Urologic Cancer Overview
Urologic cancers at a glance
- Urologic cancers are caused by abnormal cell growth that occurs in the organs of the urinary tract, and the male reproductive tract.
- Urologic cancers may affect the kidneys, ureter, bladder, urethra, and in men the penis, prostate and testicles.
- Most urologic cancers are treated with surgery, although other treatments are available for some conditions.
Overview of urologic cancers
Urologic cancers are growths of abnormal cells that form in the organs of the urinary tract in both men and women, and in the testicles, prostate and penis of the male reproductive system. The urinary tract produces and stores urine. It comprises the kidneys, the ureter (tubes that carry urine from the kidneys to the bladder), the bladder and the urethra (tube that carries urine from the bladder and expels it from the body).
See below for specific information about the various types of urologic cancer that can affect men and women.
Frequently, cancers in these organs produce symptoms such as pain, a lump, urinary tract infections (UTIs) or blood in the urine that prompt a person to see a physician about their health. Many of these cancers are curable when caught early.
As with other types of cancer, doctors treat most urologic cancers by attempting to remove the tumor (the clump of abnormal cells) surgically. For some conditions, physicians will recommend radiation therapy such as CyberKnife in place of or after surgery. This process uses high-energy beams, like x-rays, to control or stop cancer cells from growing. Other patients might have chemotherapy to destroy cancer cells or control their growth.
Bladder cancer is a relatively common cancer that occurs when abnormal cells grow in the bladder, the organ that stores urine in the body. Bladder cancer is more common in men, and occurs most often in people who are age 60 or older. It is more common among people who smoke, people who experience frequent bladder inflammation, and people who have been exposed to radiation and certain chemotherapy medications.
The most frequent symptom of bladder cancer is blood in urine. Some patients also feel pain or irritation, or frequent urination. It is important to see a physician about these symptoms or concerns to determine a cause.
Diagnosis and treatment
The physician will take a urine sample for laboratory analysis. He or she also will perform a cystoscopy, which is an examination of the interior of the urinary tract using a small medical instrument with a light and viewing lens. If the physician sees any suspicious tissue, he or she will take a biopsy (a small piece of the tissue) for examination.
Small tumors that have not spread beyond the bladder frequently can be removed from the wall of the bladder. Larger tumors that have spread into the bladder wall, or into other parts of the body, may require additional treatment. If the surgeon must remove the bladder, the urine must be diverted.
Other treatments for bladder cancer include chemotherapy, radiation therapy or immunotherapy.
Bladder cancer can recur. Many people who have had bladder tumors removed have follow-up treatments for years afterward to check for any possible recurrence of the cancer.
Kidney cancer is abnormal cell growth in the kidney. The kidneys are two organs, located in the mid portion of the back, that cleanse the blood through a process that produces urine. Cancer cells may grow in the tissues or tubes within the kidney. Most kidney cancers are identified early, before they spread, which makes these tumors easier to treat.
Penile cancer is a rare cancer that starts in the penis, usually as a type of cancer cell called a squamous cell, which is a flat skin cell. Typically, squamous cells grow slowly.
No one knows precisely what causes penile cancer. It is less common among men who are circumcised when they are babies. Men seem to have a higher risk if they have HPV or AIDS, if they smoke, or if they have received certain treatments for the skin condition psoriasis.
Men who have penile cancer might notice symptoms such as:
- A blister or sore on the penis
- A wart-like growth that discharges watery pus
- Abnormal discharge from under the foreskin
If a physician suspects penile cancer, he or she may do additional tests, including a biopsy, imaging (such as x-ray or ultrasound) and other scans, to determine what type of cancer it is and whether it has spread in the body.
Doctors can treat some small tumors with external beam radiation, but the most frequent treatment for penile cancer is surgery. In some cases, the physician can surgically remove only the cancer and some normal tissue around the cancer. If the cancer is only in the foreskin, circumcision may be sufficient to remove the cancer.
In other cases, the penis may be partially or completely removed. This procedure, called penectomy, is the most common and most effective treatment for penile cancer. The surgeon may remove any lymph nodes nearby as well.
Prostate cancer is the abnormal growth of cells in the prostate, the small gland situated along the male urinary tract below the bladder. Its purpose is to produce and nourish semen, the fluid that transports sperm. Prostate cancer is the most common cancer among men in the U.S. It is common among many men over age 50. Fortunately, most prostate cancer is detected early. At this stage, the prognosis is good for successful treatment. PSA testing with prostate examination is recommended for black males starting at age 45 and at age 50 for non-black men.
Read James’ story about surviving prostate cancer
Testicular cancer occurs when abnormal cells grow in the testis. The testes are the male sex organs that produce sperm. They are held in the pouch of skin called the scrotum.
The symptoms of testicular cancer are a lump or swelling in the scrotum, and pain or a sense of heaviness in the scrotum, groin or lower belly. Most men find testicular cancer themselves, during a monthly-recommended self-exam or by chance.
Testicular cancer usually occurs in only one testicle. Most testicular cancer begins in the cells that make sperm. There are two main types of testicular cancers involving germ cells: seminomas and nonseminomas. Seminomas respond well to radiation therapy. These cells grow and spread slowly. Nonseminomas grow and spread faster.
Testicular cancer is rare, but it is the most common cancer that young men experience. It is highly curable, especially when physicians catch and treat it at an early stage. No one knows what causes testicular cancer. It is possible that having an undescended testicle or the genetic defect called Klinefelter syndrome might increase a man’s risk. But many men who are diagnosed with testicular cancer have no risk factors.
Treatment for testicular cancer
A testicle that has cancer should be removed surgically. After the surgery, the testicle will be examined to verify the cancer and what kind of testicular cancer it is. Sometimes, only the testicle is removed (called orchiectomy). In some cases, the surgeon may also remove nearby lymph nodes.
After surgery, some men may have chemotherapy or radiation therapy. If the cancer has spread to other parts of the body, additional surgery may be needed to remove that cancer. In these cases, chemotherapy is often used.
Most men do not experience long-term sexual problems after testicular cancer. Most men are still able to father children, although men who experienced fertility issues before the cancer may find those issues are worse. Other treatments for cancer could cause infertility. For this reason, some men opt to save sperm in a sperm bank before their treatment.
Men who are concerned about the appearance of the genitals after the surgery may opt to have an artificial or prosthetic testicle after their surgery.
Urethral cancer is the growth of abnormal cells in the urethra, the tube that carries urine out of the body. It is a rare cancer, making up just one to two percent of urologic cancers. It is more common in older women and in people who have had bladder cancer. Its symptoms are similar to those of other urologic cancers. People should see a physician if they experience blood in urine, a stop-and-go stream of urine, pain in the groin or pelvis, or painful or frequent urination.