Cancer Flashcards
risk factors for bladder SCC?
schistosomiasis
smoking
T/F: benign bladder tumours are common
false - uncommon
> 90% of bladder malignancies are what subtype?
TCC
presentation of bladder cancer?
painless macroscopic haematuria
investigation for histological diagnosis and staging of bladder cancer?
cystoscopy and biopsy or TURBT
Ix in bladder cancer for
1) determining locoregional spread
2) distance disease
3) investigating nodes of uncertain significance
1) MRI
2) CT
3) PET CT
risk factors for transitional cell carcinoma of the bladder?
smoking
alanine dyes e.g. 2-naphthylamine and benzidine
rubber manufacture
cyclophosphamide
commonest cancer in adult males in the UK?
prostate
risk factors for prostate cancer?
age
afro-carribean ethnicity
obesity
FH
presentation of prostate cancer?
Early: few symptoms (periphery affected)
bladder outlet obstruction: hesitancy, urinary retention
haematuria, haematospermia
pain: back, perineal or testicular
PR exam in prostate cancer?
asymmetrical, hard, nodular enlargement with loss of median sulcus
1st line investigation for suspected prostate cancer?
multiparametric MRI
complications of TRUS biopsy?
sepsis
pain
fever
haematuria and rectal bleeding
treatment of metastatic prostate cancer?
GnRH agonist e.g. Goserelin (Zoladex)
Anti-androgen e.g. cyproterone acetate
Orchidectomy
when starting treatment with Goserelin in prostate cancer, what drug do you need to cover with at first?
anti-androgen (to prevent rise in testosterone - ‘flare’)
T/F: a prostate cancer screening program exists within the UK
false - men allowed to make informed choice
around ___% of men with prostate cancer have a normal PSA
20
causes of raised PSA?
prostate cancer BPH prostatitis and UTI ejaculation in prev 48hr vigorous exercise in prev 48hr urinary retention instrumentation in the urinary tract ?PR exam
commonest type of primary renal neoplasm?
RCC (hypernephroma)
commonest histological subtype of RCC?
clear cell
RCC associations
1) more common in what demographic?
2) lifestyle factor?
3) __ ___ syndrome
4) tuberous ____
1) middle-aged males
2) smoking
3) von Hippel-Lindau
4) sclerosis
Presentation of RCC? (inc classical triad)
Triad: haematuria, loin pain, abdominal mass
Pyrexia
Left varicocele
Endocrine effects: EPO, PTH, renin, ACTH
RCC may present with varicocele on which side? why?
left sided- occlusion of left testicular vein
__% of RCC patient’s have metastases at presentation
25
What is Stauffer syndrome? who does it occur in?
RCC
paraneoplastic hepatic dysfunction syndrome- cholestasis/ hepatosplenomegaly.
commonest malignancy in men aged 20-30?
testicular cancer
around 95% of testicular cancers are what subtypes?
Germ cell
sub-divisions of germ cell tumours?
Seminoma
Non-seminoma: embryonal, teratoma, yolk sac, choriocarcinoma
Non germ-cell testicular tumours?
Leydig cell tumour
sarcoma
risk factors for germ cell tumours?
infertility cryptorchidism family history Klinefelter's syndrome mumps orchitis
presentation of testicular cancer?
painless testicular lump
hydrocele
gynaecomastia
___ is elevated in around 60% of germ cell tumours
___ is elevated in around 40%
AFP
LDH
seminoma: ___ may be elevated in around 20%
HCG
first line investigation for testicular cancer?
testicular USS
T/F: prognosis is generally poor in testicular cancer
false- excellent
PSA test should be postponed how long following prostatitis/ UTI
1 month
why might gynaecomastia occur in testicular tumours?
increased oestrogren:androgen ratio
Germ-cell tumours → hCG → Leydig cell dysfunction → relative increase in oestradiol production
Leydig cell tumours → directly secrete more oestradiol and convert additional androgen precursors to oestrogens
