About Genitourinary (GU) Cancer

What is genitourinary cancer?

Genitourinary (GU) cancers is a specialised field focusing on cancers found in the urinary system and the male reproductive system. These include prostate cancer, renal cancer, bladder cancer, testicular and cancer of the penis.

Prostate cancer

Types of prostate cancer
Adenocarcinoma – 99% of Prostate cancer

Early warning signs of prostate cancer

• Burning or pain during urination
• Difficulty urinating or trouble starting and stopping whilst urinating
• Nocturia
• Loss of bladder control
• Decreased flow or velocity of urine stream
• Blood in urine (Haematuria)
• Blood in semen

About Prostate cancer

Incidence

Each year in New Zealand approximately 3,000 men are diagnosed with prostate cancer and approximately 600 men die from the disease; 80% of diagnoses are for men aged 60 years or more. 4 in every 100 male deaths are due to Prostate cancer

Survival rates

The 5 year survival rate for most men with local or regional prostate cancer is nearly 100%. For men diagnosed with prostate cancer that has spread to other parts of the body the 5 year survival rate is 30%.

Potential risk factors

• Age – Prostate cancer mainly affects men over the age of 50 and the risk increases with age
• Family history – chance of prostate cancer is doubled if father or brother has a history of prostate cancer

Bladder/urothelial cancer

Urothelial cancers encompass carcinomas of the bladder, ureters and renal pelvis. Patients with cancer of the upper urinary tract have a 30 – 50% chance of developing cancer of the bladder at some point in their lives.

About Bladder/urothelial cancer

Types of bladder cancer

• Non muscle invasive bladder cancer (Superficial bladder cancer) – tumours found in the inner lining of the bladder, the urothelium or in the lamina propria.
• Muscle invasive bladder cancer – cancer has spread beyond the urothelium and lamina propria into the muscle (muscularis propria) or surrounding fatty tissue (perivesical tissue).
  
  

Histological types of bladder cancer

• Urothelial cancer – 80 – 90% start in urothelial cells lining the bladder wall. Sometimes called TCC.
• Squamous cell carcinoma – accounts for 1 – 2% of all bladder cancer and more likely to be invasive.
• Adenocarcinoma – accounts for about 1% of all cases and likely to be invasive.
  
  

Incidence

The incidence of bladder cancer at 65 years and above is nearly six times higher than at 45 – 64 years and the mortality is 12 times higher in the older age group.

Survival rates

The general 5 year survival rate for people with bladder cancer is 77%. The overall 10 year survival rate is 70% and 15 year survival rate is 65%. Survival rates depend on type and stage of bladder cancer when diagnosed.

Potential risk factors
Cause not always clear, but the risk of developing bladder cancer increases with:

• Older age
• Smoking
• Gender – men are 3 – 4 times more likely to develop bladder cancer 
• Chronic urinary tract infections
• Unsafe exposure to some industrial chemicals
• Signs of bladder cancer
• Blood in urine (Haematuria)
• Urinary frequency or urgency
• Pain on urination

Testicular cancer

Types of cancer
In men under 60, 95% of testicular tumours originate in the germ cells. These tumours fall into one of two types:

• Seminoma
• Nonseminoma

About Testicular cancer

Incidence

According to New Zealand MoH statistics, 137 cases of testicular cancer were diagnosed in NZ in 2013 (34 Maori) and 6 men died from their cancer.

Survival rates

Now almost 90% of men with metastatic disease are cured of their cancer. The survival rate for men diagnosed with Stage 1 seminoma is about 99%. The survival rate for Stage 1 non-seminoma is about 98%.

Potential risk factors:

• Cause unknown
• Risk is higher than average if born with undescended testicles or cryptorchidism
• In NZ risk is higher in Maori population although cause unknown
  
  

Signs or symptoms of testicular cancer

• Painless lump found in either testicle
• Feeling of heaviness in the scrotum
• Swelling of the scrotum
• Pain, discomfort or numbness in a testicle or the scrotum with or without swelling
• Dull ache in the lower abdomen or groin
• Swollen lymph nodes
• Lower back pain
• Weight loss
• Fatigue

Canopy Cancer GU tumour team

The Canopy genitourinary team is made up of a group of medical oncologists focused on the cancers of the urinary system and male reproductive organs. This team is made up of Dr Fritha Hanning, Peter Fong, Osama Salih and Carmel Jacobs in Auckland; Drs Vince Newton in Whangarei and Richard North, Michelle Head and Elliot Brenman in Tauranga and Alistair Wickham and Prashanth Hari Dass in Rotorua.

The team is supported by specialist genitourinary nurses Karen Nolan and Samantha James. If you have an adult or young adult patient with a GU cancer, please contact Canopy Cancer Care with a referral to the GU team.

Canopy specialises in the care of patients requiring intensive surveillance, treatment with hormone therapy, chemotherapy and immunotherapy therapies.