February / 2000
Your Health

Surviving urologic cancers
by: Maureen McArthur

  In October 1996, cyclist Lance Armstrong was diagnosed with testicular cancer. Because he did not recognize the early signs of the disease, the cancer had spread to his lungs and brain. He was told he only had a 50 percent chance of beating the disease. 
Armstrong is lucky. The cancer has not recurred, and he staged a miracle comeback, winning the 1999 Tour de France. If his disease had been detected earlier, not only would his chances of surviving have been better, but he also might have avoided some or all of the chemotherapy he underwent.

  "Urologic cancers, which include prostate, penile, testicular, bladder, and kidney cancers, may not be as well-known or discussed as breast or skin cancer, but less public knowledge does not mean that all urologic cancers occur less frequently than breast or skin cancer," says Randall Rowland, M.D., chief, division of urologic surgery, University of Kentucky College of Medicine, and director of the Multidisciplinary Urologic Cancer Program at the UK Markey Cancer Center. 

  Some urologic cancers are not rare at all. Bladder cancer is the sixth most common cancer in the United States, with about 54,200 new cases in 1999. After skin cancer, prostate cancer is the most common cancer of American men, and is the second leading cause of cancer death in men after lung cancer.

  The less common urologic cancers still present risks, particularly to certain groups. About 7,400 new cases of testicular cancer are expected to have been diagnosed in the United States in 1999. The testicular cancer risk for white American men is about four times that of African-American men, and the risk among white Americans has more than doubled over the last 40 years. About 17,800 men and 12,200 women are expected to have been diagnosed with kidney cancer in the United States in 1999. 

  "The most important thing to remember about all urologic cancers is that patients have a better chance of beating the disease, and often undergo treatments that are less likely to result in significant side effects or complications, when the disease is caught early," Rowland says.

  Unfortunately, it is not always easy to diagnose urologic cancers at an early stage, Rowland says. But recognizing the possible symptoms and promptly consulting a physician can help.

Urologic cancer warning signs
  Symptoms of urologic cancer may also be present with other diseases or problems. Exams by your physician are the only way to distinguish cancer and noncancerous conditions with similar symptoms. Here's what to watch for: 

  Bladder cancer: Blood in the urine and changes in bladder habits, such as frequent urination or burning on urination.

Prostate cancer: Most cases of early prostate cancer cause no symptoms and are found through early screening tests. Some prostate cancers may be found because of symptoms such as slowing or weakening of the urinary stream or the need to urinate more often. Symptoms of advanced prostate cancer most frequently include pain in the pelvis, spine, hips, or ribs, and loss of appetite with weight loss.

  Penile cancer: Men should be alert in recognizing abnormal growths or other abnormalities of their penis. See a physician if you detect warts, blisters, sores, ulcers, white patches, rashes, flat growths that are bluish-brown in color, or a persistent discharge beneath the foreskin.

  Testicular cancer: In about 90 percent of cases, men have a lump on a testicle that may or may not be painful. They also may notice testicular enlargement or swelling. Men with testicular cancer may feel a sensation of heaviness or aching in the lower abdomen or scrotum.

  Kidney cancer: Blood in the urine is the most common symptom of kidney cancer. Other symptoms include low back pain not associated with injury; a mass or lump in the side; fatigue; weight loss that is rapid or not intentional; fever not associated with a cold, flu, or other infection; swelling of ankles and legs; and high blood pressure.

Maureen McArthur is a senior information specialist with the University of Kentucky Chandler Medical Center, Office of Public Relations.