The Genitourinary Cancer Program

Meet our Cancer Specialists: Jue Wang, MD, FACP  |  Shyamal Patel, MD  |  George Kallingal, MD, MPH

The term “genitourinary” refers to the body’s urinary system and its connection to the genitals. The services provided in the Genitourinary (GU) Cancer Program at  the Dignity Health – Cancer Institute at St. Joseph’s Hospital and Medical Center include the care and treatment of patients with malignant disease of the prostate, bladder, kidney, penis, testicles, urethra, and adrenal gland.  

But it’s not enough for GU cancers to be successfully treated. “We know that, in order to ensure the best outcomes and preserve best quality of life for our patients, we must treat each patient as a whole person rather than just as his or her disease.” said Jue Wang, MD, FACP, the Section Leader of the Genitourinary Oncology Division at the  Dignity Health – Cancer Institute at St. Joseph’s.

Doctors recognize how critical disease-specific expertise can be when treating cancer. And for patients and their loved ones, understanding more about these GU cancers can advance understanding of the treatment that may be selected, based on genetic profile, lifestyle, and individual circumstances.

For more information or to schedule an appointment with one of our disease-specific oncologists, please call (602) 406-8222.

Prostate Cancer

Prostate cancer is the most common cancer in men in the United States, after skin cancer. It is the second leading cause of death from cancer in men. The National Cancer Institute (NCI) estimates that nearly 221,000 men are diagnosed with prostate cancer every year, but when diagnosed early, nearly 99 percent of patients survive at least five years.

The prostate lies just below the bladder in front of the rectum. It surrounds the urethra (the tube that carries urine and semen through the penis and out of the body). Almost all prostate cancers are adenocarcinomas, cancers that begin in cells that make and release mucus and other fluids, according to the NCI. Prostate cancer often has no early symptoms and usually grows very slowly.

A majority of men with prostate cancer are older than 65 and do not die from the disease.
More advanced prostate cancers can sometimes cause symptoms, the American Cancer Society says, such as:

  • blood in urine
  • trouble getting an erection
  • problems urinating, including a slow or weak urinary stream or the need to urinate more often, especially at night
  • pain in the hips, back, chest, or other areas from cancer that has spread to the bones
  • weakness or numbness in the legs or feet
  • loss of bladder or bowel control from cancer pressing on the spinal cord.

For more information specifically about prostate cancer, visit this page put together by the National Cancer Institute: cancer.gov/types/prostate. For information about survival rates for prostate cancer, visit seer.cancer.gov/statfacts/html/prost.html.


Bladder Cancer

Bladder cancer occurs most commonly in the cells that line the inside of the bladder and this is known as transitional cell carcinoma. About 74,000 Americans are expected to be diagnosed with bladder cancer this year.

People who smoke have an increased risk of bladder cancer. Being exposed to certain chemicals and having chronic bladder infections can also increase the risk of bladder cancer. Bladder cancer is often diagnosed at an early stage, when the cancer is easier to treat.

Symptoms of this cancer may include:

  • blood in the urine. In most cases, blood in the urine (called “hematuria”) is the first warning sign of bladder cancer, according to the American Cancer Society.
  • changes in bladder habits or symptoms of irritation
  • having to urinate more often than usual
  • pain or burning during urination
  • feeling as if you need to go right away, even when the bladder is not full.

For more information specifically about bladder cancer, visit this page put together by the NCI: cancer.gov/types/bladder. For information about survival rates for bladder cancer, visit seer.cancer.gov/statfacts/html/urinb.html.


Kidney Cancer

Kidney cancerin adults either forms in the tissues of the kidney that make urine (renal cell carcinoma) or in the renal pelvis and ureter in adults (called transitional cell cancer). The National Cancer Institute says smoking and taking certain pain medicines for a long time can increase the risk of adult kidney cancer. Certain inherited disorders also can increase the risk of kidney cancer in children and adults.

Symptoms of this cancer may include:

  • blood in the urine (hematuria)
  • low back pain on one side (not caused by injury)
  • a mass (lump) on the side or lower back
  • fatigue (tiredness)
  • loss of appetite
  • weight loss not caused by dieting
  • fever not caused by an infection that doesn’t go away
  • anemia (low red blood cell counts).

About 61,500 Americans are expected to be diagnosed with kidney cancer every year, according to the NCI. For more information specifically about kidney cancer, visit this page put together by the 
NCI: cancer.gov/types/kidney. For information about survival rates for kidney cancer, visit seer.cancer.gov/statfacts/html/kidrp.html.


Testicular Cancer

Testicular cancer is the most common cancer in men 15-34 years of age, according to the NCI.  The NCI estimates that 8,400 American men will be diagnosed with this kind of cancer this year. The most common sign of testicular cancer is a lump or swelling in the testicle. Most testicular cancers can be cured, even if they are diagnosed at an advanced stage.

Treatment for testicular cancer can cause infertility by decreasing the amount of sperm made by the body. Men who want to have children may want to use sperm banking to store sperm before they begin treatment.

For more information specifically about testicular cancer, visit this page put together by the NCI: cancer.gov/types/testicular. For information about survival rates for testicular cancer, visit seer.cancer.gov/statfacts/html/testis.html.


Penile Cancer

Penile cancer is caused in about one-third of cases by human papillomavirus (HPV) infection. Circumcision (removal of the foreskin) may help prevent infection with HPV and decrease the risk of penile cancer. When found early, penile cancer can usually be cured, according to the NCI.

The American Cancer Society estimates that 1,800 American men will be diagnosed with cancer of the penis this year. Symptoms can include:

  • an area of skin becoming thicker and/or changing color
  • a lump on the penis
  • an ulcer (sore) that might bleed
  • a reddish, velvety rash
  • small, crusty bumps
  • flat, bluish-brown growths
  • discharge (fluid) under the foreskin
  • swelling at the end of the penis.

For more information specifically about penile cancer, visit this page put together by the NCI: cancer.gov/types/penile. For information about survival rates for penile cancer, visit this page from the American Cancer Society: cancer.org/cancer/penilecancer/detailedguide/penile-cancer-survival-rates.


Urethral Cancer

Urethral cancer is a rare cancer that occurs more often in men than in women. The urethra is a tube that carries urine from the bladder to the outside of the body. In women, the urethra is about 1½ inches long and is just above the vagina. In men, the urethra is about 8 inches long. It goes through the prostate gland and the penis to the outside of the body.

Urethral cancer can metastasize (spread) quickly to tissues around the urethra and has often spread to nearby lymph nodes by the time it is diagnosed. Signs of urethral cancer can include bleeding or trouble urinating.

For more information specifically about urethral cancer, visit this page put together by the the 
NCI: http://www.cancer.gov/types/urethral/patient/urethral-treatment-pdq.


Adrenal Cancer

Adrenal cancer is considered a genitourinary cancer because the two adrenal glands sit on top of the two kidneys, one on each. What’s officially called “adrenocortical cancer” is extremely rare; the American Cancer Society estimates there are only about 300 cases diagnosed every year in the United States. Adrenocortical tumors usually make extra amounts of one or more adrenal hormones, which may cause symptoms, including:

  • a lump in the abdomen
  • pain the abdomen or back
  • a feeling of fullness in the abdomen
  • weight gain in the face, neck, and trunk of the body and thin arms and legs
  • growth of fine hair on the face, upper back, or arms
  • a round, red, full face
  • a deepening of the voice and swelling of the sex organs or breasts in both males and females
  • muscle weakness
  • high blood sugar
  • high blood pressure.

For more information specifically about urethral cancer, visit this page put together by the NCI: cancer.gov/types/adrenocortical/patient/adrenocortical-treatment-pdq.

Questions to ask your oncologist about your genitourinary (GU) cancer:

  • What specific kind of cancer do I have?
  • What is my prognosis?
  • What is your experience in treating the cancer I have?
  • How will you determine the best treatment for me?
  • How long does each treatment option typically last, both individually and as a series of treatments?
  • How will you know if the treatment is making progress?

For more information about various types of cancer, cancer staging and treatment options, click on this link from the National Comprehensive Cancer Network (NCCN): NCCN Guidelines for Patients® - nccn.org/patients/default.aspx.

For more information about scheduling an appointment at the Dignity Health – Cancer Institute at St. Joseph’s, please call (602) 406-8222.


Decreasing risk for genitourinary (GU) cancers

You can minimize your risk of developing GU cancer through these four steps:

  • Avoid using tobacco products
  • Take appropriate precautions if you work around chemicals used in the rubber, leather, textiles, paint products, and printing industries. If you do work in these industries, it’s especially important not to smoke.
  • Maintain a healthy body weight.
  • Men should not take Vitamin E supplements. They have been found to increase risk of prostate cancer.