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Renal Week 3 2017/18 > 8: Prostate and bladder cancer > Flashcards

8: Prostate and bladder cancer Flashcards

1
Q

Where is the prostate gland found in relation to the bladder?

A

Neck of the bladder

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2
Q

What part of the urethra is surrounded by the prostate gland?

A

Prostatic urethra

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3
Q

What are zones of the prostate?

A

Central zone - where benign cancers arise

Peripheral zone - where malignant cancers arise

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4
Q

From which zones of the prostate do

a) BPH
b) prostate cancer

develop?

A

a) Transitional zone

b) Peripheral zones

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5
Q

What is the most common cancer found in men in the UK?

A

Prostate cancer

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6
Q

What are the investigations for prostate cancer?

A

PR exam - hard, full prostate

PSA - blood test, marker for prostate activity

Biopsy

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7
Q

Prostate cancers are either well or poorly ___ on biopsy.

A

differentiated

poorly differentiated is bad

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8
Q

What is unique about the appearance of prostate cancer?

A

Multiple different morphologies can be found in the same cancer

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9
Q

Which system is used to grade prostate cancer?

A

Gleason’s scoring

adding together the two most frequent patterns to get a score out of 10

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10
Q

In terms of staging, T1 describes __-__ cancers.

A

non-palpable

so detected by PSA

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11
Q

What is a T2 prostate cancer?

A

Palpable

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12
Q

What is a T3+ prostate cancer?

A

Found outside the prostate

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13
Q

Where does prostate cancer most commonly spread?

A

Bone

Lymph nodes

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14
Q

Metastatic prostate cancer spreads where?

A

Bones

Lymph nodes

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15
Q

What are two investigations used to check for prostate cancer spread?

A

Bone scan

MRI scan - to see if it has spread outwith the capsule

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16
Q

Summarise the investigations for

a) localised
b) metastatic

prostate cancer.

A

a) PR exam, PSA, biopsy (giving Gleason score)

b) Bone scan, MRI

17
Q

Depending on investigation results, prostate cancer is given a ___ of invasion.

A

risk

18
Q

How is low-risk, localised prostate cancer managed?

A

Monitoring

19
Q

How is intermediate to high risk, localised prostate cancer treated?

A

Prostatectomy - open or laparoscopic

Radiotherapy

20
Q

What is a possible side effect of prostate surgery in men?

A

Infertility

21
Q

Which hormone stimulates the prostate gland and is suppressed in the treatment of locally advanced disease?

A

Testosterone

LHRH injections, androgen antagonists

22
Q

Which hormone treatments slow the progression of prostate cancer?

A

LHRH injections

Anti-androgens

23
Q

Which type of epithelium lines the bladder?

A

Transitional epithelium, or urothelium

24
Q

What are the risk factors for transitional cell carcinoma?

A

Age > 40

PMX of renal disease

Smoking - the main one

Exposure to chemicals - dyes, rubber

Analgesic drugs

Chronic UTI - schistosomiasis

25
Q

TCC is more common in (men / women).

A

men

26
Q

What is the main presenting complaint of bladder cancer?

A

Haematuria

27
Q

How is bladder cancer investigated?

A

Cystoscopy - to view tumours

CT urogram - to view filling defects

28
Q

What investigation is used to diagnose a bladder cancer?

A

TURBT

transurethral resection of bladder tumour + biopsy

29
Q

How is bladder cancer staged?

A

TNM staging based off biopsy

30
Q

Patients with bladder cancer must be monitored for how long?

A

Lifelong monitoring

31
Q

Bladder tumours are classified based on whether or not they’ve invaded the ___.

A

muscle

32
Q

Which immunotherapy drug is used to treat high-risk, non-invasive bladder cancers?

A

BCG

same used in vaccine for TB

33
Q

How is

a) low risk
b) high risk

non-invasive bladder cancer managed?

A

a) Monitored

b) BCG vaccine?!??!?!

34
Q

How is bladder cancer treated if it has invaded the muscle?

A

Cystectomy

Renal Week 3 2017/18 (12 decks)

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