GU Malignancy: Prostate, Bladder, Testicular

Question 1

Bladder cancer

• epidemiology
• types
• risk factors

Answer 1

Older males

Most common - TCC
Schistosomiasis exposure - squamous

Smokers, schistosomiasis
Aniline dyes in printing, textiles -naphthylamine, benzidine
Rubber manufacturing

Question 2

Bladder cancer

• presentation
• diagnosis
• management

Answer 2

Visble/invisible hematuria => bladder cancer unless proven otherwise

Diagnosis - cystoscopy + biopsy
Staging - pelvic MRI, CT

Superficial - TURBT
Higher risk - intravesical chemotherapy/radical cystectomy/RT

Question 3

2WW criteria

• prostate
• bladder
• renal
• testicular

Answer 3

DRE abnormal
PSA high
=> 2WW

Bladder and renal => 2WW
45+ VH thats not UTI related

Bladder only 
60+ NVH and
-dysuria
-high WCC
=> 2WW

Testicular => 2WW
-non painful enlarged/changes in testis

Question 4

Prostate cancer

• epidemiology
• types
• presentation

Answer 4

Older men

Majority - adenocarcinoma in peripheral zone

Can be asymptomatic
Advanced - pelvic pain, urinary symptoms
Metastatic - bone pain

Question 5

Prostate cancer

• diagnosis
• management

Answer 5

Abnormal DRE
High PSA
-prostatitis, UTI, BPH, prostatic trauma

Diagnosis - transrectal USS + biopsy
Staging - pelvic MRI/CT, bone scan

Elderly, many comorbidities - active surveillance
Disease progression - radical treatment
-RT, brachytherapy
-radical prostatectomy
-bilateral orchidectomy/LHRH analogue, anti androgens => reduce T reaching prostate

Question 6

Testicular cancer

• epidemiology
• types
• risk factors

Answer 6

Most common in 20-30s men

Most common - germ cell tumours (seminomas, non seminomas)

Infertility
Cryptorchidism, Klinefelter
Mumps orchiditis
FHx

Question 7

Testicular cancer

• presentation
• diagnosis
• tumour markers
• management

Answer 7

Painless lump
Hydrocele
Gynceomastia

Diagnosis - US
Tumour markers 
-seminoma -hCG
-non seminoma - AFP, bHCG
-germ cell - LDH

Orchidectomy
CT, RT

Question 8

Metastasis

-bladder, prostate, testicles

Answer 8

Bone Liver Lung