Holland Hospital Urology specializes in treating a wide range of urological diseases for both men and women. Our skilled team is experienced in all areas of urology and urological surgery. We offer a full range of treatment options using the latest minimally-invasive procedures and the most advanced technology. Our services care for diseases that include:

• Bladder infections and diseases
• Female urological diseases
• Pelvic diseases
• Female incontinence
• Erectile dysfunction and prosthetics
• Kidney diseases and kidney stones
• Kidney cancer
• Prostate cancer
• Bladder cancer
• Prostate concerns (BPH: benign prostatic hyperplasia)

Prostrate Cancer
For the last 20 years, prostate cancer has been the most diagnosed cancer in Michigan men. An estimated one in six U.S. men will be diagnosed with this disease, and one in 36 will die from it. The good news is that early detection improves outcomes, and more than 1.8 million US men alive today have survived prostate cancer.

Screenings
Physicians screen for prostrate cancer with a quick and painless blood test called the PSA. Regular screening is recommended for most men beginning at 50 and has been shown to reduce the risk of dying from prostrate cancer.

Symptoms and Diagnosis
Early prostate cancer usually has no symptoms, so most prostate cancers are diagnosed through routine blood screenings or annual digital rectal exams.

Symptoms of a more advanced disease may include:

• Weak or interrupted urine flow
• Inability to urinate
• Difficulty starting or stopping the flow of urine
• Increases need to urinate, especially at night
• Blood in the urine
• Pain or burning with urination.

It is important to note that these symptoms occur frequently as a result of non-cancerous conditions as well, such as prostate enlargement  (Benign Prostatic Hyperplasia or BPH) or infection. If routine screenings indicate a potential problem, a biopsy may be recommended by your doctor.

When prostate cancer is suspected, a core needle biopsy is frequently performed to confirm the diagnosis. By examining the biopsied tissue under a microscope, an oncologist can determine whether cancer is present, its stage, rate of growth and susceptibility to treatment options. Additional tests may be required to determine if the cancer has spread beyond the prostate.

Causes and Risk Factors
Many studies have investigated the causes of prostate cancer.  They include:

• Age: Prostate cancer rates increase until about age 70, declining thereafter.
• Family history: Men with a father or brother with prostate cancer are two to three times more likely to develop the disease themselves.
• Race/ethnicity: Prostate cancer rates reflect genetic factors that vary across different parts of the world. High risk of prostate cancer is found in many populations with sub-Saharan African ancestry, while low risk is found in many populations with Asian ancestry.
• Obesity
• Physical inactivity or a sedentary lifestyle

Treatment

There are four typical treatments for prostate cancer.

Active surveillance monitors the course of your disease and intervenes if the cancer progresses. Active surveillance is often offered to men who are at low risk for the disease or have a life expectancy shorter than the speed of the cancer growth. Monitoring involves PSA blood testing every three to six months and digital rectal exams every six to 12 months. It also may include regular biopsies.

Prostatectomy is a surgery that removes all of the prostate along with nearby tissues. Lymph nodes may also be removed to determine whether the disease has spread. Several approaches can be used for prostatectomy, including Holland Hospital's minimally invasive da Vinci Robotic Assisted Surgery system. 

Radiation therapy for prostate cancer includes external beam radiation and brachytherapy.

Androgen deprivation therapy (ADT), or hormone therapy, alters the effects of male hormones on the prostate through antiandrogen medications and/or surgery. By reducing the effect of male hormones in the prostate, androgen deprivation therapy can slow the rate of tumor growth.

Prevention
There's no proven method for preventing prostate cancer, but there are several ways to lower your risk:

• Have annual screenings beginning at age 50 (or age 40 if high-risk)
• Eat a healthy diet
• Increase your activity level
• Lower stress

Kidney Cancer
The American Cancer Society estimates that more than 50,000 Americans are diagnosed each year with kidney cancer. The most common type of kidney cancer is renal cell carcinoma, accounting for up to 90% of cases of the disease.

Symptoms
Unfortunately, kidney cancer symptoms usually do not appear until the disease has progressed to a more advanced state. In fact, most often kidney cancer is detected while attempting to diagnose another condition. Symptoms of kidney cancer include:

• Blood in the urine, either seen during urination or detected by microscope
• An abdominal mass
• Pain felt on the side or lower back
• Unexplained weight loss
• Fatigue
• Swelling of the legs and ankles.

Causes
Kidney cancer develops when healthy kidney cells develop genetic mutations that cause them to grow out of control. These abnormal cells form a tumor. It's not always clear what causes this to occur, but kidney cancer has been linked to unhealthy lifestyle factors, such as smoking and poor physical condition, as well as other forms of kidney disease.

Risk Factors
Known risk factors for kidney cancer include:

• Smoking
• Being male
• Obesity
• Being more than 50 years old
• High blood pressure
• Family or personal history of kidney cancer or bladder cancer
• Dialysis
• Abuse of over-the-counter pain relievers that contained phenacetin (withdrawn from the US market in 1983).

Diagnosis
Often kidney cancer is first detected when a physician either feels a mass on a kidney or an X-ray performed for some other reason indicates the presence of a mass. When this occurs, blood tests as well as various imaging tests, such as ultrasound, CT scan and MRI, may be used to help diagnose the disease.

Ultimately, a kidney biopsy will confirm the presence or absence of cancer and determine what type it is. A kidney biopsy can be performed by fine needle aspiration. If cancer is found, more tests may need to be done to determine if the disease has spread to nearby tissues and organs.

Treatment
Typical treatments for kidney cancer include:

• Surgery to remove all or part of the kidney is standard treatment. People in the early stages are the best candidates for surgery.
• Ablation therapy is a procedure that destroys the tumor using either heat or freezing. 
• Targeted therapies use drugs that block and prevent the growth and spreading of malignant cells by attacking them directly or preventing the growth of blood vessels that provide tumors nourishment to grow.
• Radiation therapy is most often used to relieve discomfort caused by the effects of the disease. It may be used to treat the cancer itself, but is often ineffective.  
• Immunotherapy, also called biologic therapy, is a treatment option for many types of kidney caner. Immunotherapy drugs stimulate the immune system to help fight cancer.
• Chemotherapy is often used along with immunotherapy or when immunotherapy is not effective, but is not considered an effective form of treatment for kidney cancer on its own.

Prevention
There are no proven methods for preventing kidney cancer, but there are steps you can take to reduce your risk:

• Quit smoking or don't start.
• Eat a well-balanced diet. Maintaining a healthy weight and a diet rich in nutrients reduces the risk factors for many cancers.
• Know what chemicals you are exposed to in the workplace. If you are exposed to fumes, dust and chemicals, you have a right to know. Talk to your employer about precautions (like wearing the proper safety equipment) to limit your exposure.

Symptoms
The good news is that bladder cancer symptoms are few and very obvious. They include:

• Blood in the urine (hematuria) that can appear pink, brown or red, with or without clots
• Mild to severe pain while urinating (dysuria)
• Frequent urination, especially during the night
• An intense physical sensation of needing to urinate, despite having just emptied the bladder or having tried to empty the bladder.

Causes
Bladder cancer develops when healthy cells in the bladder develop genetic mutations that cause them to grow out of control. These abnormal cells form a tumor. It's not always clear what causes this to occur, but bladder cancer has been linked to smoking, parasitic infection, radiation and chemical exposure.

Risk Factors
Doctors have identified many risk factors for bladder cancer, including:

• Cigarette smoking (smoking is attributed to more than half of all cases of bladder cancer)
• Second hand smoke exposure
• Age
• Race (Caucasians develop the disease more frequently)
• Gender (males develop the disease more frequently than females)
• Family history of bladder cancer
• A diet high in saturated fat
• Inadequate intake of liquids
• Recurrent urinary tract infections
• Recurrent urinary stones
• Chronic inflammation of the bladder
• Infection of a parasite called schistosoma haematobium
• External beam radiation
• Use of aristolochia fangchi (an herb used frequently in weigh loss products)

Diagnosis
If you are being treated for a urinary tract infection and are not feeling better after taking all of your medication, it is important that you let your doctor know. Symptoms that at first seem related to a urinary tract infection, but do not respond to medication, could indicate the presence of bladder cancer. Diagnostic tests may include:

• Urinalysis and urine culture to check whether an infection is the underlying cause of your symptoms. A urine culture looks for the presence of bacteria in the urine, while urinalysis checks for the presence of blood. Your doctor may also want to check your urine for the presence of tumor markers, proteins found in the urine of people with bladder cancer.
• Urine cytology to screen your urine for abnormal cells.
• Cystoscopy to get a better look at your bladder. This procedure uses a thin, lighted tube equipped with a microscopic camera. If any suspicious areas are found, a biopsy can be done during your cystoscopy. A biopsy is the removal of small amount of bladder tissue to be examined for the presence of cancer. This is the only way to confirm if cancer is present.

Treatment
Typical treatments for bladder cancer include:

Surgery, alone or in combination with other treatments, is used in more than 90% of cases.

Immunotherapy may treat superficial, localized cancers.

Chemotherapy before surgery has improved treatment results.     

Timely follow-up care is extremely important because of the high rate of bladder cancer recurrence.

Prevention
There are no proven methods for preventing bladder cancer, but there are steps you can take to reduce your initial risk, as well as your risk for recurrence:

• Drink plenty of fluids. The more liquids you drink, the less time potentially cancer causing substances remain in your system.
• Don't smoke. If you do smoke, quit.
• Know what chemicals you are exposed to in the workplace. If you are exposed to fumes, dust and chemicals, you have a right to know. Talk to your employer about precautions (like wearing the proper safety equipment) to limit your exposure.
• Eat a well-balanced diet, which is advantageous for many reasons. A diet rich in fruits and vegetables, but low in animal fats and salt helps prevent obesity, a risk factor for all cancers.