Genitourinary Program

Overview

Our team includes some of the most experienced radiation oncologists treating genitourinary (GU) cancers in the United States. Each year we manage radiation therapy for many hundreds of patients with cancers and tumors of the prostate, bladder, kidneys, testes, penis, ureters, and urethra. Our specialists are involved in all aspects of GU cancer care including new targeted biologic therapies combined with radiation as well as quality of life research.

Our unique expertise lies in the areas of active surveillance for prostate cancer, proton therapy, and the management of bladder cancer using chemotherapy and radiation. In addition, our investigators lead major national and international trials to determine the most effective use of these and other novel approaches.

Clinical Services and Special Programs

The Genitourinary Program uses the latest state-of-the-art and innovative technologies including:

• Intensity-modulated radiation therapy (IMRT): Highly targeted conformal techniques are employed for all patients regardless of their disease or its location.
• Image-guided radiation therapy (IGRT): Daily cone beam computed tomography (CBCT) is the cornerstone of our image-guidance practice. The majority of patients have fiducial markers inserted that aid in daily alignment, matching the daily CBCT with the planning CT.
• Rectal Spacer: A rectal gel spacer is offered as well, which pushes the rectum away from the prostate, out of the high dose radiation field, helping to minimize side-effects from radiation treatment.
• Stereotactic body radiation therapy (SBRT) and Hypofractionation: These approaches are used to deliver a greater dose of radiation over a course of fewer treatments. Mass General now offers prostate treatment delivered in 4-5 weeks as compared to the 8-9 weeks given for traditional prostate radiotherapy. Five-fraction treatment, over just one week, has also been explored. Short courses of high dose radiation may now be safely given to sites of metastatic disease (when appropriate).
• Low dose-rate brachytherapy: Brachytherapy is a quick option for treatment in some patients. Radioactive seed implants are placed permanently in the organ (e.g. prostate) and deliver a concentrated dose of radiation. This can be used as a stand-alone therapy or in combination with external beam radiation.
• Intraoperative radiation therapy (IORT): Mass General has a dedicated operating room that contains a radiation treatment machine. Patients with locally advanced or locally recurrent renal cell, adrenal, or bladder cancer can be treated with electron beam radiation. IORT enables patients to have their tumors irradiated directly, with the surgeon pushing their sensitive normal tissues out of the path of the radiation beam using tools called retractors. This allows very high radiation doses to be safely given without fear of damage to the bowel, stomach, or liver.
• Proton therapy: This very precise radiation treatment has been investigated at Mass General for treatment of prostate cancer since the 1970’s. Mass General continues to lead the investigation of proton therapy (when compared to more conventional radiation therapy) in the management of this disease. This is an available option for prostate cancer patients.
• Bladder Preservation Therapy: Bladder-preserving combined-modality therapy (CMT) with chemoradiation is an appropriate treatment strategy for selected patients with muscle-invasive urothelial bladder cancer who are not surgical candidates due to other serious medical issues and for those who desire to retain their native bladder.

Multidisciplinary Treatment Approach

The genitourinary division is well integrated with their counterparts in urology and medical oncology, having shared protocols for three decades and multidisciplinary clinics for nearly two decades. The Claire and John Bertucci Center for Genitourinary (GU) Cancers at Massachusetts General Hospital Cancer Center is one of the largest and most experienced centers in New England for the treatment of genitourinary cancers. Many of the advanced diagnostic and therapeutic approaches available here are offered at only a few other centers nationwide.

Clinical Trials

Massachusetts General Hospital invites patients and the community to participate in innovative clinical trials and research studies.

Search open clinical trials.

Proton Therapy vs. IMRT for Low or Intermediate Risk Prostate Cancer (PARTIQoL) clinical trial.