Prostate, Testicular and Penile Cancer Flashcards
who is prostate cancer most common in?
black men aged 70-74 with FH (BRCA2)
what type of cancer is most prostate cancer?
adenocarcinomas
presentation of prostate cancer
asymptomatic haematuria haematospermia bone pain anorexia weight loss
diagnosis of prostate cancer
DRE as most arise in peripheral zones
PSA
TRUS biopsy
what can elevate PSA?
cancer PBH prostatitis UTI retention DRE
what must be done being giving a PSA test?
counselling
what are the risks in a TRUS biopsy?
bleeding
sepsis
vaso-vagal fainting
classification/ scoring system for prostate cancer
Gleason’s scoring
TMN staging
management of organ confined prostate cancer
surveillance
radical surgery
radiotherapy (EBRT, brachytherapy)
management of locally advanced prostate cancer
radiotherapy
hormonal therapy
management of metastatic disease
androgen deprivation therapy
steroids
chemotherapy
androgen deprivation therapy options
LHRH analogues
anti-androgens
bilateral orchidectomy
risks in hormonal therapy in prostate cancer
testosterone surge which causes spinal cord compression so anti-androgen cover is required
who is testicular cancer common in?
men 20-45
risk factors for testicular cancer
previous in contralateral testicle
cryptorchidism
HIV
FH
two types of testicular cancer
seminomatous
non-seminomatous
age of seminomatous testicular cancer
35-45
management of seminomatous testicular cancer
radiotherapy responsive
appearance of seminomatous testicular cancer
potato appearance
age of non-seminomatous testicular cancer
<35
which type of testicular cancer is more aggressive?
non-seminomatous
management of non-seminomatous testicular cancer
chemotherapy sensitive
types of non-seminomatous testicular cancer
teratoma
yolk sac
embryonal
trophoblast (choriocarcinoma)
role of normal testis
make sperm in seminiferous tubules
what do the seminiferous tubules contain?
germ cells
Sertoli cells
maturing sperm
what does the interstitial testis contain?
Leydig cells
role of Leydig cells
produce DHEA that is converted to testosterone
what is a hydrocoele?
accumulation of fluid within the tunica vaginalis in the testis
what is a spermatocele?
cystic change in vas
what is a varicocele?
varicosities of venous plexus- bag of worms
presentation of testicular cancer
scrotal cancer
pain due to bleeding
weight loss
neck lumps, chest symptoms, bone pain
diagnosis of testicular cancer
USS
CT
bloods for tumour markers- AFP, B-HCG and LDH
management of testicular cancer
radical inguinal orchidectomy (sperm preservation)
what kind of cancers are penile cancers?
skin cancers such as Kaposi’s, BCC, melanoma, sarcoma
risk factors for penile cancer
5th-6th decade premalignant conditions phismosis HPV 16/18 smoking immunocompromised
presentation of penile cancer
hard, painless lump
urinary retention
groin mass (inguinal lymphadenopathy)
management of prepucial penile cancer
circumcision
management of glans penile cancer
superficial= glans resurfacing deep= glansectomy
management of advanced penile cancer
amputation with formation of perineal urethrostomy
