Treatment of urological cancers in Paris
Dr. Adam Vardi - Urologist
Urological Oncology in Paris & Neuilly
Treatment of urological cancers in Paris
Urologic oncology is a major component of specialized surgery, covering malignant tumors of the urinary tract in both sexes and of the male reproductive system. Cancers of the prostate, kidney, bladder, and testis constitute a heterogeneous group of conditions whose prognosis depends primarily on early diagnosis.
Dr. Adam Vardi provides coordinated care, from screening through post-treatment follow-up, based on the recommendations of professional societies (AFU and EAU) and multidisciplinary consultation.
Prostate Cancer: The Challenge of Organized Screening
Urological Surgery in Paris & Neuilly
Prostate cancer is the most common cancer in men. The majority of these tumors are slow-growing adenocarcinomas, but some forms can be aggressive and require prompt radical treatment.
Diagnostic Strategy
Screening is based on two clinical pillars: a blood test for PSA (Prostate-Specific Antigen) and a digital rectal exam. Although PSA is a marker specific to the organ and not to cancer, an elevated level warrants further investigation. Multiparametric MRI of the prostate is now an essential step in locating suspicious areas before performing ultrasound-guided biopsies, which alone confirm the histological diagnosis.
Treatment Options for Urological Cancers in Paris
Dr. Adam Vardi - Urological Surgeon
Depending on the aggressiveness of the tumor (Gleason score) and the extent of the disease, several treatment strategies are considered:
- Active surveillance: For low-risk tumors, to delay treatment and avoid immediate side effects.
- Radical prostatectomy: Complete surgical removal of the gland. This procedure now benefits from minimally invasive techniques (robotic or laparoscopic surgery), aimed at preserving urinary continence and erectile function.
- Radiation therapy and hormone therapy: Alternatives or adjuncts to surgery depending on the stage of the disease.
Kidney cancer: toward nephron preservation
Kidney cancer is often discovered incidentally during an ultrasound or abdominal CT scan performed for another reason. It is a tumor that is primarily treated surgically, as conventional chemotherapy is not very effective against these types of cells.
Urological Cancer Care in Neuilly
Urologist in Paris
Partial nephrectomy: the standard of care
The current goal is to preserve renal (nephron) function. When the size and location of the tumor allow it, Dr. Vardi prefers to perform a partial nephrectomy. This procedure involves removing only the tumorous area while sparing the healthy part of the kidney. This helps minimize the risk of long-term chronic kidney disease.
Total nephrectomy
In cases where the tumor is too large or poorly located, complete removal of the kidney (total nephrectomy) is necessary. This procedure is most often performed laparoscopically, allowing for a quick postoperative recovery.
Bladder Tumors: Monitoring and Resection
Bladder cancer, or urothelial tumors, is strongly linked to smoking and certain occupational exposures. The main warning sign is hematuria (blood in the urine), which should always prompt a urological evaluation.
Transurethral Resection of the Bladder (TURB)
The first step in treatment is resection through the natural orifices. This procedure allows both the removal of visible lesions and an accurate assessment of the depth of cancer invasion.
- Non-invasive tumors (NIT): These are treated with routine resections and sometimes with intravesical instillations (BCG or local chemotherapy) to prevent recurrence.
- Invasive tumors (IT): These require more intensive treatment, often including removal of the bladder (cystectomy) and urinary diversion.
Testicular cancer: a medical emergency affecting young men
Although rare, testicular cancer is the most common malignant tumor in men between the ages of 15 and 35. It usually presents as a hard, painless lump that causes one testicle to swell.
Diagnosis and speed of execution
Any suspicious mass in the testicle should prompt an urgent scrotal ultrasound and testing for tumor markers (alpha-fetoprotein, hCG, LDH). The initial treatment is orchiectomy (removal of the testicle) via the inguinal approach.
Prognosis and fertility
The prognosis for testicular cancer is excellent, with very high cure rates thanks to the complementary nature of surgery and chemotherapy. A fertility assessment and sperm preservation are routinely offered before treatment begins.
Multidisciplinary Team Meeting (MDT)
In oncology, no decision is made in isolation. Each case is discussed during a Multidisciplinary Team (MDT) meeting that brings together urologists, medical oncologists, radiation oncologists, and radiologists. This approach ensures that the treatment plan proposed for the patient is based on the latest scientific evidence and tailored to their individual situation.
Post-treatment care is also crucial. Regular urological follow-up (clinical, laboratory, and imaging) helps ensure there is no recurrence and manages any functional side effects related to treatment, in order to preserve patients’ quality of life as much as possible.