Kidney + Bladder Cancer Flashcards
What are the common malignancies of the urinary tract?
Renal cell carcinoma
Urothelial/transitional cell carcinoma
Where does renal cell carcioma effect?
Parenchyma of the kidneys
In the cortex + medulla
Arises from the tubular cells
What is the most common renal malignant tumour in adults?
Renal cell carcinoma
What type of epithelium does renal cell carcinoma arise from?
Tubular epithelium
Risk factors of renal cell carcinoma
Dialysis
Smoking
Obesity
(male > female)
Presentation of renal cell carcinoma
- haematuria
- fatigue
- weight loss
- fever
- mass in loin
- varicocele (advanced)
Investigations of renal cell carcinoma
Ultrasound or CT
Flexible cystoscopy
Cytology
Treatment of localised renal cell carcinoma
- surveillance
- partial nephrectomy for small tumours
- radical nephrectomy for large tumours > removal of the associated renal gland, perinephric fat, upper ureter + para-aortic lymph nodes
Treatment of metastatic renal cell carcinoma
- little efffective treatment
- resistant to chemo + radiotherapy
- palliative treatment - target angiogenesis (reduces blood flow to tumours by preventing it from making more vessels))
Presentation of urothelial cell carcinoma
Haematuria
Weight loss
Loss of appetite
Signs/symptoms of obstruction
Why is renal cell carcinoma rare in children?
Long developmental time of the tumour
Demographic of renal cell carcinoma
- 60-70 years old
- Male > female
- On dialysis
- Smoker
- Obese
Why can a patient with renal cell carcinoma present with Varicocele?
- As tumour grows it can grow across left renal vein
- Blocks the testicular vein
- Fluid cannot drain into renal vein from testis
- Enlargement of vessels in scrotum
Only on left hand side (right drains into IVC)
What does a radical nephrectomy involve?
What would it be used for?
- Removal of associated adrenal gland, perinephric fat, upper ureter + para-aortic lymph node
- Large renal cell carcinoma with no distant metastases
Causes of bladder cancer
- Analgesic misuse
- Exposure to aniline dyes used in industrial manufacturing of dyes, rubber + plastics
- Smoking
Diagnosis of bladder cancer
Cystoscopy
Biopsy
CT or MRI
Chest X ray
Types of bladder cancers
Superficial
Carcinoma in situ (flat tumour)
Muscle invasive
Treatment of bladder cancer
Depends on classification:
- low risk non-muscle invasive: transurethral resection of bladder +/- intravescial chemotherapy
- high risk non-muscle invasive: transurethral resection of bladder + intravescial chemotherapy or intravescial BCG treatment + cystectomy
- muscle invasive cancer: cystectomy + radiotherapy or palliative care
How can patients with urothelial cell carcinoma of the upper urinary tract go on to develop bladder cancer?
Seeding
Malignant cells from upper urinary tract can travel to bladder > bladder cancer
Treatment of urothelial cell carcinoma of upper urinary tract
Nephro-ureterectomy
Removal of kidney, fat, ureter+ cuff of bladder
Where does urothelial cell carcinoma originate from?
Urothelium
Calyx to bladder
More commonly lower urinary tract
Risk factors of squamous cell carcinoma in bladder
- Recurrent UTI > chronic inflammation
- schistosomiasis
- stones
Where do renal cell carcinomas most commonly arise?
Proximal convoluted tubule
