Cancers of the Male GU System Flashcards
Penile cancer most common in what age?
60’s
Risk factors of penile cancer
- poor hygiene
- uncircumcised
- association with cervical carcinoma and HPV (16, 18)
- South America and Africa
in situ cancer =
cancer that is in original position or place
Bowen disease
Squamous cell carcinoma
Typically involving penile shaft
Painless red plaque with encrustations
Erythroplasia of Queyrat
Velvety, red lesion with ulcerations
Usually involves the glans
Bowen Disease vs Erythroplasia of Queyrat cancers
Bowen = closer to Balls (shaft)
Erythroplasia of Queyrat = on End (glans)
Bowen Disease and Erythroplasia of Queyrat treatments
local excision or topical agents
Invasive carcinoma of penis
squamous cell carcinoma consisting of more than just an external lesion
Pattern of penile cancer spread
lymphatic channels to femoral and iliac nodes
Most treatable cancers in men
melanoma
testicular cancer
Most common cancer affecting men 15-35 yrs old?
testicular cancer
Most common testicular tumor in a patient older than 50 years
lymphoma
Secondary tumors of testes
lymphoma (>50)
leukemic
infiltration of the testis (kids)
Benefit of orchipexy for cryptorchidism
lowers risk of malignancy if performed before age 13
Biggest risk factors for testicular cancer
undescended testes
exogenous maternal estrogen during pregnancy
Common signs of testicular cancer
painless mass or enlargement of testis (10% will have pain)
gynecomastia
+/- hydrocele
Biomarkers in dx and management of testicular carcinoma
AFP
hCG
LDH
How to assess testicular tumor?
scrotal U/S
if cancer confirmed, get CXR and CT of abd and pelvis to stage
________ is the most common misdiagnosis in patients with testis cancer
Epididymitis
Most common cancer deaths in men
- Lung
2. Prostate
Prostate cancer: who to screen and who to treat?
DRE on all men over 40
Offer PSA screen for men over 50 (with 10+ life expectancy, fhx, black, or abnormal DRE)
Available screening tools for prostate cancer?
PSA
History (fhx, aortic aneurysm)
DRE
Why is PSA not prostate cancer specific?
PSA is prostate specific
Elevated in BPH, prostatitis, and prostate cancer
PSA can be artificially lowered by 5a-reductase inhibitors
What to do if induration or nodule on DRE?
check PSA
refer to urology
When to refer to urology for prostate cancer?
persistent elevated or rising PSA with no sx’s
Abnormal DRE
