Urologic Oncology

What is cancer?

According to the American Cancer Society, cancer is a disease in which cells grow out of control and crowd out normal cells, making it difficult for the body to function properly. Cancer can start any place in the body, and can grow or spread either very rapidly or more slowly. There are many forms of cancer, and each responds to treatment in different ways. The Urologic Oncology experts at Stony Brook Medicine are here to aid patients in determining the best treatment methods specific to their case.

Urologic Cancer Program Overview:

The Urologic Oncology program provides comprehensive care for cancer of any organ of the urinary system and the male reproductive system. These include cancers of the bladder, kidney, ureter, prostate, penis and testis. Care ranges from screening at-risk individuals to treating those with advanced disease and providing access to clinical trials. In 2009, Stony Brook's Department of Urology was again ranked among the top 50 in the nation by U.S. News & World Report (August 5, 2009).

Types of Urologic Cancers:

 

 

Kidney Cancer

Overview
The kidneys’ are an important organ, being that they are responsible for filtering blood and removing excess water, salt, and waste. Kidney cancer begins in the tissues of the kidney and can spread to other body parts. The most common form of kidney cancer is Renal Cell Carcinoma.

kidney cancerSymptoms

Most people with renal cell carcinoma do not have obvious symptoms, and it is not found until the cancer has advanced. When symptoms begin to occur the patient will experience:

  • Blood in the urine (hematuria)
  • Pain in the sides of mid-back
  • Mass in the abdomen or side of back
  • In men → swelling around left testicle

When to see a doctor

Visit your doctor if you have any of the symptoms listed above. Your doctor may perform an ultrasound or computed tomography (CT) scan, to look at the kidneys.

Treatments we offer

  • Active Surveillance 
  • Medical Therapy
  • Renal Mass Ablation (percutaneous cryosurgery) - Generally reserved for frail patients that cannot undergo surgery  
  • Robotic Radical Nephrectomy (surgical removal of the kidney) - Used in cases where the patient has multiple tumors, or the tumor is large and located centrally within the kidney. Removing the kidney is a safe option if the other kidney is functioning normally.
  • Robotic Partial Nephrectomy (do not remove the entire kidney) - This is a common treatment that is sometimes preferred for patients who kidneys do not work well, because it allows both kidneys to keep working. During this treatment the cancer is destroyed by burning it.

Helpful Resources on Kidney Cancer:

Bladder Cancer

Overview
Bladder cancer occurs when cells in the bladder begin to rapidly grow out of control. Bladder cancers develop on the inner layer of bladder, and become more difficult to treat as the cancer cells spread to the wall of the bladder.

Bladder cancerSymptoms

  • Blood in the urine
  • Unable to urinate
  • Lower back pain

When to see a doctor

Visit a doctor if you are experiencing any of the previous symptoms in order to diagnose the problem.

Treatments we offer

Treatment of bladder cancer will be determined by the stage and grade of cancer, and the health of the patient.

  • Robotic Cystectomy (surgical removal of the bladder)
    • Works best with preoperative chemotherapy
    • For High-grade T1 cancers
    • In men→ this requires removal the bladder, prostate, and seminal vesicles
    • In women→this requires removal of the bladder, uterus, cervix, and upper vagina
  • Bladder preservation (partial removal of the bladder)
    • Bladder cancer may be more likely to recur
    • For those who would not be able to tolerate major surgery

Helpful Resources on Bladder Cancer:

Prostate Cancer

Overview
Prostate cancer can be viewed as unusual compared to other cancers, being that in many cases it does not spread to other parts of the body. Prostate cancer grows very slowly and may not give a patient problems for years. Proper management of prostate cancer can lead to good health and quality of life for several years.

prostate cancerSymptoms

  • Frequent Urination
  • Weak urine flow
  • Blood in the urine

When to see a doctor

Visit a doctor if you are experiencing any of the above symptoms to determine the cause of the problem and a proper diagnosis.

If you are a man age 40 or over, be proactive about your health. For information about screening for prostate cancer or to make an appointment with a Stony Brook urologist, call (631) 444-4000 or CLICK HERE.

 Treatments we offer

  • Active surveillance - monitoring low risk prostate cancer
  • Robotic prostatectomy - surgery to remove the entire prostate gland and seminal vesicle
  • External-beam radiation therapy - curing the disease by killing cancer cells
  • Brachytherapy (seed implants) - radiation therapy given from inside the body
  • Cryosurgery - kills the cancer cells in the prostate by freezing them

Helpful Resources on Prostate Cancer:

Testicular Cancer

Overview
Testicular cancer can develop in one or both of the testicles.Testicular cancer is the most common cancer in young men. Fortunately, testicular cancer is one of the most curable cancers and more than 95% of patients survive their disease.

Symptoms

  • Painless lump / swelling in the scrotum
  • Ache / heavy sensation in the belly, anus, scrotum
  • Pain is the first symptom in 10% of men

When to see a doctor

Visit a doctor as soon as possible if you feel a lump on your testicles.

Treatments we offer

  • Radical inguinal orchiectomy - Surgical removal of the entire testical (This is the first step for diagnosis and treatment)
  • Chemotherapy - Medicine that kills cancer cells or stops them from growing
  • Lymph node removal - Surgical removal of lymph nodes in the back of the abdomen
  • Radiation therapy - Use of high-energy x-rays to remove or stop the growth of a tumor
  • Surveillance - Men with small stage I cancer may only need regular follow up appointments after orchiectomy

Helpful Resources on Testicular Cancer:

Penile Cancer

Overview
Penile cancer is a rare form of cancer that occurs mostly in male patients that are not circumcised. Epidermoid/squamous cell carcinoma is the most common type of penile cancer (95%).

Symptoms

  • A growth or sore on the penis (can be on foreskin or shaft)
  • Change in the color of the penis
  • Skin of the penis starts to thicken

When to see a doctor

Visit a doctor if you begin to experience any changes or pain in the penis. Your doctor will help to find the cause of the changes and properly diagnose the issue.

Treatments we offer

  • Surgery - Removing the tumor and surrounding tissues
  • Radiation Therapy - high-energy x-rays to destroy the cancer cells
  • Chemotherapy - use of drugs to destroy cancer cells
    • Topical Chemotherapy - cream applied to the surface
    • Systemic Chemotherapy - reaches cancer cells through the bloodstream

Helpful Resources on Penile Cancer:

Ureter / Renal Pelvis Cancer

Overview
The ureters are two tubes that connect the kidneys to the bladder, allowing the kidney's to empy urine. The renal pelivs is the top part of the ureter that acts like a funnel for urine to leave the Kidneys. Ureter cancer is rare, but when it occurs, it affects mainly men over 65 years of age.

Symptoms

  • Unintentional Weight Loss
  • Dark urine
  • Painful or burning urination

When to see a doctor

Please visit a doctor if you are experiencing any of the symptoms listed above in order to receive a proper diagnosis.

Treatments we offer

  • Nephrectomy - complete kidney is removed, or only part of the kidney(if possible)
  • Robotic Nephroureterectomy - removal of the kidney, ureter, and upper bladder
  • Laser Therapy - inserting a ureteroscope to destroy the tumor using an intense laser beam

Helpful Resources on Ureter / Renal Pelvis Cancer:

Adrenal Tumors

Overview
An adrenal tumor is a mass, greater than 1 cm in diameter, found on the adrenal gland by radiologic examination. The discovery of such mass must be evaluated to determine whether it is malignant (cancerous) and functioning.

Symptoms

  • Weight Gain
  • Muscle weakness
  • Pain in the belly, side, or lower back

When to see a doctor

Visit a doctor if you are having any of the symptoms in order to get a proper diagnosis.

Treatments we offer

Most patients will need to get surgery in order to remove the cancer. After surgery, a patient will undergo other treatments such as:

  • Chemotherapy - Medicines that kill cancer cells / stop the growth of cancer
  • Radiation Therapy - Using radiation to kill cancer cells

Helpful Resources on Adrenal Tumors:

 

 

Physicians

Wayne Waltzer Adler Fitz Golombos Spaliviero
Wayne C. Waltzer, MD, FACS
Professor & Chairman of Urology
Kidney Transplantation
Urologic Oncology
Howard L. Adler, MD, FACS
Associate Professor
General Urology
Men's Health
Endourology
John Fitzgerald, MD, MSCI
Assistant Professor
General Urology
Urologic Oncology

Robotic Surgery
David Golombos, MD
Assistant Professor
General Urology
Urologic Oncology

Robotic Surgery
Massimiliano Spaliviero, MD
Assistant Professor
General Urology
Urologic Oncology

Robotic Surgery
Clincial Staff        
melanie dale deborah feliciano arielle maggio-ferguson matthew petersen jean peterson
Melanie Dale, RN, BS, OCN Deborah Feliciano, NP-C Arielle Maggio-Ferguson, MS, PA-C Matthew Petersen, PA-C Jean Peterson, ANP