass detection on ultrasound
Tomography, bone scintigraphy, Pet/ct for staging

How Is Testicular Cancer Treated?
When the testicular tumor is diagnosed, the operation should be performed quickly. Under general or spinal anesthesia, the testicle and cord are removed with an incision made from the groin area. According to the pathology result and staging results, lymph node removal (RPLND), chemotherapy or radiotherapy treatment can be applied with a second surgery.

BLADDER CANCER
What Is Bladder Cancer?
It is a tumoral formation that starts from the inner layer of the bladder and then can hold its deeper layers. Bladder cancer is the 11th most common type of cancer worldwide. Although it is more common in men than women, it is more aggressive in women.
Its frequency increases in direct proportion to age. Although bladder tumor is caught in 75% early stage, follow-up especially in the first 5 years after diagnosis is very important to prevent tumor recurrence and stage jump.

What Are The Bladder Cancer Risk Factors?

Cigarettes and other tobacco products
Exposure to chemical agents (especially those working in occupations related to dyes, textiles, leather and petroleum products)
Chronic irritation (bladder stone, infection, catheter, etc. staying for a long time)
Some parasites (schistosoma)
Having received radiotherapy

Bladder Cancer Symptoms

Painless bleeding in the urine (may be clotted)
Difficulty urinating, burning when urinating, pain, frequent urination,
Weight loss in advanced tumors, loss of urine and defecation control, bone pain, cough, confusion

What Are The Diagnostic Methods?

Cystoscopy: Under local anesthesia, it is visualized by entering the external urinary tract with a camera.

Biopsy: If bladder tumor is suspected during cystoscopy, pathological evaluation can be performed by taking parts during the procedure. When the biopsy procedure is performed in the form of a TOUR procedure, it can be both diagnostic and therapeutic.

Urinary Cytology: It is the evaluation of the urine sample taken under a microscope to evaluate the presence of a smaller tumor in case no tumor is seen during cystoscopy but suspicion persists.

Display Methods
Ultrasound
Tomography
Pet/CT if MRI is required

What Are The Treatment Methods of Hydrocephalus?

The main determinants in the treatment of bladder cancer are the type, pathological stage and degree of aggressiveness of the tumor, the general health status and age of the patient.
Stage 1 tumors only involve the epithelial layer, which is the innermost layer of the bladder. At this stage, chemotherapy or BCG drugs applied into the bladder after the procedure are usually sufficient when the TOUR procedure is necessary. The purpose of these treatments is to stop tumor recurrence and progression. Nevertheless, periodic cystoscopy controls of these patients are required.
Stage 2 tumors cause deeper muscle layer involvement. The gold standard treatment method in these patients is radical cystectomy, in which lymph tissues are taken along with the bladder. After the bladder is removed, a new bladder is made from the patient's intestines with various examinations. Although it can be performed with open surgery in general, radical cystectomy surgery can be performed with laparoscopic and robotic methods with less risk.
Stage 3 tumors, where the outer layer of the bladder (serosa) is involved by the tumor,
In cases where Stage 4 tumors are detected to spread cancer to other organs, Systemic Chemotherapy is applied first, and radiotherapy or surgery (radical cystectomy) options can be applied according to the response to be received.

Adrenal Gland Tumor

The adrenal glands (adrenal or adrenal glands) are two glands that are responsible for the production of hormones just above the kidneys. Adrenal gland tumors, which are usually detected by chance that do not require benign surgery, increase in frequency, especially with aging.

What Are The Symptoms?

If it causes hormone release;
High blood pressure, palpitations, sweating,
Weight gain, increased hair growth, increased fat in the face and abdomen,
Headache, irritability, acne
Sexual dysfunctions
If the mass is very enlarged, signs of pressure (constipation, abdominal pain, etc.)
Symptoms related to distant organ metastasis

How Is The Diagnosis Made?

For a patient with a mass in the adrenal gland, blood tests are used to determine hormone release in the first place, and computed tomography or MRI is used to differentiate between benign and malignant. Imaging methods have an accuracy of over 90%.

When Is Surgery Recommended?

Masses that do not cause hormone production of less than 4 cm in the adrenal gland are suitable to be followed up for 6 months or annually.
Surgery is also recommended for masses suspected of being malignant, those producing active hormones, those larger than 4 cm, and those growing faster than 10 mm per year.
When the operation is decided, robotic laparoscopic or open surgery can be performed. Robotic and laparoscopic surgery is recommended with rapid healing, small incision, less bleeding and less hospital stay.
If surgery is decided, the operation can be performed by laparoscopic, robotic or open methods.Laparoscopic and robotic surgery is the gold standard in experienced hands and provides many advantages. From a cosmetic point of view, it saves from a large incision scar and provides a comfortable and fast healing process.

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