What is cancer? Our bodies are made up of trillions of cells. Usually, every cell has a certain function in the body. Cancer is caused by cells that no longer work properly. Uncontrolled cell growth can crowd out other cells and become a tumour (Fig. 1). Fig. 1: Cancer cells crowding out healthy cells. Types of
This section offers general information. Your specific treatment will be recommended by your doctor based on your individual needs. Individual recommendations may depend on your country and health care system. The treatment you have will depend on: what you prefer what your doctor thinks is best for your type of cancer which treatments are available
Penis cancer is classified by stage based on the aggressiveness of the cancer cells. Staging is a standard way to describe whether the cancer has spread. The kind of treatment you receive will depend on the stage. For staging, the Tumour Node Metastasis (TNM) classification is used. This classification system describes the penile tumour (T),
Your doctor will talk with you about your symptoms and medical history. The doctor will do a physical exam of your penis and check the lymph nodes in your groin for swelling. Tests might be arranged if your doctor thinks you could have penis cancer: Fluid might be drawn from swollen lymph nodes for examination
The type of penis cancer depends on the type of cell that started growing. More than 90% of penis cancer starts in skin cells called squamous cells. Penis cancer develops mostly on the skin at the glans (head) or in the inner layer of the foreskin. Carcinoma in situ (CIS) is a type of squamous
Penis cancer usually appears on the penis skin. It can look like a rash or a sore that doesn’t heal. You might notice bleeding or a bad smell. If you have a foreskin, it might change in appearance or become too tight to pull back. If you notice these symptoms, ask your doctor if you
The exact cause of penis cancer is not known. Men with certain conditions have a higher risk of getting penis cancer: A foreskin A tight foreskin that cannot be pulled back over the head of the penis (phimosis) Human papilloma virus (HPV) infection, usually of the foreskin A condition called lichen sclerosis, which only affects
Europa Uomo chairman André Deschamps sets out the need for an improved approach to prostate cancer diagnosis and treatment. 30 million men in Europe are confronted with a diagnosis of prostate cancer in their lifetime. Each year 75,000 men die from prostate cancer. A questionnaire amongst our members in 24 European states showed that: Less
Cancer survivorship has traditionally received little prioritisation and attention. For a long time, the treatment of cancer has been the main focus of healthcare providers’ efforts. It is time to increase the amount of attention given to patients’ long-term well-being and their ability to return to a productive and good life. This article describes the
Preoperative chemotherapy Different types of urethral cancer are treated differently. Some urethral cancer, called urothelial carcinoma, specifically affects urothelial cells. Chemotherapy followed by surgery is critical to remove urothelial carcinoma. Chemotherapy that contains platinum (eg, cisplatin, carboplatin) is most effective against urethral cancer. Chemotherapy combinations like MVAC (which uses the drugs methotrexate, vinblastine, Adriamycin [doxorubicin],
Primary radical urethrectomy Your doctor will recommend complete removal of the urethra (urethrectomy), including part of the bladder and the surrounding tissue to ensure the highest chance of cure. Usually, the bladder neck is closed during the procedure, and a new way to store and regulate the flow of urine is created (urinary diversion). Urethra-sparing
Localised urethral cancer Localised primary urethral cancer is confined to the urethra. Treatment for men and women differs. Your doctor will recommend a treatment that aims to remove all cancer and preserve your quality of life. To do this, the location of the tumour is important. Treatment for men Treatment for women Locally advanced primary
Partial urethrectomy Partial urethrectomy: If your cancer is limited to the part of the urethra nearest the opening, but still close to the tip, partial removal of the urethra (urethrectomy) with penile preservation may be the best option. Your doctor might also recommend removal of enlarged lymph nodes to rule out metastasis. The main goal
Tumours are classified by stage and subtype to describe the extent of cancer spread. The potential of the tumour to grow aggressively (tumour grade) will also be assessed. The kind of treatment you receive will depend on these elements. Tumour stage and subtype are based on whether or not the cancer is limited to the
Symptoms Primary urethral cancer has no typical early symptoms. Most patients experience bloody discharge from the urethra (haematuria). If you have advanced cancer, you may be able to feel a hard mass in your genital tract. You have problems urinating if the tumour blocks the opening of your bladder or fills out the urethra completely.
Talk to family or friends and people who are close to you. It can help to discuss things with someone outside your inner circle. Your doctor may be able to refer you to a counsellor or specialist nurse. Efforts are being made to promote patient advocacy for urethral cancer. Ask your oncologist if a urethral
After surgery, your doctor will schedule you for a series of check-ups. During these visits, a urine sample will be checked for cancer cells, and your urethra will be examined with a cystoscope (urethrocystoscopy) and with imaging. Please be sure to attend these visits. Regular check-ups are critical to ensuring that complications or disease recurrences
Castration-resistant prostate cancer can be managed with radiation therapy. The radiation damages and kills cancer cells. The treatment will help to relieve pain and may allow you to live longer. Common side effects are a burning sensation when you urinate, urinary frequency, and anal irritation.
Chemotherapy with docetaxel Chemotherapy is a type of cancer treatment that uses chemicals to destroy cancer cells. Chemotherapy drugs can be injected into the bloodstream to attack cells throughout the body. They can also be applied directly to the tumour. Your doctor may recommend the chemotherapy docetaxel to manage castration-resistant prostate cancer. The drug relieves
Immunotherapy is a type of treatment that uses your own immune system to fight the tumour cells. In prostate cancer the drug Sipuleucel-T is used as immunotherapy. Because your own blood is used to prepare the drug, you need to get blood drawn before the procedure. Immunotherapy is administered through an IV, in an outpatient
Urachal cancer is often diagnosed at later stages. Based on your disease stage and predicted outcomes, recommended treatment may include: Surgery Chemotherapy Palliative care Recommended treatment and predicted outcomes will be based on your cancer stage. The planned treatment approach should be discussed by a multidisciplinary tumour board. This board is made up of practitioners
Your doctor will classify the severity and aggressiveness of urachal cancer. A cancer stage will be determined based on: The histologic examination of the tissue The size of the tumour and whether it has grown into surrounding organs or tissue Whether the tumour cells have spread to other organs or tissue (metastases) Classification by cancer
The diagnosis of urachal cancer is usually based on: Blood in the urine A tumour located outside, in the middle, or on top of the urinary bladder Mucus-producing cells in the tissue Physical exam and imaging An initial diagnosis will include a physical examination, ultrasound of the abdomen, and a urine test (urinary swab test).
Symptoms of urachal cancer become noticeable when the cancer cells grow into surrounding tissue or organs (advanced stage). Symptoms may include: Blood in the urine (haematuria) Pain Bladder irritation Recurrent bladder infections Mucus from the navel (umbilical discharge) or in the urine (mucusuria)
There is a risk of urachal cancer if part of the urachus or the whole urachus is present. Years of chronic inflammation and remodelling or possibly leftover embryologic cells can cause urachal cancer. An intact urachus is indicated by: Recurrent infections of the navel or bladder Production of mucus by the navel or bladder Navel
What is the urachas? The urachus is a tube-like structure that forms in a developing embryo. It connects the umbilical cord to the urinary bladder before birth. After birth, the urachus usually shrinks into a small ligament. However, traces of the urachus (called urachal residues) can be detected in up to one-third of adults. Urachal
Can testicular cancer kill you? Current treatments for testicular cancer are very effective. Death from testicular cancer is rare. What is my prognosis? Your prognosis is your risk of the cancer growing quickly and/ or coming back after treatment. The type and stage of testicular cancer will help you and your doctor understand this. How
A cancer diagnosis is often stressful and confusing. Good information about your disease can help you feel more in control. Talk with your health care team and learn as much as you can. The more informed you are, the better able you will be to make choices about your care. Living with one testicle A
Testicular cancer is usually treated with surgery. The testicle must be removed (orchiectomy) to remove the cancer (Fig. 1). The tissue may be examined during surgery to confirm the diagnosis and stage. Additional surgery, drug treatment (chemotherapy), or radiation therapy also may be needed. Fig. 1: Orchiectomy—incision in the groin area. Surgery to remove the
Your doctor will give you a physical exam and ask about your medical history. Depending on your symptoms and risk factors, blood tests and ultrasound may be ordered to check for testicular cancer. If testicular cancer has spread to other parts of the body (metastasis), you might have dull aches or feel lumps in other
As testicular cancer grows, you might feel a lump or swelling in part of one testicle (Fig. 1). This is the most common symptom. You might have pain in a testicle or the scrotum, but testicular cancer is not usually painful. Fig. 1: Tumour in the testicle.
Age 18 to 35 years An undescended testicle (cryptorchidism), in the past or the present Opening for urine on the underside of the penis instead of at the tip (hypospadias) Poor sperm production that makes it difficult getting a partner pregnant Abnormal testicle development Family history (father or brother had testicular cancer) White race
What is testicular cancer? The testicles (also called the “testes”) are part of the male reproductive system (Fig. 1). They are found in the scrotum—the pouch of skin that hangs below the penis. The testicles make testosterone and sperm. Testicular cancer is a growth called a tumour that starts in the testicle (Fig. 2) and
Hormonal therapy is a treatment option for metastatic prostate cancer. It aims to slow down the growth of the tumours. The growth of prostate cancer cells is dependent on male sex hormones called androgens. Testosterone is the most important androgen. Androgens are mainly produced in the testicles. Hormonal therapy either stops the production of androgens,
Drug treatment is a common option for metastatic kidney cancer. There are several types of treatment: Antiangiogenic therapy, commonly described as targeted therapy Immunotherapy Chemotherapy, in combination with immunotherapy These drugs influence the mechanisms that tumours use to grow. All decisions about the right therapy for you are taken after careful consideration of your general
Kidney tumours can spread to other organs or distant lymph nodes. This is called metastatic disease. In metastatic disease, the kidney tumour is referred to as the primary tumour and the tumours in other organs are called metastases. Your doctor may recommend to treat metastatic disease with surgery, usually in combination with antiangiogenic therapy, also
What is localised kidney cancer? Localised kidney cancer refers to a tumour which is limited to the kidney and has not extended to other parts of your body. It may be a stage I or II tumour, depending on its size (Fig 1 and 2). If you are diagnosed with localised kidney cancer, your doctor
Active surveillance is a form of treatment for localised kidney cancer in which the doctor actively monitors the tumour. It is recommended if surgery is not the best option for you and you have a tumour in your kidney which is smaller than 4 cm. Some of the reasons why your doctor may say you
Kidney tumours are classified according to their stage, subtype, and the grade of aggressiveness of the tumour cells. These three elements are the basis for your possible treatment pathway. Staging system Tumour stage indicates how advanced the tumour is and whether or not there are metastases in the lymph nodes or other organs. Kidney tumour
Because there are several types of kidney tumours, the doctor does a series of tests to better understand your specific situation. These tests include a medical history, laboratory tests and scans. Sometimes a family history is also taken. A CT scan or MRI scan will reveal the size of the tumour and if it has
In most cases kidney cancer is asymptomatic, which means that there are no clear symptoms to indicate it. Most kidney tumours are found during a routine ultrasound or a similar imaging procedure for other conditions such as back pain. About 1 in 10 people do experience symptoms like pain in the side of the body,
The causes of kidney cancer are often difficult to determine. General risk factors are smoking and obesity. Having a first-degree relative with kidney cancer or high blood pressure are also potential risk factors. Certain lifestyle changes, most importantly quitting smoking and keeping a healthy weight, may reduce the risk of developing kidney cancer.
There are different stages of kidney cancer. If the tumour is limited to the kidney and has not spread, this is called localised kidney cancer. In locally advanced kidney cancer, the tumour has grown out of the kidney into surrounding tissue and invaded veins, the adrenal gland, or lymph nodes. Doctors speak of metastatic disease
Prostate cancer is a malignant tumor in the prostate gland. It is the most common form of cancer in older men. There are various treatment options for localised prostate cancer. Two of the most common ones are radical prostatectomy and radiation therapy. These treatment options can affect sexual health, and men frequently experience erectile dysfunction
What is castration-resistant prostate cancer? Castration-resistant prostate cancer is a type of prostate cancer that usually develops during treatment for metastatic disease. Hormonal therapy either stops the production or blocks the action of androgens. This is known as castration. When effective, hormonal therapy stops the growth of the tumour. This effect will not last and
What is metastatic disease? Prostate cancer can spread to other organs or lymph nodes outside the pelvic area. This is called metastatic disease. The tumours in other organs or lymph nodes are called metastases. Your doctor may recommend treating metastatic disease with hormonal therapy. It is important to realise that metastatic disease cannot be cured.
What is locally-advanced prostate cancer? Locally-advanced prostate cancer refers to a tumour which has spread outside of the prostate. It may be a T3 or T4 tumour, depending on where and how far outside of the prostate it has grown. T3 means that the tumour has grown just outside the prostate or to the seminal
What is localised prostate cancer? Localised prostate cancer refers to a tumour which is limited to the prostate and has not extended to other parts of your body. It may be a T1 or T2 tumour, depending on its size and where it is located in the prostate. T1 means that the tumour is too
PSA testing One of the most frequently used tools to diagnose prostate conditions is a blood test to check the level of prostate specific antigen (PSA). If the PSA level is too high, this suggests that the cells in the prostate are behaving unusually. This could be because of a tumour in the prostate, but also
Prostate cancer is generally asymptomatic, which means that there are no clear symptoms to indicate it. In most cases, symptoms are caused by benign prostatic enlargement (BPE), or an infection. If prostate cancer does cause symptoms it is usually a sign that the disease has advanced. Because of this it is important that you see
There are several known risk factors for prostate cancer, of which age is the most important one. Prostate cancer is rare in men younger than 40 and mostly develops in men over the age of 65. A family history of prostate cancer can increase the risk. This type of cancer is most commonly diagnosed in
Many men who are diagnosed with prostate cancer, or are managing the disease, experience some level of anxiety and/or depression. Caregivers may also be affected. The psychosocial challenges surrounding treatment choices and side effect management can have a negative impact on the prostate cancer journey. Anxiety and depression aren’t always effectively treated, in part because
After any kind of cancer treatment follow-up is essential to minimise complications and to detect and treat recurrences early. After complete removal of the bladder or other treatments, you will be asked to see your general practitioner, urologist, oncologist, radiologist, or a nurse practitioner at specific, fixed time intervals for monitoring and evaluation. A specialist
Local recurrence Local recurrence takes place in the soft tissue where the bladder has been before removal or at the site of the lymph nodes that were removed. This is due to the fact that even after removal of the local pelvic lymph nodes, some nodes are left in place. Most local recurrences appear within
Prognostic factors and treatment decisions If your bladder cancer has spread to another body organ (Fig. 1), treatment is unlikely to cure you. Treatment options are limited to controlling the spread of disease (metastasis) and reducing symptoms. Fig. 1: Metastatic spread. Treatment options for metastatic disease Chemotherapy In 90-95% of bladder cancer cases the histological
What is muscle-invasive bladder cancer? About a quarter of patients diagnosed with bladder cancer have a muscle-invasive form that has grown into the muscular part of the bladder wall (stages T2–T4). This type of cancer has a higher chance of spreading to other parts of the body (metastatic) and needs a different and more radical
What is non-muscle-invasive bladder cancer? Non–muscle-invasive bladder cancer, also called superficial bladder cancer, is a superficial cancer that has not grown into deeper layers of the bladder wall (Fig. 1). There are three subtypes based on how they grow: Stage Ta tumours are confined to the bladder lining. Stage T1 tumours have invaded the connective
Classification Bladder tumours are classified by tumour stage and subtype and by grade of aggressiveness of the tumour cells. Staging is a standard way to describe the extent of cancer spread. The kind of treatment you receive will depend on these elements. Stage and subtype Tumour stage is based on whether or not the cancer
A higher risk does not necessarily mean that someone gets cancer. Sometimes bladder cancer develops without any known cause. It is important to maintain a healthy lifestyle. If you smoke, try to stop. Follow workplace safety rules and avoid exposure to harmful chemicals. Some evidence suggests that drinking a lot of fluids, mainly water, might
The side effects you might have vary from person to person and depend on the cancer drugs you are taking. Side effects can happen as a direct result of medical treatment. All drugs used to treat cancer cause side effects. It can be easy to confuse drug side effects with symptoms of cancer. Symptoms happen
What is the impact of cancer on my life? Getting diagnosed with cancer has a great impact on your life and the lives of your loved ones. It can cause feelings of anxiety, uncertainty, fear, or even depression. Undergoing treatment for cancer is intense and will affect your work and social life. You may worry about
What is a biomarker? Biomarkers are substances that doctors can measure in the body to help them tell if a patient has a disease, how a disease is developing or if a treatment is working. Urine biomarker tests for bladder cancer Early detection of bladder cancer can improve the chance of successful treatment. Therefore, doctors
Your doctor will take a detailed medical history and ask questions about your symptoms. You can help your doctor by preparing for the consultation. Make a list of your previous surgical procedures. Make a list of the medications that you take. Mention other diseases and allergies that you have. Describe your lifestyle, including exercise, smoking,
Blood in the urine is the most common symptom when a bladder tumour is present. Tumours in the bladder lining (non–muscle-invasive) do not cause bladder pain and usually do not present with lower urinary tract symptoms (urge to urinate, irritation). If you have urinary tract symptoms such as painful urination or need to urinate more
What causes bladder cancer? Several biological factors and harmful substances can increase the risk of developing bladder cancer. A higher risk does not necessarily mean that someone gets cancer. Sometimes bladder cancer develops without any known cause. Risk factors for bladder cancer Bladder cancer develops slowly and is more common in older people (age 60
What is bladder cancer? Bladder cancer is the growth of abnormal tissue (tumour) in the bladder. There are several stages of bladder cancer. Your treatment and experience will depend on the specific characteristics of the tumour (referred to as “staging” the tumour) and the expertise of your medical team. This section provides general information about
What is prostate cancer? Prostate cancer is a malignant tumour in the prostate. There are several stages of prostate cancer. Your treatment and experience depend on the specific characteristics of the tumour and the expertise of your medical team. The sections in this series provide general information about prostate cancer, diagnosis, and various treatment options. Discuss
Several biological factors and harmful substances can increase the risk of developing cancer. A higher risk does not necessarily mean that you will get cancer. Sometimes urethral cancer develops without any known cause. Men may have a higher risk of primary urethral cancer if they have had radiation therapy, chronic inflammation, or a sexual transmitted
What is primary urethral cancer? You have been diagnosed with primary urethral cancer. This means you have a cancerous growth (malignant tumour) in your urethra. The urethra carries urine out of the body from the bladder, also known as urinary bladder. In men, the urethra runs through the prostate and the penis (Fig. 1a). In women,
What is kidney cancer? Kidney cancer is a malignant cell growth (a tumour) in the kidneys. Its medical name is renal cell carcinoma. A tumour in the kidney can also be benign (non-cancerous). Kidney cancer is a general term. There are many variations of tumours in the kidney and stages of the disease. Your treatment and
What is penis cancer? Cancer is abnormal cell growth in the skin or organ tissue. When this cell growth starts in the penis, it is called penis cancer or penile cancer. Penis cancer is rare and affects less than 1% of men in Europe. It is more common in men older than age 40, but
A growth called a tumour that starts in the testicle and can spread throughout the body.
A tumour that grows into deeper layers of tissue, adjacent organs, or surrounding muscles.
A tumour that grows on the tissue surface without growing into deeper layers or adjacent organs. This type of cancer represents an early stage.
A tumour that grows from the metastasized cells of primary cancer.
A malignant tumour in the urethra.
The first type of cancer to develop, the cancer of origin.
Cancer that remains in the location where it started.
Abnormal cell growth in the skin or organ tissue
Bladder, kidney and urethral cancer.
A kidney cancer where the tumour is limited to the kidney and has not spread.
A prostate cancer where the tumour is limited to the prostate and has not spread.
A cancer where the tumour has grown out of the kidneys into surrounding tissue and invaded veins, the adrenal gland, or lymph nodes.
A prostate cancer where the tumour has spread outside of the prostate and into surrounding tissue.
A type of prostate cancer that needs lower levels of androgens to continue to grow.
Follow-up After penis cancer treatment, your doctor will schedule you for regular visits to check your progress. Visits will be more frequent in the first year or two after surgery and then less often over time. Your doctor will talk with you about how you’re feeling and any symptoms or concerns. A physical exam will
If a tumour has grown into surrounding tissue, removing it surgically is the best chance of cure. If the tumour is in your penis tissue, some or all of your penis might need to be removed to get rid of the cancer. A recommendation of penectomy raises many questions. Talk with your doctor about your
Sexual Health: Maintaining Closeness after Prostate Cancer A prostate cancer diagnosis can be overwhelming and devastating for men and their partners. Since the prostate is part of the sexual system, treatment of prostate cancer may result in sexual dysfunction. Sexual dysfunction is often identified as the most common long term side effect after prostate cancer
It’s common for people to experience anxiety or depression due to prostate cancer; and it’s not confined to only the man with the disease. Prostate cancer can have a negative psychological impact on the caregiver/wife or partner of the man with prostate cancer, as well as his family members and close friends. A cancer diagnosis
If your urethral cancer has come back after treatment or has spread to other organs, you may be referred to centres where clinical trials are available. These experimental studies are typically designed to test how a treatment works among patients with specific characteristics. Your doctor will provide all information you might need before participating in
Hormonal therapy with abiraterone acetate The body needs an enzyme called CYP17 (17α-hydroxylase) to produce testosterone. CYP17 is found in the testicles, adrenal glands, and prostate cancer cells. The new hormonal agent abiraterone acetate blocks CYP17 so that no testosterone is produced. Treatment with abiraterone acetate aims to slow the growth of the tumour and
When you have been treated with either surgical or chemical castration, your doctor may recommend additional treatment with anti-androgen therapy. The most common anti-androgen drug to manage castration-resistant prostate cancer is bicalutamide. Treatment with this drug aims to slow down the growth of the tumour. It will not relieve your symptoms. Side effects may include
Photodynamic diagnosis (PDD) is available at some centres. PDD makes cancer cells visible under violet light. This makes abnormal growths (tumours) easier to find and remove. More complete removal reduces the risk of cancer coming back. PDD is used in urology to test for bladder cancer. A catheter is inserted through the urethra and into