Patient Information

Kidney Cancer

• Treatment Options

Kidney Disorders

• Kidney Disorders
• Blockage of the Ureter

Prostate Cancer

• Prostatectomy
• Types of Prostatectomy

Bladder Cancer

• Bladder Cancer Advocacy Network

Kidney Cancer

Kidney Cancer can form in the small tubes inside the kidney. Those tubes located in the center of the kidney where urine collects, are used to filter blood. Each year in the United States , kidney cancer is diagnosed in about 54,000 Americans and more than 13,000 do not survive the disease. 1 Kidney cancer is slightly more common in men and is usually diagnosed between the ages of 50 and 70 years. The most common kidney cancer is called renal cell carcinoma.

It is important to realize that with early diagnosis and treatment, kidney cancer can be cured. If found early, the survival rate for patients with kidney cancer ranges from 79 to 100 percent. 2

Treatment Options

Kidney cancer is fairly resistant to radiation and chemotherapy. As a result, the gold standard treatment for localized kidney cancer is removal of the kidney or kidney tumors.

Kidney surgery is traditionally performed using an open approach, meaning doctors must make a large incision in the abdomen. Another approach is conventional laparoscopy. It is less invasive, but limits the doctor's dexterity, vision and control, compared to open surgery. If your doctor recommends surgery for kidney cancer, you may be a candidate for a new, minimally invasive approach — da Vinci® Robotic Partial Nephrectomy Surgery.

Kidney Disorders

The kidneys are two small fist-sized organs located behind the abdomen on each side of the spine above your waist. By producing urine, kidneys remove toxic by-products and excess fluids from the body to help maintain a critical balance of salt, potassium and acid.

Diseases of the kidney are found more often in racial and ethnic minority populations in the United States than in the Caucasian population. African Americans, Asian Americans, Hispanics/Latinos, and Pacific Islander Americans are three times more likely to suffer from kidney failure than Americans of European descent.

Blockage of the Ureter

One of the most common conditions affecting the kidneys is blockage of the ureter - the tubes that transport urine from the kidneys to the bladder. This condition is found in adults, but more commonly diagnosed in children.

Normally, a single ureter drains a single kidney but sometimes there may be two ureters draining one kidney. One ureter drains the upper part of the kidney and the second ureter drains the lower part. As long as they both enter the bladder normally, this "duplicated collecting system" is not a problem.

In rare cases, a child may be born with an ectopic (abnormally positioned) ureter. This is a ureter that fails to connect properly to the bladder and drains somewhere outside the bladder. In girls, the ectopic ureter usually drains into the urethra or even the vagina. In boys, it usually drains into the urethra near the prostate or into the genital duct system . The urethra is a canal that carries the urine from the bladder and in males also serves as a passageway for semen

The most common cause of blockage in the urinary tract in children is a congenital obstruction at the point where the ureter joins the renal pelvis — the ureteropelvic junction (UPJ) - the area at the center of the kidney where urine collects and is funneled into the ureter. This problem occurs in roughly one in 1,500 children. 1 These obstructions develop prenatally as the kidney is forming and today most are diagnosed on prenatal ultrasound screening. In UPJ obstruction, the kidney produces urine at a rate that exceeds the amount of urine able to drain out of the renal pelvis into the ureter. This causes an accumulation of urine in the kidney. This accumulation, also called hydronephrosis , is visible on ultrasound and often allows the doctor to predict the presence of UPJ obstruction before the baby is born.

Although less common in adults, UPJ obstruction can occur as a result of kidney stones, previous surgery or disorders that can cause inflammation of the upper urinary tract.

Blockages of the ureter can create serious side effects like infections and kidney stones. If left untreated, blockages can cause chronic pain and may damage the kidney over time.

Prostatectomy

The gold standard treatment option for men under 70 with early-stage, organ-confined cancer is surgical removal of the prostate using nerve-sparing radical prostatectomy. Prostatectomy is also the most widely used treatment for prostate cancer today in the US.1

The primary goal of prostatectomy is removal of the cancer. A secondary goal is to preserve urinary function and -- when applicable -- erectile function. Preservation of the nerves necessary for erections can be an extremely important goal for patients. These nerves run alongside the prostate and are often damaged when removing the prostate. A nerve-sparing prostatectomy attempts to preserve these nerves so that the patient may be able to return to his prior erectile function.

Types of Prostatectomy

Approaches to this procedure include traditional open surgery, conventional laparoscopic surgery or da Vinci ® Prostatectomy, which is a robot-assisted laparoscopic surgery.

With a traditional open procedure, your surgeon uses an 8-10 inch incision to access the prostate. This approach often results in substantial blood loss, a lengthy, uncomfortable recovery and a risk of impotence and incontinence.

Conventional laparoscopy uses a specialized surgical camera and rigid instruments to access and remove the prostate using a series of small incisions. This approach provides your surgeon with better visualization than an open approach. In addition, it provides patients the benefits of a minimally invasive procedure.

Despite these advantages, conventional laparoscopy relies on rigid instruments and standard 2D video, technical limitations that can be challenging for the surgeon. Because of these drawbacks, conventional laparoscopy doesn’t lend itself well to complex procedures like prostatectomy. Therefore, very few urologists use this approach for prostatectomy. Moreover, neither laparoscopy nor open surgery can provide adequate visualization for a very precise, nerve-sparing prostatectomy.

Learn more about da Vinci at http://www.davincisurgery.com/

Bladder Cancer Advocacy Network