Cancer Flashcards
How might urological malignancies present
Haematuria
Dysuria, frequency, nocturia
Hypertension
History of dyes, smoking
Differentials for urological cancer
If young more likely to be nephrological cause
BPH
Infection
Nephrolithiasis
Which urological cancer would you rather have and why
Transitional cell carcinoma of bladder because TCC is less metastatic at presentation than RCC
Also because TCC of UUT has 40% chance of spreading to bladder too
What type of cancer do you get following chronic inflam like schistosomiasis
Squamous cell carcinoma- a type of TCC but of squamous cells rather than urothelial cells
What type of urological cancer should you consider if it’s anterior midline
Cancer of patent urachus, meaning it’s an adenocarcinoma
What can cause raised PSA
BPH, urinary retention, recent DRE, prostate cancer, UTI
Where does prostate cancer metastasise to
Bone
Treatments for prostate cancer
Transrectal US first to biopsy
Then can surgically resect but mainly radiotherapy
If mets then Medical castration via LHRH agonists so less LH and less testosterone
Or surgical castration and cut balls off
What type of cancer is prostate
Adenocarcinoma
What does RCC look like under microscopy
Glycogen inside cells
Angiogenesis so can see red blood cells
How might you present with RCC
Haematuria, hypercalcemia because it releases PTH like peptides
Varicocele on R is more suspicious
Tumour can go renal vein into IVC and cause pulmonary embolism
Weight loss
How is treatment for RCC and TCC different
RCC is chemo and radio resistant so surgery needed. Or drugs targeting angiogenesis eg tyrosine kinase inhibitors
Upper UT TCC needs nephrouretectomy, chemo if mets
Bladder TCC (most common type of TCC) flexible cystoscopy tumour resection, deliver chemo into tumour, if invaded muscle radial cystectomy or radiotherapy
