Genitourinary cancer and other solid tumors

What it is

Each one behaves differently. Kidney cancer these days is often discovered incidentally, on an ultrasound or CT scan done for another reason. Bladder cancer usually announces itself with blood in the urine. Testicular cancer has an important particularity: it mostly affects young men, ages 15 to 35, and is usually noticed as a small lump or an increase in the size of one testicle, almost always painless.

Although they are different diseases, they share the same message: changes in your urine and changes in your testicles are nothing to be embarrassed about — they are a reason to see a doctor. Caught in time, these tumors have more treatment options.

Risk factors

Kidney

• Smoking.
• Obesity and high blood pressure.
• Family history of kidney cancer and some uncommon inherited conditions.
• Advanced kidney disease with long-term dialysis.

Bladder

• Smoking (the most important factor: the chemicals in smoke become concentrated in the urine).
• Workplace exposure to certain chemicals (dyes, rubber, paints, leather tanning).
• Chronic bladder irritation and repeated urinary infections.
• Age over 55; more common in men.

Testicle

• An undescended testicle in childhood (cryptorchidism), even if it was corrected with surgery.
• A family history (father or brother) or personal history of testicular cancer.
• Age between 15 and 35.

Warning signs / common symptoms

• Blood in the urine (visible to the naked eye or found on a test), with or without pain.
• Burning, urgency, or urinating more often that does not improve with treatment for an infection.
• Persistent pain in one side or the lower back, or a mass you can feel in the abdomen.
• A small lump, hardening, or increase in the size of one testicle, almost always painless.
• A feeling of heaviness in the scrotum or a dull ache in the groin or lower abdomen.
• Tiredness, weight loss, or fever without explanation.

These problems can come from urinary infections, stones, cysts, or other common causes that are not cancer. Only a doctor can evaluate them. If you notice blood in your urine or a change in a testicle, do not let it go: come in for an evaluation.

How it is detected and diagnosed

The path begins at the consultation, with your medical history and a physical exam. Depending on the case, tests are ordered: a urine test, ultrasound, CT scan, and blood tests (for the testicle, certain indicators called tumor markers are also measured, which help with diagnosis and follow-up).

For the kidney and bladder, diagnosis may require a biopsy or an endoscopic evaluation of the bladder (cystoscopy) in coordination with urology. For the testicle, a biopsy through the scrotum is not done: when suspicion is firm, the diagnosis is confirmed with the surgery that removes the affected testicle through the groin, which is also the first treatment. The Unidad de Oncología Menonita performs the evaluation appointment, the appropriate biopsies, and the necessary tests, and coordinates with other specialists when the case requires it.

Treatment options

Treatment depends on the organ affected, the type of tumor, and its extent. The unit offers:

• Cancer surgery: the foundation of treatment in many cases of kidney (removing the tumor or the affected kidney), bladder, and testicular cancer (orchiectomy through the groin).
• Chemotherapy: especially relevant in testicular cancer and in certain bladder cases.
• Immunotherapy: a current option for selected kidney and bladder cases.
• Targeted therapy: medicines used mainly in advanced kidney cancer.
• Palliative care: symptom control and support at any stage.

Being honest about referrals: some cases require treatments not performed at the unit, such as radiation therapy (for example, in certain testicular or bladder tumors) or highly specialized urologic surgeries. In those cases, the patient is referred to Chihuahua City or another appropriate center, and the unit's team coordinates the referral and keeps following the complete treatment.

Early detection / prevention

• Not smoking lowers the risk of kidney cancer and, very significantly, of bladder cancer.
• Keeping a healthy weight and controlling blood pressure protects the kidneys.
• When working with industrial chemicals, use the recommended protective equipment.
• Testicular self-exam: starting in adolescence, men are advised to check their testicles once a month (after a bath or shower, with the skin relaxed), looking for lumps, hardening, or changes in size. It does not replace a consultation: any change should be evaluated by a doctor.
• There is no population-wide screening test for kidney or bladder cancer; when there is blood in the urine, a timely medical evaluation is the key measure.

Frequently asked questions

Is blood in the urine always cancer? No. It is often caused by infections or stones. But it should never be ignored, even if it appears only once and does not hurt: come in for an evaluation.

Does a lump in the testicle hurt if it is something bad? Usually not: most testicular tumors do not hurt at first. That is why the monthly self-exam and a timely consultation are so important.

Does testicular cancer treatment affect fertility? It can in some cases, depending on the treatment needed. Each situation is explained in consultation and, when possible, guidance is given on options to preserve fertility before starting treatment.

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