Bladder and Kidney Cancer Flashcards
What are the main risk factors of bladder cancer?
PeeSAC
Chronic cystitis
Long term catheter
Pelvic radiotherapy
What does PeeSAC stand for in terms of bladder cancer risk factors?
Phenacitin
Smoking (#1 risk factor)
Analine
Cyclophosphamide
What is the most common type of bladder cancer?
Transitional cell carcinoma
What are the two main types of bladder cancer?
Urothelial
Non-urothelial
Non-urothelial consists of what types of bladder cancer?
Adenocarcinoma
Squamous cell carcinoma
What defines a low grade urothelial carcinoma?
Non muscle invasive
What are the major presenting features of bladder cancer?
Haematuria (visible/invisible)
Weight loss/loss of appetite
What are the two types of renal cancer?
Renal carcinoma
Urothelial cancer
What are the different types of renal carcinoma?
Clear cell Papillary type 1 & 2 Chromophobe Collecting duct Renal medullary
What is the meant by urothelium?
Special type of transitional epithelium of the bladder.
What step precedes squamous cell carcinoma?
Squamous cell metaplasia
Squamous cell carcinoma of the bladder is commonly caused by what?
Chronic irritation e.g urinary tract infection or kidney stones.
Schistosoma parasitic infection
How does schistosoma parasitic infection cause squamous cell carcinoma?
Schistosoma causes chronic inflammation of the bladder.
Primary adenocarcinomas of the bladder are commonly derived from where?
Glandular tissue (therefore produce mucins)
What is the allantois?
Allowed urine to flow from the fetal bladder to the amniotic sac.
What is the urachus?
The embryological remnant of the allantois.
What are the two main types of urothelial carcinomas?
p53 dependant
p53 independant
What is characteristic of p53 dependant urothelial carcinomas?
Invasive
Flat tumour
What is characteristic of p53 independant urothelial carcinomas?
Less aggressive
Papillary tumour
What is the most common type of kidney cancer?
Renal cell carcinoma aka adenocarcinoma
Where do renal cell carcinomas form from?
Epithelial cells in the proximal convoluted tubule.
What are the main symptoms of renal cell carcinomas?
Flank pain or near hip Palpable mass Haematuria Inflammation Paraneoplastic syndromes
What is a paraneoplastic syndrome?
The tumour cells generate a hormone which causes it’s own set of symptoms.
What effect can renal paraneoplastic syndromes have.
Excessive EPO production can lead to polycythemia.
Excessive renin increasing bp.
Excessive PTHrP leading to hypercalcemia.
Excessive ACTH which can lead to cushings.
How can a large renal cell carcinoma affect the left renal vein and what symptoms may be seen?
Can occlude the left renal vein, which can then impede the venous drainage of the left testes.
This can lead to a varicocele (dilated veins in the tests bag of worms).
Why does a large renal cell carcinoma not affect the right testes in the same way?
The right testicular vein drains directly into the right vena cava, and thus will not form a varicocele.
What does TNM stand for in the TNM cancer staging system?
T - size of the tumour and whether it has grown into nearby areas.
N - degree of spread to reteroperitoneal lymph nodes.
M - Degree of metastasis.
What cells make up Willm’s tumour?
Metanephric blastemal cells (cells evolved in kidney development).
Amongst which population is Willm’s tumour seen?
Children
What is the presentation of Willm’s tumour?
Large flank mass (palpable, unilateral)
Haematuria
Hypertension (caused by excess renin)
Willm’s tumour aka
Triphasic nephroblastoma
What are the general risk factors of kidney cancers?
Obesity Smoking Previous thyroid cancer Chronic renal failure - dialysis Hypertension
What is the “classic triad” of presenting features in renal cancers?
Haematuria
Loin pain
Mass
Presentation of bone pain with renal cancer suggests what?
Metastisis
What are the main investigations carried out in renal cancers?
Urine test
Blood test
US/MRI/CT scan
Renal cell carcinomas arise from where?
Renal cell carcinomas (RCCs) arise from proximal tubular epithelium.
Storage symptoms
The collective term for symptoms including urgency, frequency and nocturia.
