neoplasms and cancers

Question 1

prostate cancer?

Answer 1

gnerally slow -growing, malignant neoplams of the adenomatous cells

Question 2

what can Pr. CA lead to?

Answer 2

urinary obstruction and metastatic disase

Question 3

where do th)e majority of pr Ca originate?

Answer 3

in the peripheral zone (outer portion that is palpable on rectal exam)

then the transition zone (portion that surrounds the urethra)

then the central zone (ejaculatory ducts)

Question 4

epidemiology of pr cancer

Answer 4

most common non-skin cancer in men

Question 5

what are some risk factors for Pr, Can?

Answer 5

genetic predisposition, hormonal influence, dietary and environmental factors, infectious agents

*** old age

Question 6

what can be used for Pr cancer screening?

Answer 6

PSA, DRE

Question 7

what are the clinical features of Pr. Ca?

Answer 7

+many asx

+ urinary obstruction or irritative voiding if tumor invaded into the urethra, bladder neck, or trigone of the bladder

+enlarged, nodular, asymmetric prostate

Question 8

where may Pr Ca metastasize?

Answer 8

bone! may lead to possilbe spinal cord impingement if the vertebral bodies are involved

Question 9

what dx studies can be done for Pr ca?

Answer 9

+PSA usually elevated
+patholgical exam
+ transrectal US
+biopsy

+may see incrased LFTs (alk phos)

Question 10

what would apathologic exam of tissue reveal in Pr. Ca?

Answer 10

obstructive prostatic hyperplasia shows that 10% have malignancy

Question 11

what would a US show for Pr ca?

Answer 11

hypoechoic lesions in prostate

Question 12

what confirms the dx of prostate cancer?

Answer 12

biopsy; and allows histolgical grading

Question 13

what grading system is used for prostate cancer?

Answer 13

the Gleason: adds together the pimary and secondary grades of the tumor; final score btw 2-10

*higher score, worse prognosis

Question 14

tx of pro. c?

Answer 14

depends on staging

Question 15

what dx tools/imaging is used to stage pros cancern?

Answer 15

abdominal/pelvic CT or MRI, pelvic lymphandencetomy, bone scan

Question 16

low grade prs tumors

Answer 16

may not need tx

Question 17

stages A and B pr cancer tx?

Answer 17

tumore confined to prostate

tx with Radical retropubic* prostatectomy (RRP), brachytheraphy, or external beam radiation therapy

Question 18

stage C Pr. cancer tx?

Answer 18

tumor w/ local invasion; tx the same as stage A and B

Question 19

stage D pr cancer tx?

Answer 19

hormonal manipulation using orchiectomy, antiandrogens, LH agonists, estrogens

palliative care

Question 20

what is brachytheraphy?

Answer 20

are radiated and implanted in prostate They remain in prostate even after radiation has degraded about 60 days.

This treatment is best for localized, contained cancer.

Question 21

bladder cancer general features?

Answer 21

uroepithelial tumors

+most are transitional cell carcinomas

Question 22

what pt population is more likely to get bladder cancer?

Answer 22

men, pts 40-70

Question 23

what are some causal risk factors for bladder cancer?

Answer 23

exposure to tobacco, occupational carcinogens from rubber, dye, printing, and chemical industries, schistosmiasis,

exposure to cyclophosphamide, and chronic infection

Question 24

what is schistomiasis?

Answer 24

also known as bilharzia, is a disease caused by parasitic worms.

Question 25

what are the clinical features of bladder cancer?

Answer 25

painless hematuria is the most common also, bladder irritability and infection

Question 26

what dx studies can be done for bladder cancer?

Answer 26

CBC and blood chemistry: infx, renal funx

Question 27

what is the definitive dx of bladder cancer?

Answer 27

cystoscopy, and bx confirms the pathologic diagnosis

Question 28

what other radiologic procedures can be used for staging and to find tumors?

Answer 28

IV urogram, Pelvic/abdominal CT, chest sr, bone scan, retrograe pyelography fro renal pelvic for uretral tumors

Question 29

how is bladder cancer trx?

Answer 29

depends on stage

Question 30

how are superficial bladder cancer lestions tx?

Answer 30

with endoscopic resection and fulguration followed by cystoscopy every 3 mtns

Question 31

how are recurrent or multiple lesion tx in bladder cancer?

Answer 31

intravesical instillation of thiotepa, mitomycin-C, or bacillus calmette- guerin (BCG)

Question 32

what can BCG also be used for?

Answer 32

prevent TB

Question 33

what can be used for recurrent bladder cancer? or diffuse TCC in situ, or for tumors tha have invaded the muscle

Answer 33

radical cystectomy,

Question 34

what is reserved for pts taht are not surgical candiddates due to significant comorbid medical conditions?

Answer 34

external beam irradiation therapy

Question 35

what is renal cell carcinoma?

Answer 35

aka hypernephroma or renal adneocarcinoma +most common type of renal malignancy

Question 36

what population is most likely to get RCC?

Answer 36

men older than 55 american indian, alsakan native

Question 37

what risk factor has been linked with RCC?

Answer 37

cigarette smoking

Question 38

what are the other forms of RCC?

Answer 38

hereditary: von Hipple Lindau dz, herediatry papillary renal carcinoma

Question 39

what are the clinical features of RCC?

Answer 39

wide range of s/sx "internists' tumor" bc commonly discovered as an incidental finding on abdominal imagins

Question 40

what ist he most common sx of RCC?

Answer 40

gross or microscopic hematuria, followed by pain or an abdominal mass +this triad is not commonly seen

Question 41

what other paraneoplastic syndromes is RCC associated with?

Answer 41

erythrocytosis, hypercalcemia, htn, hepatic dysfuction

Question 42

what dx should be done for RCC?

Answer 42

pts w/ hematuria should under go an US to r/o stone

Question 43

what is the primary technique for diagnosis RCC?

Answer 43

CT scanning w and w/o contrast others: MRI w/ contrast or arteriography

Question 44

how is RCC graded?

Answer 44

using Fuhrman grade (1-4) and TNM of tumor

Question 45

how is localized RCC dz tx?

Answer 45

radical nephrectomy

Question 46

where may RCC dessiminate to?

Answer 46

brain, bone, lungs *treat with radiation theraphy

Question 47

what meds have been shown to have some sucess in reduction grown of RCC?

Answer 47

interferon-A and interleukin

Question 48

testicular cancer general characteristics?

Answer 48

young men! | hx of cryptorchidism or previous hx of testicular cancer

Question 49

what are the clinical features of testicular cancer?

Answer 49

painless, solid testicular swelling | -may also complain of a heaviness

Question 50

what lymph nodes may be involved in testicular cancer?

Answer 50

para-aortic; may present as a ureteral obstrctions

Question 51

what part of the body may also be involved int testicuar cancer?

Answer 51

lungs- pulmonary metastases shown on chest xray

Question 52

what ist he most common type of testicular cancer?

Answer 52

nonseminomatous (embryonal carcinoma, teratoma, mixed cell type, and choriocarcinoma) then seminomatous

Question 53

what is dx for nonseminomatous germ cell tumors?

Answer 53

elevated alpha-fetoprotein or Beta human chorionic gonadotrioub