Types of Urologic Cancer in Men

• Being 40 years old or older
• African-American background
• Having a father, brother, or son who has had prostate cancer

About 90 percent of prostate cancers are diagnosed at a localized state where cancer is confined to the prostate without evidence of further spreading. Diagnosing prostate cancer usually involves several different types of testing to determine the severity and type of cancer you may be experiencing, including:

• Digital Rectal Exam (DRE): We contour a gloved finger into the rectum to feel the prostate’s size, shape, and hardness
• Prostate Specific Antigen Test (PSA): The prostate makes a substance called PSA. This test measures the PSA level in the blood, which may be higher in men with prostate cancer. However, other conditions such as an enlarged prostate, prostate infections, and certain medical procedures may also increase PSA levels
• Biopsy

We know it can be difficult to discuss treatment plans for prostate cancer. Our doctors are here to help make you to feel at ease throughout the treatment process. What can you expect with the different treatment options?

• Active Surveillance, observation, is used in some cases of low-risk disease, as well as among older patients for whom active treatment with surgery or radiation therapy may not be possible or necessary. Active surveillance is most often used because some prostate cancers may never become life threatening.
• Radical Retropubic Prostatectomy (RRP) – involves removing the prostate gland and surrounding lymph nodes through a small open incision above the pubic bone. The procedure can be used to treat a range of prostate cancer, including low, intermediate, and high-risk localized prostate cancers. Depending on the stage and risk, radical retropubic prostatectomy can be performed with nerve-sparing, which provides the best chance of return of erections following surgery in men with good erectile function before treatment.
• Robotic-Assisted Laparoscopic Prostatectomy (RALP) is the most common surgical treatment for prostate cancer. This approach uses laparoscopy as well as small surgical working elements that replicate human hand movement. Generally, RALP means less blood loss, a lower chance of a needed blood transfusion, decreased pain after surgery, and shorter recovery.
• Radical Perineal Prostatectomy involves removing the prostate through an incision in the area between the scrotum and anus. Perineal prostatectomy is relatively uncommon, but is still used in certain cases, such as in larger patients in which getting to the prostate from pelvis would be difficult.
• 3D Conformal and Intensity-Modulated Radiation Therapy – Radiation therapy can be used to manage low and high-risk cases. This approach targets the prostate with the aid of image guiding to more accurately deliver radiation doses to the prostate with less radiation exposure to surrounding tissues.
• Interstitial Prostate Brachytherapy places small radioactive pellets, or “seeds” into the prostate. Generally, this treatment can be used for small to normal sized prostates.

• Blood in urine, which may make urine look rusty or darker red
• Side pain that doesn’t go away
• A lump or mass in your side or abdomen
• Weight loss for no known reason
• Fever
• Fatigue

There may be several different risk factors, or causes, for kidney cancer, including:

• Smoking
• Family history

Testing for kidney cancer in women will usually involve several different types of testing to determine the severity and type of cancer you may be experiencing, including:

• Urinalysis (urine test) – checks urine for blood and other signs of disease
• Blood tests — A blood sample is collected and checks blood for several substances, including creatinine. A high creatinine level may indicate that the kidneys aren’t functioning properly.
• Ultrasound — This test uses sound waves to create a picture of your kidneys and nearby tissues, which can show a kidney tumor.
• CT scan – A series of detailed pictures of your abdomen show your urinary tract and lymph nodes, and may show if cancer is present in your kidneys, lymph nodes, or elsewhere in the abdomen.
• MRI – This large machine uses a magnet linked to a computer to create detailed pictures of your urinary tract and lymph nodes. An MRI can show cancer in your kidneys, lymph nodes or other tissues in the abdomen.
• IVP – A dye is injected into a vein in your arm and travels through the body to collect in your kidneys which makes the kidneys show up on x-rays. A series of x-rays then tracks the dye’s movement through your kidneys to your ureters and bladder. The x-rays can indicate a kidney tumor among other problems.

We know it can be difficult to discuss your treatment plan for urologic cancer. Our doctors are here to help make you to feel at ease throughout the treatment process. What can you expect with the different treatment options?

• Active surveillance of small, early-stage, low-risk kidney cancers may be an option for those not interested in surgery or ablative therapy. Active surveillance may be appropriate for older individuals with small kidney tumors for whom surgery risk is too great.
• Ablative therapies use radiofrequency energy and extremely low temperatures to cause tissue destruction. Ablative therapy is most commonly used in older or medically unhealthy patients for whom surgical risk is too great.
• Partial nephrectomy includes the removal of the tumor without removing the entire kidney and is often recommended for smaller kidney tumors, in patients with a single kidney or tumors in both kidneys. We may also recommend this procedure for patients with diabetes or hypertension to preserve as much renal function as possible. This can be done through a conventional (larger) incision or with a robotically assisted laparoscopic approach.
• Radical nephrectomy consists of removing the entire kidney with the surrounding tissue. This approach is most often used in cases in which a partial nephrectomy is not possible because of tumor size or location. Radical nephrectomy is also the standard treatment for high-risk kidney cancers.

• Blood in the urine (hematuria)
• Painful urination
• Urinary frequency
• Urinary urgency
• Abdominal pain
• Anemia
• Bone pain or tenderness
• Lethargy or fatigue
• Urinary incontinence
• Weight loss

There are a variety of risk factors, or causes, for bladder cancer, including:

• Cigarette Smoking —The risk of bladder cancer is increased nearly fivefold and as high as 30 percent of all bladder cancers in women may be caused by cigarette smoke. People who quit smoking have a gradual decline in risk.
• Chemical Exposure At Work — About one in four bladder cancer cases is caused by exposure to cancer-causing chemicals (carcinogens) on the job. Dye workers, rubber workers, aluminum workers, leather workers, truck drivers, and pesticide applicators are at the highest risk.
• Radiation And Chemotherapy — Women who received radiation therapy to treat cervical cancer have an increased risk of developing transitional cell bladder cancer. Some people who have received the chemotherapy drug cyclophosphamide (Cytoxan) are also at increased risk.
• Bladder Infection — A long-term (chronic) bladder infection or irritation may lead to squamous cell bladder cancer. Bladder infections do not increase the risk of transitional cell cancers.
• Parasite Infection — Infection with the schistosomiasis parasite has been linked to bladder cancer.

Testing for bladder cancer in men usually involves several different types of testing to determine the severity and type of cancer you may be experiencing, including:

• Abdominal CT scan
• Cystoscopy (examining the inside of the bladder with a camera)
• Bladder biopsy (usually performed during cystoscopy)
• Intravenous pyelogram (IVP)
• Urinalysis
• Urine cytology

We know processing this information and planning treatment can be difficult. Our doctors are here to help make you to feel at ease throughout the treatment process. Here are some things you can expect with the different treatment options. If the cancer has spread into the bladder wall or outside the bladder, treatment may include:

• Cystectomy With Urinary Diversion — In men, the bladder and prostate are identified, dissected and removed. Surrounding lymph nodes are removed to assess the extent or spread of the cancer.
• Chemotherapy — A systemic treatment in which drugs are given throughout the entire body. It’s designed to kill cancer cells. Typically, it is administered intravenously (through a vein).
• Radiation Therapy with Chemotherapy — Radiation uses high-energy x-rays to destroy cancer cells. The addition of systemic chemotherapy makes cancer cells more vulnerable to the killing effects of radiation. Radiation therapy is also used to relieve symptoms of advanced bladder.

• A lump or enlargement in either testicle
• A heavy feeling in the scrotum
• A dull ache in the abdomen or groin
• A sudden collection of fluid in the scrotum
• Pain or discomfort in a testicle or the scrotum
• Enlarged or tender breasts
• Unexplained fatigue or a general feeling of not being well

• An Undescended Testicle (Cryptorchidism) – Testes usually descend into the scrotum before birth. Men who have a testicle that never descended are at greater risk of testicular cancer than men whose testicles descended normally. The risk remains even if the testicle has been surgically treated.
• Abnormal Testicle Development – Conditions that cause testicles to develop abnormally, such as Klinefelter’s syndrome.
• Family history
• Age – Testicular cancer affects teens and younger men, particularly between ages 15 and 34. However, it can occur at any age.
• Race – More common in white men than in black men

Diagnosing testicular cancer usually involves several different types of testing to determine the severity and type of cancer you may be experiencing, including:

• Blood test
• Ultrasound

We know that processing this information and planning your treatment plan can be difficult. Our doctors are here to help make you to feel at ease throughout the treatment process. Here are some things you can expect with the different treatment options:

• Surgery
• Chemotherapy
• Radiation