Urological Cancer
Urological cancer includes tumors of the kidney, bladder, prostate, testicles and penis. All except penile cancer are becoming commoner, though as yet the reasons why are poorly understood.
What particular symptoms and signs may point to urological cancer? Kidney cancer is seen in more men than women. The most frequent presenting symptom is blood in the urine (haematuria). Many tumours are fortunately discovered whilst they are small as a chance finding when a patient is undergoing an abdominal scan for other reasons. Surgical removal of the kidney is the main treatment.
Bladder cancer has a higher incidence in men; however the incidence in women is increasing as more women smoke. Smoking is a strong risk factor for this cancer. Almost all people with bladder cancer first notice blood in their urine. There are many stages and types of tumors which are treated differently. Also the different types of bladder cancer have very different outcomes.
Cancer of the prostate can manifest itself in a large number of ways. The commonest is increasing urinary difficulties, i.e. poor urinary stream, difficulty in starting, frequency and getting up at night. Non cancerous enlargement of the prostate can also produce these problems. A blood test called prostate specific antigen (PSA) can help separate the cancers from the non cancers. Unfortunately there is considerable overlap between the serious and non serious types of prostatic enlargement with this blood test. Meaning many patients need extra tests to make an accurate diagnosis. There is intense world wide debate as to whether or not the PSA blood test should be used to screen for prostate cancer. At present the general consensus is that it is not yet ready to be used as a screening test. The test is available via GPs in the UK if a man wishes to have it performed. Prostate cancer can be treated by surgery, radiotherapy and hormones.
A lump in the testicle is by far the commonest sign of a testicular cancer. These can be easily detected by self examination, and there are many guides printed showing how to do this. The treatment of testicular cancer is one of the great success stories of the last three decades. Now with a combination of surgery, chemotherapy or radiotherapy over 90% of these tumors are cured. Interestingly penile cancer has become very rare with only a handful of cases in the last 10 years.
M J Stower, June 2003