Neoplastic disease of GU & PCKD Flashcards
bladder cancer is the ___ most common cancer in men and ___ most common in women
4th MC in men
13th MC in women
what is the mean age of Dx for bladder cancer
73yo
who is bladder cancer more common in for race?
whites
what are causes of bladder cancer?
smoking contributies 50-60% of dx high risk continues 10 yrs after smoking dyes and solvent exposure Schistosoma haematobium parasite catheter use
bladder cancer originated from what cell line?
98% are epithelial malignancies
what are S/S of bladder cancer
hematuria presenting symptoms in 85-90% of pts with bladder cancer
Irritative voiding
may be asymptomatic
palpable tumors, organomegaly and lyphadenopathy
Diagnostic testing for bladder cancer
U/A shows hematuria
US,CT,MRI may show masses in bladder
Dx confirmed by cystoscopy with Bx
what is the Tx for bladder cancer?
depends on stage dz
superificial cancers-lesions and intravesical chemo
radio-therapy with chemo
renal cell carcinoma causes
smoking only identifiable RF
2:1 male:female
renal cell carcinoma s/s
gross or microscopic hematuria
flank pain
abdominal mass
renal cell carcinoma dx testing
U/A hematuria, anemia
CT,MRI,US incidental findings
renal cell CA Tx
partial nephrectomy-small tumor
radical nephrectomy-large tumor
renal cell 5 yr prognosis
90-100% for tumor confined to renal capsule
50-60% for tumors beyond renal capsule
0-15% for node positive
Wilms tumor
rare kidney cancer that affects children also called nephroblastoma
MC in kids 3-4 yrs old
occurs in 1 kidney
wilms tumor s/s
abdominal swelling/pain/mass
fever
hematuria
wilms tumor testing
CBC,LFT, Renal funx, UA, CT/MRI
PET scan, Bx resection
wilms tumor tx
nephrectomy, chemo, radiation, lymphnode bx
wilms tumor prognosis for 5 yrs
> 90%
prostate cancer in men is the MC what type of cancer?
non cutaneous cancer
what increases risk for prostate cancer?
50yo american male 40% chance of developing latent CA
Blacks, FHx, high fat diet
what type of cancer is prostate cancer
95% are adenocarcinomas
prostate cancer s/s
may find on DRE or PSA
obstructive or voiding symptoms
hematuria or hematospermia(blood in sperm)
lymph node involvement may cause LE edema
METs are common to bone>back pain and pathologic fx
Prostate cancer dx findings
Increased PSA but can be falsely elevated in BPH and prostatitis
Controversial test, 4.0 ng/ml considered “normal” PSA level
what is the Tx of prostate cancer
based on tumor stage and age/ health of pt
Prostatectomy-incontinence and ED
Brachytherapy
cryosurgery
chemo
Androgen deprivation dz because prostate cancer is hormone sensitive
what are S/E of androgen deprivation
decreased libido, impotence, weight gain, fatigue, anemia, hot flashes,
prostate cancer screening
Discussion should start at 50yo with avg risk, 45 yo with high risk, 40yo with highest risk
testicular cancer incidence
MC in men 20-35yrs old
MC in right testicle
MC in cryptorchidism
testicular caner s/s
MC is painless enlargement of testes
sensation of heaviness
discrete mass or diffuse testicular enlargement
testicular cancer testing
HCG, alpha fetoprotein, LDH
LFT, CBC
Scrotal U/S
Orchiectomy is needed for Bx
testicular CA tx
orchiectomy
retroperitoneal radiation
chemo
lymph node bx
testicular surveillance
pt followed monthly for 2 yrs then bimonthly in 3rd yr
tumor marker q visits, CXR and CT q 3months
what are identifiable genes for PCKD?
ADPKD1 on chromosome 16 (85-90% of pts)
ADPKD2 on chromosome 4 (10-15% of pts)
PCKD affects how many americans?
500,000
of cysts in PCKD depends on what
age
PCKD s/s
abdominal/flank pain microscopic or gross hematuria hx of UTI and kidney stones common FHx in 75% of cases Large kidneys on exam HTN+abdominal mass suggest dz
PCKD diagnostic testing
CBC, U/A U/S confirms Dx 2+ cysts <30yo 2+ cysts in each kidney 30-59yo 4+ cysts in each kidney at 60+
PCKD tx
aimed to control complications BP monitoring goal <125/75 Tx HTN w/ ACE or ARB Tx for UTI and stones avoid contact sports renal transplant Pts at risk for cerebral aneurysm MRA screen
PCKD prognosis
50% will have ESRD by 60yo
Accounts for 10% of pts on dialysis
