Urology >> Urological Cancer

Urological cancers other than testis cancer are rare under the age of 40 years, but unfortunately, one can never say never. See Screening and Diagnosis of Urological Cancer

Prostate cancer only affects men and is the commonest non-cutaneous cancer in men, and second commonest cause of cancer death after lung cancer). It commonly presents after a PSA test done as part of the investigation of urological symptoms, or as a screening test. Occasionally, it can present at an advanced stage, particularly in men who have not had a PSA test for several years.

Bladder cancer is about three times more common in men than women. It is the fourth commonest cancer in men and eighth commonest cancer in women. It tends to present with blood in the urine or new bladder symptoms, and can sometimes mimic urinary infection or cystitis.

Kidney cancer is the third most common urological cancer. Like other urological cancers, it is more common in men than women. It tends to present itself as an unexpected finding when having an investigation that images the kidneys and other internal organs. It can also present with haematuria or flank pain. See nephrectomy (includes radical nephrectomy, partial nephrectomy, ablation of renal masses.

Testis cancer is most common in young men (post-puberty to 40 years), but can affect older men. It is generally detected by the man noticing a swelling within or on the testis, and is usually painless. See radical orchidectomy.

Cancer Terminology

Tumour Types

A organ can give rise to various tumour types, according to the cell type of origin. The cell type may influence treatment options, and prognosis. The cell type is determined by pathological examination of biopsy material.

Tumour Staging

Tumour stage describes the extent to which a tumour has invaded from its origin. A tumour first invades within the organ of origin (prostate, bladder or kidney etc). It may then extend beyond the organ into adjacent surrounding tissues or adjacent organs. The extent of the primary tumour is described by a “T” stage category (e.g. T1, T2, T3, T4), and the meaning of the code is specific for the organ of origin. Cancerous cells may jump to other parts of the body (when it is then called a Metastasis). This may be local lymph glands (assigned a “N” category, or more distant tissues, most commonly bone, lung, liver (“M” category). The extent of the spread can usually be determined X-rays, CT scan, and bone scan.

Grading of Urological Cancer

Tumours are graded from tissue biopsies by pathologists. The grade describes the microscopic appearances of the tumour and relates to their biological behaviour. Grading is most important for tumours that have not yet spread, rather than tumours that have been seen to have spread by tumour staging investigations.

As a general rule, lower numbers for tumour grade indicate less aggressive tumours and better prognosis. Prostate cancer is graded by Gleason Grade, consisting of two numbers each between 1 and 5 that are added together to give a “Gleason Sum Score” (between 2 and 10, e.g.”3+4”). Bladder cancer is graded from 1 – 3. Kidney cancer is graded by Fuhrman Grade (1-4).