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Renal > Prostate and Urinary Bladder Cancers > Flashcards

Prostate and Urinary Bladder Cancers Flashcards

1
Q

What are the part of the prostate?

A

Apex
Base
Prostatic urethra

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2
Q

What is the verumontanum?

A

It is the areas where the ejaculatory ducts open into.

if it is closed the semen doesnt flow

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3
Q

60 y/o polyuria, and peeing at night. Which area of the prostate affected?

A

Enlargement of the transition zone as it wraps around the urethra - gives rise to BPH

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4
Q

65 y/o man urinary symptoms differential

A

Prostate enlargement (BPH)

Cancer (rare as it arises from the peripheral zone)

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5
Q

Transition zone

A

mesoderm

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6
Q

Peripheral zone

A

endoderm

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7
Q

What are the 3 zones of the prostate?

A

Transitional, central, peripheral

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8
Q

What is the most common malignancy affecting men in the UK?

A

Prostate cancer

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9
Q

What is the mortality for prostate?

A

2nd highest cancer mortality

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10
Q

Is the incidence or mortality of prostate cancer more?

A

Incidence is higher

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11
Q

Is PSA prostate-specific or prostate-cancer specific antigen?

A

Prostate specific antigen –> cancer or infection can cause it. Hence marker of prostate disease

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12
Q

Where is prostate cancer more common in the world?

A

Western world

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13
Q

What is the most common symptom in prostate cancer?

A

BPH - from transitional zone
cancer - peripheral zone

Asymptomatic

  1. Picked up by PSA and DRE findings
  2. Hard prostate
  3. urinary symptoms –> quite later on
  4. bone pain, anorexia, weight loss
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14
Q

What increases the risk of prostate cancer?

A

family

westen lifestyle

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15
Q

What do you find in DRE?

A
  • Asymmetry
    • Nodule
    • Fixed craggy mass
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16
Q

What is the main function of PSA?

A

GLycoprotein produced by the secretory epithelial cells of the prostate gland

Liquefaction of semen

17
Q

What would raised PSA signify?

A

US, combined with 10 biopsy samples (5 from each prostate) and DRE

18
Q

What are the PSA findings in a healthy individual?

A

high semen PSA levels and low seum PSA levels

19
Q

Why do you take 10 samples in prostate biopsy?

A

As prostate cancers are multifocal adenocarcinomas

20
Q

What are the common sites for metastatic deposits in prostate cancer?

A

pelvic lymph nodes and the skeleton

sclerotic lesions are characteristic

21
Q

What is the scoring system for prostate cancer?

A

Gleason’s scoring

Take the most fequent appearance 1st(eg: 3), then the 2nd frequent one

score range - 2-10

4-6 low risk
7-8 moderate
>8 - severe

4+4 = 8

22
Q

Stage prostatic cancer

A

T-Primary Tumour

T1 Clinically in-apparent tumour not palpable or visible by imaging

T2 Tumour confined within the prostate

T3 Tumour extends through the prostatic capsule

T4 Tumour fixed or invades adjacent structures other than seminal vesicles: bladder neck, external sphincter, rectum, levator muscles or pelvic wall

23
Q

What are the imaging modalities for prostate cancer staging?

A

Bone scan
MRI
CT scan

24
Q

T1-2 N0 M0

A

Organ-confined disease

25
Q

T3-4 N0 M0

A

locally advanced disease

26
Q

N+, M+

A

Metastatic disease

27
Q

gleason 6, and the person is quite old and more likely to die with another disease

A

Let it be

28
Q

Intermediate risk and high risk

A

Radical prostatectomy - open/ laparectomy/ prostate

Radical radiotherapy - external beam RT< pr brachytherapy - put something inside

29
Q

Locally advanced disease treatment

A

Hormonal therapy - symptomatic patients, who need palliation of symptoms, stop testosterone, shrink the tumour

blocks the testosterone effects on the cancer cells (reduce the LH/ FSH secretion)

30
Q

Side effects of androgen deprivation therapy:

A

depression/ cognitive impairement

gynaecomastia

31
Q

Where does the steroid act on for androgen deprivation therapy?

A

Block testosterone at the receptor level

32
Q

mucosal staging of bladder cancer

A

PT, then PT1, PT

33
Q

How does blaadder cancer present?

A 
Painless Haematuria (95%)
-elderly patient >45 y/o should be investigated
34
Q

What are the investigations for bladder cancer?

A 
Flexible cystoscopy
CT scan (if allergic to contrast --> MRI)
35
Q

What is the most common urinary bladder?

A

Transitional cancer

36
Q

What are the two tupes of transitional cell carcinoma?

A

Papillary and Non-Papillary cancer

37
Q

How serious are papillary type of cancer?

A

no that scary, 50% infiltrative malignancies

38
Q

How serious are non-papillary type of cancer?

A

all are malignant

39
Q

What is the gross appeatance on imaging studies?

A

mutlifocal lesions vs single lesions

most common- non-invasive lesions

Renal (21 decks)

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