Prostate, Bladder and Kidney Cancer
The Siteman Cancer Center offers the latest in specialized treatments for all forms of urological cancer, including cancer of the prostate, kidney, bladder and testicle. In the area of minimally invasive surgery, for example, our physicians are leading the way in refining this technique to treat cancer. Using small incisions in the skin, they are able to freeze (cryoablation) or use heat (radiofrequency ablation) to destroy cancer cells, achieving the same outcomes as conventional surgery with substantially reduced pain and discomfort to patients.
Prostate Cancer Detection and Treatment
Prostate cancer is the most common form of cancer seen at Siteman. About 800 patients each year are treated by our program, which is recognized internationally for its pioneering work in the diagnosis and treatment of this disease.
Our physicians have done groundbreaking work in several areas. First, they have pioneered the prostate-specific antigen (PSA) blood test as a tool for early prostate cancer detection. Currently, they are conducting the world’s largest single-institution prostate cancer screening study with more than 32,000 men. They also have successfully developed the free PSA test for improving the accuracy of prostate cancer detection. With this experience in early diagnosis, they frequently handle problem cases in which a patient’s PSA level may be elevated, though initial biopsies do not reveal the cause for the elevation.
Siteman has an international reputation for its nerve-sparing surgical approach to prostate cancer. Our urologists are renowned for performing nerve-sparing (and potency-preserving) radical prostatectomies, in which small tumors can be removed with fewer long-term side effects. We have completed more than 1,850 of these operations — the second largest number in the world.
Rates of sexual potency and urinary continence associated with this technique are generally higher in patients treated at Siteman, with published overall potency ranges of 65 percent to 85 percent.
Chemotherapy and Radiation Therapy Expertise
Siteman physicians use newer drugs, including new hormonal and biological therapies, to fight prostate cancer. Some of these therapies take away cancer cells’ ability to spread through new tissues or form new blood vessels. We also have pioneered studies of effective chemotherapy for patients with advanced prostate cancer. For patients who have failed standard therapy and are looking for experimental approaches, Siteman offers a range of chemotherapy clinical trials.
Our radiation oncologists were among the first in the United States to use 3-D conformal radiation therapy to enhance the delivery of high doses of radiation for prostate cancer. They can precisely aim treatment to the prostate, thereby reducing radiation delivery to the adjacent bladder and rectum. It is expected that the higher radiation dose delivered to the prostate with this technology will result in more frequent cures.
Siteman also was the first medical center in the region to perform brachytherapy, or radioactive seed implantation, for prostate cancer. In this technique, radiation oncologists insert small “seeds” containing radioactive material throughout the prostate under ultrasound guidance. The seeds emit radiation for several weeks then remain permanently and harmlessly in place.
Advances in Bladder Cancer Treatment
The urological cancer team at Siteman is one of the most experienced in the world in performing nerve-sparing bladder removal and creating neobladders, replacement bladders made out of intestinal tissue. Instead of creating an opening to the skin to divert urine, the surgeon places the new bladder where the cancerous bladder was removed. This surgical technique allows both men and women to achieve nearly normal continence. Men who have nerve-sparing bladder removal and a neobladder can continue to have normal erections and urinate through their penis. Women also experience more comfortable sexual intercourse with a neobladder.
Medical oncologists at Siteman currently are investigating a series of new anti-cancer drugs that can be placed in the bladder, either in combination with standard medications or alone.
Leading the Way in Kidney Cancer Care
Our team of urologic surgeons performed the world’s first kidney removal using minimally invasive laparoscopic surgery. Compared to traditional surgery, laparoscopic surgery substantially reduces the pain and discomfort of patients and hastens recovery. Laparoscopic kidney removal requires only three or four small punctures, whereas traditional surgery requires a large incision. The team also has developed techniques to perform laparoscopic partial kidney removal – a complex procedure being performed at only a few centers around the country.
We are one of two major medical centers in the country currently offering treatment for kidney cancer patients ineligible for any type of surgery due to their failing health or age. This group of patients may receive percutaneous cryoablation, a procedure that involves inserting probes through the skin to freeze small tumors in the kidney. This procedure currently is appropriate only for small tumors or for patients who have no other alternative. Because this technique holds the promise for being the least debilitating of all kidney cancer treatments, researchers are focused on expanding its application for the future.