Fos-related antigen 1 (Fra-1) is a Fos family member overexpressed in several types of human cancers. Here, we report that Fra-1 is highly expressed in the muscleinvasive form of the carcinoma of the bladder (80%) and to a lesser extent in superficial bladder cancer (42%). We demonstrate that in this type of cancer Fra-1 is regulated via a C-terminal instability signal and C-terminal phosphorylation. We show that manipulation of Fra-1 expression levels in bladder cancer cell lines affects cell morphology, motility and proliferation. The gene coding for AXL tyrosine kinase is directly upregulated by Fra-1 in bladder cancer and in other cell lines. Importantly, our data demonstrate that AXL mediates the effect of Fra-1 on tumour cell motility but not on cell proliferation. We suggest that AXL may represent an attractive therapeutic target in cancers expressing high Fra-1 levels.

Ureteric obstruction is a rare consequence of inguinoscrotal hernias. We report the case of a 71-year-old man who presented with a left hemiscrotal swelling and ipsilateral hydronephrosis. Following investigations, he was found to have a sliding inguinal hernia involving the left ureter. His left inguinal hernia was repaired electively and without complication. Follow-up imaging revealed resolution of the hydronephrosis and a more conventional course of the left ureter.

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Objective: As part of the national Be Clear on Cancer campaign, the 'blood in pee' campaign was launched in 2013. We aimed to evaluate the impact of the campaign on 2-week wait (2WW) referrals and the resulting diagnoses of malignancy at a single trust, and secondly, to evaluate the socioeconomic background of patients referred. Patients and methods: Suspected cancer 2WW patients in the 3 months pre-and post-campaign were included. Demographics, investigations and diagnoses were recorded. A Kolmogorov-Smirnov test demonstrated a normal distribution. The data were treated as parametric and analysed with the unpaired Student's t-test. Results: Referrals for visible haematuria significantly increased by 52% from 135 pre-campaign to 205 post-campaign (p = 0.03). There was a fall in the proportion of patients diagnosed with malignancy from 20.27% pre-campaign to 15.36% postcampaign. The mean index of multiple deprivation score of referrals did not change: p = 0.43. Conclusion: This campaign has increased referrals without increasing the proportion of malignancies diagnosed, placing large demand on services without benefit or extra funding. Nor has the campaign effectively reached deprived socioeconomic groups. There is little evidence as to the efficacy of untargeted cancer awareness campaigns and further work is needed to improve their pickup of malignancies.

We present a case of a 51-year-old gentleman, previously diagnosed with high-grade superficial transitional cell carcinoma of the bladder and treated with intravesical mitomycin C and BCG, who developed serial recurrences in the prostatic urethra. This was resected and treated further with intraurethral mitomycin-C gel. He subsequently developed an almost impassable distal penile urethral stricture, corresponding to the site of penile clamp application which we hypothesise is secondary to a combination of the mitomycin-C gel and penile clamp pressure.