Malignancy

Question 0

For patients with prostate cancer, describe the usual presentation, diagnostic pathway, natural history and principles of treatment

Answer 0

Usual presentation - asymptomatic, benign enlargement, bone pain (metastases), haematuria (advanced)
Diagnostic pathway - digital rectal examination (DRE), serum PSA (prostate specific antigen), transrectal ultrasound (for guided biopsy)
Principles of treatment - surveillance, radical prostatectomy, radiotherapy, hormones (castration), palliative (radiotherapy, bisphosphonates, chemotherapy)

Question 1

List the common urinary malignancies

Answer 1

Renal cell carcinoma 
Transitional cell carcinoma
Bladder carcinoma
Prostate cancer
Testicular cancer

Question 2

For patients with urological haematuria of malignant origin, understand differential diagnosis, aetiology, principles of investigation and principles of treatment

Answer 2

Differential diagnosis - cancer, stones, infection, inflammation, benign prostatic hyperplasia
Aetiology - smoking, occupation, family history
Investigations - blood (FBC, u&e), urine (culture, cytology), endoscopy (flexible cystoscopy), radiology (ultrasound)
Treatment - intravesical chemotherapy/immunotherapy, radical cystectomy (ileal conduit), radiotherapy