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Unusual Cancers of Childhood (PDQ®)

Patient Version
Last Modified: 08/15/2014

Unusual Cancers of the Reproductive and Urinary Systems

Bladder Cancer
Testicular Cancer
Ovarian Cancer
Cervical and Vaginal Cancer



Bladder Cancer

Bladder cancer is a disease in which malignant (cancer) cells form in the tissues of the bladder. The bladder is a hollow organ in the lower part of the abdomen. It is shaped like a small balloon and has a muscle wall that allows it to get bigger or smaller. The bladder stores urine until it is passed out of the body. Urine is the liquid waste that is made by the kidneys when they clean the blood. The urine passes from the two kidneys into the bladder through two tubes called ureters. When the bladder is emptied during urination, the urine goes from the bladder to the outside of the body through another tube called the urethra.

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Anatomy of the female urinary system; drawing shows a front view of the right and left kidneys, the ureters,  urethra, and bladder filled with urine. The inside of the left kidney shows the renal pelvis. An inset shows the renal tubules and urine. The spine, adrenal glands, and uterus are also shown.
Anatomy of the female urinary system showing the kidneys, adrenal glands, ureters, bladder, and urethra. Urine is made in the renal tubules and collects in the renal pelvis of each kidney. The urine flows from the kidneys through the ureters to the bladder. The urine is stored in the bladder until it leaves the body through the urethra.

The most common type of bladder cancer is transitional cell cancer. Squamous cell and other more aggressive types of bladder cancer are less common.

Risk Factors, Signs and Symptoms, and Diagnostic and Staging Tests

In teenagers who were treated with certain anticancer drugs for leukemia, the risk of bladder cancer is increased.

Bladder cancer may cause any of the following signs and symptoms. Check with your child’s doctor if your child has any of the following:

  • Blood in the urine (slightly rusty to bright red in color).
  • Frequent urination or feeling the need to urinate without being able to do so.
  • Pain during urination.
  • Lower back pain.

Other conditions that are not bladder cancer may cause the same signs and symptoms.

Tests to diagnose and stage bladder cancer may include the following:

See the General Information section for a description of these tests and procedures.

Other tests used to diagnose bladder cancer include the following:

  • Urinalysis : A test to check the color of urine and its contents, such as sugar, protein, red blood cells, and white blood cells.

  • Urine cytology : Examination of urine under a microscope to check for abnormal cells.

  • Cystoscopy : A procedure to look inside the bladder and urethra to check for abnormal areas. A cystoscope is inserted through the urethra into the bladder. A cystoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.

Prognosis

In children, bladder cancer is usually low grade (not likely to spread) and the prognosis is usually good following surgery to remove the tumor.

Treatment

Treatment for bladder cancer in children is usually transurethral resection (TUR). This is a surgical procedure to remove tissue from the bladder using a resectoscope inserted into the bladder through the urethra. A resectoscope is a thin, tube-like instrument with a light, a lens for viewing, and a tool to remove tissue and burn away any remaining tumor cells. Tissue samples are checked under a microscope for signs of cancer.

See the PDQ summary on adult Bladder Cancer Treatment for more information.

Testicular Cancer

Testicular cancer is a disease in which malignant (cancer) cells form in the tissues of one or both testicles. The testicles are 2 egg-shaped glands located inside the scrotum (a sac of loose skin that lies directly below the penis). The testicles are held within the scrotum by the spermatic cord, which also contains the vas deferens and vessels and nerves of the testicles.

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Anatomy of the  male reproductive and urinary systems; drawing shows front and side views of ureters, lymph nodes, rectum, bladder, prostate gland, vas deferens,  penis, testicles, urethra, seminal vesicle, and ejaculatory duct.
Anatomy of the male reproductive and urinary systems, showing the prostate, testicles, bladder, and other organs.

There are two types of testicular tumors:

  • Germ cell tumors: Tumors that start in sperm cells in males. Testicular germ cell tumors may be benign (not cancer) or malignant (cancer). The most common testicular germ cell tumors in young boys are benign teratomas and malignant nonseminomas. Seminomas usually occur in young men and are rare in boys.
  • Non-germ cell tumors: Tumors that begin in the tissues that surround and support the testicles. These tumors may be benign or malignant.

Signs and Diagnostic and Staging Tests

A painless lump in the testicles may be a sign of a testicular tumor. Other conditions may also cause a lump in the testicles.

Tests to diagnose and stage non-germ cell testicular cancer may include the following:

See the General Information section for a description of these tests and procedures.

Treatment

Treatment for non-germ cell testicular cancer in children may be surgery.

See the PDQ summary on Childhood Extracranial Germ Cell Tumors Treatment for more information on testicular germ cell tumors.

Ovarian Cancer

Ovarian cancer is a disease in which malignant (cancer) cells form in the ovary. The ovaries are a pair of organs in the female reproductive system. They are located in the pelvis, one on each side of the uterus (the hollow, pear-shaped organ where a fetus grows). Each ovary is about the size and shape of an almond. The ovaries produce eggs and female hormones (chemicals that control the way certain cells or organs function).

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Anatomy of the female reproductive system; drawing shows the uterus, myometrium (muscular outer layer of the uterus), endometrium (inner lining of the uterus), ovaries, fallopian tubes, cervix, and vagina.
Anatomy of the female reproductive system. The organs in the female reproductive system include the uterus, ovaries, fallopian tubes, cervix, and vagina. The uterus has a muscular outer layer called the myometrium and an inner lining called the endometrium.

Most ovarian tumors in children are benign (not cancer). They occur most often in females aged 15 to 19 years.

There are several common types of malignant ovarian tumors:

Risk Factors, Signs and Symptoms, and Diagnostic and Staging Tests

The risk of ovarian cancer is increased by having one of the following conditions:

Ovarian cancer may cause any of the following signs and symptoms. Check with your child’s doctor if your child has any of the following:

  • Painful menstrual periods.
  • A lump in the abdomen.
  • Pain or swelling in the abdomen.
  • Having male sex traits, such as body hair or a deep voice.
  • Early signs of puberty.

Other conditions that are not ovarian cancer may cause these same signs and symptoms.

Tests to diagnose and stage ovarian cancer may include the following:

See the General Information section for a description of these tests and procedures.

Prognosis

Ovarian epithelial cancer is usually found at an early stage in children and is easier to treat than in adult patients.

Treatment

Treatment of ovarian epithelial cancer may include the following:

Treatment of ovarian stromal tumors may include the following:

  • Surgery to remove one ovary and one fallopian tube, for early cancer.
  • Surgery followed by chemotherapy for cancer that is advanced.
  • Chemotherapy for cancer that has recurred (come back).

See the following PDQ summaries for more information:

Cervical and Vaginal Cancer

Cervical cancer is a disease in which malignant (cancer) cells form in the cervix. The cervix is the lower, narrow end of the uterus (the hollow, pear-shaped organ where a fetus grows). The cervix leads from the uterus to the vagina (birth canal). Vaginal cancer forms in the vagina. The vagina is the canal leading from the cervix to the outside of the body. At birth, a baby passes out of the body through the vagina (also called the birth canal).

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Anatomy of the female reproductive system; drawing shows the uterus, myometrium (muscular outer layer of the uterus), endometrium (inner lining of the uterus), ovaries, fallopian tubes, cervix, and vagina.
Anatomy of the female reproductive system. The organs in the female reproductive system include the uterus, ovaries, fallopian tubes, cervix, and vagina. The uterus has a muscular outer layer called the myometrium and an inner lining called the endometrium.

The most common sign of cervical and vaginal cancer is bleeding from the vagina. Other conditions may also cause vaginal bleeding.

Treatment

Treatment for childhood cervical and vaginal cancer may include surgery to remove as much of the cancer as possible, followed by radiation therapy. Chemotherapy may also be used but it is not yet known if this is an effective treatment.