Cancers can occur in the kidney, bladder, prostate, testes and penis. If you are concerned about cancer in any of these areas, your GP will refer you without delay to one of the consultants for specialist advice. Urological cancers can occur in the kidney and bladder in men
and women, and in the prostate, testicles and penis in men.
An Introduction to Urological Cancers
Prostate cancer is the commonest cancer in men and about 34,000 men in the UK are diagnosed with it every year. It generally affects men over 50, and is rarely found in younger men. Approximately one half of all men in their 50s have some cancer cells within their prostate and 8 out of 10 men (80%) over the age of 80 have a small area of prostate cancer. Most of these grow very slowly and so, particularly in older men never cause any problems. The causes of prostate cancer remain unclear but it is thought that diet and ethnic race may have an influence. Men with a father or brother with prostate cancer and 50% more likely to develop it themselves. Pros tate cancer is usually diagnosed in the early stages but in 1 in 10 men (10%), the prostate cancer will be advanced when it is diagnosed. The treatments vary depending on when the diagnosis is made but if the cancer is caught early it can be cured.
Each year over 10,000 people in the UK are diagnosed with bladder cancer and is the fifth most common cancer. It is more common in men and rarely seen in patients under 40. The most common cause is smoking. It takes many years for the chemicals from cigarettes to cause bladder cancer. Exposure to certain chemicals used in dye factories and in industries working with rubber, textiles, paints and printing were linked to bladder cancer in the 1950s and 60s and have since been banned. However, it can take more than 25 years for the bladder cancer to develop. If you think you may have experienced this type of exposure, let your doctor know. Repeated (chronic) urinary infections and untreated bladder stones have also been linked with a less common type of bladder cancer called squamous cell cancer. Most bladder cancers develop in the lining of the bladder and can be managed successfully with minor surgery via the water-pipe (urethra). Following this kind of treatment the bladder will need regular inspections to check whether the cancer has returned. If the cancer has grown into the muscle of the bladder, this is more serious and will require removal of the bladder or chemotherapy and in some circumstances both treatments at once.
Each year, about 7,800 people in the UK are diagnosed with kidney cancer. It is more common in men than women and becomes commoner as people get older. It is rare for people under 40 to get kidney cancer but there is an uncommon type called Wilms’ tumour, that affects very young children. Usually only one kidney is affected and it’s rare for cancer to occur in the other kidney. Doctors don’t know exactly what causes kidney cancer and for many people the cause is never found, but a number of things are known to increase the risk of developing it.
- Cigarette smoking
- Being overweight (obese)
- Some medical conditions, such as having high blood pressure (hypertension), may increase the risk. People with advanced kidney disease, especially those who need to have dialysis, have a higher risk of developing kidney cancer.
- Exposure to certain materials at work may affect a person’s risk, such as, blast furnaces or coke-ovens in the steel and coal industries, or working with Trichloroethylene (Tric) a petroleum by-product used in the heavy engineering industry. Being exposed to cadmium, lead or asbestos at work may also increase risk.
- Inherited risk. Most kidney cancers aren’t inherited but occasionally, two or more members of the same family develop kidney cancer. If this happens, the other members of the family may have a higher than average risk of getting kidney cancer. Surgery is the main treatment for kidney cancer.
Symptoms: What should I look out for?
Blood in the Urine (Haematuria)
The causes of blood in the urine are not always serious but they should always be investigated. Investigations include urine testing, cystoscopy (examination of the bladder with a telescope usually under local anaesthetic) and an ultrasound scan of your kidneys and bladder. The bleeding can be caused by infection or inflammation of the bladder or the presence of stones. In men it can be caused by an enlarged prostate but it can also be caused by cancer in the bladder, kidney or prostate (in men) so should not be ignored.
Urinary Symptoms in Men
Some men may experience urinary symptoms such as frequency of urination and a weak flow and should seek advice from their GP. 40% of men over 60 years of age have Benign Prostatic Hyperplasia (an enlarged prostate). Investigations will include a digital examination of the prostate via the back passage, a flow test to establish the rate of flow and a PSA (prostate specific antigen) blood test. PSA is a natural protein that leaks out of the prostate into the bloodstream and is raised; when the prostate is enlarged, in the presence of cancer of the prostate, if there is an infection, and if you have a urinary catheter. Sometimes the raised level just appears for no particular reason which may be normal for you. If the PSA is raised in the absence of infection, you will most likely be advised to have prostate biopsies to exclude the diagnosis of prostate cancer.
Other urological cancers
Lumps in the Testicles
Most lumps in the scrotum are benign and if painful are unlikely to be cancer. However, it is very important to discuss the problem with your doctor. Testicle cancers are uncommon and with correct speedy treatment more than 90% of patients are cured. It is important to remember that regular self examination is known to detect testicular cancer early and reduce the amount of treatment necessary.