Laparoscopic surgery involves the performance of procedures through small openings in the abdominal and pelvic cavity through which surgical procedures can be performed without the need of making large incisions. These techniques are now routinely used in surgery of the kidney (particularly for kidney cancer) and for surgery of the adrenal glands. Partial nephrectomy (where only the tumor is removed and the major portion of the kidney is allowed to remain intact) is also being done with increasing regularity.

The Mount Sinai Medical Center has also been a leader in the development of procedures to remove the bladder and to perform a variety of urinary reconstructions to accommodate this for bladder cancer. These include:

• Retroperitoneal lymph node dissection for patients who must undergo this procedure for treatment of testicular cancer
• Pelvic lymph node dissection for patients who require this as part of their approach to prostate cancer
• Radical prostatectomy in treatment for patients with prostate cancer

In addition, a variety of reconstructive procedures are also performed using these approaches. This is particularly advantageous for the pediatric population in which the development of new instrumentation has permitted children to be operated upon and cured of their conditions without the need for a large incision. This allows them to get back to a normal life with a minimum of physical (and psychological) trauma.

Chemotherapy uses drugs to kill cancer cells throughout the body. Given by a medical oncologist, these drugs are effective at killing cancer cells, but can also cause side effects. These include:

• Nausea
• Vomiting
• Fatigue

Chemotherapy may also damage normal cells in the body including skin, blood and nerve cells. Common side effects of chemotherapy are:

• Low blood counts
• Increased risk of infection
• Hair loss
• Mouth sores
• Numbness or tingling in the hands and feet

Various treatments prescribed by your doctor can minimize many of these side effects. For instance, blood growth factor injections are used to keep white and red blood cell counts from becoming too low.

The newer chemotherapy methods cause fewer side effects. and are as effective as older treatments. Chemotherapy has been shown to improve both the length and quality of life in people with urinary cancer of all stages.

Radiation therapy, also known as radiotherapy, consists of using strategically aimed doses of radiation to kill cancer cells. Performed by a specialist known as a radiation oncologist, radiation therapy destroys the cancer cells directly in its line of fire as well as any healthy cells within its aim. Because of this it cannot be used to treat large areas of the body. Common side effects include:

• Fatigue
• Loss of appetite

There are also other possible side effects, each associated with whatever part of the body is being treated. Most, however, go away after radiation treatment is completed.

In recent years, various molecular targeted therapies have been developed for the treatment of urinary cancer. These stop the action of the abnormal proteins that are causing cancer cells to grow uncontrollably. These therapies are showing great promise and are constantly evolving, becoming more and more sophisticated and effective.

Alongside the broad range of standard treatments—radiation, chemotherapy, and surgery—to combat cancers at every stage, Mount Sinai offers pioneering new as well. You can learn more about the options available to urinary cancer patients by consulting with your doctor.