21 Urological Cancers 1 (Renal Cell Carcinoma and Transitional Cell Carcinoma) Flashcards
Where are renal cell carcinomas likely to be located and where are trasitional cell carcinomas likely to be located?
- RCC: kidney tubules
- TCC: renal pelvis, ureter, bladder
How might a localised renal cell carcinoma present?
Unsymptomatic (incidental finding on imaging eg ultrasound/CT)
Haematuria
Palpable mass (rare)
How might an advanced renal cell carcinoma present?
Unsymptomatic (incidental finding on imaging eg ultrasound/CT)
Haematuria
Palpable mass (rare)
+
Large varicocele (most common in left)
Weight loss, appetite loss (symptoms of metastasis)
Hypercalcaemia
How might a localised transitional cell carcinoma present?
Unsymptomatic (incidental finding on imaging eg ultrasound/CT)
Haematuria
How might an advanced transitional cell carcinoma present?
Unsymptomatic (incidental finding on imaging eg ultrasound/CT)
Haematuria
+
Weight loss, appetite loss (symptoms of metastases)
DVT
Lymphodema
How can we classify haematuria?
A patient presents with haematuria. What are the differential diagnoses?
If a patient presents with haematuria, what is examined for urologically ?
- BP
- Abdominal mass
- Varicocele
- Leg swelling
- Assess prostate by digital rectal examination (DRE)
- Size
- Texture
What are the 3 common sites of spread of a renal cell carcinoma?
How is a renal cell carcinoma treated?
- Surveillance
- Excision
- Radical nephrectomy- open or laproscopic
- Partial nephrectomy- open or robotic
- Ablation (basically burning tumour off)
How is metastatic (advanced) renal cell carcinoma treated?
Palliative
Can use therapies to slow down cancer:
- Biological therapies
- Targeted therapies- eg targeting angiogenesis
What % of bladder cancers are transitional cell carcinomas?
90%
Give 3 factors that increase your risk of developing renal cell carcinoma.
Smoking
Obesity
Dialysis
Give 2 risk factors that increase your risk of developing bladder transitional cell carcinoma.
Smoking
Occupational exposure
Rubber/plastic manufacture
Handling carbon/crude oil etc
How should muscle-invasive Bladder transitional cell carcinoma be treated? (think curative and not curative)
Why is the ileum used to form a ‘bladder’ following a radical cystectomy?
If ureter used - would stenose and urine on skin=irritant
Give 3 risk factors for developing upper urinary tract transitional cell carcinoma.
- Smoking
- Phenacetin abuse (pain-relieving and fever-reducing drug)
- Balkan’s nephropathy (chronic dietary exposure to low concentrations of a toxin called aristolochic acid)
If you have a upper urinary tract transitional cell carcinoma, what is your chance of going on to have a bladder tumour?
40% chance
What investigations can be done for a suspected upper urinary tract transitional cell carcinoma?
What is the standard treatment for an upper urinary tract transitional carcinoma?
What treatment options are available for metastatic transitional cell carcinoma of the bladder or the upper urinary tract?
