Urologic Cancer

Bladder cancer can sometimes be found early, and finding it early improves your chances that it can be treated successfully. Some doctors may suggest bladder cancer tests for people at very high risk, such as:

• People who had bladder cancer before
• People who had certain birth defects of the bladder
• People exposed to certain chemicals at work

Testing for bladder cancer

If bladder cancer is suspected, exams and tests will be needed to confirm the diagnosis. If cancer is found, further tests will be done to help determine the extent (stage) of the cancer.

Urinalysis

One way to test for bladder cancer is to check for blood in the urine (called hematuria). A urinalysis is a simple test to check for blood and other substances in a sample of urine. This test is sometimes done during a general health checkup.

Blood in the urine is usually caused by benign (non-cancerous) conditions such as infections, but can be the first sign of bladder cancer. Large amounts of blood in urine can be seen if the urine turns pink or red, but a urinalysis is needed to find small amounts.

Urine cytology

In this test, the doctor uses a microscope to look for cancer cells in urine.

Urine tests for tumor markers

Several newer tests look for substances in the urine that might indicate bladder cancer.

Urine culture

If you are having urinary symptoms, this test may be done to see if an infection (rather than cancer) is the cause

Cystoscopy

If bladder cancer is suspected, doctors will recommend a cystoscopy. For this exam, a urologist places a cystoscope – a thin tube with a light and a lens or a small video camera on the end – through the opening of the urethra and advances it into the bladder. Sterile salt water is then injected through the scope to expand the bladder and allow the doctor to look at its inner lining.

Enhanced cystoscopic techniques

• Transurethral resection of bladder tumor (TURBT)
• Biopsy
• Magnetic resonance imaging (MRI) scan
• Ultrasound
• Intravenous pyelogram (IVP)

Kidney cancer is often difficult to detect in its early stages. In fact, before a tumor has grown or the disease has spread, kidney cancer is most commonly caught when it’s discovered by an X-ray or ultrasound performed for another reason.

Kidney tumors can be targeted with a variety treatments and technologies. A multidisciplinary team of kidney cancer experts will answer your questions and recommend treatment options based on your unique diagnosis and needs. Treatment options for kidney cancer may include:

• Surgery, including radical, laparoscopic, and partial nephrectomy
• Chemotherapy
• Interventional radiology, or real-time, image-guided procedures to remove the cancer
• Targeted therapy using specialized drugs
• Immunotherapy, for advanced kidney cancers

Screening

Some medical organizations recommend men consider prostate cancer screening in their 50s, or sooner for men who have risk factors for prostate cancer. Discuss your particular situation and the benefits and risks of screening with your doctor. Together, you can decide whether prostate cancer screening is right for you.

Prostate screening tests might include:

• Digital rectal exam (DRE). During a DRE, your doctor inserts a gloved, lubricated finger into your rectum to examine your prostate, which is adjacent to the rectum. If your doctor finds any abnormalities in the texture, shape or size of the gland, you may need further tests.
• Prostate-specific antigen (PSA) test. A blood sample is drawn from a vein in your arm and analyzed for PSA, a substance that's naturally produced by your prostate gland. It's normal for a small amount of PSA to be in your bloodstream. However, if a higher than normal level is found, it may indicate prostate infection, inflammation, enlargement or cancer.

Diagnosing prostate cancer

If a DRE or PSA test detects an abnormality, your doctor may recommend further tests to determine whether you have prostate cancer, such as:

• Ultrasound
• Collecting a sample of prostate tissue
• MRI fusion

Men with testicular cancer usually have concerns about how their treatment will affect their sexual health, fertility, and quality of life. Each man should discuss these topics with his doctor before treatment begins because there is often more than one single treatment option available. The final choice of a treatment plan depends on the patient’s specific situation.

Treatment options and recommendations depend on several factors, including the type and stage of cancer, possible side effects, and the man’s preferences and overall health. The first treatment for testicular cancer is usually surgery to remove the testicle. Rarely, chemotherapy is given first if the cancer has already spread beyond the testicle when diagnosed.

After surgery, chemotherapy or radiation therapy may be recommended. Germ cell tumors are highly sensitive to chemotherapy and are usually curable even if the cancer has spread. But chemotherapy is not very effective for a type of germ cell tumor called a teratoma. This type needs to be removed with surgery. Because many non-seminomas are a mixture of teratoma and other types of germ cell tumor, successful treatment often requires chemotherapy followed by surgery to remove any of the remaining tumor.

Radiation therapy may be recommended for men with early-stage seminoma or cancer that has spread to the brain.