Prostate cancer is usually a silent disease until it reaches advanced stage.

• The most common symptoms are of urinary outflow obstruction - hesitancy, poor stream, chronic retention of urine, acute retention of urine
• Lower urinary tract symptoms may also occur - frequency, nocturia
• Bone pain and pathologic fractures may be presenting features
• Rarer presentations are with reduced ejaculate volume (caused by obstruction of the ejaculatory ducts), hematospermia (caused by involvement of the seminal vesicle) or impotence (caused by invasion of the neurovascular bundle)
• May present with unexplained deep vein thrombosis or recurrent thrombophlebitis
• Digital rectal examination may reveal an area of increased firmness, loss of the median sulcus, or an irregularly enlarged prostate
• Benign prostatic enlargement does not exclude prostatic cancer; 10-30% of men with benign prostatic hyperplasia have occult prostatic cancer
• Disease progression is by local extension via lymphatics or by hematologic spread to distant sites, particularly bone. Local extension tends to be into and through the prostatic capsule, the bladder base, and the seminal vesicles. Extension to the urethra or rectum is uncommon
• Unusually, anemia, marrow suppression, retroperitoneal fibrosis, or disseminated intravascular coagulation may occur
• Rarely, paraneoplastic syndrome from ectopic hormone production may occur
• In advanced stage, prostate may be enlarged, hard, and fixed, with extension to seminal vesicles
• In advanced stage, patient may present with acute renal failure due to bilateral ureteric involvement
• In advanced stage, the patient may present with lower body edema

Renal cell carcinoma (RCC) is a tumor that spreads via the vascular system and by direct invasion into other organ structures and lymph nodes.

• Approximately 90% of all primary kidney cancers are renal cell carcinoma (RCC)
• There are five main types of RCC: clear cell, papillary, chromophobic, oncocytic, and collecting duct
• The great majority of RCC (approx. 80%) are of clear cell type
• The main sign is hematuria (40%), followed by back/flank pain (35%), and a palpable mass (30%)
• Approximately 50% of cases are detected as an incidental finding e.g. following abdominal imaging for other conditions
• RCC is symptomatically similar to many diseases; only 5–10% of patients present with the classic triad (abdominal mass, flank pain, and hematuria)
• Approximately 45% of patients present with localized disease (stage I and II), 25% with locally advanced disease (stage III), and 30% with metastatic disease (stage IV)
• Weight loss and malaise may be indicative of metastatic disease
• Radical nephrectomy is the primary treatment for RCC
• Systemic chemotherapy, immunotherapy, and radiation therapy (for radiosensitive tumor types) are adjunctive therapies in select patients with metastatic disease. Interferon, sorafenib and sunitinib (a tryrosine kinase inhibitor) are FDA-approved for the treatment of metastatic RCC. The role of bone marrow transplantation is under investigation
• Survival is related to disease stage – 5-year survival ranges from 75–90% for stage I/stage II disease to 11% for stage IV