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Cancer Flashcards

1
Q

how much does a young healthy prostate weigh

A

20g

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2
Q

where is the base of prostate?

A

at the top of the prostate

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3
Q

and where is the apex of prostate

A

inferior portion of prostate

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4
Q

what kind of epithelium is the prostatic urethra covered in?

A

transitional epithelium

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5
Q

what is the verumontanum a landmark of

A

seminal vesicles

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6
Q

what is the transitional zone of the prostate

A

surrounds prostatic urethra proximal to verumontanum

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7
Q

what percentage of prostate tumours arise from the transitional zone

A

20%

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8
Q

what does the transitional zone give rise to?

A

benign prostatic hyperplasia

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9
Q

what is the central zone?

A

cone shaped region that surrounds ejaculatory duct

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10
Q

what percentage of cancers raised from the central zone

A

1-5%

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11
Q

what is th peripheral zone

A

majority of the glandular tissue.

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12
Q

where does most of the carcinomas arise and what type are they?

A

peripheral zone and they are adenocarcinomas

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13
Q

what age are most patients who’d develop prostate cancers

A

> 65

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14
Q

are black or caucasians at more risk of prostate cancer?

A

black

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15
Q

is there a familial link in prostatic cancer?

A

yes

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16
Q

how re most prostatic cancers picked up?

A

by PSA screening tests

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17
Q

what symptoms would present with prostatic cancers?

A

lower urinary tract symptoms, haematuria/ haematospermia, bone pain, anorexia, weight loss

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18
Q

what would you note on palpation of a possible prostate tumour?

A

craggy, asymmetry and nodular

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19
Q

what happens to serum PSA in those with prostatic cancer?

A

serum levels increase

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20
Q

what are other conditions that raise the PSA

A

benign prostatic hyperplasia, prostatitis/ UTIs, retention, catheterisation,

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21
Q

when would you use a trans- rectal USS guided prostate biopsy

A

abnormal rectal examination, elevated PSA

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22
Q

where is the most common sites for metastatic prostate tumour?

A

pelvic lymph nodes and skeleton

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23
Q

what is the pattern of growth of the prostate tumour

A

through urethra, bladder base, seminal vesicles, perineurial invasion and autonomic nerves

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24
Q

what type of lesions are seen in prostate tumours

A

sclerotic

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25
what is th scoring method used for prostates
grading- gleasons scoring (1-5, 5 being the worst)
26
what is the initial feature of malignancy in prostate cancer?
loss of basement membrane
27
what imaging modality is used for staging?
bone scan, CT, MRI
28
what treatment options are available for prostate cancer
organ confined- watch and wait until further symptoms present, active monitoring, radical surgery, radical radiotherapy, locally advanced disease- radiotherapy with neo adjuvant hormonal therapy, watchful waiting, hormonal therapy (non curative) Metastatic disease- androgen deprivation therapy (LHRH, anti-androgens, bilateral sub scapular orchidectomy, maximal androgen blockade), cytotoxic chemotherapy, steroids
29
what hormones control the prostate cancer cells
testosterone and dihydrotestosterone
30
where does the majority of testosterone come from?
testis and adrenal gland
31
does testosterone exert a positive or negative effect on hypothalamic LH secretion
negative
32
what happens to the prostate cells if they are deprived of androgenic stimulation
apoptosis
33
how do LHRH agonists work?
down regulation of LHRH receptors with suppression of LH and FSH and testosterone secretion
34
what is given along with LHRH agonists to prevent suppression of spinal cord compression?
anti androgen cover for 1 week prior to LHRH injection and 2 weeks after first dose
35
what are side effects of LHRH agonists
loss of libido, hot flushes and sweats, weight gain, gynaecomastia
36
what do anti androgens do
compete with testosterone for binding sites on receptors thus promoting apoptosis and inhibiting prostate cancer growth
37
what do you use to diagnose bladder cancer
CT, Xray angiography, sonography, excretory urogram
38
what is the most common type of uroepithelial tumour?
transitional cell tumour
39
what are the two types of transitional cell carcinoma?
papillary, nonpapillary
40
what is the commonest type of transitional cell carcinoma?
papillary (80%)
41
which is the more malignant type of transitional cell carcinoma
non papillary
42
what does transitional cell tumours look like on imaging studies?
single lesion/ multiple discrete lesions/ diffuse and confluent lesions
43
what cancers are commonly linked with bladder cancer?
pelvis and ureter
44
what age group is bladder cancer most common?
50 yo>
45
what is the main difference between squamous and transitional cell carcinoma
calcified in squamous cell
46
what are benign renal tumours
renal cysts, oncocytoma, angiomyolipoma
47
where is majority of transitional cell carcinoma seen?
bladder
48
how are lesions identified in kidneys?
US - CT
49
are renal cysts bad?
most are benign- USS to examine fluid filled cysts
50
what is angiomyolipoma
blood vessels, muscles and fat tumour- in wrong proportions
51
what is oncocytoma
bening tumour- excessive mitochondria resulting in a granular cytoplasm
52
what is the best imaging for oncocytoma
central scar on CT
53
how is oncocytoma diagnosed?
difficult to tell, usually only diagnosed at nephrectomy
54
what is the presentation of renal cell carcinoma
triad: loin pain, renal mass, haematuria usually incidental on imaging paraneoplastic syndromes- anaemia, hypertension, WL, hypercalcaemia
55
what age does RCC commonly affect
65-75
56
what is a renal cell carcinoma?
adenocarcinoma - epithelial in origin
57
how to diagnosis RCC
CT scan- solid lesion take up contrast that is enhancing
58
where are most renal cell carcinomas confined to?
capsule
59
how is RCC spread
lymph, haematogenous spread
60
where is RCC commonly spread tp
lung liver bone and brain
61
what is the RCC treatment?
radical nephrectomy (standard treatment-laparscopically), partial nephrectomy, radiofrequency ablation, cryoablation
62
what is standard practice involving the removal of adrenal gland in RCC nephrectomy
do not remove- unless it is involved
63
why is partial nephrectomy good?
doesn't get rid of all the nephrons
64
what can you give to patients with metastatic disease
ECOG performance studies (best), (IL2, Interferon alpha- very rarely used) TKI- sunitinib- progression free survival by reducing neo vascularisation
65
what is the survival for people with Stage 1 RCC
75%
66
what is the most common type of penile carcinoma
squamous cell carcinoma
67
what is balanitis xerotica obliterates (BXO)
causes tight foreskin in men. Causes fissuring in men, need a circumcision to fix this.
68
is there a predisposition of BXO to malignancy?
not really that high
69
what does squamous cell carcinoma look like
red velvety patches on glans of penis - check if not inflammation
70
how would you treat carcinoma in situ
topical 5 flourouracil
71
how would invasive squamous carcinoma occur?
older men, do not tell people about, late presentation, HPV infection
72
how would squamous carcinoma present on penis?
red raised areas, foul smelling, phimosis (hygiene) and fun gating mass
73
how do we diagnose squamous carcinoma of penis
USSa nd MRI
74
what is the treatment of squamous cell carcinoma of penis
surgery- total or partial penectomy, inguinal node therapy, radiotherapy can be used palliatively
75
what is the symptoms of testicular tumours
painless, insensitive testicular swelling- usually hard
76
what imaging is used for testicular tumours
USS, CXR for metastasis 'cannonball' risk
77
when is CT scan done for tsticaulr tumours?
CT abdomen thorax after surgery has occured
78
what are the markers for testicualr tumour
AFP- never raised in seminoma , HCG, LDH,
79
what is orchidectomy?
inguinal operation- must clamp vessels before going to scrotum
80
what extra letter is included in testicular tumours?
s- serum

Renal (18 decks)

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