Urogenital cancers

Urogenital cancers

Urogenital cancers are varied, since they include tumors of the kidney and bladder, and, in men, of the prostate and testicle.  Urogenital cancers differ widely. Treatment strategies are adapted to each patient and determined via a multidisciplinary consultation meeting.

• Prostate cancer is the most frequent of these cancers, with almost 70,000 new cases per year in France. It occurs in men most frequently after the age of 65, but mortality rates are low, and patients often recover or keep it under control as a chronic disease over the long term.
  Prostate cancer is suspected when there is an increase in the prostate-specific antigen (PSA) in the blood, and is then diagnosed via additional tests, namely biopsies and MRIs. These elements, along with a clinical examination, also enable the stage and aggressiveness of the tumor to be clarified. According to these criteria, the intensity of symptoms, the general state of health and age, the patient may be offered several different options, from basic monitoring to a curative treatment through surgery, radiotherapy and/or hormone therapy. Chemotherapy is indicated in advanced and/or metastatic forms. Sometimes there may be a choice from among the various treatments, and the patient’s preferences are taken into consideration.
• Another cancer affecting men, testicular cancer (a little over 2,300 cases per year in France), is most frequent in young adults aged between 20 and 30. About 96% of patients make a full recovery. The patient should consult a physician after the appearance of swelling or an increase in volume of one of the testicles.
  The physician performs a manual exam of the testicles, an ultrasound and a search for blood markers. Surgical removal of the affected testicle is the initial treatment. Before this procedure, as a precaution the patient will be asked to give a semen sample to be stored in a “bank” after freezing. Other therapies may be used to complete the treatment plan, including chemotherapy and even radiotherapy, or surgery of abdominal-pelvic masses or remaining lymph nodes.
• Kidney cancer (around 10,500 cases per year) affects twice as many men as women, and most frequently after the age of 65. It is sometimes diagnosed by chance, revealed by an imaging test carried out for a different reason.
  The physician will establish the diagnosis after a clinical exam and abdominal scan. Treatments include surgery and chemotherapy. There are familial forms of kidney cancer; a genetic analysis is therefore often carried out when the disease is diagnosed in a patient aged 30 or 40. If a hereditary predisposition is found, the other members of the family may be closely monitored.
• Bladder cancer (almost 12,000 cases per year in France) is linked mainly to smoking and to exposure to some toxic products used in industry. It affects twice as many men as women, mostly over the age of 70. The proportion of women affected is increasing due to their rise in tobacco use.
  The symptom that often suggests bladder cancer is the presence of blood in the urine. The need to urinate frequently and burning sensations, without urinary infection or stones, are two of the later signs.
  The diagnostic exams involve an ultrasound of the urinary tract, a urine analysis, and bladder exploration via cystoscopy (which can be followed by a surgical resection) for diagnosis and sometimes for treatment.

Several types of treatment are available depending on each case: surgery (removal of the bladder, construction of a new bladder or installation of a colostomy bag), chemotherapy, or more targeted treatments via immunotherapy or radiotherapy.

Treatment for and characteristics of this type of cancer at Institut Curie

Innovation is a strategic priority at Institut Curie, with the committed involvement of physician-scientists in immunotherapy as part of clinical trials, along with one of the most complete technical radiotherapy platforms in France, all making Institut Curie a hospital center authorized to offer care as part of a complete framework or in partnership with surgical teams from Paris region hospitals, such as the Institut mutualiste Montsouris (Paris) and Hôpital Foch (Suresnes).

• Prostate cancer

• Volumetric-modulated arc therapy (with development toward hypofractionated radiotherapy) or brachytherapy using iodine 125-grain implants are among the radiotherapy treatments offered to patients with localized forms.
• Hormone therapy is used to offer effective and lasting treatment to patients with advanced forms of cancer.
• Tumor sequencing can offer the option of a special, targeted drug therapy as part of a dedicated therapeutic trial, to be decided upon during a molecular multidisciplinary consultation meeting.
• Clinical research in immunotherapy is opening up new and promising opportunities for patients, particularly those with metastases.

• Testicular cancer
  • Medical Oncology
• Kidney cancer
  • Interventional radiology is a real asset in the fields of diagnostics (biopsies) and both curative and palliative treatment (cementoplasty, radiofrequency), combining minimally-invasive procedures with high precision.
• Bladder cancer

• Tumor sequencing can offer the option of a special, targeted drug therapy as part of a dedicated therapeutic trial, to be decided upon during a molecular multidisciplinary consultation meeting.
• If surgery is not possible, radiotherapy combined with chemotherapy is offered.

Post-operative radiotherapy is offered against aggressive forms, usually with a tumor extension outside the bladder, mainly in the lymph nodes.

Our Research

At Institut Curie, collaboration between physicians and researchers allows us to offer vital pre-clinical studies before offering patients innovative protocols.

Scientific research continues at Institut Curie’s Research Center to better understand the mechanisms that lead the cells of the urogenital organs to become cancerous. The Molecular Oncology team at the Sub-Cellular Structure and Cellular Dynamics unit (CNRS/Institut Curie) is studying carcinoma of the bladder with the aim of identifying the genes involved, understanding their role, studying the genetic and epigenetic mechanisms at play, and characterizing the related signaling pathways.