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Visit the MaineHealth Cancer Resource Center

The Maine Medical Center Cancer Institute

Prostate/Genitourinary Cancer Program

Genitourinary cancer, also called GU cancer, refers to cancers in the parts of the body that play a role in reproduction, getting rid of waste products in the form of urine, or both. GU cancers include prostate cancer, one of the most common cancers diagnosed at Maine Medical Center Cancer Institute.

Types of cancer treated in the Genitourinary Cancer Program include: 

Scroll through the content below or click on a topic to go directly to that content. 

Our Approach

The MMC Cancer Institute's Genitourinary Cancer Program provides multidisciplinary, subspecialty care in the diagnosis and treatment of genitourinary cancer to some of the largest patient volumes in all of New England. The program is one of the most advanced and comprehensive programs of its kind in the nation.The Genitourinary Cancer Program brings together its specialists in medical oncology, surgery, chemotherapy and radiation to discuss their patients’ cases and plan the best care for them. The experts also discuss quality improvement measures designed to improve future care.

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Comprehensive Treatment Options

MMC Cancer Institute's Genitourinary Cancer Program offers the region's most comprehensive array of treatment resources:

Medical Oncology
Therapeutic options include chemotherapy, hormonal therapy and immunotherapy, as well as vaccine-based and new targeted biological therapies. In addition, patients have access to promising new drug options by participating in our clinical trials.

Surgery
Surgical options include nerve-sparing procedures for prostate, testicular and bladder cancers; laparoscopy for kidney cancer; and state-of-the-art lower urinary tract reconstruction and organ-sparing approaches for bladder cancer.  

  • Laparoscopic nephrectomy  
  • Robot-assisted partial nephrectomy  
  • High-risk nephrectomy with cardiopulmonary (CP) bypass  
  • Robot-assisted radical cystectomy  
  • Neobladder reconstruction  
  • Cryosurgery for prostate and kidney cancers   
  • Retroperitoneal lymph node dissection (RPLND) for testicular cancer

Radiation Oncology
Our American College of Radiology (ACR)-accredited program (the only one in Maine) offers comprehensive and advanced therapeutic options:  

  • High-dose rate (HDR) brachytherapy
  • Intensity-modulated radiation therapy (IMRT) 

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Patient and Family Support and Education Resources

The MMC Cancer Institute offers comprehensive educational and supportive resources to ensure that patients diagnosed with GU cancer and families have the care, guidance and support they need throughout their cancer journey, including:  

  • A full-time Genitourinary Clinical Patient Navigator to help patients understand their diagnosis and treatment options and facilitate the decision-making process regarding which treatment to undergo  
  • Access to support groups to address the concerns of patients, families and caregivers dealing with prostate cancer at the Cancer Community Center  
  • Pain management and palliative care   
  • Genetic testing and counseling  
  • Nutrition counseling  
  • Licensed social workers to help link patients with appropriate programs and resources  
  • An array of community health education programs, classes and seminars through the five MaineHealth Learning Resource Center (LRC) locations

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National Recognition

Our Prostate Cancer Program was recognized as one of five model prostate cancer programs nationally by the Association of Community Cancer Centers. This designation reflects the success of the program's strong commitment to developing an individualized care program for each patient diagnosed with prostate cancer, coordinating prostate cancer care through Maine's first and only Genitourinary Cancer Clinical Patient Navigator service, and providing the most comprehensive and advanced treatment options available. Read more about our recognitions.

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Quality of Life Outcomes for Prostate Cancer Patients

Optimal prostate cancer care intends to both treat the cancer and maintain quality of life. All men with prostate cancer at MMC are routinely surveyed regarding quality of life using a standardized questionnaire. The tables below, based on those surveys, show the percentage of patients who have normal urinary and erectile function 2 years after treatment.  In general, younger and healthier men can expect to have better urinary control and erectile function as compared to older men.

Normal urinary function after surgery means requiring no (i.e., zero) pads per day. After radiation therapy, it is defined as “no problem, a small problem or a very small problem.” 

Normal erectile function for both treatment methods is defined as an erection adequate for intercourse or masturbation. 

Note: A direct comparison of radiation therapy and surgical patients is not possible as these patients represent different patient populations. Patients undergoing radiation therapy are on average older and have more health problems which could impact erectile dysfunction as compared to surgical patients. Radiation therapy patients are also often treated with hormonal therapy (40 – 50% of the time) which can also impact erectile function.

Table 1: Normal urinary and erectile function rates 2 years after radiation treatment (2006-2012)

Patients are stratified by age group and by urinary function before treatment -- normal vs. abnormal. Some patients with normal function before treatment may notice declining function at 2 years, and some patients with poor function before treatment may experience improvement in function following radiation.  Erectile function outcomes are separated by radiation therapy alone versus radiation therapy with hormones. It is expected that those who undergo hormonal treatment will have a decrease in erectile function.

RADIATION THERAPY

Age Group Avg. Age Normal Urinary Function
2 Years After Treatment
Normal Erectile Function
2 Years After Treatment

Normal urinary function before treatment

Abnormal urinary function before treatment * RT Alone * RT w/ Hormone
<60 56 78% (14/18) 75% (6/8) 67% (8/12) 20% (1/5)
60-69 64 85% (47/55) 63% (25/40) 76% (29/38) 21% (4/19)
70+ 73 89% (50/56) 67% (29/43) 61% (14/23) 8% (1/12)
* Includes patients treated with High Dose Rate (HDR) internal beam, or Intensity-Modulated Radiation Therapy (IMRT) external beam, or both.

Table 2: Normal urinary and erectile function rates 2 years after robotic-assisted radical prostatectomy (2003-2012)

This includes urinary function for all patients undergoing surgery. Erectile function outcomes are separated by the type of procedure: sparing both nerves, sparing one nerve, or sparing no nerves. As one might expect, men who have both nerves spared have better erectile function 2 years after surgery. As the data show, younger and healthier patients have better urinary control and erectile function following surgery.

SURGERY

Age Group Avg. Age Normal Urinary Function
2 Years After Treatment
Normal Erectile Function
2 Years After Treatment
Bilateral
Nerve Sparing
Unilateral
Nerve Sparing
No
Nerve Sparing
<60 55 86% (249/293) 78% (141/180) 59% (55/94) 25% (1/4)
60-69 64 79% (299/380) 64% (116/180) 45% (50/112) 22% (6/27)
70+ 71 65% (48/77) 58% (14/24) 44% (11/25) 0% (0/7)
Robotic assisted laparoscopic prostatectomy

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Why Choose Our Genitourinary Cancer Program    

  • Close-to-home access to one of the most advanced and comprehensive programs of its kind with a level of subspecialty care that is unrivaled in northern New England  
  • A truly multidisciplinary approach to care, with radiation oncology, surgical urology and medical oncology  
  • A twice-monthly genitourinary tumor conference that brings together all the appropriate specialists to help determine the optimal course of treatment  
  • Access to a Clinical Patient Navigator for GU cancers to help patients understand their diagnosis and treatment options, and make the most informed and timely treatment decisions possible  
  • A full complement of the most advanced medical, surgical and radiation therapy options currently available  
  • A robust database for tracking patient outcomes and continually monitoring and improving the quality of care provided  
  • Clinical outcomes that are consistently excellent compared to national benchmarks

 

Contact Us

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Next, help choosing the treatment that is best for you? Visit MaineProstate Cancer.com

Video: "Man takes wait and see approach to prostate cancer," a recent story on WCSH6


Oncology Issues: Association of Community Cancer Centers 
Maine Medical Center's Cancer Institute is featured as a model program for demonstrating best practices for prostate care in the community. Read the article (.pdf)

Click Here for Detailed Information About Leading Edge Research Going on in Genitourinary Cancer at Maine Medical Center.

22 Bramhall Street | Portland, Maine 04102-3175 | 1-(877)-831-2129