What should you know about prostate and bladder cancer?

Prostate cancer starts in the prostate, a gland below the bladder that surrounds part of the urethra. Bladder cancer starts in the lining or wall of the bladder, the organ that stores urine. These cancers can cause overlapping urinary changes, but a urinary symptom by itself cannot identify where a problem began.

Blood in the urine, changes in urinary flow, frequent urination, urgency, or difficulty passing urine can have several causes, including conditions that are not cancer. A clinician may ask when the change began, whether it is persistent, and whether pain, fever, weight change, or back or pelvic symptoms are also present. The assessment may include urine tests, blood tests, a physical examination, imaging, or tissue sampling. Cystoscopy allows a clinician to look inside the bladder with a thin camera; other tests are chosen according to the suspected site and findings.

Arrange a medical assessment for new or ongoing urinary changes, especially visible blood in the urine or difficulty passing urine. Bring a list of medicines and note the timing, frequency, and pattern of symptoms. Do not assume that a symptom confirms cancer, and do not delay assessment because symptoms are mild.

If cancer is diagnosed, treatment depends on the organ involved, the tumour's features and extent, overall health, and personal priorities. Options may include an operation, chemotherapy, immunotherapy, or treatments delivered directly into the bladder. Intravesical BCG therapy is one bladder-directed treatment used in selected situations. Some people need more than one approach, while the plan can change as results become available. Ask how each option affects urination, sexual function, fertility, recovery, and follow-up.

Seek urgent medical help if you cannot pass urine, if urine contains a large amount of blood or clots, or if bleeding is accompanied by faintness, severe weakness, or severe pain. Fever with urinary symptoms, pain in the side or back, or vomiting also needs prompt assessment because infection or blockage may require treatment.

For symptoms that are less severe but do not settle, book an appointment rather than waiting for them to become disruptive. Difficulty passing urine can have causes other than cancer, but it still deserves evaluation, particularly when it is new, worsening, or associated with blood in the urine.

Which organ appears to be involved, and what tests will confirm it? Has the cancer stayed within the organ or spread beyond it? What does the tissue report show? What are the goals of the proposed treatment, and how could it affect bladder control, erections, fertility, or daily activities? Ask who to contact if urinary symptoms, fever, bleeding, or treatment side effects develop.