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Urology Centre

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  • Uroflowmetry 
  • Urodynamic Study 
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  • Prostate Biopsy  
  • Extracorporeal Shockwave Lithotripsy 
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Health Knowledge

Renal Cancer Treatment

Urology HealthRenal Cancer

Renal Cancer Treatment

With the increasing popularity of health checks and body imaging, many cases of renal cancer can be detected at an early stage, where surgical resection has a cure rate exceeding 90%.  Surgical options include total nephrectomy or partial nephrectomy. Total nephrectomy involves the complete removal of the entire kidney along with the tumor, while partial nephrectomy involves removing only the tumor while preserving the remaining normal kidney tissue. Studies have found that if the renal tumor is 5 cm or smaller, total nephrectomy and partial nephrectomy have similar cure rates. Furthermore, partial nephrectomy allows for the preservation of more normal kidney tissue, reducing the chances of future chronic kidney failure and the need for dialysis, improving the long-term survival rates for patients.   (Principles of partial nephrectomy)   CUHK Medical Centre has acquired the latest software for 3D imaging reconstruction for partial nephrectomy. It enables precise analysis of renal vascular anatomy, tumor location and surrounding structures for improved surgical outcomes.   Renal Cancer Treatment Options Minimally invasive laparoscopic surgery Through a few small skin incisions on the abdomen the doctor completes the radical nephrectomy or partial nephrectomy procedure. Post-operative pain is minimised, and patient recovery is further enhanced.  Robotic assisted laparoscopic surgery Suitable for partial nephrectomy for larger and more complex renal tumors. Robotic instruments are used for more precise tumor excision and haemostasis, reducing intra-operative blood loss and time of operation. Open radical nephrectomy If the tumor is too large, the physician will perform a radical nephrectomy using the conventional open surgical approach to completely excise the renal cancer.   Percutaneous tumor ablation Can be used to treat small (less than 4 cm) renal tumor if the patient is not fit for operation. Commonly used percutaneous renal tumor ablation techniques include cryoablation and radiofrequency ablation.    Cryoablation Cryoablation utilises argon-helium gas and the Joule Thomson effect to produce freezing and thawing effects within the tumor, hence killing tumor cells. Radiofrequency ablation In radiofrequency ablation, the fine needle put into tumor releases radiofrequency energy and generates heat energy within the planned treatment area, raising the temperature to over 60 degrees Celsius to achieve the effect of killing tumor cells.   Late Stage or Metastatic Renal Cancer Postop recurrence rate for renal cell carcinoma with lymph node metastasis or high grade cancer is still relatively high. Apart from regular imaging surveillance, these types of high-risk patients can now undergo adjuvant immunotherapy to reduce the chance of recurrence. As for late stage or metastatic renal cancer, conventional chemotherapy or target therapy are not sufficient for disease control. In recent years, newer combination therapy with PD-L1 inhibitors are bringing new hopes to suitable patients for improved survival outcomes.

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Imaging and Diagnosis of Prostate Cancer

Prostate HealthProstate Cancer

Imaging and Diagnosis of Prostate Cancer

Traditionally, men with elevated PSA would require transrectal ultrasound-guided prostate biopsy to look for any prostate cancer. However, transrectal approach has a 1-2% chance of severe infection, and the biopsy procedure may also be prone to sampling error.  Recently, there have been a lot of advances in prostate cancer diagnosis. For men with elevated PSA, a MRI scan can be arranged to look for any tumours or suspicious lesions within the prostate gland. The MRI images can be fused into the ultrasound image during prostate biopsy, and targeted biopsy of the prostatic tumour can be performed. This will increase the accuracy of the biopsy procedure. On the other hand, if the MRI scan shows a completely normal prostate gland, prostate biopsy may also be safely avoided.    Conventional transrectal prostate biopsy requires puncture of the rectal wall, and bacteria within the rectum may enter the body and result in infection. In order to reduce the risk of infection, transperineal prostate biopsy can be performed. The perineum will first be disinfected during the procedure, and the perineal skin will be punctured in order to sample tissue from the prostate gland. The rectal wall remains intact during the whole prostate biopsy procedure, therefore bacteria within the rectum would not be able to enter the bloodstream. In recent years, transperineal prostate biopsy has gained increasing interest and adoption globally. For patients with confirmed prostate cancer, it is important to look for any distant metastasis before deciding on the appropriate treatment. PSMA PET-CT scan is an accurate imaging for staging prostate cancer. In patients with localized disease, curative treatment such as robotic surgery, radiotherapy and focal therapy can be considered. In patients with metastatic prostate cancer, medical treatment such as hormonal therapy and chemotherapy may be considered. Information about the different types of prostate cancer treatment can be found here.

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