Introduction

SEMINARS IN

Vol 28, No 3 August 2012

INTRODUCTION

ADVANCES in surgical procedures and knowledge gained regarding tumor pathobiology haveimproved the therapeutic options and survival for patients with genitourinary (GU) malignan-cies. In 2012, approximately 66% of all patients diagnosed with cancer survive at least 5 yearscompared with 50% in 1975.1 According to the American Cancer Society, about 1,638,910 new

cases of cancer are expected to be diagnosed in 2012.2 Prostate cancer accounts for 241,740 new cases(29%), accounting for the majority of GU cancers. The November 2011 issue of Seminars in Oncology

Nursing provides a comprehensive overview of prostate cancer. Therefore, this malignancy will not beincluded in this issue. Bladder cancer accounts for 73,510, and cancer of the kidney and renal pelvisaccount for 64,770 new cases, in addition to testicular, penile, ureter, and other urinary and genialcancers.

Management of GU malignancies is based on tumor histology and disease stage. Surgical interventionsand treatment options for GU cancers vary greatly depending on tumor grade, staging, and patientco-morbidities. Presumptive clinical stage determines initial diagnostic work-up and primary surgicalintervention. Understanding the pathologic differences in GU malignancies can be challenging, Woodand Zhou provide information to assist oncology nurses in educating patients about overall diseasemanagement and to support the treatment decision-making process. Tyler provides a review of urothelialcancers that include the upper urothelial tract, renal pelvis, and bladder. Advances in surgical techniqueshave improved surgical outcomes and quality of life for many patients diagnosed with bladder cancer.Maximizing quality of life for patients must focus on education and psychosocial support for both thepatient and significant other that must begin before surgical intervention. Lester emphasizes that nursesmust be aware of the options for urinary diversions, including the risks, benefits, and potential compli-cations associated with various procedures that should be included when teaching patients and familymembers about the management of urinary diversion.

In renal cancer, Esper describes the improved understanding of the molecular pathology of renalcancer and how this knowledge has contributed to the development of molecularly based targeted ther-apies. Patient education about early and ongoing communication regarding side effects and an emphasison ways to improve adherence are important to successful therapy.

Testicular cancer continues to have a cure rate greater than 90%, emphasizing the importance ofpatient education regarding long-term follow-up and a focus on sexuality and quality of life, and shouldinvolve the patient’s partner whenever possible. Viatori describes how testicular cancers are classified asseminomas or non-seminomas, with unique differences that can impact both initial systemic therapy anddecisions regarding modification of chemotherapy because of treatment-related toxicity, prognosis, andactive surveillance following initial therapy. Penile cancer is a rare malignancy and a pathology review forthis disease has been incorporated into the article by Held-Warmekessel.

Patients with GU malignancies are living longer as a result of advances in surgical techniques andsystemic therapies, emphasizing the need for improved understanding of the issues regarding survivor-ship, late effects of treatment, and quality of life. Nurses play a key role in supporting patient’s decisionmaking and enhancing patient education and understanding of their treatment plan.

This issue of Seminars in Oncology Nursing provides an overview of the GU malignancies, overalldisease management, and the importance of providing education and support to patients and their lovedones. Knowledge regarding the pathophysiology, surgical management, systemic therapies, and support-ive care strategies is necessary for nurses caring for patients in various clinical settings. Awareness of

142 INTRODUCTION

quality of life and long-term survival issues provides oncology nurses with information that will allowthem to better meet the physical and emotional needs of patients with urothelial malignancies and theirfamily members.

REFERENCES

1. Vogelzang NJ, Benowitz SI, Adams S, et al. Clinical cancer advances 2011: annual report on progress against cancer from the

American Society of Clinical Oncology. J Clin Oncol 2012;30:88-109.

2. Siegel R, Naishadham D, Jemal A. Cancer Statistics, 2012. CA Cancer J Clin 2011;62:10-29.

Laura S. Wood, RN, MSN, OCN�

Renal Cancer Research Coordinator

Cleveland Clinic Taussig Cancer Institute

Cleveland, OH

Guest Editor

Introduction

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