New Choices: SLUCare Urology
Pictured: SLUCare Urological Oncologist Dr. Zachary Hamilton
Cancer can be a formidable opponent. But evolving medical technology is more than equal to the task of saving lives, says SLUCare urologic oncologist Dr. Zachary Hamilton, who sees patients at SSM Health St. Mary’s Hospital and SSM Health Saint Louis University Hospital. He says modern medicine offers key breakthroughs in finding and treating prostate, bladder, testicular and kidney cancers.
“September is Prostate Cancer Awareness Month, so it’s a good time to think about screening for it,” Hamilton says. “It’s the most common solid-organ cancer among men in the U.S., and it can be slow-growing or aggressive.” Doctors use a PSA (prostate-specific antigen) blood test to screen for it and MRI (magnetic resonance imaging) to give a detailed picture of affected tissues, he explains. “With MRI, you can increase the detection of cancers by as much as 40 percent,” he says. “It helps us identify lesions that could be aggressive tumors needing treatment. And MRI data now can be incorporated into ultrasound imaging to give us a very clear picture of what’s happening.”
For patients with less aggressive prostate cancers, SLUCare physicians use an ‘active surveillance’ plan to monitor the condition regularly. “If it’s cancer that probably will not spread or isn’t life-threatening, we keep an eye on it with blood tests, biopsies and an occasional MRI,” Hamilton says. “This way, we avoid overtreatment but can intervene quickly if something changes.”
MRI technology also can be useful when bladder or kidney cancer is suspected, Hamilton says. “Bladder cancer is most commonly found in patients in their 60s and 70s, and is much more common in men,” he notes. It’s associated with cigarette use, so patients who smoke and notice blood in their urine should see a doctor immediately for diagnostic tests. “We also may perform a cystoscopy, which uses a tiny camera inserted through the urethra to check the bladder lining for tumors,” Hamilton says. “If the cancer progresses into the muscle layer of the bladder, it’s considered invasive.”
If tumors are found, a biopsy can be performed and surgery may be needed. Some bladder tumor patients also can be treated with medication in fluids administered through a catheter, while those with invasive tumors may require a radical cystectomy, or removal of the bladder; a section of the patient’s small intestine can be used to replace it, Hamilton says.
For those who do need chemotherapy, long-term survival rates are greater than 98 percent.”SLUCare urologist Dr. Zachary Hamilton on testicular cancer
There’s plenty of good news for men with testicular cancer, he notes. “It usually affects patients ages 20 to 40, and masses often can be detected through self- examination, so we encourage that,” Hamilton says. When cancer is found, the first line of defense is usually surgical removal of the testicle on an outpatient basis, and that is usually curative. “For those who do need chemotherapy, long-term survival rates are greater than 98 percent,” he adds.
Modern genetic testing is giving doctors a fuller understanding of cancer risk, and robotic technology has improved the precision of cancer surgery, according to Hamilton. “For example, if you needed a radical cystectomy in the past, there was an incision from your pubic bone to your navel,” he says. “With the robotic system, we can make five or six small incisions. That means less blood loss, less pain and a quicker recovery.” And genetic analysis can detect the likelihood of aggressive and nonaggressive cancers, allowing doctors to tailor treatment plans that offer each patient the best chance for success.
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By Julia M. Johnson