Bladder and Prostate Cancer Flashcards
Risk factors for bladder cancer
Smoking
Occupational exposure to dyes, amines
Previous exposure to cyclophosphamide
Previous radiotherapy
Signs/symptoms of bladder cancer
Gross/microscopic hematuria Obstructive voiding symptoms Irritative voiding symptoms Pelvic pain (late sx)
Treatment for non-muscle invasive bladder CA
Resection +/- perioperative chemotherapy
Intravesical therapy
Treatment for muscle invasive bladder CA
Surgery (radical cystectomy) +/- neoadjuvant chemotherapy
What do you need to remove in
1. Men
2. Women
for a radical systectomy
- bladder, prostate, seminal vesicles, pelvic lymph nodes
2. bladder, uterus, cervic, ovaries, anterior vagina, pelvic lymph nodes
3 intravesical agents
Bacille Calmetter-Guerin (BCG)
Mitomycin
Gemcitabine
Function of PSA
Enzyme secreted into the semen
Liquifies it to increase fertility
4 risk factors for prostate cancer
African American
Family history (especially first degree relative)
Age
Previous abnormal biopsy
3 tests to diagnose prostate cancer
PSA
DRE
Transrectal ultrasound biopsy
What can cause elevations in PSA?
Infection BPH Infarction Instrumentation Inflammation Prostate cancer
How do we grade prostate cancer?
Add the most common and second most common gleason grades
2-6 = low risk
7 = intermediate risk
8-10 = high risk
How do we treat
1. Low risk
2. Intermediate and high risk
prostate cancer?
- Active surveillance
2. Radical therapy, hormone therapy if spread outside capsule or mets
4 complications of radiotherapy
Radiation exposure to bladder and rectum
Nerves may be damaged causing erectile dysfunction
Urinary incontinence (leakage)
SMALL possibility of secondary late malignancies
What is involved in active surveillance?
Periodic rectal exams and PSA measurements
Repeat prostate biopsies
