A diagnosis of cancer can be life altering under the best of conditions,
especially when it comes to the multitude of office visits and appointments
needed to see a variety of specialists. But now patients have a unique
clinic available to save tremendous time and effort in the diagnosis and
treatment of genitourinary cancers. The Multidisciplinary Genitourinary
Oncology Clinic (MGOC) is a team of specialists from UNMC and The Nebraska
Medical Center who will serve patients with urinary tract cancers including
kidney, bladder, prostate, penile, testicular and other rare pelvic and
abdominal cancers.
There is no service available like this clinic in the state of Nebraska,
said KC Balaji, M.D., associate professor, urologic surgery. Patients
sometimes may need to see three different specialists a surgeon, radiologist
and oncologist to discuss management options and decide on the best treatment
plan for these types of cancers. This means three different appointments,
at three different locations, extra travel and office time. In addition,
patients have to wait for all these specialists to confer with each other
and agree upon a treatment plan and these group consultations can take
days or even weeks. But all of this inconvenience, loss of time and inefficiency
ends at our clinic door. We provide a consensus of opinion following discussion
by all specialists involved, in one visit to our patients.
The patients diagnosis and pertinent medical information can be reviewed
and discussed by all members of the clinic prior to seeing the patient,
said Charles A. Enke, M.D., professor and chair of the department of radiation
oncology. The patient is able to ask questions of all the different
specialists at the same time, which results in improved communications
between the patient and physicians. In addition, the physicians constantly
educate one another on new information pertaining to their specialty
information that may benefit patients.
MGOC began serving patients in late November, meeting every other week
for three hours and seeing four to five patients per clinic. In March,
the clinic will be open every Thursday from 8 to 11 a.m. Clinic staff anticipate
serving up to 15 patients per month, which is a significant patient load
for genitourinary cancer.
In addition to Dr. Balaji and Dr. Enke, the clinic team includes George
P. Hemstreet, M.D., professor and chair of urologic surgery; Ralph Hauke,
M.D., assistant professor of medicine in the department of internal medicine
and chief of oncology at the Veterans Administration Medical Center in
Omaha; Sonny Johansson, M.D., Ph.D., professor, department of pathology
and microbiology, and Neil Abrahams, M.D., assistant professor, department
of pathology and microbiology.
Dr. Hemstreet specializes in prostate and bladder cancer and is internationally
known for his work in molecular markers for prostate and bladder cancer
risk assessment and detection via quantitative fluorescence image analysis.
Dr. Balaji is fellowship trained in urological oncology from one of
the premier cancer centers in the world Memorial Sloan Kettering Cancer
Center in New York, N.Y. He specializes in performing robotic and
laparoscopic surgery in patients with urological cancers. He has performed
70 robotic/laparascopic surgical procedures including the removal of the
prostate, kidney and bladder, as well as numerous urinary diversion procedures.
He also is primary investigator on a number of projects involving advanced
prostate cancer.
Dr. Enkes expertise is in the treatment of prostate cancer with radiation
therapy. He has treated more than 1,400 men for prostate cancer and
has been using IMRT (Intensity Modulated Radiation Therapy) to treat prostate
cancer for four years. Higher doses of radiation have been associated with
an improved success rate, and IMRT is the nations leading technology that
enables the radiologist to deliver higher doses while decreasing the risk
of side effects or complications.
Dr. Hauke specializes in the use of medications for treatment of genitourinary
malignancies. These treatments include standard chemotherapy agents as
well as new investigational agents including antibody therapy and vaccines.
In addition, UNMC and The Nebraska Medical Center offer the only high-dose
interleukin-2 program in the area for patients with metastatic kidney cancer.
The accurate diagnosis of all genitourinary cancers depends upon the
pathologic handling of the specimen, as well as the final analysis of grade
assignment (measure of cancers aggressiveness) and staging (measure of
tumor spread). Therefore, it is on the information provided by pathologists
Drs. Johansson and Abrahams that the other team physicians must plan and
implement their treatment strategy. Drs. Johansson and Abrahams bring
more than 30 years of combined experience and progressive technology to
the diagnosis and management of patients with urologic disorders.
Alan Gissler, 54, a native of Osceola, Neb., is one of the MGOCs initial
patients. Dr. Balaji successfully removed Gisslers prostate cancer and
associated lymph nodes using the robot. After the surgery he felt
great and was in no pain, Gissler said. Dr. Balaji made only make five
tiny incisions that can barely be seen, Gissler said. Remarkably, Gissler
lost only a half pint of blood so no transfusions were necessary (in conventional
open surgeries for removal of prostate cancer, blood loss average is around
two pints). He continues to receive a form of hormonal therapy for his
prostate cancer. In April he will begin radiation
treatments under Dr. Enke. Even though hell have to drive 180-miles
round trip to Omaha five days a week for eight weeks, Gissler is expected
to continue his employment as superintendent of the Ryan Hill Country Club
while he undergoes his radiation treatments.
For more information about the Multidisciplinary Genitourinary Oncology
Clinic, contact 402-559-4292 or visit the MGOC Web site at www.unmc.edu/urologicsurgery.
With a history dating back to 1869, The Nebraska Medical Center is known
for excellence, innovation and quality patient care. As the teaching hospital
for the University of Nebraska Medical Center, this 735 licensed bed facility
has an international reputation for providing solid organ and bone marrow
transplantation services and is well known nationally and regionally for
its oncology, neurology and cardiology programs.