Renal Clear Cell Carcinoma (RCCC) is a cancer of the PCT cells. It causes the large majority of cancers that arise from the kidney. They’re called clear because the malignant cells appear empty under a microscope. The cancerous cells are brimming with glycogen and fat, but standard staining techniques wash them away, leaving behind lots of big white blobs of empty cytoplasm. The tumors often appear yellow due to the high fat content. Smoking is a risk factor. Symptoms include flank pain, flank mass, hematuria (classic triad). But any hematuria in an adult is suspicious for RCCC. The renal cortex is an endocrine organ, so paraneoplastic syndromes are fairly common. The paraneoplastic syndromes are rooted in normal renal endocrine function. Look out for oversecretion of EPO (polycythemia), Renin (hypertension) and PTHrp (hypercalcemia, hypophosphatemia). Most RCCCs are sporadic, but it can be genetic as in the case of von Hippel-Lindau syndrome (VHL deletion on c3). RCCC has an unusual proclivity to spread through the venous system. It likes to grow into the renal veins, which can cause a unilateral varicocele on the affected side. 

Wilms Tumor (Nephroblastoma) is the most common renal cancer in children aged 2 to 4. The symptoms are pretty standard: flank mass and pain, hematuria and hypertension. The Wilms Tumor is commonly part of systemic pediatric syndromes like WAGR complex or Beckwith-Wiedemann syndrome. WAGR stands for Wilms tumor, Aniridia (no iris), GU malformations and Retarded development. Beckwith-Wiedemann syndrome is characterized by a Wilms tumor and hemihyperplasia (half of the body grows).

Urothelial Carcinoma (Transitional Cell Carcinoma) is the most common cancer of the genitourinary tract. It can arise anywhere there is uroepithelium, which includes the bladder, ureters and renal pelvis. It typically presents with painless hematuria. Risk factors include smoking, exposure to chemical dyes (aromatic amines) and cyclophosphamide. 

Squamous Cell Bladder Carcinoma also typically presents with painless hematuria. It’s caused by chemicals or infections that chronically irritate the bladder, which includes smoking (tobacco is excreted in the urine) and Schistosoma haematobium infection (a tiny water-dwelling parasitic worm common in the Middle East). 

Prostate Cancer is the most common cancer in men. Thankfully it’s very slow growing. Cancer typically grows along the periphery of the prostate, making it unlikely to cause urinary retention. During a rectal exam, the peripheral prostate can be palpated, and it will feel bumpy if there is cancer. The Prostate Specific Antigen (PSA) test is a controversial screening lab test that has fallen out of favor as of late.