renal and urological cancer

Question 1

risk factors for kidney cancer

Answer 1

smoking 
>45
male
obesity
high bp

Question 2

what percentage of kidney cancers are renal cell carcinoma?

Answer 2

95%

Question 3

signs of kidney cancer

Answer 3

mass

nodes

Question 4

symptoms of kidney cancer

Answer 4

haematuria
flank pain
weight loss

Question 5

mortality rate for kidney cancer

Answer 5

30%

Question 6

what percentage of kidney cancer patients have mets on presentation?

Answer 6

30%

Question 7

what percentage of kidney cancers are found accidentally?

Answer 7

66%

Question 8

treatment of kidney cancer

Answer 8

surgery

PKIs work better if primary tumour has gone

Question 9

risk factors for bladder cancer

Answer 9

smoking
long term catheter
schistosomiasis
bladder stones
paraplegia
occupational 
drugs (aspirin, phenacetin, cyclophosphamide)

Question 10

what are 90% of bladder cancers?

Answer 10

transitional cell carcinoma

Question 11

which type of bladder cancer is associated with schistosomiasis?

Answer 11

squamous cell carcinoma

Question 12

what is the mortality rate for bladder cancer?

Answer 12

50%

Question 13

diagnosis of bladder cancer

Answer 13

cystoscopy

imaging

Question 14

treatment of bladder cancer

Answer 14

cystectomy
use ileum to reconstruct bladder
BCG
mitomycin as chemo

Question 15

in which zone of the prostate does cancer tend to grow?

Answer 15

peripheral zone

Question 16

what percentage of men die from prostate cancer?

Answer 16

3%

Question 17

what percentage of men over 80 have prostate cancer?

Answer 17

80%

Question 18

mean age at diagnosis for prostate cancer

Answer 18

72

Question 19

what do the different T stages mean for prostate cancer?

Answer 19

T1 - no palpable tumour on DRE
T2 - palpable tumour confined to prostate
T3 - palpable tumour extending beyond prostate

Question 20

pathology of prostate cancer

Answer 20

adenocarcinoma
highly androgen sensitive
most lethal type is castration resistant

Question 21

treatment of castration resistant prostate cancer

Answer 21

2nd line hormone therapy
chemo
bisphosphonates

Question 22

why is PSA raised with prostate cancer?

Answer 22

architecture of cells disrupted –> more leakage

Question 23

symptoms of prostate cancer

Answer 23

LUTS

local symptoms

Question 24

signs of prostate cancer

Answer 24

high serum PSA (sensitive but not specific)

high serum PSMA (prostate specific membrane antigen)

Question 25

what is the mortality rate of prostate cancer?

Answer 25

25%

Question 26

risks of treatment for prostate cancer

Answer 26

toxicity
urinary dysfunction
erectile and ejaculatory dysfunction

Question 27

complications of prostate cancer

Answer 27

metastases to bone

Question 28

diagnosis of prostate cancer

Answer 28

test for biomarkers in serum - PSA and PSMA
US
biopsy
imaging

Question 29

treatment of prostate cancer

Answer 29

surgery - radical prostatectomy
radiotherapy
observation
focal therapy (e.g. high intensity ultrasound)

Question 30

testicular cancer risk factors

Answer 30

20-40 year old men
cryptorchidism
family history
previous testicular tumour

Question 31

what percentage of testicular tumours are malignant?

Answer 31

92%

Question 32

which patients tend to get testicular seminomas?

Answer 32

older men

these tumours are slow growing and respond well to chemo

Question 33

which patients tend to get non-seminomas?

Answer 33

teenage boys

these tumours are usually embryonal carcinoma

Question 34

sign of testicular cancer

Answer 34

craggy hard lump on testicle

lump does not transilluminate

Question 35

symptoms of testicular cancer

Answer 35

usually painless lump

Question 36

diagnosis of testicular cancer

Answer 36

US
test for tumour markers (e.g. AFP)
CXR if respiratory symptoms (cannonball mets)

Question 37

treatment of testicular cancer

Answer 37

chemotherapy before surgery

surgery - orchidectomy

Question 38

which lymph nodes are affected first by testicular cancer?

Answer 38

peri-aortic lymph nodes