cancers (-RCC) Flashcards
myeloma
cancer of plasma cells - overproduction, accumulate in bone marrow and/or soft tissue
(plasma cells = type of B lymphocyre that produce antibodies)
4 classic features of myeloma
CRAB Calcium - high Renal failure Anaemia Bone lesions/pain
plasma viscosity in myeloma
increases due to more proteins in the blood
–> causes easy bruising, purplish palmar erythema
myeloma presentation
bone pain/weakness - lytic lesions
anaemia
raised Ca, ESR, plasma viscos
low WBC - recurrent infections
light chain cast nephropathy
myeloma diagnosis
bloods -> protein electrophoresis-> lots of abnormal protein + free light chains
urine -> Bence Jones protein -> light chain/Ig in urine
what part of the prostate is prostate cancer commonly found?
peripheral zone (adenocarcinomas)
physiological with age = central + transitional zones
prostate cancer presentation
weight loss
LUTS - weakflow, terminal dribbling, hesitancy
haematuria
(may be asymmtomatic)
PSA
glycoprotein produced by epithelial cells of prostate
secrete in semen + small amount entering blood - makes semen thinner
unreliable
raised can indicate prostate cancer
prostate cancer investigations
DRE + PSA
multiparametric MRI
biopsy (if MRI >=3 + clinical suspicion)
–> TRUS
Gleasons grading system for prostate cancer
based on histology from biopsy - graded 1-5 (5 bad)
2 scores added together - 1st + 2nd most prevalent pattern
6=low risk
7= intermediate (3+4 lower 4+3)
8+ = high risk
management of prostate cancer
surveillance in early
external bean radiotherapy
brachytherapy - implanting radioactive metal seeds into prostate
hormone therapy
radical prostatectomy
hormone therapy for prostate cancer
androgen-receptor blockers - bicalutamide
GnRH agonists - goserelin
SE = hot flushes, gynaeomastia, sexual dysfunction
most common bladder cancer
transitional cell carcinoma
types of bladder cancer
transitional cell carcinoma (90%) - papillary in appearance
squamous cell carcinoma (5 - schistosomiasis)
adenocarcinoma, sarcoma, small cell
risk factors for bladder cancer
!!! smoking !!!
occupational exposure - dye, rubber
chronic bladder infections
schistosomiasis –> squamous cell
smoking is the biggest risk factor to which cancer (other than lung)
bladder
bladder cancer presentation
painless haematuria
recurrent UTIs
suprapubic pain, burning mucturition
retired dye factory worker/lake malawi (schistosomiasis)
bladder cancer investigations
CT urogram
flexible cystoscopy
bladder cancer staging
Tis - only urothelium + flat
Ta - only urothelium + projecting into blaffer
T1 - invading connective tissue layer beyond urothelium, not muscular layer
muscle-invasive = T2-T4
medical (Symptomatic) treatment of bladder cancer
anticholinergic - inhibits bladder smooth muscle contraction
beta agonist
management of non-muscle invasive bladder cancer
transurethral resection of bladder tumour (TURBT)
intravesical chemo via catheter (post TURBT)
management of muscle invasive bladder cancer
radical cystectomy - urostomy with ileal conduit
external beam radiotherapy
types of testicular cancer
seminomatous - 35-45yrs (sergeants older)
non-seminomatous (teratomas) - <35 (troops, younger)
risk factors for testicular cancer
undescended testes = cryptochidism male infertility fam history increased height white causasian + usa
presentation of testicular cancer
painless lump - hard, irregular, not fluctuant
gynaecomastia –> Leydig cell tumour
tumour markers of testicular cancer
alpha-fetoprotein - teratomas
beta-hCG - teratomas + seminnomas
LDH = non-specific
penile cancer, commonest site/type
skin cancer - 95% squamous cell carcinoma
commonest site = glans (bell end)
risk factors for squamous cell carcinoma of bladder
schistosomiasis
long term cather - squamous METAPLASIA
