Genitourinary Cancer Team

During a routine exam, the doctor inserts a lubricated, gloved finger into the rectum to feel the prostate for hard or lumpy areas. This quick test can detect abnormalities that may need more evaluation.

The prostate-specific antigen (PSA) test measures PSA levels in the blood and is a common starting point for screening. PSA can be elevated in prostate cancer, but also with noncancerous conditions (such as infection or enlargement). An elevated PSA does not always mean cancer, and a low PSA does not completely rule it out. Trends over time — like a steadily rising PSA — can also be informative and may prompt additional testing.

This molecular test detects RNA from the prostate cancer gene 3 (PCA3), which is produced in higher amounts by prostate cancer cells. It can help clarify whether an elevated PSA is more likely due to cancer or another cause.

The 4Kscore estimates the likelihood that a man with an elevated PSA has an aggressive (high‑risk) prostate cancer. The result helps patients and doctors decide whether a biopsy is appropriate or if monitoring is reasonable.

First, you have an MRI. A specially trained radiologist reviews the images, marks suspicious areas (lesions) and assigns a score from 1 to 5, with 5 being most concerning.

Next, you have an ultrasound in the office. A small probe is placed in the rectum to capture real‑time images. Using specialized software, the marked MRI is aligned (“fused”) with the live ultrasound. As the probe moves, the MRI stays synchronized.

With the fused images, the urologist can clearly see and target specific lesions for biopsy.

Research shows that MRI/ultrasound‑guided biopsies are better at finding clinically significant cancers—the ones more likely to need treatment—while reducing samples from low‑risk tumors that may not require immediate therapy.

Although no test finds every cancer, fusion‑guided biopsy can lower the need for repeat biopsies by identifying higher‑risk tumors and can also help avoid unnecessary procedures for low‑risk findings.

Kidney (Renal Cell Carcinoma)
We use robotic, laparoscopic or open approaches to remove the tumor while preserving kidney function whenever possible. Options include partial nephrectomy (nephron‑sparing) or radical nephrectomy for larger/complex tumors, with thermal ablation (cryoablation or radiofrequency) considered for select small tumors or patients unfit for surgery.

Bladder Cancer
Most patients start with transurethral resection of bladder tumor (TURBT) for diagnosis and local control, with repeat TURBT as needed. Depending on stage and goals, treatment may include bladder‑sparing chemoradiation or radical cystectomy (robotic or open) with urinary diversion—orthotopic neobladder, Indiana pouch or ileal conduit—tailored to anatomy and preference.

Prostate Cancer
For localized and select locally advanced disease, we offer robotic‑assisted radical prostatectomy (most common), using nerve‑sparing techniques when appropriate. Open or laparoscopic options are also available. Surgery is recommended based on cancer risk, life expectancy and patient goals.

Testicular Cancer
Radical inguinal orchiectomy is the standard first surgery and cures many early‑stage tumors. In select cases, such as certain nonseminomatous germ cell tumors or residual masses after chemotherapy, we perform nerve‑sparing retroperitoneal lymph node dissection (RPLND).

Learn more about surgery for genitourinary cancer by choosing your cancer type.

Kidney Cancer
For advanced renal cell carcinoma, we use targeted therapies and immunotherapy. Immune checkpoint inhibitors are first‑line options for many patients, tailored to risk, disease burden and overall health.

Bladder Cancer
After  transurethral resection of bladder tumor (TURBT) for non–muscle‑invasive disease, intravesical therapies such as BCG or chemotherapy help lower the risk of recurrence and progression. For muscle‑invasive or metastatic disease, platinum‑based chemotherapy is standard, with maintenance or subsequent‑line immunotherapy, and in select cases, antibody–drug conjugates or targeted agents.

Prostate Cancer
Androgen deprivation therapy (ADT) is the backbone for advanced disease and is often paired with radiation for higher‑risk localized cases. For metastatic castration‑sensitive disease, we may intensify treatment with androgen receptor pathway inhibitors and/or docetaxel; in nonmetastatic castration‑resistant disease, next‑generation ARPIs can delay spread.

Testicular Cancer
Many early‑stage patients can avoid chemotherapy with active surveillance guided by imaging and tumor markers, while advanced or relapsed disease is treated with curative, risk‑adapted chemotherapy regimens with high survival rates.

Learn more about medical oncology for genitourinary cancer by choosing your cancer type.

Kidney Cancer
In select cases where surgery isn’t possible or for limited sites of spread, stereotactic body radiation therapy (SBRT) can target tumors precisely and help control disease.

Bladder Cancer
For carefully selected patients, a bladder‑preserving approach combines maximal  transurethral resection of bladder tumor (TURBT) with concurrent chemoradiation (trimodality therapy), offering an alternative to cystectomy with close follow‑up.

Prostate Cancer
External beam radiation—typically IMRT/VMAT with image guidance—treats localized and locally advanced disease, with hypofractionation or SBRT as options for some patients. Brachytherapy may be used alone or with external radiation, and is often combined with ADT for unfavorable intermediate‑ and high‑risk cancers.

Testicular Cancer
For early‑stage seminoma, radiation is an option alongside surveillance or chemotherapy, depending on risk and preference. Radiation is not standard for nonseminoma, where systemic therapy and surgery are the primary treatments.

Learn more about radiation oncology for genitourinary cancer by choosing your cancer type.