The examinations needed to confirm and refine diagnosis of a urological cancer depend on the organ where the tumour has appeared.
- For kidney cancer, an ultrasound, MRI or CT scan is carried out. A targeted, scan-guided biopsy may also be taken. If partial surgery or conservative treatment is planned, an angioscan is also carried out to identify the vascular network that supplies and drains the kidney.
- In the case of bladder cancer, a vesical endoscopy is carried out, possibly with the prior injection of fluorescent substances that make it easier to see small-size or “in-situ” tumours.
- For testicular cancer: following a clinical examination, a Doppler ultrasound test, a blood analysis to measure certain tumour markers and a medical imaging examination (MRI and/or PET scan) are carried out. Because of the risk of the cancer spreading, biopsies are rarely taken.
- Cancer of the penis is rare, but on the increase as its development is associated with the human papillomavirus (HPV), the same virus responsible for cervical cancer in women. Penile cancer takes the form of an ulcerous lesion that fails to heal. Diagnosis can usually be confirmed by clinical examination.
Here too, the treatment chosen depends on the organ concerned.
- Kidney cancer: surgical removal of the tumour (with all or part of the kidney) using robotic technology is common. Radiofrequency ablation using high frequency ultrasound is reserved for small-size tumours. If the cancer is at an advanced stage (with metastases), targeted drug therapy is also a therapeutic option.
- Bladder cancer: total ablation of the bladder is necessary if the cancer has penetrated the vesical muscle. Such surgery is always followed by physiotherapy to help manage incontinence problems and care is given by an enterostomal therapist who specialises in dealing with urinary bags and stoma. In some cases, the bladder may be surgically reconstructed. Surgery is sometimes preceded by neoadjuvant chemotherapy. Half of all bladder cancers are due to smoking and support from a nicotine addiction specialist is also offered to patients who smoke.
- Testicular cancer: surgical ablation of the testicle (and its replacement by a prosthesis) is fairly standard because it must be analysed in order to decide on further treatment. When successfully conducted, a multidisciplinary approach to this cancer can cure 90% of patients. Treatment is always preceded by the collection and cryopreservation of sperm in order to preserve the patient’s future fertility.
- Cancer of the penis: the tumour is removed by laser or by surgery. If necessary, the lymph nodes are also removed using the sentinel lymph node technique, of which the Institut Jules Bordet was a pioneer.
All male urological and genital cancers are discussed by the Institut Jules Bordet’s Urological Tumours Multidisciplinary Oncology Team. This team includes urologists, medical oncologists, surgeons, radiotherapists, imaging and nuclear medicine specialists, pathologists, a cancer psychologist and cancer care coordinator nurse. Some cancers and their treatments require a high level of psychological support and/or follow-up.
The Institut Jules Bordet's nurses, most of whom specialise in oncology, are committed to caring for patients with thought, humanity and professionalism.
Their role does not stop at care and treatment follow-up; they also meet families, and try to be as available as possible and by patients' sides while being attentive to everything confided in them. The role of education, information and support is an integral part of their profession.
They must have relational, technical and scientific skills in line with the gravity and the complexity of the cancerous pathology. The nurses are particularly attentive to the treatment of pain and other symptoms resulting from cancer treatment.
They also focus on their role as trainers to welcome and supervise students, and give them incentive to practice the profession in the best possible conditions.
With the medical teams, many other healthcare professionals support the patients. They are dedicated to help patients in managing their illness and treatments, and to promote their wellbeing.
The aims of post-cancer care are multiple:
- to keep an eye on the physical and psychological state of the patient
- to manage any medium or long-term secondary effects of certain treatments
- to detect any recurrence as soon as possible
- to identify any new cancer.
Recurrence means that cancer cells reappear after a period of remission that can vary from a few months to several years. It can also happen that the same patient develops different cancers several years apart. In all these cases, the earlier a recurrence or cancerous disease is detected, the faster a new therapeutic strategy can be offered.