More than 1.7 million people receive a cancer diagnosis each year, reports the National Cancer Institute, and more than 600,000 will lose the battle. While cancers may occur in any area of the body, their occurrence in the reproductive systems is among the most common. Genitourinary (GU) cancer is the term given to those affecting males and, while it may sound like a less-common form, it is prevalent.
More importantly, the rate of mortality remains higher among men than women and since the most common form of GU cancer is prostate cancer, it comes as no surprise that this cancer carries a grim reputation. GU cancer may occur at age, but it is most common later in life. With that in mind, men should know a few things about GU cancer, including where it may occur and how available treatment options, such as cryotherapy and radiotherapy, work.
Background on Genitourinary Cancer
Genitourinary cancer includes several types of cancer that occur in the male reproductive tract and the adrenal glands. When these same types of cancers occur in women they are known as gynecologic cancers. Survival and remission rates vary by the location of the cancer, such as prostate cancer or adrenal cancer.
Prostate, adrenal, bladder, and kidney cancer are all types of GU cancer. Prostate cancer is the second most common cancer in men. Bladder cancer is the fourth, and kidney cancer is among the top 10 cancers diagnosed annually.
GU Cancer Treatment Depends on Unique Factors
Treatment for prostate cancer or other forms of GU cancer depend on the severity of the cancer, such as its size and whether it has metastasized. If the cancer remains small and can be contained, local treatment options, such as radiotherapy or cryotherapy may be the go-to solutions.
Cryotherapy and Chemotherapy Can Increase Risk of Short- and Long-Term Complications
Cryotherapy involves the freezing of affected tissues, encouraging cells to undergo apoptosis, also known as cellular death. Today, cryotherapy is considered a minimally invasive and safer procedure than more drastic options, such as the surgical removal of tissues.
For instance, surgical removal of the prostate gland can be effective in treating prostate cancer, but it can also lead to permanent complications, including sexual dysfunction and risk of infection. Cryotherapy offers a less invasive solution, but many men may still suffer from long-term sexual dysfunction after cryotherapy. Depending on the size of the tumor, cryotherapy may also damage surrounding tissues, potentially affecting risk for bowel problems. However, providers may still turn to cryotherapy even when such risks exist. It all depends on the unique factors affecting each cancer.
Care providers often use cryotherapy for early-stage cancer that has not spread. If the cancer returns after cryotherapy, a round of chemotherapy may be used to further keep it under control.
Unfortunately, the damage inflicted by cryotherapy can be severe, so most care providers do not recommend it for men in these categories:
- Those with an active sexual life.
- Men who have previously suffered or had surgery for anal or rectal cancer.
- Men with enlarged prostates or other obstructions that result in an inability to view the prostate by ultrasound during the procedure.
- Men with tumors that have grown too large to be treated without risking damage to nearby organs and tissues.
These recommendations set the boundaries between when to use cryotherapy versus radiotherapy for prostate cancer.
Another distinction exists. Cryotherapy is limited to areas that can be easily accessed without risking damage or the potential spread of infection. As a result, its primary use in GU cancers is prostate treatment. If the cancer exists in another part of the male reproductive system, such as the bladder or the kidneys, cryotherapy becomes a less-attractive option.
Advances in Radiotherapy for GU Cancer Significantly Lower Risk of Side Effects
Unlike cryotherapy, radiotherapy treatments exist for every known cancer. Unfortunately, the history behind radiotherapy includes a scare-factor: there was a time when radiotherapy meant exposing the whole body to deadly radiation. That’s no longer true, as advancements have changed how physicians use radiotherapy.
Today, radiotherapy for GU cancer uses high-energy particles to kill cancer cells. The radiation dosage and number of sessions needed depend on the individual tumors. According to the American Cancer Society, radiotherapy stands out as the preferred treatment for all men with confined prostate cancers. Yet, its ease of use and relative safety compared to other treatments, including cryotherapy, make it an ideal option for men with cancers that have grown beyond the prostate as well. Even in cancers that cannot be forced into remission, radiotherapy may restrict growth and prevent the worsening of symptoms.
As with any medical treatment, radiotherapy for GU cancers does carry some risk. As a form of radiation, treatment may lead to damage among nearby tissues. For men with prostate cancer, the rectum has the highest risk due the thin veil of tissue between the prostate and the colon.
Radiation exposure to bowel tissue may lead to radiation proctitis. In such circumstances, men experience severe diarrhea, incontinence, blood in the stool and abdominal discomfort. However, medical experts have found solutions to minimize the risk of radiation proctitis. One solution is image guidance (IGRT) to accurately treat the prostate while minimizing dose to adjacent tissues. Another solution is by placing a spacing material behind the prostate to separate the prostate from the rectum.
For example, SpaceOAR uses a gel-like substance that is injected into the tissues in the period prior to radiotherapy. Upon injection, the material forms a cushion to absorb radiation, and over time, the body naturally absorbs the material. The kidneys excrete the remnants, and cancer hopefully rescinds its hold on the organ.
Radiotherapy for other GU cancers, such as cancer of the adrenal glands, remains rare, but its safety and low risk profile make it an ideal solution for inoperable cancers. Even when cancers arise from other areas beyond the GU system, they may begin to metastasize within the adrenal glands. Provided the tumors remain small, less than five centimeters, radiotherapy may be the best option. Traditional surgery may also be an option for those with multiple tumors in the adrenal glands. The prime reason for considering radiotherapy in non-prostate GU cancers goes back to its wide use and ability to tackle small-cell cancers in any area of the body.
Evaluate All Treatment Options for Your GU Cancer Care
There is not a one-size-fits-all approach to treating and managing cancer. While certain providers may opt for cryotherapy or radiation therapy as a primary treatment option for GU cancers, others may recommend a focus on traditional, surgical options. To maximize chances of survival, those living with GU cancer must carefully consider available treatment options and their unique situation. Non-invasive options, including radiotherapy, should be prioritized if possible.
Radiation therapy for prostate cancer and other types of GU cancer is much safer today than it was in the past. The treatment takes little time to complete and relies on advanced diagnostic imaging tools to plan exposure and minimize risk of damage to nearby tissues. In fact, the use of radiation therapy and SpaceOAR may be the best option for men that wish to preserve quality of life during and after cancer treatment.
Ask your care team to consider all available treatment options. If not already mentioned, also ask about the use of radiotherapy for your treatment. A multidisciplinary team such as the experts at Southeast Radiation Oncology Group (SERO) can help you make the right decision for your situation. Contact us online today or by call 1-704-333-7376.