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Placement > Oncology > Flashcards

Oncology Flashcards

1
Q

Diagnostic investigation for prostate cancer

A

multiparametric MRI scan - can show Ca and staging

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2
Q

Which part of the prostate is effected in BPH

A

transitional zone, hence why it usually presents with lower urinary tract symptoms

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3
Q

Which part of the prostate is effected in prostate cancer

A

peripheral zone

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4
Q

zones of the prostate

A

central, peripheral, transitional

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5
Q

epidemiology of prostate ca

A

8% of all men. peak >70

western disease. afrocaribean 3x more likely

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6
Q

Presentation of prostate ca

A

opportunistic screening
haematuria/haematospermia
?LUTS
Advanced - bony pain, neurology/cauda equina, systemic symptoms

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7
Q

LUTS

A

storing - urgency, urgent incontinence, nocturia

voiding - dribbling, hesitancy, slow stream, incomplete emptying

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8
Q

Red flag symptoms for prostate cancer

A

UTIs, bed wetting, haematuria, neurology. FH pf prostate ca and breast ca (related to BRCA1)

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9
Q

PSA density

A

PSA/prostate volume.

over 1.5 then more likely to be prostate ca

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10
Q

free PSA levels and Ca risk

A

higher risk of ca if free:total PSA ratio is low (ie there is higher levels of free psa)

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11
Q

normal PSA level

A 
40-50 = 2.5
50-60 = 3.5
60-70 = 4.5
70-80 = 6.5 
in general if over 3 not normal
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12
Q

psa level and mets

A

less than 1% with a PSA under 20 have bony mets and less than 5% have nodal mets

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13
Q

2WW to urology referal criteria for prostate ca

A

prostate feels malignant
PSA levels are above age-specific range
consider PSA in men with LUTS, erectile dysfunction or visible haematuria

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14
Q

staging of prostate ca

A

T1 - inside prostate, cant be felt by dr during exam
T2 - inside. can be felt but not spread outside
T3 - Cancer spread outside into nearby tissues
T4 - cancner spread into nearby organs

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15
Q

Grading of prostate Ca

A 
transperineal vs transrectal 
Gleason grading 1-5 (1= small, unifrom glands. 2=more space (stroma) between glands. 3=distinctly infiltration of cells from glands are margins. 4=irregular masses of neoplastic cells with few glands. 5=lack of occasional glands, sheets of cells). takes 2 most common grades of cell and adds them together to make the gleason score. 
1=3+3 (insignificant, just keep an eye)
2=3+4
3=4+3
4=8
5=9-10
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16
Q

treatment options for prostate ca

A

watchful waiting - usually in elderly or infirm. symptomatic treatment if they become symptomatic
active surveillance - presever QoL. watch and give treatment if get worse
Radical prostatectomy/radiotherapy - definitive treatment

17
Q

side effects of radiacal prostatectomy/radiotherapy

A

loss of sexual function (in up to 90%) and incontinence (5% at 1 year)

18
Q

which cancers usually metastasise to the bone

A 
prostate 
kidneys 
lungs 
thyroid
breasts
(come in twos or 2 lobes)
19
Q

what is special about prostate bony mets

A

prostate sclerotic.

lung, kidney, thyroid, breast are lytic

20
Q

management of diagnosis of advanced prostate cancer (cauda equina)

A

catheter
degarelix (hormonal therapy - LHRH antagonist - immediate reduction in testosterone
dexmethosome 16mg initially then 4mg QDS

21
Q

risk factor for bladder ca

A

occupation (pain and rubber), older men, smoking

22
Q

main type of bladder ca

A

transitional
squamous - western world if have long term catheter, recurrent UTI,, stones. egypt - schistomtiasis
adenocarcinoma- urethral remnant

23
Q

2WW criteria for bladder ca

A

man over 40 with visible haematuria
over 60 unexplained non-visible haematuria and dysuria/raised WCC
consider non urgent referral if over 60 and recurrant UTI

24
Q

investigations for bladder ca

A

Cystoscopy
CT urogram (in visible haematuria)
TURBT - muscle invasiv or not? grade and staging

25
Q

treatment for high risk TCC bladder ca

A

BCG (injection?)

Placement (10 decks)

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