Urological Cancers
Urological cancersrefer to cancers that occur in the urinary tract in men and women and in the reproductive organs in men. More than 10% of cancer cases in the world are urological cancers. Urological cancers are more common in men than women. In this section, the cancers that we encounter most frequently in urology practice will be briefly mentioned. The subject of the treatment of these cancers with robotic surgery is given in more detail in the "Robotic Urology-Robotic Surgery in Adults" section of this site.
Kidney Cancer
Kidney cancer originates from the cells (epithelium) in the kidney that line the small urinary canals that collect urine. These are called renal cell cancers. Urothelial cancers can also be seen in the kidney, originating from the renal pelvis, the pool at the exit of the kidney, and in many respects like cancers in the bladder. Nephroblastoma (Wilms tumor) is the most common in childhood and accounts for 80% of kidney tumors in this age. Renal cell cancer is the most common in the adult age group and constitutes 85% of all malignant kidney tumors. Currently, approximately 30% of patients with kidney cancer have spread at the time of initial diagnosis. In addition, metastatic disease may develop in the advanced period in 20-30% of patients who have undergone kidney removal (radical nephrectomy) due to localized cancer. It should not be forgotten that kidney cancer will be completely cured if early diagnosis and appropriate treatment is given. The most important feature of kidney cancers is that they are resistant to radiotherapy or chemotherapy. They also respond poorly to hormonal therapy.
Bladder Cancer
Bladder cancers are among the most common tumors of the urinary system. Bladder cancer develops from the cells lining the inner surface of the bladder. It is also called transitional cell carcinoma. In cases where it is not detected and treated, there is a possibility of spreading to the muscle layer and from there to the surrounding organs and the whole body. For this reason, it is important to catch it at an early stage for the success of the treatment and the treatment method. Initially, transurethral resection of the bladder tumor (TUR-BT) is performed to determine the type and stage of the tumor. According to the pathology result, the next treatment method is determined. If it is a superficial tumor, a chemotherapeutic drug (such as mitomycin, doxorubicin, epirubicin) or a weakened form of the tuberculosis bacillus known as BCG is instilled to the bladder for 6 weeks. There is no need to stay in the hospital for this procedure. Since bladder tumor is a disease with a high risk of recurrence, it is necessary to repeat the cystoscopy procedure at regular intervals. If the tumor has spread to the muscle layer or is an aggressive and frequently recurring tumor, an operation in which the bladder is completely removed, known as radical cystectomy, is required. Cystectomy surgery can be performed with open or closed methods. In the meantime, according to the general condition and age of the patient, either a new bladder is made from the intestine (neobladder), or the urinary channels are mouthed to the skin on the anterior abdominal wall (ureterocutaneostomy, ileal loop). After these surgeries, the urine fills into a bag attached to the anterior abdominal wall and the patient changes this bag as it fills. In previous years, patients who had a urinary bladder were carried with a bag, but today, these patients can live comfortably with an artificial bladder made of intestines.
Prostate cancer
Prostate cancer is one of the most common types of cancer in men and occurs when cells in the prostate gland grow out of control. Cancerous cells first show uncontrolled growth and spread into the prostate. Then it extends into the capsule surrounding the prostate, passes the capsule and spreads outward from the prostate. In prostate cancer, as in other cancers, mortality rates can be reduced by early diagnosis. To detect prostate cancer early, blood test measuring the protein level known as prostate specific antigen (PSA), digital rectal examination and/or transrectal (rectal) ultrasound methods are used. In the treatment of prostate cancer, different treatments can be preferred according to the growth rate of the cancer, the spread of the cancer, the general health status of the patient and the effectiveness of the treatment to be applied. If prostate cancer is at an early stage, follow-up may be recommended instead of immediate treatment. Surgery is the most common and effective treatment for prostate cancer. The aim of the surgical approach is to remove the entire prostate (radical prostatectomy). Robotic, laparoscopic, and open surgical methods are available.
Testicular Cancer
Testicular cancer is one of the rare cancers seen in only 1% of men, but it is common in men under the age of 35. Most testicular cancers originate from cells called "germ cells" that produce sperm. The most common finding is a painless mass in the testicles. In the treatment, first, cancerous testicular tissue is removed with an incision made over the groin, which is called radical inguinal orchiectomy. Then, the next treatment is planned according to the pathology and stage of the cancerous tissue. In men with advanced or high-risk cancer, retroperitoneal lymph node dissection (RPLND, surgical procedure to remove abdominal lymph nodes) may be recommended. Drug therapy (chemotherapy) and radiation therapy (radiotherapy) may also be added to the treatment to treat cancerous cells that have spread outside the testicles.