Cancerous tumors of the urogenital tract, both female and male, are usually of primary nature, which means they start to grow in the urogenital region, with the ability to invade or spread to other parts of the body. Urogenital tumors in female can develop as vulvar cancer, vaginal cancer, cervical cancer, uterine cancer, endometrial cancer as well as ovarian cancer. Urogenital tumors in male patients can develop as penile cancer, prostate cancer or testicular cancer. Urinary cancer can affect both, male and female, and can develop as renal cell carcinoma (kidney cancer), or bladder cancer. A neoplasm or also called a tumour is a group of cells that have undergone unregulated growth and may form a mass, but can also be distributed diffusely throughout the body.
Tumour cells show a number of characteristics, including abnormal cell growth and division absence of programmed cell death, high number of cell divisions, promoting of blood vessel formation, invasion of tissue and metastasis.
Signs and symptoms of the disease are wide and may include itching, burn or bleeding from the genitals, haematuria, dysuria, change of the skin around the genitals, bloating, diarrhea, constipation, and nausea.
These tumors are classified by several grading systems, as well as primarily by its histological appearance. The histopathological analysis for a receptor status is standard in these cancer diagnosis and plays a crucial role in the decision making process for the right therapy. Urogenital tumor cells are known to have receptors on their surface, and the first step is an analysis that evaluates for hormones that bind to these receptors. Patients, whose tumor tissue has been tested positive for one or more of these receptors may benefit from an anti-hormone treatment, or a treatment with humanized monoclonal antibodies, or treatment with antibody-drug conjugates (ADCs). Patients, whose tumor cells have not any of the receptor types are known to have further surface markers, such as PD-1, PSMA, Survivin, NYESO, WT1, etc., that can be targeted by a precision-based immunotherapeutic approach.
These tumors are evaluated for surgical intervention, in combination with a chemotherapy and/or a radiotherapy beforehand, following or even instead of a surgical intervention. The most modern method nowadays is the usage of immunotherapies in urogenital cancer patients that are mainly used within a so called umbrella concept.
An umbrella concept considers all aspects of the patient’s medical history, other diagnosis, and general well-being, as well as the available diagnostic constellations and ongoing treatments. An umbrella concept does not rely on one therapeutic option or the other. It is highly considering a precision-based combination of therapies that are evaluated for each individual case.
In case of a suspicion of an urogenital carcinoma, a comprehensive physical examination takes place, usually followed by a PET-CT-Scan, which helps to see whether and where tumor masses are located. It shows us whether the cancer has already spread to other tissues (metastasis). If a mass has been confirmed, it should be biopsied in order to determine the dignity of the tumor. A histopathological analysis can determine the exact (cell) type of the tumor. There are many different types of tumors, and each of them presents unique genetic characteristics.
What most patients do not know is, that when the first examination on the biopsy has been performed (to determine the tumor type), the tissue is kept and stored at the histopathology department of the hospital, where the biopsy has been performed. This stored tissue material can be used for thorough (genetic) tissue analyses and in-depth sequencing. It is known that tumors show the accumulation of several genetic modifications, thus providing cancer cells with the selective growth advantage to initiate expansion. Now, sophisticated high-throughput technologies enable the identification of these mutated genes in cancers that can lead to a potent targeted therapy.
It is crucial to perform a thorough broad-spectrum screening so that every patient has a chance to explore all possibilities of a targeted treatment, may it be in a private setting or a clinical trial elsewhere. So it is most important to first find a laboratory that looks for all markers and mutations, and second, to find an oncologist who is willing to work with you in the best (and targeted) way possible.
Step 1 : Contact us
Important: Our oncological team is happy to talk to you by phone to get a deeper understanding about your specific case, enabling to provide you with a provisional treatment plan and cost estimate. Our oncologists will provide you all the details on medications, therapeutics and treatments including underlying mechanism and side effects. After a physical examination and an in-depth discussion with you on-site, the definite treatment plan will be discussed. Please understand that complex medical processes as mentioned above can only be explained through a thorough consultation on-site.