Urologic Cancer Program

Although prostate cancer is the second leading cause of cancer death in people with prostates in the U.S., early detection leads to better treatment outcomes. Medical experts recommend prostate cancer screening for most people with prostates starting at age 55. Some black people, and those with a first-degree relative with prostate cancer, may be at higher risk and should talk with their doctor about starting screenings at age 50. Learn more about prostate cancer screening.

Our urologic oncologists have advanced training and extensive expertise in recognizing the signs and symptoms of urologic cancers. If you already have a diagnosis, our team will review your most recent test results. We may recommend additional testing to assure a precise diagnosis. From there, we build a treatment plan tailored to your needs and goals. 

Diagnosing urologic cancer often involves invasive biopsies. Stanford researchers are developing less invasive tests that can diagnose urologic cancer using medical imaging or blood or urine tests.

If we suspect that you may have urologic cancer, you may need one or more tests, such as:

• Lab tests: Some types of cancer, including prostate, bladder, and testicular, release tumor markers into the blood or urine. Lab tests can detect these tumor markers and provide information about your overall health.
• Imaging: Doctors use advanced imaging to examine cancer tumors and evaluate whether the cancer has spread beyond its original location. The types of imaging studies your doctor may use in diagnosing urologic cancer include X-ray, ultrasound, MRI, CT scan and PET/CT scan.
• Cystoscopy: In this procedure, your doctor passes a flexible fiber optic endoscope through your urethra to examine the urinary tract.
• Biopsy: Your doctor collects a small tissue sample with a fine needle. A pathologist examines the tissue for the presence and type of cancer.
• Genetic testing: Some types of cancer are inherited. If a family member has received a cancer diagnosis, your doctor may recommend genetic testing to determine your risk.

Surgery is often the first treatment for many types of urologic cancer. We offer minimally invasive procedures whenever possible to reduce pain and recovery time and maintain sexual and urinary function.

Surgical procedures vary by the type and stage of cancer and range from removal of a small tumor to removal of an entire organ. Stanford surgeons have decades of experience and offer the most advanced techniques for each type of urological cancer:

• Bladder cancer surgery: Your surgeon may use a minimally invasive procedure through the urethra to remove small tumors from the bladder (transurethral resection of bladder tumor). Larger, more invasive tumors may require removal of part or all of your bladder (cystectomy). If your entire bladder is removed, our surgeons have extensive experience restoring urinary flow using incontinent diversion, continent diversion, and neobladder reconstruction procedures.
• Prostate cancer surgery: Robotic assisted laparoscopic prostatectomy is a minimally invasive procedure to help to reduce recovery time and maintain sexual and urinary function, while treating the cancer.
• Kidney cancer surgery: A nephrectomy involves partial or full removal of the kidney. We perform most nephrectomies using robotic assisted laparoscopic procedures.
• Testicular cancer surgery: Removal of the testicle (radical inguinal orchiectomy) is often the first treatment for testicular cancer. If cancer has spread to the lymph nodes and residual disease is present after chemotherapy, our doctors perform a procedure to remove the lymph nodes (retroperitoneal lymph node dissection).
• Penile cancer surgery: The goal of surgery is to completely remove while preserving the penis. Penile cancer surgery typically removes the tumor and a small border of normal tissue. In rare cases of advanced cancer, the surgeon may remove part or all of the penis (penecmtoy).

Our medical oncologists are cancer specialists who use medications that you receive orally, intravenously (IV), or intravesically (delivered to your bladder through a catheter inserted into your urethra). Our treatment approach emphasizes using the most effective therapies with the fewest side effects.

The types of medical oncology therapy we use to treat urologic cancers include:

• Chemotherapy
• Hormone therapy
• Immunotherapy
• Intravesical therapy
• Targeted therapy

We frequently use these therapies together or in combination with other treatments. For example, chemotherapy before bladder surgery may make the surgical procedure more effective.

Stanford Health Care is at the forefront of targeted therapy use and development. These agents bind to proteins in cancer cells to destroy them or stop them from spreading but leave noncancerous cells alone. We continually offer new targeted therapies through clinical trials. You can find out if you are eligible to participate in a trial by talking to your doctor.

Radiation therapy destroys cancer cells using high-energy X-rays. The radiation can come from outside the body (external radiation) or a radiation source placed inside or next to the tumor (brachytherapy).

The types of external radiation that can treat urologic cancer include:

• 3D conformal radiation therapy
• Intensity-modulated radiation therapy
• Stereotactic ablative radiotherapy (SABR/SBRT)

With SBRT, an intense dose of radiation is focused on the tumor. Stanford Health Care has been a leader in developing SBRT technology, and we continue to find ways to make radiation therapy safer and more effective. Current SBRT systems, including CyberKnife, Trilogy, and TrueBeam, expand treatment options and give our doctors flexibility in developing treatment plans. 

Interventional radiology delivers cancer treatment directly to the tumor using minimally invasive techniques. For urologic cancers, our interventional radiologists offer tumor ablation. Using a needle or probe, we can obtain biopsies, apply microwaves or cryotherapy to the tumor to destroy it. We can also use high-intensity focused ultrasound energy on cancer tumors. Stanford Health Care is one of the few centers on the West Coast that offers high-intensity focused ultrasound for prostate cancer. 

Cancer tumors have unique genes or proteins called biomarkers. By identifying these biomarkers, doctors can choose a treatment designed for that cancer. Some biomarkers can also help your care team monitor the tumor during and after treatment. Our experienced pathologists perform biomarker testing and work with your doctor to develop your treatment plan. 

Your wellness plays a role in the success of your treatment. We offer a range of support services to assist you and your family throughout your cancer journey. Whether its spiritual counseling, a new wig, or help with your finances, we’re here for you whenever you need us.