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Urological Cancer Types Treated at Baylor Hospitals in DFW 
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Urological Cancer 

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.

Kidney CancerCáncer de Riñón

Kidney Cancer

Illustration of the anatomy of the kidney
Click Image to Enlarge

What is kidney cancer?

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.

What are the risk factors for 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.

What are the symptoms of renal cell 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

  • Fatigue

  • 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.

How is kidney cancer (renal cell cancer) diagnosed?

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.

How is kidney cancer treated?

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

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.

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Testicular CancerCáncer Testicular

Testicular Cancer

What are the testicles?

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.

Illustration of  the anatomy of the male reproductive tract
Click Image to Enlarge

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.

What is testicular cancer?

Cancer that develops in a testicle is called testicular cancer. It is one of the most curable forms of cancer.

What are the symptoms of testicular 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.

What causes testicular cancer?

The exact cause of testicular cancer is not known. However, a number of factors that increase the risk for the disease.

What are the risk factors for testicular cancer?

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.

  • Family history

  • Personal history of cancer in the other testicle

  • Race and ethnicity. The rate of testicular cancer is higher in whites than in other populations.

  • HIV infection

Can testicular cancer be prevented?

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.

How is testicular cancer diagnosed?

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 of testicular cancer

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.

Treatment for testicular cancer

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

Testicular cancer can occur in one or both testicles, usually in young men. It can be treated and very often cured.

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Prostate CancerCáncer de la Próstata

Prostate Cancer

Prostate cancer statistics

The fear of having prostate cancer can be devastating to men. However, it is most successfully treated when found early. Consider these statistics from the American Cancer Society (ACS):

  • More than 90 percent of all prostate cancers are discovered while they are either localized (confined to the prostate) or regional (nearby). The five-year survival rate for men diagnosed with prostate tumors discovered at these stages is nearly 100 percent.

  • In the past 25 years, the five-year survival rate for all stages combined has increased from 68 to nearly 100 percent.

  • Prostate cancer is the most common cancer among men, excluding skin cancer.

  • For 2012, the ACS estimates 241,740 new cases of prostate cancer will be diagnosed in the U.S.

  • Year 2012 estimates also include 28,170 deaths occurring from prostate cancer in the U.S. alone, making it the second leading cause of cancer death in men.

Illustration of  the anatomy of the male reproductive tract
Click Image to Enlarge

Facts about the prostate gland

The prostate is a sex gland in men. It is about the size of a walnut, although it can grow larger, and surrounds the neck of the bladder and urethra—the tube that carries urine from the bladder. The prostate is partly muscular and partly glandular, with ducts opening into the prostatic portion of the urethra. It is made up of three lobes: a center lobe with one lobe on each side.

The prostate gland secretes a slightly alkaline fluid that forms part of the seminal fluid, a fluid that carries sperm.

What are the symptoms of prostate cancer?

There are usually no specific signs or symptoms of early prostate cancer. A prostate-specific antigen (PSA) blood test and digital rectal exam (DRE) can provide the best chance of identifying prostate cancer in its earliest stages, but these tests can have drawbacks. Talk to your doctor about whether prostate cancer screening is right for you.

The following are the most common symptoms of prostate cancer. However, each individual may experience symptoms differently. Symptoms may include:

  • Weak or interrupted flow of urine

  • Urinating often (especially at night)

  • Difficulty urinating or holding back urine

  • Inability to urinate

  • Pain or burning when urinating

  • Blood in the urine or semen

  • Nagging pain in the back, hips, or pelvis because cancer has spread to the bones 

  • Painful ejaculation

The symptoms of prostate cancer may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.

As a man gets older, his prostate may grow bigger and obstruct the flow of urine, or interfere with sexual function. An enlarged prostate gland—a condition called benign prostate hyperplasiamay require treatment with medicine or surgery to relieve symptoms. This common benign prostate condition, which is not cancer, can cause many of the same symptoms as prostate cancer.

What are risk factors for prostate cancer?

In general, all men are at risk for prostate cancer. However, there are specific risk factors that increase the likelihood that certain men will develop the disease, including the following:

  • Age. Age is a risk factor for prostate cancer, especially for men 50 and older. Nearly two-thirds of all prostate cancers are diagnosed in men over the age of 65.

  • Race. Prostate cancer is more common among African-American men than it is among white American men. Japanese and Chinese men native to their country have the lowest rates of prostate cancer. However, when Chinese and Japanese men immigrate to the U.S., they have an increased risk of and mortality rate from prostate cancer when compared to their native populations. In Japan, the incidence of prostate cancer has increased as Western diets and lifestyles have been adopted.

  • Diet. Epidemiological data suggest that the diet consumed in Western industrialized countries may be a factor in developing prostate cancer. Consider the following information regarding diet and its effect on the risk for prostate cancer:

    • Fat. Some studies suggest that men who eat a high-fat diet, especially if it is high in red meat or high-fat dairy products, may have a greater chance of developing prostate cancer.

    • Fruits and vegetables. Diets high in fruits and vegetables may lower prostate cancer risk, although it is not clear which nutrient(s) may be responsible for this. 

    • Vitamin E and selenium. The antioxidant Vitamin E, combined with selenium, has been shown to inhibit tumor growth in laboratory animals. But a large study found that supplements of these substances did not lower the risk of prostate cancer in men. In fact, the men taking vitamin E had a slightly higher risk of prostate cancer. 

    • Carotenoids. Carotenoids, such as lycopenes, have been shown to inhibit the growth of human prostate cancer cells in tissue cultures (cells grown in the laboratory). The primary source of lycopenes is processed tomatoes. Again, however, it is not clear if lycopenes affect prostate cancer risk in men, as not all studies have found a benefit.

  • Obesity. Most studies have not found obesity to affect the risk of getting prostate cancer, but obese men may be more likely to develop more aggressive forms of prostate cancer.

  • Environmental exposures. Some studies show an increased risk of prostate cancer in men who are farmers, or those exposed to the metal cadmium while making batteries, welding, or electroplating. Additional research is needed in this area to confirm whether this is a true association.

  • Having a vasectomy, BPH (benign prostatic hyperplasia), or an STD (sexually transmitted disease). Researchers have looked at whether men who have had a vasectomy, BPH, or those who have been exposed to a sexually transmitted disease are at increased risk for prostate cancer. Some studies suggest a link, while others do not support these claims.

  • Family history of prostate cancer. Having a father or brother with prostate cancer more than doubles a man's risk of developing this disease. The risk is even higher for men with several affected relatives, particularly if the relatives were young at the time of diagnosis. Geneticists (doctors and scientists who study inheritance and the causes of genetic disease) divide families into three groups, depending on the number of men with prostate cancer and their ages of onset, including the following:

    • Sporadic. A family with prostate cancer present in one man, at a typical age of onset; sporadic means occurs by chance.

    • Familial. A family with prostate cancer present in more than one person, but with no definitive pattern of inheritance and usually an older age of onset.

    • Hereditary. A family with a cluster of three or more affected relatives within any nuclear family (parents and their children), a family with prostate cancer in each of three generations on either the mother or father's side, or a cluster of two relatives affected at a young age (55 or younger). Five to 10 percent of prostate cancer cases are considered hereditary.

  • Genetic factors. In the center of each cell of the human body, our genetic material—chromosomes—are found. Normally, cells contain 46 chromosomes, or 23 pairs, half of which are inherited from our mother, half from our father. The chromosomes contain genes—the body's blueprint. Genes code for traits, such as eye color and blood type, and also control important regulatory functions in the body such as the rate of cell growth. Some genes, when altered or mutated, give a higher risk for uncontrolled cell growth, which, in turn, can lead to tumor development. These genes have various names, but overall are referred to as cancer susceptibility genes. Approximately five to 10 percent of all prostate cancers are known to be attributed to an inherited DNA change.

Procedures used to evaluate prostate problems

In addition to regular physical examinations that may include blood, urine, and possibly other laboratory tests, many groups, such as the American Cancer Society, suggest talking to your doctor to learn more about the pros and cons of screening for prostate cancer to help you decide if it is right for you. Other expert groups have different recommendations. For example, the U.S. Preventive Services Task Force recommends against routine prostate cancer screening because the task force believes the benefit does not outweigh the harm. The tests used for screening include:

  • DRE (digital rectal examinations). The doctor places a gloved and lubricated finger into the rectum to examine the rectum and feel the prostate gland. DREs may be conducted annually for men over the age of 50 who choose to be screened. Men in high-risk groups, such as African-Americans, or those with a strong family history of prostate cancer, should consult their doctors about being tested at age 45.

  • PSA (prostate-specific antigen). PSA is a substance produced by the prostate gland, which may be found in higher amounts in the blood of men who have prostate cancer. PSA tests may be done annually for men over the age of 50 who choose to be tested. Men in high-risk groups, such as African-Americans, or those with a strong family history of prostate cancer, should consult their doctors about being tested at an earlier age.

What are some other prostate cancer evaluation procedures?

If the DRE or PSA results are unusual, your doctor may repeat the tests or request other procedures. These evaluation tools may include:

  • Prostate biopsy. A test where the doctor inserts thin, hollow needles into the prostate to get samples for examination under a microscope to determine if cancer cells are present.

  • Transrectal ultrasound (TRUS). A test using sound wave echoes to create an image of the prostate gland to visually inspect for abnormal conditions such as gland enlargement, nodules, penetration of tumor through capsule of the gland, and/or invasion of seminal vesicles; may also be used for guidance of needle biopsies of the prostate gland and/or guiding the nitrogen probes in cryosurgery.

  • Computed tomography scan (also called a CT or CAT scan). A diagnostic imaging 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 diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

  • Radionuclide bone scan. A nuclear imaging method that helps to show whether the cancer has spread from the prostate gland to the bones. The procedure involves an injection of radioactive material that helps to locate diseased bone cells throughout the entire body, suggesting possible metastatic cancer.

  • Lymph node biopsy. A procedure in which tissue samples are removed (with a needle or during surgery) from the lymph nodes for examination under a microscope to determine if cancer or other abnormal cells are present.

The diagnosis of cancer is confirmed only by a biopsy.

Prostate Cancer

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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