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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
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Symptoms that may be caused by urethral cancer include:
Bleeding from the urethra or blood in the urine,
Weak or interrupted flow of urine,
Urination occurs often, painful urination, inability to pass urine,
A lump or thickness in the perineum or penis,
Discharge from the urethra,
Enlarged lymph nodes or pain in the groin or vaginal area.
Urethral cancer is cancer originating from the urethra. Cancer in this location is rare, and the most common type is papillary transitional cell carcinoma. The most common site of urethral cancer is the bulbomembranous urethra.
Early prostate cancer usually has no clear symptoms. Sometimes, however, prostate cancer does cause symptoms, often similar to those of diseases such as benign prostatic hyperplasia. These include frequent urination, nocturia (increased urination at night), difficulty starting and maintaining a steady stream of urine, hematuria (blood in the urine), and dysuria (painful urination). A study based on the 1998 Patient Care Evaluation in the US found that about a third of patients diagnosed with prostate cancer had one or more such symptoms, while two-thirds had no symptoms.
Prostate cancer is associated with urinary dysfunction as the prostate gland surrounds the prostatic urethra. Changes within the gland, therefore, directly affect urinary function. Because the "vas deferens" deposits seminal fluid into the prostatic urethra, and secretions from the prostate gland itself are included in semen content, prostate cancer may also cause problems with sexual function and performance, such as difficulty achieving erection or painful ejaculation.
Metastatic prostate cancer that has spread to other parts of the body can cause additional symptoms. The most common symptom is bone pain, often in the vertebrae (bones of the spine), pelvis, or ribs. Spread of cancer into other bones such as the femur is usually to the proximal or nearby part of the bone. Prostate cancer in the spine can also compress the spinal cord, causing tingling, leg weakness and urinary and fecal incontinence.
Symptoms of ureteral cancer may include "blood in the urine (hematuria); diminished urine stream and straining to void (caused by urethral stricture); frequent urination and increased nighttime urination (nocturia); hardening of tissue in the perineum, labia, or penis; itching; incontinence; pain during or after sexual intercourse (dyspareunia); painful urination (dysuria); recurrent urinary tract infection; urethral discharge and swelling".
Ureteral cancer is cancer of the ureters, muscular tubes that propel urine from the kidneys to the urinary bladder. It is also known as ureter cancer, renal pelvic cancer, and rarely ureteric cancer or uretal cancer. Cancer in this location is rare.
Ureteral cancer is usually transitional cell carcinoma. Transitional cell carcinoma is "a common cause of ureter cancer and other urinary (renal pelvic) tract cancers."
Prostate cancer is the development of cancer in the prostate, a gland in the male reproductive system. Most prostate cancers are slow growing; however, some grow relatively quickly. The cancer cells may spread from the prostate to other parts of the body, particularly the bones and lymph nodes. It may initially cause no symptoms. In later stages it can lead to difficulty urinating, blood in the urine, or pain in the pelvis, back or when urinating. A disease known as benign prostatic hyperplasia may produce similar symptoms. Other late symptoms may include feeling tired due to low levels of red blood cells.
Factors that increase the risk of prostate cancer include: older age, a family history of the disease, and race. About 99% of cases occur in those over the age of 50. Having a first-degree relative with the disease increases the risk two to threefold. In the United States, it is more common in the African American population than the white American population. Other factors that may be involved include a diet high in processed meat, red meat, or milk products or low in certain vegetables. An association with gonorrhea has been found, but a reason for this relationship has not been identified. Prostate cancer is diagnosed by biopsy. Medical imaging may then be done to determine if the cancer has spread to other parts of the body.
Prostate cancer screening is controversial. Prostate-specific antigen (PSA) testing increases cancer detection but does not decrease mortality. The United States Preventive Services Task Force recommends against screening using the PSA test, due to the risk of overdiagnosis and overtreatment, as most cancer diagnosed would remain asymptomatic. The USPSTF concludes that the potential benefits of testing do not outweigh the expected harms. While 5α-reductase inhibitors appear to decrease low-grade cancer risk they do not affect high-grade cancer risk and thus are not recommended for prevention. Supplementation with vitamins or minerals does not appear to affect the risk.
Many cases can be safely followed with active surveillance or watchful waiting. Other treatments may include a combination of surgery, radiation therapy, hormone therapy or chemotherapy. When it only occurs inside the prostate it may be curable. In those in whom the disease has spread to the bones, pain medications, bisphosphonates and targeted therapy, among others, may be useful. Outcomes depend on a person's age and other health problems as well as how aggressive and extensive the cancer is. Most people with prostate cancer do not end up dying from the disease. The 5-year survival rate in the United States is 99%. Globally it is the second most common type of cancer and the fifth leading cause of cancer-related death in men. In 2012 it occurred in 1.1 million men and caused 307,000 deaths. It was the most common cancer in males in 84 countries, occurring more commonly in the developed world. Rates have been increasing in the developing world. Detection increased significantly in the 1980s and 1990s in many areas due to increased PSA testing. Studies of males who died from unrelated causes have found prostate cancer in 30% to 70% of those over age 60.
Many malignancies can develop in vulvar structures. The signs and symptoms can include:
- Itching, burn, or bleeding on the vulva that does not go away.
- Changes in the color of the skin of the vulva, so that it looks redder or whiter than is normal.
- Skin changes in the vulva, including what looks like a rash or warts.
- Sores, lumps, or ulcers on the vulva that do not go away.
- Pain in the pelvis, especially during urination or sex.
Typically, a lesion presents in the form of a lump or ulcer on the labia majora and may be associated with itching, irritation, local bleeding or discharge, in addition to pain with urination or pain during sexual intercourse. The labia minora, clitoris, perineum and mons are less commonly involved. Due to modesty or embarrassment, patients may put off seeing a doctor.
Melanomas tend to display the typical asymmetry, uneven borders and dark discoloration as do melanomas in other parts of the body.
Adenocarcinoma can arise from the Bartholin gland and present with a painful lump.
Vulvar cancer is a malignant, invasive growth in the vulva, or the outer portion of the female genitals. The disease accounts for only 0.6% of cancer diagnoses but 5% of gynecologic cancers in the United States. The labia majora are the most common site involved representing about 50% of all cases, followed by the labia minora. The clitoris and Bartholin glands may rarely be involved.
Vulvar cancer is separate from vulvar intraepithelial neoplasia (VIN), a superficial lesion of the epithelium that has not invaded the basement membrane—or a pre-cancer. VIN may progress to carcinoma-in-situ and, eventually, squamous cell cancer.
According to the American Cancer Society, in 2014, there were about 4,850 new cases of vulvar cancer and 1,030 deaths from the disease. In the United States, five-year survival rates for vulvar cancer are around 70%.
A urogenital neoplasm is a tumor of the urogenital system.
Types include:
- Cancer of the breast and female genital organs: (Breast cancer, Vulvar cancer, Vaginal cancer, Cervical cancer, Uterine cancer, Endometrial cancer, Ovarian cancer)
- Cancer of the male genital organs (Carcinoma of the penis, Prostate cancer, Testicular cancer)
- Cancer of the urinary organs (Renal cell carcinoma, Bladder cancer)
BPH is the most common cause of lower urinary tract symptoms (LUTS), which are divided into storage, voiding, and symptoms which occur after urination. Storage symptoms include the need to urinate frequently, waking at night to urinate, urgency (compelling need to void that cannot be deferred), involuntary urination, including involuntary urination at night, or urge incontinence (urine leak following a strong sudden need to urinate). Voiding symptoms include urinary hesitancy (a delay between trying to urinate and the flow actually beginning), intermittency (not continuous), involuntary interruption of voiding, weak urinary stream, straining to void, a sensation of incomplete emptying, and terminal dribbling (uncontrollable leaking after the end of urination, also called post-micturition dribbling). These symptoms may be accompanied by bladder pain or pain while urinating, called dysuria.
Bladder outlet obstruction (BOO) can be caused by BPH. Symptoms are abdominal pain, a continuous feeling of a full bladder, frequent urination, acute urinary retention (inability to urinate), pain during urination (dysuria), problems starting urination (urinary hesitancy), slow urine flow, starting and stopping (urinary intermittency), and nocturia.
BPH can be a progressive disease, especially if left untreated. Incomplete voiding results in residual urine or urinary stasis, which can lead to an increased risk of urinary tract infection.
Male breast cancer (male breast neoplasm) is a rare cancer in males that originates from the breast. Many males with breast cancer have inherited a "BRCA" mutation, but there are other causes, including alcohol abuse and exposure to certain hormones and ionizing radiation.
As it presents a similar pathology as female breast cancer, assessment and treatment relies on experiences and guidelines that have been developed in female patients. The optimal treatment is currently not known.
Penile cancer is a malignant growth found on the skin or in the tissues of the penis. Around 95% of penile cancers are squamous cell carcinomas. Other types of penile cancer such as Merkel cell carcinoma, small cell carcinoma, melanoma and other are generally rare.
Like many malignancies, penile cancer can spread to other parts of the body. It is usually a primary malignancy, the initial place from which a cancer spreads in the body. Much less often it is a secondary malignancy, one in which the cancer has spread to the penis from elsewhere. The staging of penile cancer is determined by the extent of tumor invasion, nodal metastasis, and distant metastasis.
The T portion of the AJCC TNM staging guidelines are for the primary tumor as follows:
- TX: Primary tumor cannot be assessed.
- T0: No evidence of primary tumor.
- Tis: Carcinoma "in situ".
- Ta: Noninvasive verrucous carcinoma.
- T1a: Tumor invades subepithelial connective tissue without lymph vascular invasion and is not poorly differentiated (i.e., grade 3–4).
- T1b: Tumor invades subepithelial connective tissue with lymph vascular invasion or is poorly differentiated.
- T2: Tumor invades the corpus spongiosum or cavernosum.
- T3: Tumor invades the urethra or prostate.
- T4: Tumor invades other adjacent structures.
Anatomic Stage or Prognostic Groups of penile cancer are as follows:
- Stage 0—Carcinoma "in situ".
- Stage I—The cancer is moderately or well differentiated and only affects the subepithelial connective tissue.
- Stage II—The cancer is poorly differentiated, affects lymphatics, or invades the corpora or urethra.
- Stage IIIa—There is deep invasion into the penis and metastasis in one lymph node.
- Stage IIIb—There is deep invasion into the penis and metastasis into multiple inguinal lymph nodes.
- Stage IV—The cancer has invaded into structures adjacent to the penis, metastasized to pelvic nodes, or distant metastasis is present.
As in females, infiltrating ductal carcinoma is the most common type. While intraductal cancer, inflammatory carcinoma, and Paget's disease of the nipple have been described, lobular carcinoma in situ has not been seen in males. Breast cancer in males spreads via lymphatics and blood stream like female breast cancer. Accordingly, the TNM staging system for breast cancer is the same for males and females.
Size of the lesion and lymph node involvement determine prognosis; thus small lesions without lymph node involvement have the best prognosis. Estrogen receptor and progesterone receptor status and HER2/neu (Human Epidermal Growth Factor Receptor 2) gene amplification need to be reported as they may affect treatment options. About 85% of all male breast cancers are estrogen receptor–positive, and 70% are progesterone receptor–positive.
Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate. Symptoms may include frequent urination, trouble starting to urinate, weak stream, inability to urinate, or loss of bladder control. Complications can include urinary tract infections, bladder stones, and chronic kidney problems.
The cause is unclear. Risk factors include a family history, obesity, type 2 diabetes, not enough exercise, and erectile dysfunction. Medications like pseudoephedrine, anticholinergics, and calcium channel blockers may worsen symptoms. The underlying mechanism involves the prostate pressing on the urethra thereby making it difficult to pass urine out of the bladder. Diagnosis is typically based on symptoms and examination after ruling out other possible causes.
Treatment options including lifestyle changes, medications, a number of procedures, and surgery. In those with mild symptoms weight loss, exercise, and decreasing caffeine intake is recommended. In those with more significant symptoms medications may include alpha blockers such as terazosin or 5α-reductase inhibitors such as finasteride. Surgical removal of part of the prostate may be carried out in those who do not improve with other measures. Alternative medicine such as saw palmetto do not appear to help.
About 105 million people are affected globally. BPH typically begins after the age of 40. Half of males age 50 and over are affected. After the age of 80 about 90% of males are affected. Although prostate specific antigen levels may be elevated in males with BPH, the condition does not increase the risk of prostate cancer.
Anterior urethral cancer is a disease in which malignant cancer cells are found in the part of the urethra that is closest to the outside of the body.
Symptoms vary between individuals and can be dependent upon the stage of growth of the carcinoma. Presence of the carcinoma can lead to be asymptomatic blood in the urine (hematuria), Hematuria can be visible or detected microscopically. Visible hematuria is when urine appears red or brown and can be seen with the naked eye. Other symptoms are not specific. Other inflammatory conditions that affect the bladder and kidney can create similar symptoms. Early detection facilitates curing the disease. Other symptoms can involve:
- pain or burning on urination
- the sensation of not being able to completely empty the bladder
- the sensation of needing to urinate more often or more frequently than normal
These symptoms are general and also indicate less serious problems.
PUNLMPs can lead to blood in the urine (hematuria) or may be asymptomatic.
Signs and symptoms of TCC are entirely dependent on the location and extent of the cancer.
In urologic pathology, PUNLMP, short for papillary urothelial neoplasm of low malignant potential, is an exophytic (outward growing), (microscopically) nipple-shaped (or papillary) pre-malignant growth of the lining of the upper genitourinary tract (the urothelium), which includes the renal pelvis, ureters, urinary bladder and part of the urethra.
"PUNLMP" is pronounced "pun"-"lump", like the words "pun" and "lump".
As their name suggests, PUNLMPs are neoplasms, i.e. clonal cellular proliferations, that are thought to have a low probability of developing into urothelial cancer, i.e. a malignancy such as bladder cancer.
Examples of functional problems of the reproductive system include:
- Impotence - The inability of a male to produce or maintain an erection.
- Hypogonadism - A lack of function of the gonads, in regards to either hormones or gamete production.
- Ectopic pregnancy - When a fertilized ovum is implanted in any tissue other than the uterine wall.
- Hypoactive sexual desire disorder - A low level of sexual desire and interest.
- Female sexual arousal disorder - A condition of decreased, insufficient, or absent lubrication in females during sexual activity
- Premature ejaculation - A lack of voluntary control over ejaculation.
- Dysmenorrhea - Is a medical condition of pain during menstruation that interferes with daily activities
Examples of cancers of the reproductive system include:
- Prostate cancer - Cancer of the prostate gland
- Breast cancer - Cancer of the mammary gland.
- Ovarian cancer - Cancer of the ovary.
- Penile cancer - Cancer of the penis.
- Uterine cancer - Cancer of the uterus.
- Testicular cancer - Cancer of the testicle/(plural:testes).
- Cervical Cancer - Cancer of the cervix.
Invasive urothelial carcinoma is a type of transitional cell carcinoma or TCC and urothelial cell carcinoma or UCC. It is a type of cancer that develops in the urinary system: the kidney, urinary bladder, and accessory organs. It is the most common type of bladder cancer and cancer of the ureter, urethra, renal pelvis, the ureters, the bladder, and parts of the urethra and urachus.. It originates from tissue lining the inner surface of these hollow organs - transitional epithelium. The invading tumors can extend from the kidney collecting system to the bladder.
Carcinoma (from the Greek "karkinos", or "crab", and "-oma", "growth") is a type of cancer. A carcinoma is a cancer that begins in a tissue that lines the inner or outer surfaces of the body, and that generally arises from cells originating in the endodermal or ectodermal germ layer during embryogenesis.
Transitional cell carcinoma (TCC) also urothelial carcinoma (UCC), is a type of cancer that typically occurs in the urinary system. It is the most common type of bladder cancer and cancer of the ureter, urethra, and urachus. It is the second most common type of kidney cancer, but accounts for only five to 10 percent of all primary renal malignant tumors.
TCC arises from the transitional epithelium, a tissue lining the inner surface of these hollow organs.
When the term "urothelial" is used, it specifically refers to a carcinoma of the urothelium, meaning a TCC of the urinary system.
MAGI includes infections (bacterial, viral, fungal etc) involving one or more of the following male genital organs or tracts:
- seminal vesicles (seminal vesiculitis)
- prostate gland (prostatitis)
- vas deferens
- epididymis (epididymitis)
- testicles (orchitis)
- urethra (urethritis)
- Cowper's glands