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Urinary > Cancer of the Urinary System 2 > Flashcards

Cancer of the Urinary System 2 Flashcards

1
Q

Which micronutrient helps to decrease risk of developing UTI?

A

Zinc

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2
Q

How are most prostate cancer cases diagnosed?

A

Through opportunistic testing:

  • PSA test
  • digital rectal exam
  • TRUS-guided prostate biopsy
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3
Q

What is PSA and what does it test for?

A

Prostate specific antigen

Is specific to the prostate but not necessarily cancer

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4
Q

Describe the symptoms related to local prostatic cancer

A 
Weak stream, Hesitancy
Increased frequency
Urgency
Sensation of incomplete emptying
Urge incontinence UTI.
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5
Q

Describe the symptoms related to locally-invasive prostatic cancer

A 
Haematuria,
Perineal and suprapubic pain,
Impotence, 
Incontinence, 
Loin pain or anuria resulting from obstruction of the ureters,
Symptoms of renal failure, 
Haemospermia, 
Rectal symptoms including tenesmus
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6
Q

What is the commonest site of prostate metastases?

A

Bone

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7
Q

What is the normal serum range for PSA?

A

0-4.0 ug/ml

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8
Q

Describe the age-related ranges for PSA

A
  • < 50 years: 2.5 is upper limit
  • 50-60 years: 3.5 is upper limit
  • 60-70 years: 4.5 is upper limit
  • > 70 years: 6.5 is upper limit
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9
Q

Give seven possible causes of an elevated PSA test

A
  • UTI
  • chronic prostatitis
  • instrumentation (e.g. catheterisation)
  • physiological (e.g. ejaculation)
  • recent urological procedure e.g. TURP
  • BPH (benign prostatic hyperplasia)
  • prostate cancer
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10
Q

What is the half life of PSA?

A

2.2 days

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11
Q

After what time period can a repeat PSA be taken?

A

3 weeks (8 half lives)

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12
Q

What method is used to grade prostatic cancer?

A

Gleason Grading system

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13
Q

What are the stages of prostatic cancer?

A
  • Localised stage
  • Locally advanced stage
  • Metastatic stage
  • Hormone refractory stage
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14
Q

Describe the final stage of prostate cancer

A

• Hormone refractory stage – in prostatic cancer, metastatic disease is NOT the final state. Metastases of prostate cancer can be treated by hormone treatment, but eventually will stop responding – this is hormone refractory stage and is the final stage of prostate cancer.

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15
Q

Describe the treatment options for locally advanced prostate cancer

A
  • Watchful waiting
  • Hormone therapy followed by surgery
  • Hormone therapy followed by radiation
  • Hormone therapy alone (or combination!)
  • Intermitted hormone therapy (clinical research)
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16
Q

Describe the potential complications of prostate cancer

A
  • Bone: pain, pathological fractures, anaemia, spinal cord compression
  • Rectal: constipation, bowel obstruction
  • Ureteric: obstruction resulting in renal failure
  • Pelvic lymphatic obstruction: lymphoedema, DVT
  • Lower urinary tract dysfunction: haematuria, acute retention
17
Q

How long does it usually take for prostate cancer to reach the hormone-refractory stage?

A

18-24 months after commencing treatment

18
Q

How does testicular cancer usually present?

A

Painless testicular lump

- may become painful after trauma

19
Q

Give three tumour markers that can signify testicular cancer

A

– AFP (alpha-fetoprotein) - teratoma
– beta-HCG (Human Chorionic Gonadotrophin) - mature-type seminoma
– LDH (Lactate dehydrogenase) - non-specific marker of tumour burden

20
Q

What is the differential diagnosis for a lump in the testis?

A

Testicular cancer
Infection
Epididymal cyst
Missed testicular torsion

(Cancer until proven otherwise)

21
Q

How is a testicular lump investigated?

A

MSSU
Testicular ultrasound scan and CXR
Tumour markers

22
Q

How is testicular cancer treated?

A

Radical orchidectomy (inguinal, not through scrotum)

23
Q

Why should an orchidectomy be done inguinally and not through the scrotum? (When treating testicular cancer)

A

to avoid disturbing lymphatics and risking metastasis

24
Q

Which lymph nodes are most likely to be invaded by testicular cancer cells?

A

Para-aortic lymph nodes

Urinary (11 decks)

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