Cancers of the Male GU System

Question 1

Penile cancer most common in what age?

Answer 1

60’s

Question 2

Risk factors of penile cancer

Answer 2

• poor hygiene
• uncircumcised
• association with cervical carcinoma and HPV (16, 18)
• South America and Africa

Question 3

in situ cancer =

Answer 3

cancer that is in original position or place

Question 4

Bowen disease

Answer 4

Squamous cell carcinoma
Typically involving penile shaft
Painless red plaque with encrustations

Question 5

Erythroplasia of Queyrat

Answer 5

Velvety, red lesion with ulcerations

Usually involves the glans

Question 6

Bowen Disease vs Erythroplasia of Queyrat cancers

Answer 6

Bowen = closer to Balls (shaft)

Erythroplasia of Queyrat = on End (glans)

Question 7

Bowen Disease and Erythroplasia of Queyrat treatments

Answer 7

local excision or topical agents

Question 8

Invasive carcinoma of penis

Answer 8

squamous cell carcinoma consisting of more than just an external lesion

Question 9

Pattern of penile cancer spread

Answer 9

lymphatic channels to femoral and iliac nodes

Question 10

Most treatable cancers in men

Answer 10

melanoma

testicular cancer

Question 11

Most common cancer affecting men 15-35 yrs old?

Answer 11

testicular cancer

Question 12

Most common testicular tumor in a patient older than 50 years

Answer 12

lymphoma

Question 13

Secondary tumors of testes

Answer 13

lymphoma (>50)
leukemic

infiltration of the testis (kids)

Question 14

Benefit of orchipexy for cryptorchidism

Answer 14

lowers risk of malignancy if performed before age 13

Question 15

Biggest risk factors for testicular cancer

Answer 15

undescended testes

exogenous maternal estrogen during pregnancy

Question 16

Common signs of testicular cancer

Answer 16

painless mass or enlargement of testis (10% will have pain)
gynecomastia
+/- hydrocele

Question 17

Biomarkers in dx and management of testicular carcinoma

Answer 17

AFP
hCG
LDH

Question 18

How to assess testicular tumor?

Answer 18

scrotal U/S

if cancer confirmed, get CXR and CT of abd and pelvis to stage

Question 19

________ is the most common misdiagnosis in patients with testis cancer

Answer 19

Epididymitis

Question 20

Most common cancer deaths in men

Answer 20

1. Lung

2. Prostate

Question 21

Prostate cancer: who to screen and who to treat?

Answer 21

DRE on all men over 40

Offer PSA screen for men over 50 (with 10+ life expectancy, fhx, black, or abnormal DRE)

Question 22

Available screening tools for prostate cancer?

Answer 22

PSA
History (fhx, aortic aneurysm)
DRE

Question 23

Why is PSA not prostate cancer specific?

Answer 23

PSA is prostate specific

Elevated in BPH, prostatitis, and prostate cancer

PSA can be artificially lowered by 5a-reductase inhibitors

Question 24

What to do if induration or nodule on DRE?

Answer 24

check PSA

refer to urology

Question 25

When to refer to urology for prostate cancer?

Answer 25

persistent elevated or rising PSA with no sx’s

Abnormal DRE