The diagnosis and detection of urogenital cancers

Abstract

Previously, histologic precision in the diagnosis of urologic cancers had, for some time, remained stable. More recently, variations in classifications of testis tumors, prostate cancer, and to some degree, bladder tumors, have been introduced. Most systems have in concurrence a desire or an attempt to infer better prognostic assessment in the overall results to treatment. With the advent of additional biological markers or direct enzymatic measurements, e.g., in prostate cancer, further improvements in identifying at risk populations, responses to treatment, and possible indications for variations in treatment, have ensued. These developments alone unquestionably mark the greatest area of change in the recent decade. The extent of disease assessment prior to definitive therapy, whether by arteriography, ultrasound, CAT scanning, or an occasional lymphangiography, has also influenced or modified treatment decisions. For continuing care and follow-up, several of these noninvasive techniques are now becoming included in the more standard approaches. Noninvasive techniques have been introduced for the therapy of renal tumors such as inducing infarction of the primary tumor. Endoscopic ultrasonic techniques have been particularly useful in assessing the size of pelvic tumors and response to treatment, even in detection of unexpected multiple primaries or metastatic extensions. Overall, the precision in urologic cancer, both for diagnostic and detection purposes, has been increased with these introductions.