Neoplastic GU Maclary

Question 1

Causes of bladder cancer

Answer 1

• Cigarettes (50-60%)
• Exposure to industrial dyes and solvents
• S. haematobium parasite in developing countries
• Prolonged catheter use, calculi

Question 2

What is the MC type of bladder cancer?

Answer 2

Epithelial (98%), usually urothelial cell carcinomas

Question 3

What is the MC presenting symptom of bladder cancer?

Answer 3

Hematuria (gross or microscopic) in 85-90% of pts

Question 4

How is bladder cancer diagnosis confirmed?

Answer 4

Cystoscopy with biopsy

Question 5

Treatment of superficial bladder cancer

Answer 5

Lesion resection and intravesical chemo

Question 6

Treatment of invasive but localized bladder cancer

Answer 6

• Radical cystectomy

- Chemo and RT

Question 7

Treatment of muscle invasion bladder cancer

Answer 7

Systemic chemo prior to radical cystectomy

Question 8

Define intravesical chemo

Answer 8

Chemo delivered directly to bladder weekly x 6-12 weeks

Question 9

What is the only identifiable risk factor for renal cell carcinoma?

Answer 9

Smoking

Question 10

Who is MC affected by renal cell carcinoma?

Answer 10

2:1 males

6th decade of life

Question 11

Where does renal cell carcinoma originate from?

Answer 11

Proximal tubule cells

Question 12

Treatment of renal cell carcinoma

Answer 12

• Partial nephrectomy (small tumors)
• Radical nephrectomy (large tumors)
• No effective chemo for mets renal cell cancer

Question 13

Prognosis of renal cell carcinoma

Answer 13

• 90-100% 5 yr survival when tumor is confined to renal capsule
• 50-60% 5 yr survival for tumors beyond renal capsule
• 0-15% for node positive tumors

Question 14

Prognosis of bladder cancer

Answer 14

• 98% 5 yr survival for superficial in situ

- 88% 5 yr survival for Stage I

Question 15

What is Wilms’ tumor?

Answer 15

• Rare kidney cancer that primarily affects children (3-4 yo, less likely after 5 yo)
• Aka nephroblastoma

Question 16

What is the MC kidney cancer in children?

Answer 16

Wilms’ tumor

Question 17

Prognosis of Wilms’ tumor

Answer 17

5 yr survival rate over 90%

Question 18

What type are most prostate cancers?

Answer 18

Adenocarcinoma (over 95%)

Question 19

How is histologic aggressiveness of prostate cancer measured?

Answer 19

Gleason grading system

Question 20

MC clinical presentation of prostate cancer

Answer 20

Many pts asymp (60%)

Question 21

Prognosis of prostate cancer

Answer 21

Overall 10 yr survival 70-80%

Question 22

What is the MC cancer in men 20-35 yo?

Answer 22

Testicular

Question 23

Main types of testicular cancer

Answer 23

• Nonseminomas (65%)

- Seminomas (35%)

Question 24

Key features of testicular cancer

Answer 24

• MC in cryptorchidism

- MC on right testicle

Question 25

What is the MC clinical presentation of testicular cancer?

Answer 25

Painless enlargement of testis

Question 26

When do recurrences of testicular cancer occur?

Answer 26

80% of recurrences occur in first 2 years (so early surveillance after treatment is necessary)

Question 27

Prognosis of testicular cancer

Answer 27

Excellent 5 yr survival (55-100%)

Question 28

Testicular self exams

Answer 28

• Have not been studied enough to show benefit
• No recommendation on monthly self exams
• High risk pt should have awareness (undescended testicle, fam hx)

Question 29

Describe polycystic kidney disease

Answer 29

• Multiple cysts in bilateral kidneys
• Many different types including autosomal dominant
• Hereditary disorder

Question 30

Identifiable genes of polycystic kidney disease

Answer 30

• ADPKD1 on chromosome 16 (85-90% pts)

- ADPKD2 on chromosome 4 (10-15% pts)

Question 31

What confirms diagnosis of PKD?

Answer 31

US

Question 32

Treatment of PKD

Answer 32

• BP monitoring (keep under 125/75)
• Tx UTI and stones
• Avoid contact sports if enlarged kidneys

Question 33

What are PKD patients at risk for?

Answer 33

Cerebral aneurysm

Question 34

Prognosis of PKD

Answer 34

• 50% will have ESRD by 60 yo

- 10% of pts on dialysis have PKD