GU Cancer

Question 1

What are the stages and treatment for Bladder/Urothelial Cancer?

Answer 1

Localized non-muscle Invasive - TURBT +/- intavesivular BCG

Localized Muscle Invasive - Neoadjuvant chemotherapy, followed by cystectomy + lymph node dissection) OR chemo + radiation

Metastatic - Chemotherapy

Question 2

What is the management for localized ovarian cancer?

Answer 2

Localized: Surgery (TAH + BSO + LN dissection + peritoneal washing)

Question 3

What is Stage III ovarian cancer and how is it managed?

Answer 3

Stage III: Malignant ascites & visible peritoneal deposits

Treat with cytoreduction (debulk) and adjuvant chemotherapy with curative intent.

Question 4

How is Stage IV ovarian cancer managed?

Answer 4

Palliative chemo +/- debulking surgery

Question 5

What is a typical adjuvant chemotherapy regimen in ovarian cancer?

Answer 5

Platinum (carboplatin) + taxane (paclitaxel)

Question 6

What is done to work up suspected ovarian cancer?

Answer 6

DO NOT biopsy due to risk of seeding.

Imaging - abdo & transvaginal U/S AND CT chest/abdo/pelvis

Tumour Markers - Serum CA-125

Question 7

How is renal cell carcinoma managed if it is a localized renal mass (3 scenarios)?

Answer 7

(A) < 1 cm = active surveillance
(B) 1-4 cm = CT or MRI to better characterize and then consider partial nephrectomy if good surgical candidate, or biopsy and ablation if poor.
(C) > 4 cm = Nephrectomy