Prostate cancer
Prostate cancer may be suspected because of PSA, examination, MRI or other findings. A raised PSA does not automatically mean cancer. PSA can be affected by benign enlargement, infection and other factors.
Assessment may include
- PSA level and trend over time
- Prostate size and clinical examination
- Multiparametric MRI
- Prostate biopsy when indicated
- Staging scans in selected patients
Raised PSA: what it means and what happens next →
Treatment depends on cancer grade, stage, PSA, MRI findings, life expectancy, general health and patient priorities. Options can include active surveillance, surgery, radiotherapy, hormonal treatment and other systemic therapies depending on the situation.
Kidney cancer
Many kidney tumours are now found incidentally during ultrasound or CT imaging. The treatment plan depends on tumour size, position within the kidney, imaging appearance, kidney function, the opposite kidney and whether disease has spread.
Where oncologically appropriate, preserving functioning kidney tissue can be important. This is why some tumours are treated with partial nephrectomy while others require radical nephrectomy or another approach.
Questions that shape the plan
- Can the tumour be removed while preserving the rest of the kidney?
- Is surgery needed immediately, or is surveillance reasonable?
- Is a minimally invasive approach appropriate?
- What is the baseline kidney function?
- Is there evidence of spread outside the kidney?
Bladder cancer
Visible blood in the urine is an important warning symptom and should be evaluated, particularly when it is painless. Assessment may include urine testing, imaging and cystoscopy.
Blood in urine: causes and when it needs investigation →
Many bladder tumours are initially removed endoscopically through the urinary passage using transurethral resection of bladder tumour (TURBT). Further management then depends heavily on pathology: tumour grade, depth of invasion, presence of carcinoma in situ and recurrence risk.
Minimally invasive and robotic surgery
Dr Goel has fellowship training in uro-oncology, laparoscopy and robotic urology. Minimally invasive approaches can be appropriate for selected kidney and prostate cancer operations, but the choice of technique should follow the cancer plan rather than drive it.
The first questions remain oncological: can the tumour be removed completely, can function be preserved where appropriate, and what treatment gives the best balance of cancer control and quality of life?
What should I bring for a cancer consultation?
- All imaging reports and, if possible, the actual CT/MRI images
- PSA history rather than only the latest value
- Biopsy and histopathology reports
- Previous operation notes
- Kidney function and blood-test results
- Details of previous radiotherapy, chemotherapy or hormone treatment
- Current medication and major medical conditions
Does every prostate cancer need immediate treatment?
No. Some lower-risk prostate cancers can be managed with active surveillance, while higher-risk or more advanced cancers may need active treatment. The pathology, PSA, MRI, stage, age and general health all matter.
Does every kidney tumour mean the whole kidney must be removed?
No. Partial nephrectomy can preserve kidney tissue in selected tumours. Whether it is appropriate depends on tumour anatomy, size, kidney function and oncological considerations.
Is blood in urine always cancer?
No. Stones, infection, prostate disease and other conditions can cause blood in urine. However, visible haematuria should be evaluated rather than assumed to be benign.