Cancer Reg Flashcards
Types of kidney cancer
85% renal cell carcinoma
10% transitional cell carcinoma
5% others
Kidney cancer investigations
Painless haematuria
- flexible cystoscopy
- CT urogram
- renal function
Persistent non visible haematuria
- flexible cystoscopy
- US KUB
Suspected kidney cancer
- CT renal triple phase
- staging CT chest
- bone scan if symptomatic
Kidney cancer staging
T1- tumour<7cm
T2 - tumour>7cm
T3 - extends out kidney but not beyond ipsilateral adrenal or perinephric fascia
T4 - tumour beyond into surrounding structures
N1 - met in single regional LN
N2 - met in >2 regional LN
M1 - distant met
Kidney grade
Fuhrman
1 - well differentiated
2 - moderately differentiated
3+4 - poorly differentiated
Kidney cancer management
Patient specific
Excision either via:
- partial nephrectomy
- radical nephrectomy
Small tumour and unfit for surgery
-cryosurgery
Metastatic
-receptor tyrosine kinase inhibitors
Bladder cancer types
> 90% transitional cell carcinoma
1-7% squamous cell carcinoma
2% adenocarcinoma
Bladder cancer investigations
Painless visible haematuria
- flexible cytostoscopy
- CT urogram
- renal function
Persistent microscopic haematuria
- flexible cystoscopy
- US KUB
If biopsy proven muscle invasive then staging investigation
Bladder cancer staging
Ta - non invasive papillary carcinoma
Tis - carcinoma in situ
T1 - invades subepithelial connective tissue
T2 - invaded muscularis propria
T3 - invades perivisceral fat
T4 - prostate, uterus, vagina, bowel, pelvic or abdominal wall
N1 - 1 LN below common iliac birufication
N2 - >1 LN below common iliac birufication
N3 - mets in a common iliac LN
M1 - distant mets
Bladder grade
WHO classification
G1 - well differentiated
G2 - moderate differentiated
G3 - poorly differentiated
Cystoscopy and transurethral resection of bladder lesion
Uses heat to cut out all visible bladder tumour
Provides histology and also can be curative
Bladder cancer management
Non muscle invasive
- if low grade and no CIS then consideration of cystoscopic surveillance +/- intravesicular chemotherapy / BCG
Muscle invasive
- cystectomy
- radiotherapy
- +/- chemotherapy
- palliative
Prostate cancer type
95% is adenocarcinoma
Prostate cancer investigation
Blood test - PSA is prostate-specific but not prostate-cancer-specific. Can be elevated in (UTI, prostatitis, benign prostatic hyperplasia)
MRI
Trans perineal prostate biopsy - systemic template biopsies of the prostate. Used over transrectal biopsy as less risk of infection and able to sample all areas of prostate
Prostate cancer staging
T1 - non palpable or visible on imaging T2 - palpable tumour T3 - beyond prostatic capsule into periprostatic fat T4 - tumour fixed onto adjacent structure/pelvic side wall N1 - regional LN (pelvis) M1a - non regional LN M1b - bone M1x - other sites
Prostate grade
Gleason score
2-6 - well differentiated
7 - moderately differentiated
8 - poorly differentiated
