Chapter 35: Male Reproductive and Genitourinary Tumors Flashcards
A total dose of 7200 cGy in fractions of 180 cGy is used to treat which male reproductive cancer?
Prostate
A total dose of 2500 cGy in fractions of 160 cGy is used to treat which male reproductive cancer?
Testicle
Which cancer can be treated using a water bath to provide dose homogeneity by compensating for the irregular surface with tissue-equivalent material?
Penis
Cancer of which urinary organ is most common?
Bladder
Cancer of which of the following male reproductive system components is most common?
Prostate
What is the most common form of kidney cancer?
Transitional cell carcinoma
What is the most common form of bladder cancer?
Transitional cell carcinoma
What is the standard dose used when irradiating the entire bladder?
4500 to 5000 cGy
What is the most common form of testicular cancer?
Germ cell tumors
What is the most common form of penile cancer?
Squamous cell carcinoma
What region might receive prophylactic radiation therapy for advanced right-sided testicular cancer?
Left SCV nodes
What is the primary treatment option for kidney cancer?
Surgery
What is the most common symptom of testicular cancer?
Painless mass
What is the 5-year survival of all stages of testicular cancer combined?
50%
What is the treatment of choice for testicular cancers?
Surgery
What is the 5-year survival of all stages of prostate cancer combined?
99%
Who has the most significant risk of developing prostate cancer?
70-year-old black male
Which of the following treatment techniques are most frequently used when irradiating the prostate? I. Supine positioning II. Prone positioning III. Full bladder IV. Empty bladder
a. I and III
I. Supine positioning
III. Full bladder
Which of the following cancers is most likely to occur in a 27-year-old male?
Testicle
Which of the following is least likely to be used in the management of a patient with prostate cancer?
Chemotherapy
Which lymph node chains will be treated if a man is diagnosed with right-sided testicular cancer that has not spread outside the testicle?
I. Right SCV nodes
II. Para-aortic nodes
III. Right inguinal nodes
II and III
II. Para-aortic nodes
III. Right inguinal nodes
Which of the following treatment techniques can be used to treat the prostate?
a. 4-field box
b. IMRT
c. Brachytherapy
d. All of the above
All of the above
Kidney carcinoma can be attributed to which of the following?
I. Cigarette use
II. Obesity
III. Betel nut chewing
I and II
I. Cigarette use
II. Obesity
To which surface of the prostate gland do the seminal vesicles attach?
Posterior superior
Gleason’s grading system is based on the tumor’s _______________.
morphology
How many new cases of kidney cancer are there each year?
Is it increasing or decreasing?
51,000
Increasing
How many deaths from kidney cancer each year?
12,900
What is a cause of kidney disease?
von Hippel-Lindau disease (Hereditary condition)
Symptoms of kidney cancer? (6)
Asymptomatic Hematuria (Blood in urine) Pain Mass Fatigue Weight loss
What is the treatment of choice for kidney cancer?
Surgery
Radiation dose range for kidney cancer?
4500-5000 cGy
How many new cases of bladder cancer per year?
6700
How many deaths from bladder cancer each year?
1,375
Symptoms of bladder cancer? (2)
Hematuria
Change in bladder habits
percentage of metastasis in kidney cancer?
25-35%
Dose for bladder cancer?
4500-5000 cGy
How many new cases of ureter cancer each year?
2500
Deaths from ureter cancer each year?
690
Risk factors for ureter cancer? (2)
Smoking
Occupational exposures
Symptoms of ureter cancer? (5)
Hematuria Pain Mass Obstruction Incontinence
Type of ureter cancer?
Transitional cell carcinoma
New cases of penile cancer each year?
1500
Deaths from penile cancer each year?
280
Risk factors for penile cancer? (6)
Hygiene, phimosis, and smegma HPV Smoking Psoriasis treatment AIDS Circumcision
Symptoms for penile cancer? (4)
Skin changes -Color -Thickness Discharge Ulcer Swelling
Does metastasis for penile cancer occur early or late?
Late
Bladder cancer is more common in men than in women.
True
Bladder cancer occurs about four times more often in men than in women
Early prostate cancer is asymptomatic.
True
Carcinoma of the prostate can be asymptomatic until reaching a significant size.
Hormone therapy can be used as a curative treatment for prostate cancer.
False
Hormone therapy is used in addition to other therapies.
Injury to the testicles is a known risk factor for developing a seminoma.
False
Prostate cancer is the most common cancer affecting American men.
True
Carcinoma of the prostate is the most common malignancy in males in the United States.
PSA is only useful in diagnosing prostate cancer.
False
PSA is also helpful post treatment.
Radiation therapy treatments for seminoma include the primary tumor and regional lymph nodes.
False
Patients with stage I testicular seminoma should receive megavoltage irradiation to the paraaortic or para-aortic and ipsilateral pelvic lymph nodes. The primary tumor has been removed and therefore is not in the treatment field.
Radiation therapy is typically used as a primary treatment option for cancers of the bladder.
False
Treatment of bladder cancer includes some form of surgical resection.
Scrotal irradiation is a commonly accepted practice for testicular cancer.
False
The 1989 Consensus Conference in Leeds, England, recommended that inguinal or scrotal irradiation be omitted even if scrotal interference has occurred.
The survival data for external beam radiotherapy and brachytherapy are better than surgery for prostate cancer when like groups are compared.
False
Results with both external beam radiation and radiaoisotopic implant are much the same as for surgery if like groups are compared.
Topical chemotherapy is often used when treating low staged penile cancers.
True
Bowen disease and erythroplasia of Queyrat can be treated with topical 5-FU (5% cream), a local excision, or superficial x-rays (4500 to 5000 cGy in 4 to 5 weeks).
Variations in rectal fullness have very little effect on the daily position of the prostate.
False
Exact prostate positions varies daily due to a number of factors including rectal fullness.
What is the number one cancer incidence for males in the US?
prostate cancer
Prostate cancer is ___ in mortality in the US
second in mortality
lung first
Who presents later stage and have worse prognosis than caucasians?
african americans
Overall prostate cancer is a ____ growing malignancy
slow
What is the average age of onset for prostate?
60 years
What are side effects of a box field technique?
cystitis, proctitis, diarrhea, dysuria
What does a full bladder do?
decreases bladder dose and displaces small bowel in lateral fields
What male cancer has a low occurrence but is the most common male cancer for 15 to 35 year old males?
Testicular
Is testicular cancer more common in Caucasian or african americans?
Caucasian
Is Penile cancer common in the US?
no, rare in the US but higher incidence in Asia, Africa, South America
What is the age range for penile cancer?
range from 22 to 90
generally a disease of older men
in the US 29% were younger than 30 years old
What is etiology for penile cancer?
no circumcision at birth Phimosis poor hygiene, smegma HPV Ultraviolet radiation smoking
What is the most common pathology of penile cancer?
Squamous Cell Carcinoma
The most common cancer of germinal origin of the testis is?
seminoma
Testicular cancers are most frequently diagnosed in men aged
15 to 35
Gleason developed a grading system based on the degree of differentiation seen in tissue samples. His system uses ____ different histologic patterns
5
Of the following tumors, which would require the lowest dose to control disease?
testis
When irradiating seminoma stages I, IA IB the following nodes should be incldued:
a. paraaortic
b. Ipsilateral iliac
c. mediastinal
d. scalene
a paraaortic and b ipsilateral iliac
The most common histologic type found in prostate cancer is
adenocarcinoma
Brachytherapy in the management of prostate cancer would be
LDR interstitial
The patient complaining of diarrhea should be advised to
avoid high fiber foods
The inguinal nodes should be included in RT fields for
penile
What is in the urinary system?
kidney and bladder
What age is median age of onset of kidney (renal) cancer?
55 to 60 years old
Men are affected twice as much w kidney cancer as women?
True
Where are bladder cancers more common?
high incidence in industrial cities
Men are 2.5 times more likely than women to get bladder cancer?
True
What is the median age of bladder cancer?
68
What is usually the cause of death in bladder cancer patients?
liver failure and uremia
What is cystectomy?
Cystectomy is the surgical removal of all or part of the bladder.
Which of the following examinations are best used in the detection of bladder cancer?
TURB
Urine cytology
cytoscopy
most bladder cancers arise in the
posterior wall
lateral wall
trigone
What is TURB
transurethral bladder removal
The ureters attach the ____ surface of the bladder
posterolateral
The right kidney is slightly lower than the left due to the presence of the
liver
The most common presenting symptom of bladder cancer is
hematuria
The ureters enter the kidney at the
renal pelvis
Urine passes from the bladder to the outside of the body via
urethra
The most common pathology of malignant tumors of the prostate is
adenocarcinoma
Most common type of kidney tumor is:
Transitional cell Carcinoma
Cancer with highest incidence rate for males is:
Prostate Cancer
Which of the following are common immobilization-repositioning devices used in the treatment of prostate cancer?
I. Polyurethane foam molds
II. Vacuum devices (Vac Locks)
III. Belly Board
I, II, and III
For patients with bladder cancer, the bladder should be ________ during whole-bladder radiation.
empty
A side effect associated with the treatment of prostate cancer , in which the adult male is unable to obtain an erection, is:
impotence
The prostate gland is located _______ to the rectum.
anterior
The tumor of the male reproductive and genitourinary system that requires the lowest dose to control the disease is:
seminoma
The tumor of the male reproductive and genitourinary system for which a brachytherapy implant is most likely used to control the disease is:
prostate
the most common testicular tumor pathology is:
seminoma