Dr. Singal provides investigation, diagnosis and treatment of urological cancers, including cancers of the prostate, kidney or bladder. Cancer is a common disease that affects both women and men. General statistics on common types of cancers in Canada can be found on the Canadian Cancer Society site. Urological Cancers are among the most commonly diagnosed with prostate cancer accounting for almost 1 in 4 newly diagnosed cases each year in men. Cancer care is coordinated across this province by Cancer Care Ontario. Find out more about the CCO Ontario Cancer Plan for 2011-15
Prostate cancer is a common disease – not everyone who is diagnosed with this disease with die from it. However, it is important to understand your own individual risk factors and can assist with early detection of prostate cancer. Management of prostate cancer ranges from watchful observation, surveillance with delayed treatment, radiation therapy to surgery.
There is no single way to diagnose prostate cancer. Detecting prostate cancer involves evaluating several diagnostic factors including physical examination of the prostate and obtaining a blood test, PSA. PSA is a substance produced by the prostate and released in small amounts into the bloodstream. There is no clear PSA measurement below which prostate cancer can be excluded. Your doctor will interpret your PSA value based upon several factor including your age, the size of your prostate as well as whether it has changed over time. Other variables include age, family history of prostate cancer and ethnicity. Several risk calculators are available online including this calculator from the University of Texas. An important step in managing prostate cancer is having a baseline PSA reading. Obtaining a PSA test and making an effort to know your number is important.
Dr. Singal can help to evaluate your risk of prostate cancer, if necessary he will order and perform a prostate biopsy. Further information about how to prepare for the prostate biopsy procedure can be found here
If you are diagnosed with prostate cancer there are many treatment options available. Most prostate cancers are very slow growing and of little threat. A patient with an early-stage, slow growing tumor will have periodic visits for routine observation. If the tumor is more aggressive additional treatment may be required. Several factors including patient age and general health as well as patient preference will guide this decision-making.
As a surgeon, Dr. Singal performs both open and robotic radical prostatectomy. If radiation is required, it will be provided at the Odette Cancer Centre. Toronto East General Hospital has a partnership with the Odette Cancer Centre and there are regular multidisciplinary meetings between the two institutions to discuss complex cancer cases. TEGH and Odette form the Northern component of the Toronto Central Regional Cancer Program
There are many resources available to learn more about prostate cancer
Kidney cancer is the sixth most common cancer diagnosed each year in Canada. While symptoms include blood in the urine or back and flank pain, the majority of kidney tumours are found serendipitously by an ultrasound, often ordered for other reasons. If the cancer has not spread and is only found in the kidney, it is highly curable by surgery. Depending on characteristics of the kidney cancer, part (partial nephrectomy) or the entire kidney (laparoscopic nephrectomy) may be removed through a surgical procedure. It is possible to have normal kidney function with the remaining one kidney. Find out more about this cancer at Kidney Cancer Canada
Bladder cancer is a cancerous growth in the lining of the bladder. In North America, smoking is easily the biggest risk factor. Certain occupation exposures to dyes may also contribute to risk. The most common presentation is blood in the urine. The vast majority of these tumours can both be diagnosed and treated with surgical procedure known as Transurethral Resection of Bladder Tumour. (TURBT). Medications such as Mitomycin and BCG that are directly instilled into the bladder can also be used to lessen the risk of developing recurrence. For most aggressive tumours, the entire bladder may require removal with surgical procedure known as a radical cystectomy. This always requires a careful discussion and collaberation with our medical and radiation oncology colleagues.