Dr. Gunjesh Kumar Singh


Medical & Haemato Oncologist

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Urogenital Malignancies

Urogenital cancers are varied, since they include tumors of the kidney and bladder, and, in men, of the prostate and testicle. Urogenital cancers differ widely. Treatment strategies are adapted to each patient and determined via a multidisciplinary consultation meeting.

1) Prostate Cancer is the most frequent of these cancers, with almost 70,000 new cases per year in France. It occurs in men most frequently after the age of 65, but mortality rates are low, and patients often recover or keep it under control as a chronic disease over the long term. Prostate cancer is suspected when there is an increase in the prostate-specific antigen (PSA) in the blood, and is then diagnosed via additional tests, namely biopsies and MRIs. These elements, along with a clinical examination, also enable the stage and aggressiveness of the tumor to be clarified. According to these criteria, the intensity of symptoms, the general state of health and age, the patient may be offered several different options, from basic monitoring to a curative treatment through surgery, radiotherapy and/or hormone therapy. Chemotherapy is indicated in advanced and/or metastatic forms. Sometimes there may be a choice from among the various treatments, and the patient’s preferences are taken into consideration.

2) Another cancer affecting men, Testicular Cancer (a little over 2,300 cases per year in France), is most frequent in young adults aged between 20 and 30. About 96% of patients make a full recovery. The patient should consult a physician after the appearance of swelling or an increase in volume of one of the testicles.
The physician performs a manual exam of the testicles, an ultrasound and a search for blood markers. Surgical removal of the affected testicle is the initial treatment. Before this procedure, as a precaution the patient will be asked to give a semen sample to be stored in a “bank” after freezing. Other therapies may be used to complete the treatment plan, including chemotherapy and even radiotherapy, or surgery of abdominal-pelvic masses or remaining lymph nodes.

3) Kidney Cancer (around 10,500 cases per year) affects twice as many men as women, and most frequently after the age of 65. It is sometimes diagnosed by chance, revealed by an imaging test carried out for a different reason.
The physician will establish the diagnosis after a clinical exam and abdominal scan. Treatments include surgery and chemotherapy. There are familial forms of kidney cancer; a genetic analysis is therefore often carried out when the disease is diagnosed in a patient aged 30 or 40. If a hereditary predisposition is found, the other members of the family may be closely monitored.

4) Bladder Cancer (almost 12,000 cases per year in France) is linked mainly to smoking and to exposure to some toxic products used in industry. It affects twice as many men as women, mostly over the age of 70. The proportion of women affected is increasing due to their rise in tobacco use.
The symptom that often suggests bladder cancer is the presence of blood in the urine. The need to urinate frequently and burning sensations, without urinary infection or stones, are two of the later signs.
The diagnostic exams involve an ultrasound of the urinary tract, a urine analysis, and bladder exploration via cystoscopy (which can be followed by a surgical resection) for diagnosis and sometimes for treatment.
Several types of treatment are available depending on each case: surgery (removal of the bladder, construction of a new bladder or installation of a colostomy bag), chemotherapy, or more targeted treatments via immunotherapy or radiotherapy.

Symptoms -

People with bladder cancer may experience the following symptoms or signs. Sometimes, people with bladder cancer do not have any of these changes. Or, the cause of a symptom may be a different medical condition that is not cancer.
- Blood or blood clots in the urine
- Pain or burning sensation during urination
- Frequent urination
- Feeling the need to urinate many times throughout the night
- Feeling the need to urinate, but not being able to pass urine
- Lower back pain on 1 side of the body.
Most often, bladder cancer is diagnosed after a person tells their doctor about blood in the urine, also called hematuria. "Gross hematuria" means that enough blood is present in the urine that the patient can see it. It is also possible that there are small amounts of blood in the urine that cannot be seen. This is called "microscopic hematuria," and it can only be found with a urine test.

Causes -

Bladder cancer begins when cells in the bladder develop changes (mutations) in their DNA. A cell's DNA contains instructions that tell the cell what to do. The changes tell the cell to multiply rapidly and to go on living when healthy cells would die. The abnormal cells form a tumor that can invade and destroy normal body tissue. In time, the abnormal cells can break away and spread (metastasize) through the body.