GU Cancer Flashcards
What is renal cell carcinoma?
PCT epithelium carcinoma
MC renal cancer
Uncommon <40
RF?
smoking*
haemodialysis (15% chance)
hereditary
VONHIPPELLINDAN (auto dom, loss of tumour suppressor gene)
Sx of vonhippellindan?
RCC (50%) Bilaterally + renal + pancreatic cysts + cerebellum cancers
Sx?
often aSx, metastasised cases at Px
Triad = flank pain, haematuria, abdo mass (may have left sided varicocele)
May also have htn - tumour releases renin
anemia - low EPo
Dx?
1st line - USS
GS - CT Chest/abdo/pelvis (more sensitive)
Staging for RCC?
ROBSON STAGING 1-4
Tx for RCC?
Nephrectomy (full/partial if bilateral)
If met = IFN alpha or biologics eg. sunitinib
what is wilms tumour?
seen in?
aka nephroblastoma
Renal mesenchymal stem cell tumour
SEEN IN CHILDREN (<3y/o)
Much rarer
Bladder cancer
Mc subtype of?
If Px has schistosomiasis, more likely to have what type of carcinoma?
transitional (urothelium) - lines renal pelvis to bladder
squamous cell than transitional
What is bladder cancer?
transitional cell carcinoma (TCC) of bladder
Bladder cancer RF?
Occupational exposure to dyes/paints/rubber
(painters, hairdresser, mechanic working with tyres)
smoking, chemo/radio therapy, age (mean age at Px=73) + male
Sx of bladder cancer?
painless haematuria (macro/microscopic)
Dx of bladder cancer?
Flexible cystoscopy + biopsy (GS)
Tx of bladder cancer?
Conservative = supportive eg. specialist nurse
medical = chemo/radio
Surgery = TURBT (Transurethral resection of bladder tumour or cystectomy - remove bladder (last resort)
What is the MC male malignancy ?
prostate cancer
what is prostate cancer?
Outer zone of peripheral prostate (adenocarcinoma) neoplastic, malignant proliferation
Rf of Pros cancer?
Genetics - BRCA 12, HOXB13
increased age
afrocarribean ethnicity
fHx
Sx of prostate cancer
LUTS (like BPH) But with systemic cancer sx (weight loss, fatigue, night pain) + bone pain
Why do u get bone pain in prostate cancer?
typically metastasises to bone (lumbar back pain) - sclerotic lesions
also to liver, lung, brain
Dx of prostate cancer?
DRE + PSA in community
transrectal US (+ biopsy) = diagnostic GS
What’s the grading system used for prostate cancer?
GLEASON SCORE
higher = worse prognosis - based on biopsy
Tx for prostate cancer?
local = prostatectomy
Metastatic = hormone therapy (low testosterone = low cancer growth/even death)
Radio/chemo
Best = Bilateral orchiectomy (both testickles removed)
GnRH receptor agonist eg. Goserelin
SE + How GnRH receptor agonist work?
Agnoises GnRH which increases LH + FSH but results in exogenous suppression of the HPG axis
Erectile dysfunction, libido loss
This cancer is the most..
hormone sensitive cancer
