Hearing the word cancer changes the room. In our experience the most helpful thing a physician can do at that moment is to be clear and honest in the same breath. When it is true, we say it plainly: you have cancer, but it's very treatable. Many of the cancers our specialties diagnose, particularly when they are found early, fall into that category, and knowing what comes next makes the news easier to carry.
This page is about the cancers our urologists and gynecologists at NYMD Center diagnose and help treat, and how we work with oncology when more is needed. It is different from our cancer screenings page, which covers routine screening for people without symptoms. Here the focus is on warning signs, the workup when something is found, and what treatment looks like.
Much of cancer care starts with a symptom that seems minor: a little blood in the urine, spotting after menopause, a lump noticed in the shower. Taking those signs seriously, and having the right test done quickly, is where good outcomes begin.
Warning signs worth a visit
None of the following means you have cancer, and most turn out to have benign causes. Each is still a reason to be seen rather than to wait:
- Blood in the urine, visible or found on a urine test, even once and even without pain.
- Any vaginal bleeding after menopause.
- A lump, swelling or heaviness in a testicle.
- Bleeding between periods or after intercourse, or a change in your usual cycle after 40.
- Persistent bloating, pelvic pain or feeling full quickly.
- Pain in the side that does not go away, or a mass in the abdomen.
- Unexplained weight loss, loss of appetite or ongoing fatigue.
Urologic cancers
Prostate cancer
Prostate cancer is the cancer our urologists see most. Most men have no symptoms early, so it is usually found through prostate cancer screening with a PSA blood test and exam. When PSA is elevated, we use additional tests to decide whether a biopsy is needed, and prostate MRI and targeted biopsy to find and sample suspicious areas accurately. Many prostate cancers grow slowly. For low-risk disease, active surveillance, which the National Cancer Institute describes as closely following the condition without treatment unless test results change, lets men avoid or delay treatment and its side effects. For higher-risk cancers, we discuss surgery, radiation and other options and coordinate with the specialists who provide them.
Bladder cancer
The most common sign of bladder cancer is blood in the urine, according to the National Cancer Institute. It is often painless and may come and go, which tempts people to ignore it. Blood in the urine means a urine test, imaging of the kidneys and urinary tract, and cystoscopy, a look inside the bladder with a thin, lighted scope, which our urologists perform in the office. Many bladder cancers are found at an early, non-invasive stage when treatment is less demanding.
Kidney cancer
Kidney cancer often causes no symptoms early and is frequently found on imaging done for another reason. When symptoms occur they can include blood in the urine, a lasting pain in the side, a mass in the abdomen and weight loss. Ultrasound is done in our office, and CT or MRI is arranged when a kidney mass needs to be characterized. Small kidney tumors can sometimes be monitored or treated with kidney-sparing approaches; we explain the options and refer for the procedures we do not perform.
Testicular cancer
Testicular cancer is most common in younger men. The usual sign is a painless lump or swelling in a testicle, sometimes with a dull ache or heaviness in the scrotum, as described by the National Cancer Institute. A scrotal ultrasound, which we do on site, and blood tumor markers usually give a quick answer. Testicular cancer is one of the most treatable cancers, which is exactly why a lump should never wait.
Gynecologic cancers
Cervical cancer
Cervical cancer is largely preventable. Regular Pap and HPV testing finds precancerous changes years before they become cancer, and HPV screening and colposcopy lets our gynecologists examine and treat abnormal areas early.
Endometrial (uterine) cancer
Endometrial cancer most often shows itself through abnormal bleeding, and the National Cancer Institute lists bleeding after menopause as a key sign. Because it tends to cause symptoms early, it is often caught at a stage where treatment works well. Evaluation includes a pelvic ultrasound and a sample of the uterine lining, sometimes with hysteroscopy.
Ovarian cancer
Ovarian cancer is harder to catch early, because its symptoms, such as bloating, pelvic pain and feeling full quickly, are vague and common. Symptoms that are new and persist for weeks deserve an exam and pelvic ultrasound. Women with a strong family history or a known BRCA or Lynch variant have a higher risk and a different plan.
How we evaluate a possible cancer
We start with your history and an examination, then use the tests that answer the question fastest. Blood work and urinalysis are done in the office, as are ultrasound, cystoscopy and Pap and HPV testing. CT, MRI, mammography and other imaging are arranged by referral, and biopsies are planned according to the organ involved. When the pattern of cancers in your family suggests an inherited risk, we also discuss genetic testing, which can change both your treatment and your relatives' screening.
Treatment and coordination with oncology
Treatment depends on the type and stage of cancer and on your health and priorities. For some early prostate cancers, careful monitoring is the right first step. Other cancers call for surgery, radiation, chemotherapy, hormone therapy or newer targeted drugs. When your care needs a medical oncologist, radiation oncologist or surgical specialist, we refer you and stay involved: we share records, help you understand recommendations, manage your other medical conditions during treatment, and follow you afterward for surveillance and side effects.
What to expect at your visit
Bring any prior test results, imaging reports and a list of medications, and, if you can, your family history of cancer. We explain what we are looking for, perform the office tests that make sense that day, and tell you honestly what we find and what happens next. If the news is cancer, you will leave with a plan and a clear point of contact. We care for adults only; children should see a pediatrician.
Questions patients ask
Is blood in the urine always a sign of cancer?
No. Most blood in the urine comes from infection, kidney stones, an enlarged prostate or other benign causes. But it is the most common sign of bladder cancer and can signal kidney cancer, so it always deserves an evaluation, usually a urine test, imaging and cystoscopy, even if it happened only once and caused no pain.
How is this page different from cancer screening?
Screening looks for cancer in people who feel well and have no symptoms, using tests such as PSA, Pap and HPV tests, mammograms and colonoscopy. This page covers what happens when there is a warning sign or an abnormal result: the diagnostic workup, the cancers our specialties treat and how we coordinate with oncology.
Does every prostate cancer need treatment right away?
No. Many prostate cancers grow slowly. For low-risk disease, active surveillance, which means close monitoring with PSA tests, exams, MRI and repeat biopsies, lets many men avoid or delay treatment and its side effects. Treatment starts if tests show the cancer is changing. Higher-risk cancers are usually treated.
Should I worry about bleeding after menopause?
Any bleeding after menopause should be checked, even spotting. Most often it has a benign cause such as thinning of the vaginal lining or a polyp, but it is the most common sign of endometrial cancer. Evaluation usually involves a pelvic ultrasound and a sample of the uterine lining.
Do you treat cancer yourselves or refer to an oncologist?
Both, depending on the cancer. Our urologists and gynecologists diagnose these cancers and manage some, including active surveillance for low-risk prostate cancer. When chemotherapy, radiation or major surgery is needed, we refer to oncology and surgical specialists and stay involved in your care before, during and after treatment.
Sources
- Bladder Cancer Symptoms (National Cancer Institute)
- Symptoms of Testicular Cancer (National Cancer Institute)
- Endometrial Cancer Treatment (PDQ), Patient Version (National Cancer Institute)
- Prostate Cancer Treatment (PDQ), Patient Version (National Cancer Institute)
- Renal Cell Cancer Treatment (PDQ), Patient Version (National Cancer Institute)