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Bladder carcinoma

•   Bladder cancer is 3x as likely in men than women
• Transitional cell carcinoma is > 90% of bladder cancers.

Risk Factors

• Smoking!!
• Chronic irritation

Clinical Presentation

–  Bloody urine is the most common presenting symptom

• Pyuria
• Dysuria

Labs, Studies and Physical Exam Findings

•   Urinalysis shows hematuria
•   U/S, CT, MRI
•   Cytology
•   Cystoscopy and biopsy

Treatment

•   Surgical
•   Transurethral resection of bladder tumor (TURBT)
•   Partial cystectomy
•   Radical cystectomy
•   Adjuvant chemotherapy and radiation may be used

Penile Cancer

• Cancer that develops in the skin of the penis
• Most penile cancers are squamous cell carcinomas
• Rare in the US but accounted for 13,000 deaths worldwide in 2020

Risk Factors

• Multiple sexual partners and early sexual activity
• HPV infection
• Chronic inflammation
• Condyloma Acuminata ( genital warts)
• Poor hygiene

Clinical Presentation

• Thickened, red or tender penile skin
• Ulcer
• Abnormal growth on the penis
• Bleeding
• Urethral discharge

Labs & Studies

• Biopsy
• Immunostaining for HPV

Treatment

• Prevention
• Good hygiene
• Limiting sexual partners
• Use of condoms
• HPV vaccine
• Wide excision
• Radiation
• Chemotherapy

Prostate carcinoma

•   Most common cancer in men

Risk factors

•   African American
•   Family history
•   Diet
• High fat
• High in processed meats
• Advancing age – most cases occur after age 50
• Generally slow growing

–  More men die from prostate cancer than from it.

Clinical Presentation

•   Asymptomatic
• Hematuria
• Obstruction

Labs, Studies and Physical Exam Findings

•   Nodules within the prostate may be felt on digital rectal exam
•   PSA > 4.0
•   Biopsy
•   Multiple samples are taken from each of three zones
•   MRI
•   Bone Scan

Treatment

•   Radical prostatectomy
•   Radiation
•   Watchful waiting

Testicular carcinoma

•   One of the highest cure rates of all cancers
• 15-35 year old males
•   Maybe related to cryptorchidism
•   Greater than 90% of testicular tumors are germ cell tumors which includes seminomas and nonseminomas

Clinical Presentation

•   I feel a painless lump on my testicle
•   Acute pain in the scrotum
•   Feeling of heaviness or ach in the scrotum
•   Completely asymptomatic

Labs & Studies

• U/S
• CT for staging

Treatment

•   Orchiectomy
•   Adjuvant chemotherapy may be required