1.
Potomac Urology
Urologic Cancers
Specialist in
Woodbridge|Alexandria
VA

2. Our Mission
Potomac Urology is dedicated to providing personalized, state-of-the-art urology
treatmentswith exceptional care and compassion. Our providers bring a combination of
expertise, innovation, and skill to partner with patients so they may achieve the best
possible outcomes. We are physicians with extensive clinical experience and, unique
fellowship certifications in the subspecialties of urology, and we have trained at the
leading urology programs in the country. Our experienced nurse practitioners are
committed to making care accessible and individualized. At Potomac Urology, we strive
to bring you the best urological care along with the convenience and comfort of staying
close to home.
Treatment for Urologic Cancers
Prostate Cancer
The prostate is a gland that surrounds part of the urethra, the
tube that transports urine and sperm out of the body. The main
function of the prostate is to produce semen, the milky fluid that
transports sperm. Sperm is produced in the testicles, which also
produce the main male hormone testosterone.
During orgasm, the muscles of the prostate contract to push the
semen through the urethra and out through the penis.Prostate
cancer is a malignant process originating in the prostate gland.
It is the most common non-skin cancer that men face. It is also the second leading cause of
cancer death among men in the U.S.Prostate cancer usually begins in the outer part of the
prostate. In most men, the cancer grows very slowly, though there are more aggressive forms

3. as well. Prostate cancer is characterized by both "grade" and "stage." The size and extent of
the tumor determine its stage. Early stage prostate cancer, Stages T1 and T2, are limited to
the prostate gland. Stage T3 prostate cancer has advanced to tissue immediately outside the
gland. Stage T4 prostate cancer has spread to other parts of the body.
It is a serious condition, but with early detection and appropriate treatment often has a very
high likelihood of cure. In addition, in select cases, prostate cancer may not require
treatment, and can be watched to ensure it does not worsen – a process called active
surveillance. With many therapies and surveillance strategies available to a patient it is very
important that he be educated about screening, detection, and possible treatments.
The most effective means of detecting prostate cancer early is through a screening, which
involves a digital rectal exam and measuring the amount of prostate-specific antigen (PSA) in
the blood.
At Potomac Urology, we have extensive experience both diagnosing and treating prostate
cancers, as well as other conditions of the prostate. We will obtain a PSA. This test detects
most prostate cancers. PSA is a protein secreted by the prostate into the bloodstream.
Elevated levels of this protein may indicate the presence of prostate cancer. Additionally, we
may obtain urinary genetic tests (PCA3), which represent the latest tools in the detection of
cancer. This test will further direct us as to whether suspect cancer as a cause of elevated
PSA.
If cancer is suspected, we will discuss prostate biopsy as the best method of cancer detection.
By removing a tissue sample from the tumor and examining it, doctors can confirm or rule out
a diagnosis of cancer.
If a localized prostate cancer is diagnosed then our experienced physicians will extensively
counsel the patient on all available treatment strategies. Currently we offer all of the FDA
and American Urological Association suggested treatments for this disease.
These include:

4. Surgery – This involves separating the prostate from the bladder and urethra, removing the
prostate, and reconnecting the urethra and bladder. This can be done with a small open
incision, or with a surgical robot for a more minimally invasive approach. We are the first and
only group of urologists in Prince William County to perform the minimally invasive robotic
surgery for prostate cancer, and have done hundreds of robotic prostatectomies, ensuring the
best possible outcomes for our patients.
Radiation – This involves either implanting radioactive seeds within the prostate, or
traditional external radiation. We offer both of these options to all of our patients with
prostate cancer, and work in close conjunction with radiation oncologist to ensure all patients
get the right treatment.
Active Surveillance – We have extensive experience selecting appropriate patients for active
surveillance, which involves further PSA and PCA3 testing, and periodic additional biopsies to
confirm the cancer is not advancing. This technique is well suited to some men with slow
growing cancers.
Cryotherapy – This involves using needles to freeze the prostate and kill the cancer and
surrounding prostate tissue.
Each of these treatments has unique risks and benefits. Exploring and understanding each are
the most important in curing cancer and preserving the maximum quality of life.
We are happy to see patients who have concerns about prostate cancer to discuss the
screening process, as well as patients who are coming for a second opinion regarding their
previously diagnosed prostate cancer. Many patients are not offered a robotic surgical option,
and we are happy to discuss this at length.
In cases where you are coming for a second opinion, please bring the following information
with you or have it sent directly to us.
1. Recent PSAs
2. Biopsy report
3. Prior urology records including ultrasound images/reports

5. Kidney Cancer
Kidney cancer is a serious medical condition that requires
experience and expertise to treat with the best outcomes. New
medical therapies and minimally invasive techniques have
changed our approach to this disease. Today we offer many
technically advanced ways to approach these tumors.
Our surgical goal is first and foremost the effective control of
cancer. Then we focus on saving as much function of each kidney
as possible. In the majority of patients the entire kidney does not
have to be removed. This technique of “partial nephrectomy” spares kidney tissue that is not
involved by the tumor. We are proud to be among the first urologists in this area to offer
minimally invasive kidney sparing surgery for cancer. These techniques include cryotherapy
(freezing of the tumor), laparoscopic partial nephrectomy, and robotic assisted partial
nephrectomy.
Occasionally, it may be necessary to remove the entire kidney. In most of these cases the
kidney can be removed through a laparoscopic procedure. This “keyhole” surgery decreases
blood loss, recovery time, pain, and postoperative complications.
Success in these therapies us based on our extensive training and experience. We were the
first ones to perform all of these surgeries at Potomac Hospital, and continue to bring
evolving techniques to the area.
Bladder Cancer
Bladder Cancer affects approximately 70,000 in this country every year,
and is involved in the deaths of over 14,000 people per year in the

6. United States alone. Many things can affect one's risk for bladder cancer including:
● smoking
● workplace chemicals
● history of certain types of chemotherapy
● parasitic infections
● sex(male>female)
● race (caucasian>hispanic and african-american)
● family history and personal history of bladder cancer
The most common symptom related to bladder cancer is the presence of blood in the urine.
This can occur in a fashion where one can see the blood with the naked eye(gross hematuria),
and can occur with the blood only being visible with a microscope(microscopic hematuria).
Other symptoms can include irritative urinary symptoms such as urinary frequency, urgency
and dysuria. However these symptoms are all non-specific and can be related to a whole
range of problems ranging from infection to prostate enlargement.
Diagnosis of bladder cancer involves multiple tests, all of which the staff at Potomac Urology
are fully trained to provide. Testing includes:
● Laboratory tests: urinalysis(microscopic evaluation of the urine), urinary cytology(
evaluation of the cells of the urinary tract), and basic bloodwork.
● Radiologic studies: CT scan to check for possible cancer in the urinary system above
the bladder.
● Cystoscopy: Usually done as an office procedure, this involves using a extremely
small and flexible scope to inspect the bladder and urethra. If any suspicious areas
are identified, a biopsy may need to be performed.
Treatment of bladder cancer is varied, and our fellowship trained staff at Potomac Urology
tailors it individually to each patient based on severity and extent of disease, as well as
patient preference. Initial treatments can cover a range including:
● close observation after biopsy
● repeat cystoscopic removal of cancerous tissue(TURBT)
● a series of fluid based treatment instillations in the bladder
● removal of the bladder surgically(cystectomy)
With the exception of bladder removal(cystectomy), the majority of these treatments can be
performed either in the office or on an outpatient basis.

7. If removal of the bladdder is required, our physicians are among a few in the area proficient
at performing this in a minimally invasive fashion using the Da Vinci robotic system. Benefits
of this include faster recovery time, less blood loss, decreased post-operative pain, and
smaller visible scars. In addition, our staff is trained in a number of reconstructive options
ranging from creation of a neo-bladder ( creation of a new bladder out of intestinal segments)
to a urinary conduit( involving creation of a urinary stoma).
Testicular Cancer
Testicular cancer is a cancer affecting the male reproductive glands of
the scrotum. It may have many symptoms, but is often first detected
as a palpable mass. One of the key tools of early detection is regular
self-examination. It is a cancer that often affects men in young
adulthood and is the most common cancer in men 29 to 35. Treatment
options will depend on type and stage of the cancer. Treatment will
often encompass a combination of surgery, radiation therapy, and chemotherapy.
Overall, this is a rare cancer and effective treatment involves seeing an urologist that is
familiar with these cancers. Dr. P. Desai has completed a fellowship in Urologic Oncology at
Indiana University. This is the leading center in the world for testicular cancer treatment. Very
high cure rates for this disease are testament to the need for effective and experienced care.