Urologic Oncology

No matter what type of urologic oncology you have, Ochsner has the expertise to manage your care. Our urologic oncology team is comprised of highly skilled physicians who meet regularly to discuss your journey from diagnosis to wellness. Your health is guarded by the region’s best minds in urologic oncology treatment, with decades of collective experience in urology, medical oncology, radiation oncology and surgery. Our specialists use the latest screening, diagnostic and treatment guidelines set by the National Comprehensive Cancer Network and the American Cancer Society.

Ochsner offers compassionate cancer care to people in Louisiana and Mississippi. With ​multiple sites in Louisiana, we make it easy for families to be screened and to learn whether they may have a genetic risk for cancer. The urologic oncology team at Ochsner also offers virtual appointments for some visits. Find a location near you.

Prostate cancer is the most common malignancy in men, second only to skin cancer. Early detection is key to determining management. While a third of men diagnosed may not need treatment, for those that do, at Ochsner we seek to create a personalized treatment plan through a multidisciplinary approach. We believe there is a no one-size fits treatment strategy.

Screening

The incidence of prostate cancer increases with age, and family history may one of the most important factors determining one’s risk for prostate cancer. Men should consider screening for prostate cancer between the ages of 40-50, using a routine blood test checking the blood level for prostate specific antigen or PSA. When elevated a prostate biopsy may be warranted.

African American men and men with a first degree relative may consider screening earlier.

Diagnosis

At Ochsner, prostate biopsy can be performed via a trans-rectal or trans-perineal approach. Please consider talking to your doctor about which is best for you.

Prior to prostate biopsy, most men should consider obtaining a prostate magnetic resonance imaging (MRI) to ensure that you are obtaining the most comprehensive evaluation of your prostate.

At Ochsner, we routinely use prostate MRI in conjunction with novel fusion techniques to combine real-time ultrasound and MRI to accurately biopsy suspicious areas of cancer within the prostate.

Management of localized prostate cancer (in place of surgery options)

When your cancer is confined to the prostate--many options for management exist and there certainly isn’t a one-size fits all approach. At Ochsner, we use a multidisciplinary approach to help guide treatment. When appropriate, you will meet with urologic oncologist, medical oncologist, and radiation oncologist to help guide you through the decision-making process.

Active surveillance

Active surveillance may be appropriate for men with prostate cancer confined to the prostate and lower Gleason grades, suggesting that their cancer isn’t aggressive enough to warrant invasive intervention. The goal is to provide men an alternative to invasive intervention, without compromising the opportunity for cure, when cure is necessary.

Prostatectomy

Some men may be candidates for removal of their prostate for cancer control. At Ochsner, this is typically done using the DaVinci Robotic system. This modern, minimally invasive approach allows our surgeons to cure cancer with minimal blood loss, small incisions, and less post-operative pain which allows you to get back to your daily activities as soon as possible. Most men spend 0-1 night in the hospital. Since surgery can lead to loss of erectile function or urinary continence, our surgeons use novel nerve-sparing and urinary-sphincter sparing approaches during surgery to ensure your quality of life is maintained.

Radiation

While a urologist does not provide radiation treatment to the prostate, our surgeons realize that both surgery and surveillance may not be appropriate or desired by you. We encourage all our patients to discuss radiation with their urologist and consider referral to radiation oncology to discuss this treatment in further detail.

Ablation/focal therapy

Some men with localized prostate cancer may be candidates for a focal, ablative approach. In this setting, novel technology in the form of high-intensity focused ultrasound (HIFU) or cryoablation may be used to treat only the portion of the prostate involving cancer. With this approach, men may achieve cancer control with minimal compromise in erectile or urinary function. Please consider asking your doctor if this approach would be appropriate for you.

• High-intensity focused ultrasound (HIFU) is a minimally invasive treatment for localized prostate cancer that uses high-frequency sound waves directed at the cancerous tissue through an ultrasound probe inserted into the rectum. The high intensity sound waves heat up and ablate the targeted tissue, causing cell death. For men diagnosed with localized prostate cancer, HIFU provides another alternative between active surveillance, and radical surgery and radiation. HIFU is a minimally invasive, outpatient procedure. No incisions are made during treatment.

Management of advance prostate cancer

When prostate cancer is no longer localized to the prostate, but metastasize to other sites, treatment may require systemic therapy using hormone or chemo-therapy treatment. At Ochsner, our surgeons work closely with medical oncology to create a treatment plan. In some cases, enrollment in a clinical trial may be best for you. Ask your surgeon if there is a clinical trial appropriate for you.

Kidney cancer affects the paired organ located in your back known as the kidney which filters waste products in the blood to make urine. Kidney cancer routinely ranks in the top ten most common cancers in the United States, with men more commonly affected than women. Risk factors for cancer generally include increasing age, high blood pressure and smoking. Early detection is key to determining management, though unlike other cancer no screening program exists. Cancers are often diagnosed when patients are without symptoms due incidental finding on imaging, or when symptomatic with flank pain, blood in the urine or fever.

Treatment options for kidney cancer

Active surveillance

Active surveillance may be appropriate for some with small renal masses. The goal is to provide patients an alternative to invasive intervention, without compromising the opportunity for cure.

Partial or radical nephrectomy

Some patients may choose to have partial nephrectomy which is removal of the mass alone, leaving the rest of the kidney in place. This is possible in most cases, but in certain cases where the mass is very large or the location is unfavorable, radical nephrectomy which is the removal of the whole kidney may be required. Both surgical options can be done through a traditional, open approach, but also through a minimally invasive or robotic surgery approach using the Da Vinci Robotic Platform. Please ask your surgeon which approach is best for you.

Management of advance kidney cancer

Some patients may present with kidney cancer that has moved to the lymph nodes or other organs. We work closely our medical oncologists provide systemic treatment in these cases using novel immunotherapies. Surgery may still be an option for some. In certain cases, a clinical trial may be the best approach.

At Ochsner Health, we are able to provide patients with complex oncologic problems a formidable surgical solution.

Testis cancer affects the paired organs located in the scrotum of men. Early detection is key to determining management, though unlike other cancer no screening program exists. Cancers are often diagnosed when patients are without symptoms due incidental finding of a mass in the scrotum during self-examination. Family history of testicular cancer may be the strongest risk factor.

Management of localized and advanced testis cancer

Management of localized testis cancer

When a mass is found in the testis and no where else, a radical orchiectomy is the standard of care. This means removal of the testicle and testicular cord through a small abdominal incision. This procedure is often curative alone.

Management of advanced testicular cancer

The testicles start in the belly during embryonic development and descend into the scrotum just before or at birth. For this reason, when advanced testicular cancer is found it is often found in the lymph nodes in the abdomen. Management of advanced testicular cancer requires a team of experts that work together. At Ochsner, urologic oncologists work closely with medical and radiation oncologists to provide a personalized treatment plan that may require chemotherapy plus surgery or radiation. Our surgeons are trained to care for complex surgical problems and commonly perform retroperitoneal lymph node dissections for advanced testicular cancer.

Bladder cancer affects the mostly men, but rates are increasing in women, and it frequently ranks in the top ten cancers. The number one cause of this cancer is smoking, but a close second is exposure to industrial chemicals. Generally patients are found to have bladder cancer when they present with blood in their urine or lower urinary tract symptoms like new onset urgency, frequency, or dysuria. Bladder cancer generally comes in two forms: non-muscle invasive and muscle invasive. At Ochsner Health, we take pride in creating a treatment plan for your cancer diagnosis that prioritizes the preservation of your bladder when possible.

Management of non-muscle invasive bladder cancer

When a mass is found in the bladder on cystoscopy (looking inside the bladder with a camera), the next step is usually a trip to the operating room to undergo a transurethral resection of the bladder tumor, which is not only diagnostic but also curative. If your tumor is found to only in the inner lining of the bladder, then immunotherapy or chemotherapy is often used in the bladder to prevent recurrence or progression of your disease (known as intravesical therapy). These medicines unlike systemic therapy are not absorbed by the body and as a result do not carry a risk of systemic side-effects like nausea, vomiting, hair-loss, or fatigue. At Ochsner we routinely use Bacillus Calmette- Guerin or (BCG), but also other novel agents that have proven as effective or better than BCG. Lastly, we do have clinical trials specifically for those patients with recurrence after BCG who are motivated to keep their bladder and not transition to bladder removal surgery.

Management of muscle invasive bladder cancer

When a mass is found in the bladder on cystoscopy (looking inside the bladder with a camera), the next step is usually a trip to the operating room to undergo a transurethral resection of bladder tumor, which is not only diagnostic but also curative. If your tumor is found to be in the muscle and not just the inner lining of the bladder, then medicine in the bladder is typically not effective enough to treat your cancer. The current standard of care for this disease is intravenous chemotherapy and radical cystectomy (removal of the bladder) with urinary diversion. Alternatively, some may choose intravenous chemotherapy with radiation to the bladder. At Ochsner we work closely with our comprehensive cancer care team to match your desire for cancer control as well as functional outcomes to create a personalized treatment plan.

At Ochsner Health, our surgeons can perform robotic and open radical cystectomy as well as all types of urinary diversion: ileal conduit, colon pouches, continent cutaneous urinary diversions, and orthotopic neobladders.

Choosing Ochsner connects you to a ​​network of experts in nutrition, physical therapy, social work, financial assistance, nurse navigation, spiritual care, language services and other supportive programs. Whether you are newly diagnosed or on the road to wellness, we are committed to improving your health and lifestyle. Talk to your specialist to learn how you can get help for unexpected needs, including affordable or free lodging for family members involved in your care.