Urological cancer

Overview

Our kidneys work continuously to remove waste from our blood, forming urine. The pee next passes via the urinary tract, which is a collection of organs that work together to empty urine from the body. These organs contain cells that aid in the processing and transport of urine. But occasionally, something would go wrong. A mutation in the DNA might cause aberrant cells to develop throughout the urinary system, eventually producing a malignant tumor.

Urologic malignancies are abnormal cell growths that originate in the urinary tract organs of both men and women, as well as the testicles, prostate, and penis of the male reproductive system. Urine is produced and stored by the urinary tract which is made up of the kidneys, the ureter (which transports 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).

What are the types of urological cancers?

Male-specific cancers

Prostate cancer arises from the prostate gland, a walnut-shaped gland that produces prostate fluid (which is a part of semen). It is one of the most prevalent forms of cancer in males There are prostate cancer screenings available, but not all doctors suggest them for all men.
Testicular cancer is a kind of cancer that occurs in one or both testicles. It is usually limited to one testicle. This cancer is more frequent in younger men, although it can affect anybody at any age. Testicular cancer is a very treatable malignancy that is often curable.
Penile cancer is discovered on the skin or within the penile tissues. The majority of penile cancers are squamous cell tumors that develop on the foreskin or glans (head) of the penis. When penile cancer is discovered early, it is typically treatable.

Cancers that can occur in either gender

Bladder cancer is more common in elderly people, although it may affect anybody. Bladder cancer most commonly develops in the cells that lining the bladder. Fortunately, most bladder cancers are detected early because they generate blood in the urine. It is largely curable if discovered early.
Kidney cancer is a kind of cancer that affects the kidneys. Renal cell carcinoma is the most frequent kind of adult kidney cancer.

What are the risk factors for urological cancers?

Urologic malignancies may be caused by environmental, lifestyle, genetic, or other causes. Tobacco usage is a major risk factor for all urologic cancers.

Prostate cancer is the second most frequent cancer in males in the United States (after skin cancer). Men who have a family history of prostate cancer, eat a high-fat diet, and/or are older are more prone to get the condition.

Penile cancer, on the other hand, is extremely rare, accounting for fewer than 1% of all malignancies in males. It is also linked to advanced age, human papillomavirus (HPV) infection, lack of circumcision, and poor genital cleanliness.

Testicular cancer is becoming more frequent in younger men, often between the ages of 15 and 35. Although it is not always apparent what causes testicular cancer, other medical disorders, such as polycystic kidney disease for kidney cancer and chronic inflammation for bladder cancer, can be risk factors. Only a small proportion of these tumors are hereditary.

There is no one cause of bladder cancer, but risk factors include age over 55, smoking, family history, industrial chemicals (painters, machinists, and hairdressers), drinking polluted water, and using some herbs (e.g., Aristolochia fangchi, a Chinese herb).

Older age, smoking, obesity, high blood pressure (hypertension), treatment for kidney failure (dialysis), certain inherited syndromes (such as tuberous sclerosis complex, hereditary papillary renal cell carcinoma, or familial renal cancer), and a family history of kidney cancer are all risk factors for kidney cancer.

What are the signs and symptoms of urological cancers?

Prostate cancer signs and symptoms

Not everyone with prostate cancer will have symptoms. However, when cancer spreads, it may produce the following signs and symptoms:

Trouble beginning to urinate or retaining urine back.
A weak urine stream or a stream interruption
Pelvic pain
Bone pain
Erectile dysfunction (ED)
Painful urination or ejaculation
Blood in the urine
Blood in the semen

Bladder cancer signs and symptoms

Blood in the urine - Bladder cancer is commonly identified early because it causes blood in the urine (known as hematuria). The presence of blood in the urine might cause it to change color.
Changes in urination patterns - Peeing with pain or burning, urinating more frequently than normal, and feeling a strong urge to urinate even when your bladder isn't full can all be symptoms of bladder cancer.
Inability to urinate
Lower back pain, especially on one side
Loss of appetite
Weight loss
Swelling in the feet (edema)
Bone pain

Kidney cancer signs and symptoms

The signs and symptoms of kidney cancer might be similar to those of kidney infection; however, the following should always be checked out:

Blood in the urine.
Persistent back pain just below the ribs
Fatigue
Weight loss
Fever (which may come and go)

Penile cancer signs and symptoms

Changes in the skin of the penis, such as color, thickness, a sore or lump, and new tissue growth.
A rash or flat growths that may be reddish, velvety, crusty, or blueish-brown in color.
Penis discharge or leakage that may be accompanied by a bad odor.
Swelling near the tip of the penis
Swollen lymph nodes in the groin

Testicular cancer signs and symptoms

Testicular cancer usually affects just one testicle. Among the symptoms are:

A mass in the testicle
A heaviness in the scrotum
Pain in a testicle or the scrotum
Pain in the groin or lower abdomen

How urological cancers are diagnosed?

Prostate cancer diagnosis

Because prostate cancer screening is a controversial topic, doctors' recommendations differ. Digital rectal exam (DRE) and prostate-specific antigen (PSA) testing are examples of screening tests. Your doctor will enter a finger into your rectum to feel for abnormal texture, size, and form of your prostate gland during a digital rectal exam. The PSA test is a blood test that tests for elevated levels of prostate-specific antigen, which may signal cancer.

If your DRE or PSA test results are abnormal, your doctor will most likely prescribe further testing. Other prostate cancer diagnostic tests include:

Transrectal ultrasound.
Prostate biopsies (removing and analyzing a sample of cells from your prostate)

If your prostate biopsy reveals malignancy, your prostate tissue samples will be tested to see if they behave like cancer cells. If you are diagnosed with prostate cancer, your doctor may prescribe further tests to determine the stage of your disease. This is known as staging.

Bladder cancer diagnosis

If your doctor suspects you have bladder cancer, he or she may advise you to undergo testing to confirm or rule out the disease. These tests might include:

Physical examination of the bladder, which can be performed via the rectum or vagina
Urinalysis to check for blood in the urine
Cystoscopy
Lab tests such as urine cytology, urine culture, urine tumor marker test
Biopsy of the bladder
Imaging tests such as ultrasound, bone scan, computerized tomography scan (CT scan), magnetic resonance imaging (MRI)
Intravenous pyelogram (IVP) or intravenous urogram (IVU)
Retrograde pyelogram

Kidney cancer diagnosis

Kidney cancer tests are comparable to those used to diagnosis other urological malignancies. The following are the most frequent tests used to identify kidney cancer:

Blood tests
Urine tests
Imaging tests, such as computerized tomography scan (CT scan), magnetic resonance imaging (MRI)
Biopsy of kidney tissue

If you do have cancer, your doctor may request further tests to determine the stage of the disease. You may need more CT scans or other imaging tests.

Penile cancer diagnosis

If your doctor thinks you have penile cancer, he or she will order testing to confirm the diagnosis. These tests might include:

Physical exam, focusing on the penis
Biopsies:

Incisional biopsy, which just eliminates a portion of the tumor.
Excisional biopsy, which eliminates the whole tumor.
CT-guided fine needle biopsies
Lymph node biopsy, it is most commonly performed if cancer has spread far into the penis; it can be accomplished by tiny needle aspiration of the lymph nodes or surgical removal of a whole lymph node or nodes.

Imaging tests:
1. Computerized tomography scan (CT scan)
2. Magnetic resonance imaging (MRI)
3. Ultrasound

Testicular cancer diagnosis

Testicular cancer is frequently discovered via a normal self-exam of the testicles. If you or your doctor discover a lump in one of your testicles, you will almost certainly require more testing to establish whether you have cancer. These tests might include:

Ultrasound of the scrotum and testicles
Blood tests for tumor markers

If your test findings indicate that you have cancer, your doctor may advise you to have surgery to remove the afflicted testicle. This is referred to as a radical inguinal orchiectomy. After the testicle is removed, it will be examined in a lab to determine whether the development is cancerous and, if so, how advanced it is.

How urological cancers are treated?

A variety of aspects influence urological cancer treatment, including:

Type of cancer
How far the cancer has spread
Age
Overall health
Personal preferences

There are several therapy options for various forms of urological malignancies. Some treatments, such as chemotherapy and radiation therapy, are the same for all urological malignancies, though the types of chemotherapy used and the length of treatment might vary greatly.

General cancer treatments

Chemotherapy. Cancer is treated by destroying quickly developing cells. Chemotherapy is sometimes used alone, and occasionally in combination with other chemotherapeutic medicines. Chemotherapy medications can be extremely successful at locating and destroying cancer cells that have spread throughout the body. Low-dose chemotherapy is frequently used in conjunction with radiation treatment.
Radiation therapy. Cancer cells are destroyed by energy beams. It can be used alone or in combination with other therapies like surgery or chemotherapy. There are two forms of radiation therapy: external beam radiation, which is administered externally, and internal radiation, which is administered directly into the cancerous tissues (such as brachytherapy for prostate cancer treatment).
Surgery:

Mohs surgery. Microscopically controlled surgery is performed to eliminate cancer cells while conserving as much healthy tissue as possible around them. Some malignancies that have not progressed to deep tissue, such as early-stage penile cancer, can be treated with it.
Laparoscopic surgery. To perform surgery, a camera and delicate surgical equipment are placed into small incisions. Laparoscopy is a minimally invasive procedure with advantages such as reduced pain, faster healing, less scarring, and shorter hospital stays.
Robotic surgery. Is a type of minimally invasive surgery in which a robot assists the physician during the process. Swelling, bleeding, scars, and recovery time can all be reduced with robotic surgery.

Biologic therapy. The treatment, also known as biotherapy and immunotherapy, works by stimulating the body's immune system to aid in the battle against cancer cells. The immune system may be used to combat cancer in two ways: by motivating your immune system to work harder and/or smarter to attack particular cancer cells, and by giving your immune system a boost, which can help your body fight cancer.
Cryoablation. Freezes tissue to kill cancer cells. It is effective in the treatment of a variety of urological malignancies, including cervical cancer, kidney cancer, and prostate cancer.
Radiofrequency ablation (RFA). Includes putting an X-ray guided needle into cancer cells then heating and burning cancer cells with electricity. RFA might be used to treat kidney cancer, among other cancers.
Targeted therapy. This is done to prevent cancer cells from spreading by blocking aberrant signals. Targeted treatment is classified into several categories. Certain methods of therapy for kidney, prostate, and cervical cancer have been authorized by the FDA. Signal transduction inhibitors, gene expression modulators, angiogenesis inhibitors, apoptosis inducers, immunotherapies, hormone treatments, and toxin delivery agents are examples of targeted therapeutics.

Cancer-specific treatments

Prostatectomy is a procedure that removes the prostate gland. There are four fundamental approaches employed.
Robotic prostatectomy.
Retropubic surgery. Involves making an incision in the abdomen to remove the prostate.
Perineal surgery involves removing the prostate through an incision made between the scrotum and anus.
Hormone therapy is one type of prostate cancer therapy. Hormone treatment is occasionally used to reduce tumors before radiation therapy in males with early-stage cancer. It is occasionally used to shrink cancer cells and reduce tumor development in individuals with advanced prostate cancer.

Luteinizing hormone-releasing hormone (LH-RH) agonists block messages telling the testicles to make testosterone.
Anti-androgens keep testosterone from reaching cancer cells. They are often used along with LH-RH agonists.
Removing the testicles through a surgery called orchiectomy lowers testosterone levels.

Radical inguinal orchiectomy. entails the removal of one testicle It is employed in the treatment of testicular cancer. Some men opt to have a prosthetic testicle implanted during surgery; however, this is not essential.
Penectomy. Is a therapy for various stages of penile cancer. It is typically used to treat cancer that has gone deep into the penis. A partial penectomy entails the removal of the penis's tip, whereas a total penectomy involves the removal of the entire penis.
Nephrectomy. In order to treat kidney cancer, a kidney, some surrounding tissue, and the lymph nodes nearest to the afflicted kidney are removed. This operation can be performed either traditionally with open surgery or less invasively using laparoscopy.
Nephron-sparing surgery. A partial nephrectomy is a procedure used to treat kidney cancer. The objective is to preserve some healthy kidney tissue. Surgeons remove the tumor and some good tissue surrounding the tumor (the margin) during nephron-sparing surgery, leaving some kidney behind. It is especially frequent in persons who have tiny tumors or only one kidney. When possible, it is preferable over nephrectomy.
Intravesical immunotherapy. Injecting a liquid medicine into the region afflicted by cancer, such as Bacillus Calmette-Guerin (BCG) for treating early-stage bladder cancer.
Transurethral resection (TUR). A procedure used to remove bladder cancer that is contained inside the inner layers of the bladder. With an electric current, a loop-shaped wire burns away cancer cells. TUR is sometimes performed with a laser rather of electricity.
Radical cystectomy. When cancer has infiltrated the bladder wall and probably adjacent lymph nodes and organs, surgery to remove the bladder and accompanying lymph nodes is undertaken. When males have this operation, the prostate gland and seminal vesicles are frequently removed, but women generally have their uterus and ovaries removed along with the bladder. If the bladder is removed, the surgeon will have to devise a method for the body to expel urine.
Segmental cystectomy, A partial cystectomy is a surgical treatment that removes the section of the bladder that contains cancer cells.

How can urological cancers be prevented?

Prevention of kidney cancer

Because cigarette smoking is responsible for a substantial majority of instances, quitting may reduce your risk.
Obesity and hypertension are also risk factors for renal cell carcinoma. Maintaining a healthy weight via exercise and eating a diet rich in fruits and vegetables may help lower your risk of contracting this condition.
Avoiding dangerous compounds like trichloroethylene at work may also lower your chances of renal cell carcinoma.

Prevention of bladder cancer

Smoking cessation. Smoking is considered to be responsible for almost half of all bladder malignancies. (This covers all forms of smoking, such as cigarettes, cigars, and pipes.)
Limit exposure to certain chemicals. Workers in companies that utilize specific organic compounds are more likely to get bladder cancer. The rubber, leather, printing materials, textiles, and paint industries are all sectors where these compounds are extensively utilized.
Drink plenty of fluids. There is some evidence that drinking plenty of fluids, mostly water, may reduce a person's risk of bladder cancer.
Eat lots of fruits and vegetables. Some studies have shown that a high-fiber diet may help protect against bladder cancer, while other studies have not found this to be true. Nonetheless, a balanced diet has been found to offer several advantages, including decreasing the risk of some forms of cancer.

Prevention of testicular cancer

Many testicular cancer patients have no identified risk factors. Some established risk factors, such as undescended testicles, white race, and a family history of the condition, are unchangeable. For these reasons, most instances of this disease cannot be prevented at this time.

Experts advocate treating cryptorchidism in males for a variety of reasons (including maintaining fertility and body image), but it's unclear how much this reduces the child's chance of testicular cancer.

Prevention of prostate cancer

Body weight, physical activity, and diet

According to several studies, men who are overweight or obese are more likely to acquire advanced prostate cancer or prostate cancer that is fatal.

Although not all studies agree, a greater risk of prostate cancer has been reported in men whose diets are heavy in dairy products and calcium.

For now, the best advice about food and activity to potentially minimize the risk of prostate cancer is to:

Achieve and maintain a healthy weight.
Keep physically active.
Adhere to a healthy eating pattern that includes a range of colorful fruits and vegetables as well as whole grains, while avoiding or limiting red and processed meats, sugar-sweetened drinks, and highly processed meals.

Vitamin, mineral, and other supplements:

Vitamin E and selenium: Some preliminary research revealed that taking vitamin E or selenium supplements might reduce the incidence of prostate cancer.

Soy and isoflavones: Some studies have shown that soy proteins (called isoflavones) may be beneficial in decreasing the risk of prostate cancer.

Medicines: Some drugs might help reduce the risk of prostate cancer.

5-alpha reductase inhibitors

5-alpha reductase is a biological enzyme that converts testosterone into dihydrotestosterone (DHT), the primary hormone responsible for prostate growth. 5-alpha reductase inhibitors, such as finasteride (Proscar) and dutasteride (Avodart), prevent the enzyme from producing DHT. These medications are used to treat benign prostatic hyperplasia (BPH), a non-cancerous prostate enlargement.

Both of these medications have been studied extensively to determine whether they can help reduce the risk of prostate cancer. Men who received either treatment were less likely to develop prostate cancer after several years than men who received an inactive placebo in these studies.

Aspirin

According to some studies, men who use aspirin on a regular basis may have a decreased chance of developing and dying from prostate cancer. However, further study is needed to determine whether the potential advantages exceed the hazards. Long-term aspirin use can have negative effects, including an increased risk of gastric hemorrhage. While aspirin may have additional health advantages, most doctors do not advocate taking it only to reduce the risk of prostate cancer at this time.

Prevention of penile cancer

Circumcision

Circumcision (removing the foreskin of the penis) was previously indicated as a technique to reduce the incidence of penile cancer. This was based on research that found circumcised males had much lower penile cancer rates than uncircumcised men. However, after factors like as smegma and phimosis were included, the protective effect of circumcision was not shown in certain trials. Nonetheless, some scientists believe that circumcision protects penile cancer.

Even among circumcised males in the United States, the chance of developing penile cancer is minimal. Men who have not been circumcised can reduce their chance of developing penile cancer by adopting basic genital hygiene.

Genital hygiene

Good genital hygiene is perhaps the most essential element in avoiding penile cancer in uncircumcised males. Uncircumcised guys must retract the foreskin and clean the whole penis. If the foreskin is tight and difficult to retract (a condition known as phimosis), a doctor may be able to prescribe a lotion or ointment to help. If this does not work, the doctor may construct a dorsal incision in the skin of the foreskin to facilitate retraction.

HPV infection

Because HPV is highly common, even having intercourse with one other person might put you at risk. Because a man might have an HPV infection for years without showing any symptoms, the absence of visible warts cannot be used to determine whether or not someone has HPV. Even if a person does not have warts (or any other symptom), he or she might be infected with HPV and spread the virus to others.

Smoking cessation

Tobacco usage also raises the risk of penile cancer, thus abstaining from all forms of tobacco may reduce that risk. Tobacco cessation or avoidance is an effective approach to minimize your risk of numerous illnesses, including penile cancer.

Conclusion

Urine is produced and stored in the urinary tract. The kidneys, the ureter, the bladder, and the urethra are all part of it. Urologic malignancies are abnormal cell growths that originate in the urinary tract organs of both men and women, as well as the male reproductive system's testicles, prostate, and penis.

Cancers in these organs frequently cause symptoms such as pain, a lump, urinary tract infections (UTIs), or blood in the urine, prompting a person to consult a physician about their health. Many of these tumors are treatable if detected early.

As with other forms of cancer, most urologic malignancies are treated surgically in an attempt to remove the tumor. Other patients may get chemotherapy to kill cancer cells or slow their development.