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Bladder cancer is a growth that starts in the inner lining of the bladder. The inside of the kidneys and the lining of the ureters, the tubes that carry the urine from the kidney to the bladder, have a similar lining and a similar growth may arise from these organs as well.
Smoking and occupational exposure to certain carcinogens are common risk factors. They occur more commonly in men.
They often cause blood staining of the urine as the first symptom and it is important that any blood in the urine is investigated further to rule out a serious cause.
The majority of bladder cancers are superficial and not aggressive and can be managed by a cystoscopic procedure. Regular inspections are necessary to ensure the growth does not come back.
If the cancer is more aggressive, additional treatment in the form of medications instilled into the bladder, chemotherapy, radiotherapy or major open surgery may be necessary. This approach will require the involvement of cancer specialists in your treatment.
Haematuria is the medical term for the presence of blood in the urine. It may be visible blood which makes the urine look pink or red or it may be traces of blood found only on testing the urine. Since blood in the urine is not normal it will require further tests to find out if it is due to a serious condition or not.
There is no cause for alarm as often no serious cause is found. If however there is an underlying cause it is often the first symptom and testing will allow the condition to be diagnosed early and treated in time.
Prostate specific antigen (PSA) is produced by the prostate gland and can be detected in the blood and seminal fluid. The PSA level can be measured by a blood test. PSA may be raised due to many reasons including prostate cancer, urine infections, prostate infections and instrumentation or catheterisation of the bladder. It also slowly rises as men become older.
It is used in the diagnosis of prostate cancer but the test can be difficult to interpret because it can be raised in the absence of prostate cancer and less commonly prostate cancer may be present even if the PSA is normal.
If you wish to have a PSA test your doctor will help you to understand the benefits and downsides of having the test and may refer you to a Urologist for further discussion and investigations. You may then need a MRI scan and prostate biopsy where small samples of tissue are removed from the prostate for testing under the microscope.
After prostate biopsy you may see blood in the urine, seminal fluid and bowel motion for several days. About 2-3% of men may get a urine infection which can spread to the blood stream even if you have taken preventative antibiotics.
A prostate biopsy is important as it is currently the only way in which prostate cancer can be diagnosed with certainty. This may change in the future if alternative, less invasive, tests become available.