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Renal > Cancer > Flashcards

Cancer Flashcards

1
Q

In which zone does prostate cancer usually occur

A

Peripheral zone of the prostate

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2
Q

In which zone does BPH usually occur

A

Transitional zone

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3
Q

Which part of the prostate makes up most of the tissue mass

A

Peripheral zone

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4
Q

What test could be used to screen for prostate cancer

A

Prostate Specific Antigen

Not very specific though - can be raised by BPH or infection etc

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5
Q

Prostate cancer is the most common cancer affecting men in the UK - true or false

A

True

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6
Q

How does prostate cancer present

A 
usually asymptomatic - picked up by PSA 
Lower UT symptoms 
Haematuria 
Bone pain 
Weight loss 
Hard prostate
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7
Q

How do you biopsy the prostate

A

Trans-Rectal USS guided biopsy

Take 5 samples from either side of the prostate

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8
Q

What type of cancer is most common in the prostate

A

Multifocal adenocarcinoma

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9
Q

Where are the most common sites of metastasis for prostate cancer

A

Pelvic lymph nodes

Bone

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10
Q

How do you grade prostate cancer

A

Gleason score

Take the two most abundant cell patterns, score them each and add together to get final score

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11
Q

What is the TNM definition of organ-confined prostate cancer

A

T1 or 2
N0
M0

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12
Q

What is the TNM definition of locally advanced prostate cancer

A

T3 or 4
N0
M0

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13
Q

What is the TNM definition of metastatic prostate cancer

A

N+ and M+

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14
Q

How do you manage organ confined prostate cancer

A

Watchful waiting If not advanced
Radical surgery
Radical radiotherapy

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15
Q

How do you treat locally advanced prostate cancer

A

Radiotherapy with adjuvant hormone therapy
Watch and wait if asymptomatic
Hormone therapy alone if unit for radio

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16
Q

How do you manage metastatic prostate cancer

A

Androgen deprivation therapy
Steroids
Chemo

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17
Q

How does bladder cancer present

A

Painless haematuria

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18
Q

How do you diagnose bladder cancer

A

Flexible cystoscopy and CT scan

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19
Q

What is the main type of cancer to affect the bladder

A

Transitional cell cancer

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20
Q

List the most common benign renal tumours

A

Simple cysts
Angiomyolipoma
Oncocytoma

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21
Q

What is a angiomyolipoma

A

Benign tumour affecting the blood vessels, smooth muscle and fat
Seen in middle aged women

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22
Q

Which condition is angiomyolipoma associated with

A

tuberous sclerosis

23
Q

How does angiomyolipoma present

A

Loin pain
Haematuria
Mass
Some may have a massive retroperitoneal bleed

24
Q

How do you diagnose and treat angiomyolipoma

A

USS and CT

Treat if larger than 4cm with embolization or partial nephrectomy

25
Q

Describe an oncocytoma a

A

Benign kidney tumour - doesn’t metastasize
Spherical, brown and has a central scar
Cells are packed with mitochondria
Can be hard to differentiate from Renal cell carcinoma

26
Q

List the subtypes of renal cell carcinoma

A 
Clear cell - most common 
Papillary cell 
Chromophobe 
Collecting Duct 
Medullary cell
27
Q

What gene is responsible for clear cell renal carcinoma

A

VHL gene

28
Q

Which group presents with medullary cell carcinoma

A

Sickle cell patients

Often present with mets

29
Q

How does renal cell carcinoma present

A 
Haematuria 
Loin pain 
Mass 
Pyrexia 
Varicocele - varicose veins around testicle
30
Q

What investigations would you do for renal cell carcinoma

A

USS
CT of chest, abdomen, pelvis - look for mets
FBC and liver/renal functions

31
Q

List some risk factors for renal cell carcinoma

A

Obesity
Smoking
Hypertension
Long term dialysis

32
Q

How do you treat renal cell carcinoma

A 
Monitor if small and patient is unfit 
Surgical removal (partial or total nephrectomy)
33
Q

Which malignant cancers can affect the kidneys

A

Renal cell carcinoma
Transitional cell carcinoma
Lymphoma

34
Q

Describe the epidemiology of testicular cancer

A

Most common solid cancer in men 20-45
Affects white Caucasians
Most curable cancer

35
Q

What are some of the risk factors for testicular cancer

A

Previous testicular cancer - other side at risk
Undescended testes
Family history
HIV

36
Q

What are the 2 main subtypes of testicular cancer

A

Seminoma

Non-seminomatous

37
Q

How does testicular cancer present

A

Scrotal lump - hard, irregular

Delayed presentation - acute pain, bleeding, weight loss, neck lumps, chest or bone symptoms

38
Q

What investigations would you do for testicular cancer

A

Serum tumour markers - alpha feto protein, B-HCG, LDH
FBC, LFT, renal function
USS testicle
CT chest and abdomen for staging

39
Q

How do you treat urinary incontinence

A

Radical inguinal orchidectomy (remove testicle through inguinal region)
Offer sperm preservation
Re-check tumour markers 1-week post-op
CT scan
Follow up with oncology (given adjuvant chemo)

40
Q

What type of cancer affects the penis

A

Squamous cell carcinoma (skin cancer) - ulcerating
Can invade into the tissue
HIV patients may get Kaposi’s sarcoma

41
Q

List some risk factors for penile cancers

A 
Being in 5th or 6th decade 
BXO 
Phimosis 
HPV 
Smoking 
Immunocompromise

Circumcision may have protective effect

42
Q

Which part of the penis is most common

A

The glans

Then the prepuce (foreskin)

43
Q

How does penis cancer present

A

Hard painless lump

Lots of delayed presentation though - urinary retention or groin mass

44
Q

What investigations would you do for penile cancer

A

Examination of abdo, inguinal and genitalia
MRI scan
CT abdo, pelvis, chest

45
Q

How do you treat penile cancer affecting the prepuce

A

Circumcision

Remove affected inguinal nodes

46
Q

How do you treat penile cancer affecting the glans

A

Glans resurfacing or resection (depending on depth)
If disease is advanced you may need penile amputation
Remove affected inguinal nodes

47
Q

Which neoplasia’s can affect the penis

A

PEiN - penile intraepithelial neoplasia

Differentiated type is not HPV related and dedifferentiated is

48
Q

Describe the appearance of a seminoma of the testes

A

Potato tumour (when you cut it open it looks like a potato)

49
Q

What is the more common testicular cancer subtype

A

Seminoma

50
Q

What treatment is a seminoma sensitive to

A

Very radio-sensitive

51
Q

What treatment is a non-seminomatous tumour sensitive to

A

Very chemo-sensitive

Though has quick local and vascular infiltration

52
Q

How can you diagnose a trophoblast testicular tumour

A

Produces HCG so will give a positive pregnancy test

53
Q

Embryonal testicular tumours are aggressive - true or false

A

True

Quick mets and high grade

54
Q

What tumour marker is produced by yolk sca testicular tumours

A

alpha feto protein

Renal (18 decks)

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