renal and urological cancer Flashcards
Kidney, bladder, prostate, and testicular cancer.
risk factors for kidney cancer
smoking >45 male obesity high bp
what percentage of kidney cancers are renal cell carcinoma?
95%
signs of kidney cancer
mass
nodes
symptoms of kidney cancer
haematuria
flank pain
weight loss
mortality rate for kidney cancer
30%
what percentage of kidney cancer patients have mets on presentation?
30%
what percentage of kidney cancers are found accidentally?
66%
treatment of kidney cancer
surgery
PKIs work better if primary tumour has gone
risk factors for bladder cancer
smoking long term catheter schistosomiasis bladder stones paraplegia occupational drugs (aspirin, phenacetin, cyclophosphamide)
what are 90% of bladder cancers?
transitional cell carcinoma
which type of bladder cancer is associated with schistosomiasis?
squamous cell carcinoma
what is the mortality rate for bladder cancer?
50%
diagnosis of bladder cancer
cystoscopy
imaging
treatment of bladder cancer
cystectomy
use ileum to reconstruct bladder
BCG
mitomycin as chemo
in which zone of the prostate does cancer tend to grow?
peripheral zone
what percentage of men die from prostate cancer?
3%
what percentage of men over 80 have prostate cancer?
80%
mean age at diagnosis for prostate cancer
72
what do the different T stages mean for prostate cancer?
T1 - no palpable tumour on DRE
T2 - palpable tumour confined to prostate
T3 - palpable tumour extending beyond prostate
pathology of prostate cancer
adenocarcinoma
highly androgen sensitive
most lethal type is castration resistant
treatment of castration resistant prostate cancer
2nd line hormone therapy
chemo
bisphosphonates
why is PSA raised with prostate cancer?
architecture of cells disrupted –> more leakage
symptoms of prostate cancer
LUTS
local symptoms
signs of prostate cancer
high serum PSA (sensitive but not specific)
high serum PSMA (prostate specific membrane antigen)
what is the mortality rate of prostate cancer?
25%
risks of treatment for prostate cancer
toxicity
urinary dysfunction
erectile and ejaculatory dysfunction
complications of prostate cancer
metastases to bone
diagnosis of prostate cancer
test for biomarkers in serum - PSA and PSMA
US
biopsy
imaging
treatment of prostate cancer
surgery - radical prostatectomy
radiotherapy
observation
focal therapy (e.g. high intensity ultrasound)
testicular cancer risk factors
20-40 year old men
cryptorchidism
family history
previous testicular tumour
what percentage of testicular tumours are malignant?
92%
which patients tend to get testicular seminomas?
older men
these tumours are slow growing and respond well to chemo
which patients tend to get non-seminomas?
teenage boys
these tumours are usually embryonal carcinoma
sign of testicular cancer
craggy hard lump on testicle
lump does not transilluminate
symptoms of testicular cancer
usually painless lump
diagnosis of testicular cancer
US
test for tumour markers (e.g. AFP)
CXR if respiratory symptoms (cannonball mets)
treatment of testicular cancer
chemotherapy before surgery
surgery - orchidectomy
which lymph nodes are affected first by testicular cancer?
peri-aortic lymph nodes
