CONDITIONS
Cancers of the urinary tract, that is, of the kidneys, the bladder and the prostate, differ in their causes, symptoms and treatments. One thing connects them. Early diagnosis and appropriate treatment determine the prognosis.
Kidney cancer
Kidney cancer usually gives no symptoms until an advanced stage. Many tumours are discovered by chance on an ultrasound or CT scan done for another reason.
Symptoms
- Blood in the urine (haematuria)
- Pain in the lower back or side that does not go away
- Unexplained weight loss, fever, night sweats
- Fatigue, weakness, nausea
- A palpable mass
Diagnosis
- Ultrasound and CT scan
- MRI for detailed imaging
- Kidney biopsy when confirmation is needed
- Blood and urine tests
Treatment of kidney cancer
| Treatment | What it involves | Result and recovery |
|---|---|---|
| Surgery | Partial or radical nephrectomy, with the adrenal gland on the same side and the lymph nodes when needed. Laparoscopic, robotic or open. | Highly effective at the early stages. Laparoscopic and robotic techniques mean less pain and faster recovery than the open method. |
| Immunotherapy | Drugs that boost the immune system, by injection or by mouth. | Main treatment of advanced disease. Usually mild side effects. |
| Targeted therapy | Drugs that attack specific mechanisms of the tumour, often combined with immunotherapy. | Highly effective at the advanced stages, manageable side effects. |
| Radiotherapy | Rays to destroy cancer cells. | Mainly for symptom relief. Fatigue and skin irritation. |
Bladder cancer
The main symptom is haematuria. Blood in the urine is not always visible to the naked eye, is not accompanied by pain and is often intermittent, which reassures patients and delays the visit to the urologist. Every episode of haematuria needs investigation.
Symptoms
Beyond haematuria, more rarely:
- Frequent and urgent urination
- Persistent pain when urinating
- Pain or heaviness in the kidney area, the pelvis or the spine
- Recurrent urinary infections in middle and old age
- Weakness, exhaustion, weight loss
Diagnosis
- Cystoscopy, examination of the bladder with a camera
- CT scan, ultrasound of the kidneys, bladder and prostate, MRI in selected cases
- Urine cytology and biomarkers
- Full blood count, urea, creatinine, sedimentation rate
Treatment of bladder cancer
| Treatment | What it involves | Result and recovery |
|---|---|---|
| Surgery | Transurethral resection of the tumour or, in muscle-invasive disease, cystectomy, often robot-assisted. | Very high effectiveness at the early stages. After cystectomy, adjustment to a new way of urinating is required. |
| Intravesical therapy | Drugs instilled directly into the bladder through a catheter, such as BCG. | Highly effective in non-invasive cancer, mild side effects. |
| Chemotherapy | Before or after surgery, or in metastatic disease. | Depends on the stage. Nausea, fatigue. |
| Immunotherapy | Newer immunotherapies that activate the immune system against the tumour. | Encouraging results in many cases of advanced disease. |
Non-muscle-invasive cancer of low or intermediate risk, with proper follow-up by the urologist, allows many good years of life. Aggressive non-muscle-invasive and muscle-invasive cancer require prompt radical treatment, to avoid local spread and metastases.
Prostate cancer
Prostate cancer gives no symptoms at the early stages. This is why men over 50, and younger men with a family history, need regular screening. When the disease has spread, bone pain is added.
Symptoms
- Frequent urination, especially at night
- Difficulty starting or stopping urination, a thin or interrupted stream
- Burning in the urethra when urinating
- Blood in the urine or semen, painful ejaculation
- Pain in the back, hips or pelvis
Diagnosis
After the first visit to the urologist:
- PSA test, the prostate-specific antigen in the blood
- Digital rectal examination
- Prostate MRI
- Prostate biopsy, guided by imaging
- CT or bone scan for staging
Treatment of prostate cancer
| Treatment | What it involves | Result and recovery |
|---|---|---|
| Active surveillance | For low-risk cancer. Regular PSA measurements, imaging and biopsies. | Avoids the side effects of treatment as long as the disease remains indolent. |
| Surgery | Radical prostatectomy, laparoscopic or robotic. | Highly effective in localised cancer. Incontinence or erectile dysfunction are minimised with the robotic technique. |
| Radiotherapy | External beam radiation or brachytherapy with the implantation of radioactive seeds. | Comparable to surgery in early cancer. Mild side effects, fatigue or irritation. |
| Hormone therapy | Lowering testosterone to slow the disease. | Main treatment at the advanced stages. Loss of muscle mass, fatigue. |
| Chemotherapy and newer drugs | Chemotherapy, new anti-androgen agents, targeted therapies. | In advanced disease, usually in combination. Nausea, weakness. |
Prevention and early diagnosis
Every cancer of the urinary tract is different, but in all of them prevention and early diagnosis determine the outcome. As soon as you notice any of the above symptoms, and especially blood in the urine, see your urologist. Treatment is planned jointly by the urologist and the oncology team.
Your care at the 4th Oncology Clinic
Every case is discussed at the Clinic’s tumour board, where medical oncologists, surgeons, radiation oncologists, radiologists and pathologists jointly design the personalised treatment plan. Our patients have access to new treatments through the Clinical Trials Centre and, where there is a family history, to genetic counselling. Meet our team or contact us for an appointment.
Kidney, Bladder and Prostate Cancer
Book an appointment
Appointments: 210 48 09 150, 210 48 09 160
Daily 08:00 to 16:00
oncology.clinic4@gmail.com