UROLOGICAL CANCERS

By DR NUSRAT JABEENGeneral Practitioner

05-07-15

• Bladder cancer• Prostate Cancer-most common cancer of men

in UK• Renal cancer

PROSTATE CANCER

SYMPTOMS• Most men do not have any symptoms• Some have urinary problems, particularly as

the cancer advances blocking the urethra-which causes straining while passing urine, increased frequency and feeling that the bladder has not fully emptied

• Some have new onset backpain-pain in hip and pelvis

Risk of prostate cancer• Age is a risk factor• Cancer of elderly, if you are under 50, risk of

prostate cancer is very low• I in 8 men in uk will have prostate cancer• Risk increases if there is a family history of

prostate cancer• Black men-more prostate cancer

NICE GUIDELINES

any of the following symptoms could be prostate cancer

• erectile dysfunction • haematuria • lower back pain • bone pain • weight loss, especially in the elderly. These

patients should also be offered a DRE and a PSA

• Rectal examination-hard irregular prostate• Blood test for rising pSA• refer

BLADDER AND RENAL CANCERS

• Painless passing of BLOOD in urine-blood which can be seen by the naked eye-most common symptom

• ABDOMINAL MASS• Microscopic blood in urine( which cannot be seen

by the naked eye)-above 50 yrs of age should be referred; in people less than 50 yrs of age, blood test should be done to establish kidney function test, urinary ACR and the results will decide the next step of management.

RENAL CANCER

• Blood in urine• Recurrent urinary tract infection• Persistent microscopic blood in urine• Pain on the side below the ribs• Vague symptoms like loss of weight and

tiredness

EARLY SIGNS OF CANCER

By Dr Rana NabiGeneral Practitioner in Slough

BOWEL CANCER

• Colorectal Cancer-very common• Stomach cancer -uncommon

COLORECTAL CANCER

• Bowel cancer is cancer of the colon and rectum• Most bowel cancers start as innocent growth-polyps• Most of the polyps are benign• Some may become cancerous• Cancer cells multiply to form tumors which may

cause pain , bleeding and other symptoms• It can spread to other parts like liver and lungs

RISK FACTORS OF BOWEL CANCER• age – almost nine in 10 cases of bowel cancer occur in people

aged 60 or over• diet – a diet high in red or processed meats and low in fibre can

increase your risk• weight – bowel cancer is more common in people who are

overweight or obese• exercise – being inactive increases the risk of getting bowel cancer• alcohol and smoking – a high alcohol intake and smoking may

increase your chances of getting bowel cancer• family history – having a close relative (mother or father, brother

or sister) who developed bowel cancer below 50 years of age puts you at a greater lifetime risk of developing the condition

WARNING SIGNS

• About 9/10 people diagnosed with bowel cancer are over 60yrs

• A persistent change in bowel habit, especially going to the toilet more or experiencing looser stools for more than three weeks.

• persistent, severe abdominal pain or a lump in your tummy (abdomen).

• Weight loss and tiredness (a symptom of anaemia).

NICE GUIDELINE ABOUT COLORECTAL CANCER

• 40 years and older, rectal bleeding with a change of bowel habit towards looser stools and/or increased stool frequency persisting for 6 weeks

• 60 years and older, with rectal bleeding persisting for 6 weeks or more without a change in bowel habit and without anal symptoms

• right lower abdominal mass consistent with involvement of the large bowel

• a palpable rectal mass (intraluminal and not pelvic), an urgent referral should be made

• In men of any age with unexplained iron deficiency anaemia and a haemoglobin of 11 g/100 ml or below,

• In non-menstruating women with unexplained iron deficiency anaemia and a haemoglobin of 10 g/100

NHS Screening programme

• NHS Bowel Cancer Screening Programme 60 to 74• People over 75 and above can request a screening kit by

calling the freephone helpline below.• The programme should start within a few days of your 60th

birthday and continue automatically, provided you are registered with a GP practice and they have an accurate record of your home address. If you are within the screening age range and have not yet received your first test kit, please contact the national helpline to request one.

• More information is available from www.cancerscreening.nhs.uk or call 0800 707 60 60 FREE.

• Like all screening tests, the FOB test is not 100% reliable.

• There is a chance that the cancer can be missed if it was not bleeding when you did the test.

• Bowel cancer may start to develop in the two years between screening tests, so be aware of the symptoms and see your GP if concerned.

• questions regarding diagnosis• What kind of cancer do I have?• Has it spread to other parts of my body? If so, where?• What is the stage and grade of my cancer, and what does this mean

for me?• What is your opinion about the best course of action for me?• What is your experience of treating my kind of cancer?• Do I have a designated colorectal specialist nurse and how can I contact

him / her?• Questions regarding tests• Are there any further tests that I need to have?• What will they tell us? When will I have them?• How and when will I be told about the results of the tests?

Stomach cancer• Uncommon cancer Some of the increased risk factors• being aged 55 or older• being male• smoking• eating a diet that contains a lot of salted and

pickled foods• having an infection in your stomach due to a type

of bacteria known as Helicobacter pylori (H. pylori)

SYMPTOMS AND SIGNS OF STOMACH CANCER

• persistent indigestion and heartburn ( dyspeptic symptoms)

• trapped wind and frequent burping• feeling very full or bloated after meals• persistent stomach pain• Symptoms of advanced stomach cancer can include:• blood in your stools, or black stools• loss of appetite• weight loss

NICE GUIDELINE

• An urgent referral for endoscopy • any age with dyspepsia • chronic gastrointestinal bleeding • dysphagia • progressive unintentional weight loss• persistent vomiting • iron deficiency anaemia• epigastric mass • suspicious barium meal. • In patients aged 55 years and older with unexplained and persistent

recent-onset dyspepsia alone, an urgent referral for endoscopy should be made

IN PATIENTS WITHOUT DYSPEPSIA• but with unexplained weight loss with or without iron deficiency

anaemia, the possibility of upper gastrointestinal cancer should be recognised and an urgent referral for further investigation considered.

• In patients with persistent vomiting and weight loss in the absence of dyspepsia

• unexplained upper abdominal pain and weight loss, with or without back pain

• an upper abdominal mass without dyspepsia. • In patients with obstructive jaundice an urgent referral should be

made, depending on the patient’s clinical state. An urgent ultrasound investigation may

• In patients presenting with dysphagia (interference with the swallowing mechanism that occurs within 5 seconds

LUNG CANCER

RISK FACTORS

• 2nd most common cancer in UK• SMOKING –COMMONEST CAUSE OF LUNG

CANCER-cigarettes/cigar/sheesh/roll ups• Exposure to certain chemicals-asbestos• FH of lung cancer• Lung disease• Past cancer • Poor immunity

STOP SMOKINGMost important change that you can make

Signs and symptoms

• Blood in phlegm-urgent chest CXR• Persistent new cough• Change in cough symptoms you had for a long

time• Shortness of breath• Tiredness/losing weight• Ache or pain when breathing or coughing

Other signs and symptoms of lung cancer

• Cough with or without any of the following symptoms

• Pain in shoulder /chest• Difficulty breathing• Unexplained changes to your symptoms from a

lung disease you already have• Hoarse voice• Difficulty swallowing• Swelling of face and neck