Haematuria Pt2 Flashcards
commonest cancer in men
prostate
lifetime risk of prostate cancer
1/5
risk factors for prostate cancer
family history
African Caribbean
lycopene and selenium protective
signs and symptoms of prostate cancer (7)
- nocturia
- urinary frequency
- urinary hesitancy
- dysuria
- haematuria
- back pain
- nodular asymmetrical prostate
type of prostate cancer=
adenocarcinoma
most common area for formation of cancer cells in prostate
peripheral
prostate carcinoma in situ/ prostatic intraepithelial neoplasia =
small lumps of cancer cells remain confined to pre-exisiting ducts and glands - precursor lesion
nearby organs prostate cancer can invade
seminal vesicles
ejaculatory ducts
rectum
where can prostate cancer metastasise (5)
bones lymph nodes rectum bladder lower ureters
investigations for prostate cancer
PSA
serum testosterone
FBC
transrectal biopsy
staging of prostate cancer done by
gleason grading system
how is gleason score done
via prostate biopsy -microscopic appearance
cancer with high gleason score =
more aggressive and worse prognosis
scores in the gleason score
-1-10
<6 well-differentiated or low grade
->7 are moderately differentiated or intermediate grade
-8-10= poor differentiated or high grade
low risk prostate cancer (Gleason 5-6) preferred treatment
active surveillance
medium risk prostate c (gleason 7 or T2) preferred treatment
- radical prostatectomy
- radical radiotherapy
high risk prostate c (>8 gleason, T3/T4) preferred treatment
- radical prostatectomy
- radical radiotherapy with neoadjuvant hormone therapy
active surveillance of prostate cancer=
PSA every 6 months
PR examination and prostate biopsy every 12 months
prostate metastatic disease treatment
palliative care, treatment not curable
- anti-androgens
- oestrogens
- LHRH analogues (goserelin)
- bilateral scrotal orchiectomy
what does prostate specific antigen (PSA) do
stimulates the development of prostate cancer by increasing folate levels for cancer cells to survive
most common presentation of prostate cancer
LUTS
spread of advanced prostate cancer
lymphatic
haematogenous
contiguous local spread
testicular tumour signs and symptoms
- painless unilateral swelling
- solid, firm mass within testes
- dull aching in supra-pubic area
- gynaecomastia from excessive HCG from testicular germ cell tumours
risk factors for testicular tumours (6)
- cryptochidism
- family history
- testicular atrophy
- 20-34 years
- trauma
- white ethnicity
cryptochildism=
both testes fail to descend into scrotum
what type of tumour is testicular cancer
germ cell tumour
2 types of testicular cancer
seminoma
teratomas
most common form of testicular tumour
seminoma
when is testicular cancer believed to have started
in foetal development
what is carcinoma in situ of testicular cancer called
intratubular germ cell neoplasia unclassified -pre-cancerous lesion
what is the malignant transformation of carcinoma in situ characterised by
growth beyond the basement membrane
where do seminomas originate
germinal epithelium of seminiferous tubules
survival rate of seminomas
95%
slower rate of grow and spread between 2 testicular cancers
seminomas
what can some seminomas increase the level of
HCG (human chroninic gonadotropin)
teratomas are histologically characterised by
3 layers of trigeminal disc
what are teratomas made up of
several different types of tissue; hair, muscle, bone
what can non-seminomas increase levels of
alpha-fetoprotein
management of testicular cancer (3)
- inguinal radical orchiectomy +retroperitoneal lymph node dissection
- external beam radiation post-orchiectomy
- carboplatin chemo post-orchiectomy
