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Urologic cancers can occur in any organ of the urologic system and the male reproductive system. These can include kidney cancer, prostate cancer and testicular cancer. Each type of cancer has different symptoms and treatments and affects different groups of the population with varying frequency.
Most cancers are named after the part of the body where the cancer first begins, and kidney cancer is no exception. Kidney cancer begins in the kidneys--two large, bean-shaped organs--one located to the left, and the other to the right of the backbone. Renal is the Latin word for kidney, and kidney cancer may also be referred to as renal cancer.
According to the American Cancer Society (ACS), about 65,000 people in the U.S. were expected to be diagnosed with kidney and renal pelvic cancers in 2012. The most common type is called renal cell cancer. The information contained on this page refers to renal cell cancer.
The exact cause of renal cell cancer is unknown. However, there are certain risk factors that are linked to it. These risk factors, according to the ACS, are as follows:
Smoking. Smoking increases the risk of kidney cancer. The risk seems related to the amount you smoke.
Asbestos. Studies show a link between exposure to asbestos and kidney cancer.
Cadmium. There may be a link between cadmium exposure and kidney cancer. Cadmium may increase the cancer-causing effect of smoking.
Family history. Family history of kidney cancer increases a person's risk.
Gender. Men are twice as likely to develop renal cell cancer than women.
Von Hippel-Lindau syndrome. This is a disease caused by a gene mutation that increases the chances of renal cell cancer.
Birt-Hogg-Dube syndrome. Patients who have this disease are more likely to develop renal cell cancer.
Other hereditary syndromes. Patients with hereditary papillary renal cell carcinoma, hereditary leiomyoma-renal cell carcinoma, and hereditary renal oncocytoma are more likely to develop kidney cancer.
Obesity. Obesity increases a person's risk of kidney cancer.
Advanced kidney disease. Patients with advanced kidney disease who have been on dialysis for a long time may develop renal cell cancer.
High blood pressure. Patients who have high blood pressure have a higher risk for kidney cancer.
Diuretics (water pills). Drugs that eliminate excess body fluid may raise the risk of kidney cancer, although this is not clear.
Race. African-Americans have a slightly higher risk of kidney cancer.
The following are the most common symptoms of renal cell cancer. However, each individual may experience symptoms differently. Symptoms may include:
Blood in the urine
Rapid, unexplained weight loss
Low back pain (not caused by an injury)
Loss of appetite
Swelling of ankles and legs
Mass or lump on the side or lower back
Recurrent fever (not caused by a cold or the flu)
High blood pressure (less frequently)
Anemia (less frequently)
Unrelieved pain in the side
The symptoms of renal cell cancer may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.
In addition to a complete medical history and physical examination, diagnostic procedures for kidney cancer may include the following:
Blood and urine laboratory tests
Intravenous pyelogram (IVP). A series of X-rays of the kidney, ureters, and bladder with the injection of a contrast dye into the vein to detect tumors, abnormalities, kidney stones, or any obstructions, and to assess renal blood flow.
Renal angiography (also called arteriography). A series of X-rays with the injection of a contrast dye into a catheter, which is placed into the blood vessels of the kidney, to detect any signs of blockage or abnormalities affecting the blood supply to the kidneys.
Other imaging tests (to show the difference between diseased and healthy tissues), including the following:
Computed tomography scan (also called a CT or CAT scan). A noninvasive type of X-ray procedure that takes horizontal, or axial, images of the brain or other internal organs to detect any abnormalities that may not show up on an ordinary X-ray.
Magnetic resonance imaging (MRI). A noninvasive procedure that uses radio waves and strong magnets to produce very detailed two-dimensional views of an internal organ or structure, especially the brain and spinal cord.
Ultrasound (also called sonography). A diagnostic imaging technique that uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels.
Chest X-ray. A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs on film.
Bone scan. A nuclear imaging method to evaluate any degenerative and/or arthritic changes in the joints to detect bone diseases and tumors to determine the cause of bone pain or inflammation.
Based on results of other tests and procedures, a biopsy may be needed. A biopsy is a procedure in which a sample of the tumor is removed and sent to the laboratory for examination by a pathologist.
Specific treatment for kidney cancer will be determined by your doctor based on:
Your age, overall health, and medical history
Extent of the disease
Your tolerance for specific medications, procedures, or therapies
Expectations for the course of the disease
Your opinion or preference
Treatment may include:
Surgery. Surgery to remove the kidney is called a nephrectomy and it is the most common treatment for kidney cancer. The following are different types of nephrectomy procedures:
Radical nephrectomy. The whole kidney is removed along with the adrenal gland, tissue around the kidney, and, sometimes, lymph nodes in the area.
Simple nephrectomy. Only the kidney is removed.
Partial nephrectomy. Only the part of the kidney that contains the tumor is removed.
The remaining kidney is generally able to perform the work of both kidneys.
Radiation therapy. Radiation therapy uses high-energy X-rays to kill cancer cells, and is also sometimes used to relieve pain when kidney cancer has spread to the bone.
Targeted therapy. Targeted therapy uses drugs that attack specific parts of cancer cells. These drugs work differently from standard chemotherapy drugs, and often have less severe side effects. They are commonly the first line of treatment for advanced kidney cancer. Examples include sunitinib (Sutent), sorafenib (Nexavar), temsirolimus (Torisel), everolimus (Afinitor), bevacizumab (Avastin) and pazopanib (Votrient).
Biological therapy (also called immunotherapy). Biological therapy is a treatment that uses the body's own immune system to fight cancer.
Chemotherapy. Chemotherapy is the use of drugs to kill cancer cells. Unfortunately, kidney cancer is often resistant to chemotherapy drugs.
Arterial embolization. Arterial embolization is a procedure in which small pieces of a special gelatin sponge, or other material, are injected through a catheter to clog the main renal blood vessel. This procedure shrinks the tumor by depriving it of the oxygen-carrying blood and other substances it needs to grow. It may also be used before an operation to make surgery easier, or to provide relief from pain when removal of the tumor is not possible.
If you or a family member has been diagnosed with kidney cancer, you may want to consider getting a second opinion. In fact, some insurance companies require a second opinion for such diagnoses. According to the ACS, it's rare that the time it will take to get a second opinion will have a negative impact on your treatment. The peace of mind a second opinion provides may be well worth the effort.
Kidney cancer starts small and can be in either one or both kidneys. It is usually found after it has grown quite large, but often before it has spread to other organs.
The testicles are the male sex glands and are part of the male reproductive system. Testicles are also called testes or gonads. They are located behind the penis in a pouch of skin called the scrotum.
The testicles produce sperm and several male hormones, including testosterone. The hormones control the development of the reproductive organs, as well as other male characteristics. This includes body and facial hair, low voice, and wide shoulders.
Cancer that develops in a testicle is called testicular cancer. It is one of the most curable forms of cancer.
The following are the most common symptoms for testicular cancer:
Lump in either testicle, which is usually not painful
Enlargement of a testicle
Feeling of heaviness in the scrotum
Dull ache in the lower abdomen or in the groin
Sudden collection of fluid in the scrotum
Pain or discomfort in a testicle or in the scrotum
The symptoms of testicular cancer may look like other conditions or medical problems. Always consult your doctor for a diagnosis.
The exact cause of testicular cancer is not known. However, a number of factors that increase the risk for the disease.
Research shows that some men are more likely than others to develop testicular cancer. Possible risk factors include the following:
Age. About half of all testicular cancers occur in men between the ages of 20 and 34.
Undescended testicle(s) (cryptorchidism). Even after surgical repair of an undescended testicle, there is still an increased risk.
Personal history of cancer in the other testicle
Race and ethnicity. The rate of testicular cancer is higher in whites than in other populations.
Currently, there is no sure way to prevent the disease because:
There are few known causes for the disease.
Many of the suggested risk factors are those that cannot be changed.
Many men with testicular cancer do not have the suggested risk factors.
However, testicular self-exam (TSE) can improve the chances of finding a cancerous tumor early. Some doctors recommend doing them monthly, although it is not clear if they can reduce the death rate for testicular cancer. Monthly TSE is recommended by some experts for men at increased risk for testicular cancer. Risk factors include a history of cryptorchidism, a history of testicular cancer, or a family history of testicular cancer.
Testicular self-exam (TSE) procedure
The best time for testicular self-exam is just after a warm bath or shower when the scrotal tissue is more relaxed.
While standing in front of a mirror, place the thumbs on the front side of the testicle and support it with the index and middle fingers of both hands.
Gently roll the testicle between the fingers and thumbs. Feel for lumps, hardness, or thickness. Compare the feelings in each testicle.
If you find a lump, see your doctor as soon as possible.
Testicular self exam is not a substitute for routine physical exams by your doctor.
In addition to a complete medical history and physical exam, other test for testicular cancer may include:
Ultrasound. A test which uses high-frequency sound waves to create an image. This test can be used to determine if a lump on a testicle is solid or filled with fluid. (Solid lumps are more likely to be cancerous.)
Blood tests. Assessment of blood samples to check for increased levels of certain proteins and enzymes to help determine if cancerous cells are present, or to determine how much cancer is present.
Biopsy. A procedure in which tissue samples are removed (during surgery) from the body for examination under a microscope to determine if cancer is present.
When testicular tumors are present, the entire tumor, the testicle, and the spermatic cord, are typically removed during the biopsy. This is done to prevent the spread of cancerous cells through the blood and lymph systems.
Staging is the process of determining if and how far the cancer has spread. Treatment options are based on the results of staging. Procedures for determining stage include the following:
Computed tomography scan (also called a CT or CAT scan). This procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
Magnetic resonance imaging (MRI). A procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body. It is sometimes used to look for spread of the cancer to the brain.
In addition to these imaging procedures, chest X-rays, positron emission tomography (PET) scans, or other scans may be requested.
There are several kinds of treatments for testicular cancer, including:
Surgery. This is done to remove the tumor and the testicle, and possibly lymph nodes in the back of the abdomen.
Radiation therapy. This treatment helps to destroy cancer cells or slow the rate of growth.
Chemotherapy. These drugs are used to destroy cancer cells throughout the body.
High-dose chemotherapy and stem cell transplantation. These are done to remove stem cells from the patient's or a donor's bone marrow and reinfuse them into the patient to help in the production of healthy blood cells.
Testicular cancer can occur in one or both testicles, usually in young men. It can be treated and very often cured.
Prostate cancer is the second most common cancer found in American men, second only to skin cancer. Approximately one in six men will develop prostate cancer in his lifetime. We offer the da Vinci® Robotic Surgical System, a robotic-assisted procedure for men with prostate cancer.
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