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Bladder cancer
Types of bladder cancer
Bladder cancers can be non-muscle invasive or muscle invasive.
Cancer Research UK has detailed information on the different types of bladder cancer.
Investigations and diagnosis
You may be sent for a number of investigations at Belfast City Hospital or the Mater Hospital.
Cancer Research UK has detailed information on the different tests to diagnose bladder cancer.
If you are diagnosed with bladder cancer, you will be able to discuss the diagnosis with your consultant. Your results will also be discussed by the urological cancer multi-disciplinary team.
Treatment
Macmillan has a range of information on treatment for bladder cancer.
Pre-assessment clinic
You may be asked to attend an appointment with a member of the anaesthetic team for a pre-assessment before surgery. This is to ensure you are fit to undergo the treatment.
Surgery
For many patients with bladder cancer, surgery may be the most appropriate treatment. Your stay in hospital is likely to be 10 to 12 days.
Surgery for bladder cancer is a major operation and it can take a number of weeks to recover.
Types of surgery:
- Transurethral resection of bladder tumour (TURBT): This removes any unusual growths or tumours on the bladder wall.
- Partial cystectomy: This removes part of the bladder.
- Radical cystectomy: This removes all the bladder. It is the main treatment for muscle invasive bladder cancer and is occasionally followed by radiotherapy. Patients who have this procedure will have a new area created by the surgeon for storing urine. You may have a:
- urostomy (ileal conduit) – bag outside your body to collect urine
- continent urinary diversion – pouch to collect urine
- bladder reconstruction – new bladder made
- recto sigmoid pouch – pouch made from your back passage
Chemotherapy
Macmillan has comprehensive information on chemotherapy for bladder cancer.
Radiotherapy
Macmillan has comprehensive information on radiotherapy for bladder cancer.
Symptom control
Following treatment, you will be encouraged to self-manage as soon as you can, with guidance from the stoma nurse and ward nursing staff.
At first, the stoma will be slightly swollen and it can take several weeks for it to settle down to its normal size.
The nursing staff will help you look after the urostomy if one has been formed and will encourage emptying and changing of the bag as often as necessary.
When changing the bag, you should allow yourself plenty of time and privacy.
Before you leave hospital, the nurse will make sure you have a good supply of urostomy bags. You can get further supplies from a chemist. It may be a good idea to order in advance. The stoma nurse can also organise delivery to your home.
Follow-up
After your treatment is complete, you will be asked to return to the hospital for follow-up appointments.
These review appointments allow us to check the progress of your recovery. They are also an opportunity for you to discuss any concerns you may have.
If you have any problems or notice any new symptoms in between review appointments, contact your urology clinical nurse specialist, consultant or GP. You may need additional treatment or rehabilitation services.
Useful links
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Penile cancer
Types
Penile cancer is known as carcinoma of the penis.
Like many cancers, penile cancer is graded on its severity. The grade will determine the treatment options available.
Treatment
Macmillan has a range of information on treatment for penile cancer.
There are several surgical procedures used to treat penile cancer:
- wide local excision – removes the tumour and some of the healthy tissue surrounding the tumour
- microsurgery – removes the tumour and as little of the surrounding healthy tissue as possible
- laser surgery – uses a laser light to burn or cut away cancerous cells
- circumcision – removes a cancerous foreskin
- penectomy – total removal of the penis (and lymph nodes if the cancer has spread)
Penile cancer may also be treated with radiotherapy or chemotherapy.
Useful links
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Prostate cancer
Types of prostate cancer
There are several types of prostate cancer:
- localised prostate cancer: this is contained within the prostate gland
- locally advanced prostate cancer: this has spread to the area just outside the prostate gland
- advanced prostate cancer: this has spread outside the prostate gland to other parts of the body
Investigations and diagnosis
There are several investigations that can diagnose prostate cancer:
- prostate specific antigen (PSA) test
- rectal examination
- trans-rectal ultrasound (TRUS) biopsy
- multi-parametric MRI scan
- bone scan
When your investigations have been completed, your results will be discussed at the multi-disciplinary team meeting. You will then be referred to see a consultant urologist.
Treatment
Macmillan has a range of information on treatment for prostate cancer.
There are a number of treatment options for prostate cancer:
Pre-assessment clinic
You will be asked to attend a pre-operative assessment to ensure you are fit for surgery. This will take place in the Outpatients Department or as part of an overnight stay.
Your surgeon will let you know when you can expect your surgery to take place.
Surgery
Prostate cancer surgery is carried out at Belfast City Hospital by specialist surgeons.
Most patients stay in hospital for two to four days and go home with a urinary catheter in place for approximately 10 to 14 days.
After that, you will return to the hospital to have the catheter removed. This may require an overnight stay.
At this time, you will have the opportunity to see a specialist physiotherapist regarding pelvic floor exercises to help regain continence as soon as possible.
Side effects of treatment
There are a number of side effects to all treatment options for prostate cancer. The most common side effects include:
- erectile dysfunction (ED)
- loss of sex drive (libido)
- infertility
- bladder problems
- bowel problems
- hot flushes
Follow-up
After your treatment is complete, you will be asked to return to the hospital for follow-up appointments. Your GP will need to check a PSA blood test before each follow-up appointment.
These review appointments allow us to check the progress of your recovery. They are also an opportunity for you to discuss any concerns you may have.
If you have any problems or notice any new symptoms in between review appointments, contact your urology clinical nurse specialist, consultant or GP. You may need additional treatment or rehabilitation services.
Useful links
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Kidney / renal cancer
Types of kidney cancer
The majority of kidney cancers are renal cell cancers (RCC). These are sometimes called renal adenocarcinoma. The most common subtype is clear cell renal adenocarcinoma.
Other less common types of renal cancer include:
- papillary (or chromophilic)
- chromophobic
- oncocytic
- collecting duct
- sarcomatoid
A rarer type of kidney cancer is transitional cell cancer (TCC) of the urethra.
Cancer Research UK has more information on the types of kidney cancer.
Investigations and diagnosis
If your GP suspects you may have kidney cancer (usually from the results of a blood or urine test), you will be referred to a ‘one stop’ haematuria (urine sample) clinic.
At this clinic, all the diagnostic tests can often be carried out at the same time and it is possible to go home the same day. You may be asked to avoid eating or drinking for up to eight hours before this clinic appointment.
Diagnostic tests for kidney cancer include:
Treatment
Cancer Research UK has a range of information on treating kidney cancer.
Pre-assessment clinic
You may be asked to attend a pre-operative assessment to ensure you are fit for surgery. In some cases, you may have an anaesthetic assessment. If this is required, you may need to stay in hospital overnight.
Your surgeon will let you know when you can expect your surgery to take place.
Surgery
For many patients with kidney cancer, surgery may be the most appropriate treatment. Surgery to remove kidney cancer is a major operation and it will take a number of weeks to recover.
Kidney cancer surgery is carried out at Belfast City Hospital by specialist surgeons.
There are three main types of surgery to treat kidney cancer:
- partial nephrectomy: this removes part of the kidney in which a small tumour is located
- radical nephrectomy: this removes all of the kidney to prevent a serious side effect or chronic kidney disease
- laparoscopic nephrectomy: this removes some or all of the kidney by keyhole surgery
If the urology surgeon decides that you are not suitable for surgery, you may be offered an arterial embolisation. This involves inserting a catheter into a blood vessel in your groin and injecting a substance, which blocks off the blood supply to the tumour.
This procedure may also be performed if the cancer tumour is too large to remove.
Chemotherapy
Some patients may require chemotherapy as part of their treatment for kidney cancer.
Radiotherapy
Patients who require radiotherapy as part of their treatment for kidney cancer will be treated in the Cancer Centre Radiotherapy Department.
Follow-up
After your treatment is complete, you will be asked to return to the hospital for follow-up appointments.
These review appointments allow us to check the progress of your recovery. They are also an opportunity for you to discuss any concerns you may have.
If you have any problems or notice any new symptoms in between review appointments, contact your urology clinical nurse specialist, consultant or GP.
Useful links
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Testicular cancer
Types of testicular cancer
There are two main types of testicular cancer:
- seminoma: these usually occur in men between 25 and 55 years of age
- non-seminoma: these tumours usually affect younger men between 15 and 35 years of age
Rare types of testicular cancer include:
- Non-Hodgkin lymphoma
- Leydig cell tumours
- Sertoli cell tumours
Macmillan has a range of information on the types of testicular cancer.
Sometimes cancer cells from the testicle can spread to nearby lymph nodes (also known as glands). A doctor will discuss this with you if you have been diagnosed with testicular cancer.
Investigations and diagnosis
Macmillan has a range of information on the diagnosis of testicular cancer.
If your GP suspects you may have testicular cancer, you will be referred for investigation. There are a number of tests used to diagnose testicular cancer:
Treatment
Surgery
Surgery may be the most appropriate treatment for many patients with testicular cancer.
The different types of surgery for testicular cancer are:
- orchidectomy – surgical removal of the testicle
- lymph node dissection – required if cancer has spread to your lymph nodes
Testicular cancer surgery is carried out at Belfast City Hospital by specialist surgeons.
Your surgeon will let you know when you can expect your surgery to take place.
Chemotherapy
There are two main types of chemotherapy used to treat testicular cancer:
- BEP chemotherapy – delivered to inpatients in the Cancer Centre
- carboplatin chemotherapy – delivered to outpatients in the Bridgewater Suite of Belfast City Hospital
Radiotherapy
Radiotherapy is sometimes used to treat testicular cancer.
Follow-up
After your treatment is complete, you will be asked to return to the hospital for follow-up appointments, which will include blood tests, scans and x-rays. These appointments should take place in the Teratoma Clinic in the Bridgewater Suite.
It is very important that you attend your follow-up appointments.
These review appointments allow us to check the progress of your recovery. They are also an opportunity for you to discuss any concerns you may have.
If you have any problems or notice any new symptoms in between review appointments, contact the Teratoma Clinic. You may need additional treatment or rehabilitation services.
Useful links
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Multi-disciplinary team
To ensure that patients get the best care available, every new case of urological cancer is discussed by the Urological Cancer Multi-Disciplinary Team (MDT).
This team of specialists meets every week to look at all the available results for each patient. This ensures the best treatment plans are put in place.
The Urological Cancer Multi-Disciplinary Team includes:
- consultant oncologists
- consultant surgeons
- consultant pathologists
- consultant radiologists
- clinical nurse specialists
- allied health professionals