Conditions

Prostate Cancer

Prostate cancer occurs when some of the cells of the prostate reproduce far more rapidly than in a normal prostate, causing a swelling or tumour.  Prostate cancer is usually one of the slower growing cancers. Each year in Australia prostate cancer accounts for approximately 30% of cancers diagnosed in men. At present one man in eleven will develop prostate cancer in their lifetime.

Many have heard the old saying “most men die with, not of, prostate cancer” however a number of things have changed and this is no longer the case. Prostate cancer is being detected in younger men and men are living longer thus giving the cancer more time to spread. Also the prostate cancer detected in our younger men tends to be more aggressive and hence more life-threatening. Left untreated prostate cancer cells eventually escape out of the prostate and invade distant parts of the body, particularly the bones and lymph nodes.

Provided appropriate treatment commences while the cancer is still confined to the prostate gland, it is possible for “cure”.. The possibility of cure is the main reason why early diagnosis is very important. Prostate cancer has one of the highest 5-year survival rates of 92% after diagnosis4.

All men should be aware of their risk of the disease and consider being tested for it regularly from age 50 onwards, or from 40 onwards if there is a family history of prostate cancer.

Benign Prostate Disease

Benign Prostatic Hyperplasia (BPH) is a type of prostate disease quite common in older men that refers to an enlarged prostate. It is a benign condition which means it is NOT cancerous. Some enlargement of the prostate occurs in most men as they age particularly 50 onwards. Changes in urination are noticed when the enlarged prostate constricts the urethra (water pipe) and causes reduction in flow. BPH is not life threatening and there are a number of options for treatment from lifestyle changes to medicines to surgery.

Bladder Cancer

Bladder cancer is a less commonly known cancer. It most often becomes apparent when blood is passed in the urine. Sometimes it shows up on imaging studies, including ultrasound or CT scan, and often needs diagnostic testing, which is known as a cystoscopy, where a telescope is passed into the bladder to visually examine the bladder. Most bladder cancer can be treated by endoscopic techniques. When advanced, however, the bladder would need to be removed. This is referred to as cystectomy.

Kidney Cancer

Kidney cancer occurs in the cells of the kidney and is caused by the rapid abnormal overgrowth of these cells. These tumours begin small and grow larger over time usually growing as a single mass but more than one tumour may occur in one or both kidneys. Kidney cancer is mostly a disease seen in adults over 55 years of age and is rare in children.

Tumours  can be benign (not cancerous) or malignant (cancerous). Benign tumours do not spread or metastasize to other parts of the body.

Malignant tumours  may spread into surrounding tissue and to other parts of the body thus early treatment is necessary. Improved outcomes for kidney cancer are due to increases in detection and early treatment.

Kidney cancer is one of the ten most common cancers diagnosed in Australia.The most common kind of kidney cancer is known as renal cell carcinoma and accounts for approx 85%

Other types of kidney cancers include:

Transitional Cell carcinoma (TCC)

Renal Cell Sarcoma (rare) and

Wilms Tumour ( rare childhood cancer)

The cause of kidney cancer is unknown however there are some factors that put some people at higher risk. These include:

Smoking ( up to 1/3 rd of kidney cancers are thought to be due to smoking)

Overuse of analgesia containing phenacetin(no longer available)

Cadmium or asbestos exposure

Family history                   and

Being male (more likely to develop in men than women)

 

Symptoms may include:

Blood in urine

Pain or dull aching(Lower back or side)

Lump in abdomen

Constant tiredness

Unexpalined weight loss

Unexplained fever

Unfortunately in the early stages there may be no symptoms.

The main treatment for kidney cancer is surgery which may involve removal of the whole kidney known as Radical Nephrectomy or removal of part of the kidney known as Partial Nephrectomy

Surgery may be done as a stand alone procedure but is can also be done in combination with chemotherapy and /or radiotherapy.

Other treatments include Immunotherapy and tyrosine kinase inhibitors.

Prognosis in Australia for kidney cancer is 72% however it varies depending on age and health of the patient and also on the type and stage of cancer at diagnosis. Remember the earlier the diagnosis the better the prognosis.

Kidney Stone Disease

Kidney stones are also known as renal stones or renal calculi.  In the medical field kidney stone disease is known as nephrolithiasis and urolithiasis.  In most cases kidney stones are formed because of a decrease in urine production (thus more common in summer) or  increase in the minerals that form the stones in the urine and or lower than normal levels of chemicals that breakdown minerals in the urine.

Around 1 in 20 people have trouble with kidney stone disease and it is more common in men than women at 3:1. About half the people who get kidney stones once will get them again.

Stones vary in size from small grains of sand to as large as a golf ball and  while some kidney stones may pass through the urinary tract with little problem, there are times when a kidney stone causes great pain and cannot pass through the urinary tract without medical help. It is important to determine the type of kidney stone you have to allow best treatment and removal.

Some of the treatments for kidney stones include:

ESWL –  Shock waves that are sent directly to the kidney stone.  This breaks the stone in pieces small enough so that you will be able to pass them in your urine.

Nephrolithotomy, or percutaneous (meaning “through the skin”) is when a small incision is made  in your back and removes the kidney stone using a special scope called a nephroscope which is placed into the kidney. The stones are broken up with sound waves and then suctioned through the tube

Ureteroscopic kidney stone removal is a procedure that uses a scope passed through the bladder to remove a stone that is stuck in the ureter (the tube that carries urine from the kidney to the bladder). The ureteroscope is a tool that goes up the bladder to the ureter and kidney to where the kidney stone is located. Sometimes, ultrasound (ultrasonic lithotripsy), lasers or electrohydraulic lithotripsy is used directly through the scope to shatter the kidney stone.

Prevention of kidney stones and recurrence of stones is through changes in lifestyle especially in drinking, eating and exercise habits.

Urinary Tract Bleeding

Blood in the urine should always be taken seriously while sometimes bleeding in the urinary tract may be due to a non-serious condition, at other times it may suggest physical problems with the urinary tract, including stones as well as cancers of the kidney, bladder or prostate gland. The kidneys can form growths on them, they can include fluid filled structures called cysts, which are usually not serious, although sometimes kidney cysts are serious and will require either repeated observation with imaging or surgery. In addition, solid tumours of the kidney are quite often cancerous and require surgery. Surgery can involve removing only part of the kidney (partial nephrectomy) or the whole kidney. Most kidney surgery is now performed with telescopic techniques.

Vasectomy

Vasectomy is a surgical procedure for males for permanent birth control.  Some refer to this as male sterilisation. During the procedure, the vas deferens (tubes which carry sperm) are severed and then tied or sealed to prevent sperm from entering into the ejaculate. Vasectomies are now usually performed in hospital under an anaesthetic by an urologist. This is a relatively simple procedure and most men can resume normal activities with little discomfort in about a week.

It is important to understand that this is a permanent method of birth control and not easily reversed so men are advised to consider how this procedure will affect them in the long term and this decision should not be made lightly.

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