Lower Urinary Tract Cancer: Minimally-Invasive Image-Guided Interventions

Introduction:
Urinary tract neoplasia is a clinically important disease process that often presents a diagnostic and therapeutic challenge. Primary neoplasia of the kidney and ureter is rare, while bladder and urethral neoplasia are diagnosed with a much higher frequency. Transitional cell carcinoma (TCC), the most common tumor diagnosed in the bladder and urethra, often results in clinical signs such as pollakiuria, stranguria and hematuria1; additionally, prostatic carcinomas may also result in clinical signs related to the urinary tract.2 This text and lecture will focus on minimally invasive procedures utilized in the treatment of urinary tract neoplasia (and tumors affecting the urinary tract) that are actively developing in veterinary medicine. Many of these therapies are in the early stages and long-term outcome data is not available. However, the evaluation of outcomes and procedures in human medicine may provide the opportunity for improved treatment options for veterinary patients.

The specialty of Interventional Oncology (IO) is based on the utilization of image-guided minimally invasive techniques for the diagnosis and treatment of neoplasia. The indications for IO in veterinary medicine are vast, and while many therapies are unproven, early results are encouraging. The use of IO techniques in the treatment of urinary tract neoplasia is particularly attractive. Current treatment options are often insufficient to immediately relieve obstructions of the urinary tract, and the severity of local disease is the cause of demise in many cases despite treatment with the usual modalities of surgery, chemotherapy and radiation therapy. The urinary tract IO techniques that are being utilized in veterinary medicine focus on two major areas: relief of urinary tract obstruction and treatment of the primary tumor.  [...]